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CASE HISTORY


Two hours later: admitted to paediatric ward.


Nursing assessment: Temp 38.4, HR 172, RR 45, BP 112/50.
Small pin prick rash on abdomen


Ward SHO reviewed child
Sleepy but rousable, no neck stiffness or photophobia, HR 171.
No rash but he has a few old chickenpox scars.
Chest clear.


Diagnosis:  viral URTI.  Child sent home.

Child 3 years old with short history of fever, shaking and generally unwell.


ED Triage assessment:
High temperature, he looks flushed, no rash, unwell child.


Ten minutes later– ED SHO:
Febrile child, listless, irritable and drowsy.
Temp 39.7, HR 170, RR 55.
Pyrexial and drowsy: ? cause, refer to paediatric team.


  help

QUESTIONS ON CASE 2


     Q 10 of 12: Reasonable diagnosis?

YesNo <correct

CORRECT : No evidence in clinical notes to suggest viral URTI.
Further Information

Does your diagnosis make sense?


Assessing febrile children and trying to decide what is wrong with them is one of the most difficult tasks in paediatrics

It takes time to take a good history and examine a child properly. Before you discharge the patient from your care make sure that what you have done makes sense and that you can explain your actions and decisions to anyone who may ask.


LOOK IT UP


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