A febrile 17-year-old female complains of a headache and sensitivity to light. You observe a petechial rash on her exposed legs. You should first:

• A. administer oxygen.
• B. determine if she can flex her head.
• C. assess her vital signs.
• D. don a mask and gloves.

Answer: (D)

When a febrile adolescent presents with headache, photophobia, and a petechial rash that could be meningococcemia, the immediate priority is to protect yourself from potential droplet and contact transmission. Neisseria meningitidis can spread through respiratory droplets and contact with infectious secretions, so putting on a mask and gloves before any patient contact minimizes your exposure and helps safeguard others on scene.

After you’re protected, you can proceed to assess the patient’s condition—checking vital signs and overall stability—to guide urgent care decisions. Oxygen is not indicated unless there are signs of hypoxia or shock, and testing neck stiffness by flexing the head is a clinical sign that can be performed once safety precautions are in place, but it isn’t the first step. Prioritizing PPE ensures you can assess and manage the patient safely.