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Case Introduction
You are working a shift at your local free-standing emergency room when a family of three checks in to be seen (a father and his two sons).
Initial Vitals#1 (Chris, 18mo with stridor)
Temp 100.4F
HR 120
RR 40
O2 93%
Critical Actions#1 (Chris, 18mo with stridor)
Check pulse oximetry (hidden)
Administer PO Steroids
Administer Racemic Epinephrine
Reassess patient after therapy
Discharge patient
Initial Vitals#2 (Ronnie, 3yo with vomiting)
Temp 98.0F
HR 140
RR 38
O2 98%
Critical Actions #2 (Ronnie, 3yo with vomiting)
Identify Iron overdose
Obtain abdominal XR
Obtain Iron level
Administer IVF bolus
Administer deferoxamine
Initial Vitals#3 (Carson, 55yo with shock)
Temp 98.0F
HR 130
RR 28
BP 82/68
O2 92%
Critical Actions#3 (Carson, 55yo with shock)
Obtain ECG
Identify pericardial tamponade
Administer IVF Bolus (tamponade is preload dependent)
Perform pericardiocentesis
Consult CT Surgery/CVICU
Further Reading
