PODCAST: Stridor, Vomiting, Shock

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

Life in the Fast Lane – Iron Toxicity

EMDocs – Croup

EMDocs – Pericardial Tamponade

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