Case Study (August 5th, 2022)

🚑👦 You are dispatched to a private residence for a 7-year-old male patient.

The family states that he has been complaining of a stomach ache for a week now and today he is quite lethargic and breathing strange.

He is obviously fatigued taking deep and fast breaths.

He has no medical history according to parents.

Vitals 👇👇👇

👉 Skin - Normal
👉 LOC - Alert but lethargic
👉 Eyes PEARRL
👉 Resps 42 deep
👉 Pulse 128
👉 Temp Normal
👉 BP 92 / 58
👉 BGL 36mmol/L (600mg/dL)
👉 SPO2 99%
👉 ETCO2 16

❓What do you suspect is happening to the patient?

❓Why is the ETCO2 so low?

❓What treatment would you like to start for this patient?

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[isidromagallanes]

It’s common for children with undiagnosed diabetes to go into DKA, which is what I suspect is going on here evidenced by elevated BGL and deep rapid breathing. His CO2 is low likely due to his body attempting to compensate for the blood acidity brought on by DKA. As far as treatment, he’s likely in compensated hypovolemic shock due to dehydration, we would want to get NS on board ASAP (20mL/kg) not much else we can do in my opinion. Transport to pediatric hospital where he would need IV insulin and electrolyte replacement.

[Savage_Carlos]

IBS/metabolic acidosis. start high flow O2, BGL treatment, 12 lead, saline IV

[lboog]

Any indications that he got into parents medications?

[robertvalitsky]

Dka juvenile onset diabetes fluid IV 12noead monitor

[domnotabum]

Bowel obstruction, and gastroparesis can cause bloating therefore stomach pain and shortness of breath. I’d say bowel obstruction because the boy has no medical history. I am no way in the medical field just been around kids a lot and it’s usually bowel movements that cause these symptoms 😂