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Just Plain Ruff

5 year old female - headache and vomiting

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What does her abdomen present on exam, Bowel sounds? What is the provider finding on the neuro exam? Acting appropriate for the age, etc?

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The patient appears pale. She displays stupor alternating with irritability.

The abdomen is soft and nontender, and bowel sounds are positive

She has left-sided hemiparesis and parasthesia in upper and lower limbs

She has a diminished grip in the left side, she fails all your stroke tests.

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Has she been running any fevers? Any vomiting? Has she c/o any pain in the last few days? Have they noticed any bruising or unusual rashes? Any bleeding? Has she been around anyone else that has been sick? Is she on any medications? Has she been exposed to any new foods? Has she ever been vaccinated? Is there any family history? What part of Africa is she from?

Vitals? Pupils? Do you feel any masses in her abdomen? Is she protecting her airway? Does she resist any of your exam maneuvers?

EDIT: I went back and read a few posts after posting this and found the answers to some of my questions.

Edited by ERDoc

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Has she been running any fevers? Yes

Any vomiting? Yes

Has she c/o any pain in the last few days? Yes - headache

Have they noticed any bruising or unusual rashes? Milid rash

Any bleeding? None

Has she been around anyone else that has been sick? None

Is she on any medications? Vitamin for low iron

Has she been exposed to any new foods? No

Has she ever been vaccinated? Full series of vaccines and she didn't catch the autism

Is there any family history? Yes brother died of sids

What part of Africa is she from? Kenya

Vitals? Previous post

Pupils? Unequal on left

Do you feel any masses in her abdomen? soft non tender

Is she protecting her airway? Yes

Does she resist any of your exam maneuvers? Yes somewh


Now is the time you might want to think about where you want to transport her to.

Edited by Ruffmeister Paramedic

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Has she been running any fevers? Yes How high, when did it start

Any vomiting? Yes Diarrhea? Did it start before or after the headache?

Has she c/o any pain in the last few days? Yes - headache Where in the head? What does it feel like? When did she first notice it? Is it worse any certain time of day?

Have they noticed any bruising or unusual rashes? Milid rash What does it look like?

Any bleeding? None

Has she been around anyone else that has been sick? None

Is she on any medications? Vitamin for low iron Is she taking the right amount? Have they changed the dose recently?

Has she been exposed to any new foods? No

Has she ever been vaccinated? Full series of vaccines and she didn't catch the autism not YET!!!

Is there any family history? Yes brother died of sids SIDS according to who?

What part of Africa is she from? Kenya

Vitals? Previous post

Pupils? Unequal on left Unequal how?

Do you feel any masses in her abdomen? soft non tender

Is she protecting her airway? Yes

Does she resist any of your exam maneuvers? Yes somewh

Now is the time you might want to think about where you want to transport her to.

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You know the answer and I'm running out of stuff to add until someone decides to transport. I have all these labs. I might even be able to post a picture or two but I've never been very successful at that so don't expect much out of that.

But seriously, this is a good case. People need to participate. In your career if you work in an area with a population of these kids you might see up to 30 percent of these kids have this and up to 11% of these kids will actually suffer from the actual end result of this case. I'll post the link to the actual case with all the supporting documentation for you to actually learn a lot more out of this one.

Edited by Ruffmeister Paramedic

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Ebola with a side of gastroherpagonosyphiltusis

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Dammit Doc, why ruin it for the ff-medics

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Now that we have a decent physical down we can launch a bird and start driving for a meet. Lab values?

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Now that we have a decent physical down we can launch a bird and start driving for a meet. Lab values?

What labs do you want?

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