This week we highlight the case of a well-appearing child who presents with intermittent bilious emesis. The crux of the decision centered around the appropriate imaging when there is concern about malrotation with volvulus but an upper GI is unavailable. Junior learners preferred a CT abdomen with contrast whereas senior learners preferred an abdominal ultrasound. […]
Hot Seat #219: Gut-sy Decisions
Case by Brandon Ho, CNH PEM Fellow It is a wonderful Saturday evening in the ED when an 11-month-old female presents with 3 days of projectile vomiting after every feed. Vomiting occurs 4-5 times a day and is described as occasionally yellow-green. Parents note that her stomach is very hard after feeding but becomes soft […]
Hot Seat #218: Denouement
This week we highlight the case of a child who had a toothbrush impaled in the oropharynx. The crux of the decision centered around sedation for imaging with a potentially unstable oropharyngeal injury. It is important to note that though the patient was currently stable in this case, he had a high potential to be […]
Hot Seat #218: A Brush With Danger
Case by Mickey Emmanuel, CNH PEM Fellow A 3-year-old boy with no significant past medical history comes to the ED today with a toothbrush impaled in the oropharynx. Mom did not witness the event but did note that he was jumping up and down on the bed while brushing his teeth. She believes he fell […]
Hot Seat #217: A Caustic Conundrum
Case by Hannah Kotler MD, CNH PEM Fellow You are carrying the transport phone when you receive a call for a destination decision: 15-year-old M ingested “half a bottle” of household bleach in a suicide attempt. Currently, he is c/o stomach and throat pain. His vital signs are as follows: HR 80, BP 118/78, SpO2 […]