Pediatric Interesting Case


Present Illness

3 y.o. boy was playing with a quarter in the door way of a Laundromat when his mother saw him suddenly stand up, "make a funny choking sound", and fall back down. He was unresponsive. She gave him several rescue breaths and chest compressions, after which he began crying. He arrived via EMS, calm and comfortable, but drooling and refusing to speak.

Past History

No past medical history. Up to date vaccinations. Well nourished and well developed.

Medications and Allergies

No medications or allergies

Physical Exam

Appearance: He was too comfortable. HR 110, BP 95/50, RR 20, Sat 98%, Temp 37C. He would communicate by nodding.
HEENT: Drooling, but no foreign body seen on direct visualization.
Lungs: Clear bilaterally with no stridor.
Heart: Regular without murmurs.
Abdomen: Soft and non tender.
Extremities: FROM, no signs of trauma.
Neuro: Cranial nerves were grossly intact. Motor was 5/5 in all extremities. Reflexes were 2+ bilaterally and muscle tone was normal. His gait was unsteady; he would stumble to the right.




What do you think?