ERDoc Posted October 11, 2007 Author Share Posted October 11, 2007 ok, what has happened here is a terrorist unleashed a modified case of Marburg and everyone in your community will be dead shortly. back on target Transport everyone to the hospital and alert the hospital of a possible food borne illness outbreak. Keep samples of their vomit for testing by the hospital lab. If they are exhibiting signs of significant dehydration then IV's all around and fluid bolus's to stabilize them. Then give em all on orders of the doctor at the hospital - Reglan and watch for angered syndrome as a side effect of the reglan. If you can keep samples of their stools that would be helpful also. The hospital would be responsible for alerting the local health department and if there is not a health department then they would be responsible for alerting the state department of health. I'm betting that if the kids are sick then their parents are too. Is there a common denominator in where they all ate? Or could this be a more widespread outbreak like the spinach contamination? Did any of the students eat at a buffet the night before or eat at the same restaurant before school. She is the only one at the nurse's office with any GI symptoms currently. Your partner volunteers to let you hold the bag to collect the vomit. We won't even tell you what his response was to taking stool samples. Link to comment Share on other sites More sharing options...
ERDoc Posted October 11, 2007 Author Share Posted October 11, 2007 Has the child been treated for a previous UTI? i.e. sulfa derivative ? She doesn't remember ever being told about a urine infection. Link to comment Share on other sites More sharing options...
vs-eh? Posted October 11, 2007 Share Posted October 11, 2007 C. diff.... How fat is this kid. Hyperglycemia could explain her symptoms... Link to comment Share on other sites More sharing options...
ERDoc Posted October 11, 2007 Author Share Posted October 11, 2007 C. diff.... How fat is this kid. Hyperglycemia could explain her symptoms... She is fairly skinny. Link to comment Share on other sites More sharing options...
vs-eh? Posted October 11, 2007 Share Posted October 11, 2007 She is fairly skinny. Is it C. diff? Link to comment Share on other sites More sharing options...
ERDoc Posted October 11, 2007 Author Share Posted October 11, 2007 Is it C. diff? Nope, she does not have diarrhea. You will know c diff when you smell it. Link to comment Share on other sites More sharing options...
chbare Posted October 11, 2007 Share Posted October 11, 2007 The BGL is quite elevated, the most obvious problem to consider would be DKA. She will need worked up in any event. Can we obtain a 12 lead and initiate IV access? No history of any cardiac problems and her lungs are clear? If this is the case, we could administer some fluids. We should still consider GI pathology, infection, and toxins. Has she ingested any "exotic" substances? Take care, chbare. Link to comment Share on other sites More sharing options...
Scaramedic Posted October 11, 2007 Share Posted October 11, 2007 Nope, she does not have diarrhea. You will know c diff when you smell it. Having worked for a short time in a micro lab setting up stool cultures I couldn't agree more. :? Peace, Marty Link to comment Share on other sites More sharing options...
ERDoc Posted October 11, 2007 Author Share Posted October 11, 2007 The BGL is quite elevated, the most obvious problem to consider would be DKA. She will need worked up in any event. Can we obtain a 12 lead and initiate IV access? No history of any cardiac problems and her lungs are clear? If this is the case, we could administer some fluids. We should still consider GI pathology, infection, and toxins. Has she ingested any "exotic" substances? Take care, chbare. No cardiac history or "exotic" substances. Lung sounds are clear. EKG shows sinus tach, otherwise normal for her age. Who is going to step up and give a diagnosis? Put a name to this girls problem. Link to comment Share on other sites More sharing options...
Asysin2leads Posted October 11, 2007 Share Posted October 11, 2007 Okay, okay, I've got it.... ahem.... Outbreak of the coxsackie B4 virus. Provoked an autoimmune response which attacked the beta cells in the pancreas, producing new onset type I diabetes and causing the other symptoms. Link to comment Share on other sites More sharing options...
Recommended Posts