Hot Seat
Pediatric Management and Diagnostic Dilemma Tool
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Hot Seat

Dilemmas: The Art of Medicine

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Hot Seat #162: A Patient with Inadequate Imaging

HPI: 16-year-old male with no pertinent past medical history presents for medical clearance with police.  Earlier today he was in a physical altercation and was subsequently arrested.  During the altercation, he notes that he was punched multiple times in the face, and ultimately thrown to the ground. He currently reports pain in his jaw and […]

Hot Seat #157: 10 day old with elbow swelling

CC: 10 day old girl with elbow swelling HPI: 10 day old ex FT girl presenting with left elbow swelling and decreased movement of left arm. Parents report that in the middle of the night, they noticed she was not moving her left arm the same way she was her right. Waking every 1-3 hours […]

Hot Seat #180: A 13 yo with Leg Pain

By Chris Kovaleski, Inova LJ Murphy Children’s Hospital A 13-year-old boy with history of mild Factor IX deficiency presents to your ER with leg pain following a bicycle accident approximately 20 minutes prior to arrival. He states that he was riding his bicycle, un-helmeted and fell after hitting a bump in the road. He is […]

Hot Seat #179: Denouement

This week’s Hot Seat case focused on an infant with an episode of unresponsiveness at home. And while infants presenting to the emergency department following BRUE-like events are common, the recurrent nature of this patient’s symptoms and association with vomiting warranted further workup. With such a broad differential diagnosis in this case, polling showed a […]

Hot Seat #179: An Unresponsive 7-month-old

Walter Palmer, MD HPI: A 7-month-old ex-36 wk girl presents following an episode of altered mental status.  Patient presents with her mother, who reports that she was in her usual state of health in the morning.  While the mother was holding the patient, she became progressively more tired, and eventually became limp and unresponsive.  She denies abnormal movements […]

Hot Seat #178: To do or not to do…?

HPI: AS is a 12yoF ex-25 weeker, with history of hypoxic ischemic encephalopathy, currently with trach and g-tube dependence presenting with fevers and increased tracheal secretions. At baseline she is on trach collar during the day and BiPAP at night. She was last well 3 days ago when she developed nasal congestion and daily fevers […]

Hot Seat #177: Denouement

The Cases: A baby with apnea and for a toddler with a complex febrile seizure. Here’s how you answered: This week we discuss two kids with the same dilemma: Do they need an emergent lumbar puncture? In the first case, we have a baby presenting with concern for an apnea episode at home. Initially, both […]