hamilton cme
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Hamilton CME
Pediatric Case Presentation
Spring 2008
Case Intro
8 y.o. SOB Visiting family farm Playing with cousins Unknown mechanism
Case Intro
Severe dyspnea Head-bobbing Tired / lethargic
Differential Diagnoses?
Primary Assessment
“can’t breathe” Tachypneic WOB Very little AE
Primary Assessment
• Weak, thready carotid pulse• Pale ++, dry skin ++• Eyes open to voice• Confused• Obeys commands
Focused History
Playing “hide & seek” Found SOB ++ MDI medications = no relief Asthmatic history
Focused Examination
Focused Examination
AE Accessory muscle use Retractions Paradoxical breathing
Working Diagnosis?
Treatment Options
PCP– Airway– Breathing– Circulation– Drugs– Extra Care
ACP– Airway– Breathing– Circulation– Drugs– Extra Care
Enroute
Enroute
Teaching Point
Teaching Point
References
1. Emergency Medicine: A Comprehensive Study Guide - 6th Ed•PEDIATRIC ASTHMA AND BRONCHIOLITIS - Maybelle Kou, Thom Mayer
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