A client suspected of having severe acute respiratory syndrome (SARS) arrives in the emergency department. What action should you take first?

• A. Place the client on airborne and contact precautions.
• B. Infuse normal saline at 75 mL/hour.
• C. Obtain blood, urine, and sputum for cultures.
• D. Give methylprednisolone (Solu-Medrol) 1 g IV.

Answer: (A)

The priority is infection control to protect others. Suspected SARS is highly transmissible through airborne particles, so the first action is to place the client on airborne and contact precautions immediately. This includes moving the patient to a appropriate isolation area (preferably with negative pressure if available) and ensuring staff wear appropriate PPE such as an N95 respirator, gown, gloves, and eye protection. Establishing these precautions right away reduces the risk of spreading the infection to other patients and staff while you proceed with diagnostics and treatment.

Other actions don’t address transmission risk. Administering IV fluids or starting an infusion doesn’t prevent spread and can wait until after precautions are in place. Obtaining cultures is important for diagnosis but should occur once precautions are established rather than before. Administering a high-dose steroid isn’t indicated for suspected SARS without specific indications and could cause harm. The key concept is preventing transmission first.