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 25: Andy, a 9-Year-Old Boy with Respiratory Distress and Vomiting
"Andy, a 9-Year-Old Boy with Respiratory Distress and Vomiting", 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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Andy is a 9-year-old boy with intermittent asthma who is brought to the emergency department (ED) by emergency medical services with acute-onset cough; shortness of breath; nonbloody, nonbilious emesis; and what his parents describe as “loud breathing.” His symptoms started shortly after his arrival home from school and were not relieved by albuterol treatments by his parents or those given in the ambulance. In the ED, Andy receives a normal saline bolus, intravenous (IV) steroids, 2 nebulized albuterol treatments, and 1 dose of intramuscular (IM) epinephrine. His symptoms improve with these treatments; however, he is noted to have hypotension and persistent tachypnea and increased work of breathing. The ED physician orders another normal saline bolus and calls you to assess Andy for admission.