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Posted

Looks like acute injury to the inferior wall. We need rapid transport and more than one IV life line. We will of course need to monitor this patient closely and I would also get a right sided ECG.

In a patient so young, we should consider drug use first in spite the above history of no drug use. We must also rule out congenital defects, Kawasaki Disease, and anomalous left coronary artery origin from the pulmonary artery.

In any event, medications that reduce preload could be met with disastrous results.

Take care,

chbare.

Posted

ok this kid is really really sick. I'd consider air transport to the local pediatric center which is capable of handling cardiac.

That EKG looks really bad and is probably indicitive of an undiagnosed cardiac abnormality that's gonna kill him if he doesn't get to the right place at the right time.

I'd be ready for this kid to code on you so be ready.

I am leaning towards organophosphate poisoning due to some reasearch I did a few months back where it can cause significant cardiac effects and prolonging of the Qt interval and other adverse effects. Any possibility that someone just sprayed some chemical on the grass outside? Are the other kids complaining of any issues?

Posted

Yikes, we've been on scene too long.

ROFL!!! Good catch! :thumbright:

Kudos to the crew for running a 12-lead in the first place. Too many medics blow it off in peds.

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