This educational guide provides a much-needed subspeciality-specific learning resource for pediatric hospital medicine. Featuring 50 of the most commonly presenting topics encountered by pediatric hospitalists, this book brings readers into the morning meeting and walks them through patient presentation, diagnosis, treatment, and resolution, providing realistic examples in an engaging case-based format. Available for purchase at https://shop.aap.org/pediatric-hospital-medicine-a-case-based-educational-guide-paperback/
Case 4: Parker, a 3-Year-Old Boy with Difficulty Breathing
"Parker, a 3-Year-Old Boy with Difficulty Breathing", Pediatric Hospital Medicine: A Case-Based Educational Guide, American Academy of Pediatrics, Melissa G. Cossey, MD, FAAP, Lauren K. Gambill, MD, MPA, FAAP
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While on an overnight shift, you are called by the emergency department (ED) physician with a request to evaluate a new patient for admission. The ED physician tells you about Parker, a 3-year-old boy who presented tonight with difficulty breathing. Parker is healthy despite being born at 31 weeks’ gestation. He has had coughing and rhinitis for 2 days and a fever up to 38.2 °C (100.8 °F). Tonight, he was breathing louder and harder, so his parents brought him to the ED. He had significant respiratory distress in the ED, where he was given oral dexamethasone and a nebulized racemic epinephrine treatment with subsequent improvement. While he was being monitored in the ED, his symptoms returned 2 hours later, and he was treated again with racemic epinephrine. The ED physician is requesting admission for continued monitoring.