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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