Case #3

History

The patient is a 3 year old child brought to the ED by concerned parents after they picked up the child from the babysitter. Patient had "Vomited 6-7 times with streaks of blood." The child had been found with several "Vitamin Pills" scattered on the kitchen floor. She demonstrated normal behavior prior to being dropped off at the babysitters house six hours ago.

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Physical Exam

• General: Child is lethargic but arousable, in moderate distress.
• Vitals: RR=40 HR=140 BP=80/40 T=99.8
• HEENT: PERRL 4mm, EOMI, TM's Normal
• Mouth: Dry MM's, Good Gag reflex
• Lungs: CTA
• Heart: RRR no murmurs
• Abd: Soft, Mild epigastric tenderness, no masses/organomegaly
• Rectal: Heme positive
• Skin: WNL

Diagnostic Studies

• CBC: WBC=29.8 H/H 11/33 PLT 310K
• Lytes: Na=140 K=4.5 Cl=105 HCO3=15
• BUN/Cr 24/.6
• Glucose: 293
• ABG: 7.29/32/98/15

Radiology

• CXR: No Infiltrates
• KUB:

  
  

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