Round 20 (Dehydration)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











You are working a shift at EM Clerkshift General when the next chart is handed to you – a four year old male named Tommy with chief complaint of dehydration.











Initial Vitals











* Temp 100.4F* HR 132* RR 22* BP 98/64* O2 98%











Critical Actions











* Identify key historical findings (fever >= 5 days)* Identify abnormal physical exam findings (Conjunctivitis, Rash, Adenopathy, Strawberry Tongue)* Diagnose Kawasaki Disease Clinically* Administer Aspirin* Administer IVIG











Final Diagnosis











Kawasaki Disease











Tips and Tricks











* Remember the CRASH & BURN mnemonic* Always have a high index of suspicion for this diagnosis* Remember the diagnosis is CLINICAL!











Further Reading











EMDocs – Kawasaki Disease