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://www.aap.org/pediatric-hospital-medicine-a-case-based-educational-guide-paperback/
Case 6: Isaiah, an 8-Year-Old Boy with Shortness of Breath
"Isaiah, an 8-Year-Old Boy with Shortness of Breath", 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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Isaiah is an 8-year-old boy with intermittent asthma who presents to the emergency department (ED) with shortness of breath and audible wheezing that has worsened over the last day. At home, he has used his albuterol metered-dose inhaler (MDI) with spacer multiple times during the last 24 hours without improvement. In the ED, Isaiah is given multiple albuterol treatments using an MDI and spacer, ipratropium bromide, and oral dexamethasone. These treatments have improved his symptoms, but he continues to have shortness of breath, wheezing, and increased work of breathing. His oxygen saturation is 97% on room air. The pediatric emergency medicine fellow is concerned that Isaiah continues to have symptoms and calls to ask that you evaluate him for admission to the pediatric inpatient unit.