An 11-year-old with autism and breathing difficulty shows intercostal retractions but can answer questions. Which approach is appropriate?

• A. Use humor and vague descriptions to explain the next steps.
• B. Perform a complete toe-to-head assessment.
• C. Only perform necessary assessments and treatments.
• D. Treat him in the same manner as other patients.

Answer: (C)

In this situation the priority is rapid, focused care—quickly assess airway and breathing and start needed treatment without getting bogged down in a full, all-encompassing exam. Intercostal retractions show increased work of breathing, so you should move fast to stabilize, provide appropriate oxygen, and perform only the assessments necessary to guide that care. With autism, you can still ask questions the patient can answer and use clear, direct communication, but you shouldn’t add extra steps or lengthy explanations that delay treatment. Humor or vague descriptions can create confusion or distress in an urgent scenario. You should adapt your interaction to the patient’s needs while not delaying essential interventions. Therefore, the best approach is to perform only necessary assessments and treatments.