SOLVED747

n6194w A healthy, fully-vaccinated 7-year-old boy presented to the ED in the middle of the night during February 2020. The nurse triage note stated “woke up sob. felt warm so he got motrin pta. says his sob feels better.” Triage vitals were taken: Temp: 39.4C HR: 135bpm RR: 26/min Pulse ox: 95% He was roomed and seen by a PA, with direct supervision by a board-certified EM physician. The PA documented the following history: 1.jpeg The only positives on the physical exam were mild nasal congestion and a “barky” cough. The remainder of the respiratory exam was normal. The PA ordered PO dexamethasone and a viral PCR swab for RSV and influenza. The PCR swab came back positive for influenza B. The child’s temperature was re-checked and was 99.5F. The ED physician personally evaluated the child and discussed the results and treatment options with his mother. The supervisory note is here: 2.jpeg 3.jpeg The child was in the ED from 4:42am to 6:15am. During the following 36 hours, he continued to have malaise and fever. At around 7pm the next day, he was sitting on his mother’s lap. He told her he was having problems breathing, then collapsed in cardiac
SCIENCE
HEALTH SCIENCE
NURSING

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