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<< Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department

Case Presentations And Conclusions

An 8-day-old boy is brought to the ED by his mother for lethargy and “fast breathing.” She states that he has not been feeding well for the past couple of days and his breathing has become faster and more labored over the past 24 hours. This morning he became lethargic and looked pale. She denies any fever, cough, vomiting, or diarrhea. The baby was born at term and delivered at home by a midwife, and there was little prenatal care. He has been exclusively breastfed, but feeds have become progressively shorter over the preceding 48 hours. At triage, the infant appeared ashen gray and limp, with the following vital signs: temperature, 36°C; heart rate, 194 beats/min; respiratory rate, 76 breaths/min; and initial oxygen saturation, 92% on room air. He was rushed back to the resuscitation room. As you enter the room to evaluate this critically ill neonate, you consider sepsis, metabolic disease, and congenital heart disease, and wonder how you can distinguish among these potential causes of critical illness in the first weeks of life. 

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Last Modified: 11/17/2017
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