Q. A 22-year-old male presents to the emergency department with difficulty breathing. His girlfriend reports the patient was “doing fine” up until a few hours ago when he suddenly developed shortness of breath and became anxious. They were watching a movie and eating popcorn at the time, and she is unclear if he may have “swallowed something the wrong way”. She states the patient has seasonal allergies, and had a “little cold” a few days ago, but otherwise is healthy. He takes no medications, and has no other significant past medical history. On physical examination, the patient is sitting up and leaning forward with his hands resting on his knees. He is in visible distress, and appears stridorous and mildly cyanotic. The patient’s mouth is open and he is drooling.
His temperature is 38.9 degrees Celsius (102 degrees Fahrenheit), blood pressure is 130/80 mm Hg, respiratory rate is 28/min, heart rate 85/min, and oxygen saturation is 88 percent on room air. His neck is supple without lymphadenopathy, masses, or lesions. Auscultation of his chest reveals clear breath sounds in both lung fields, and his heart is in regular rhythm with no murmurs, rubs, or gallops. You provide the patient with oxygen via face mask and order a lateral neck x-ray (see image).
Based on the information you have at this point, what is the next best step in the management of this patient?