Secret Diagnosis?

Question

As an emergency medical technician , you are called to the home of a 13-week old boy who has become listless and is having trouble breathing. The parents tell you that he used to smile a lot but has not smiled lately. They said he has not show any noticeable facial expressions in the last 2 days. You notice the boy's eyes open but do not seem to be focusing.You place your outstretched fingers under his finger and he fails to grasps it. You lift his foot and it drops back to the mattress. According to the parents, he has not had any bowel movement in 3-4 days?

What is your suspicions based on what you have observed?

Based on this suspicions, do you start treatment at the patient's home, or should you transport him immediately to the local hospital?

What should be administered to the patient at the earliest opportunity?

How do babies acquire this condition?

Confirmation of the diagnosis will most likely be at state laboratories, guided by the CDCP, not at the local hospital lab Why?

Answer 1

Clear airway, stabilize neck, administer oxygen and get infant to hospital ASAP

Main differential at this age would be Shaken Baby Syndrome or similar head trauma, abuse. At highest risk are infants of young mothers living with boy friend who is not father of the child. An MRI should be taken. Unfortunately this cause is much more common than the following.

Next would be infant botulism. Constipation is a key symptom prior to development of listlessness and breathing difficulties. At highest risk are infants given honey or corn syrup in formulas or on pacifiers. A dusty or dirty environment is also a risk factor. Stool specimens should be sent for evidence of Clostridia or toxin analysis. Local labs may not be able to do this, so specimens are sent to CDC.

Answer 2

The patient's airway is the most critical issue. Try to ascertain if the airway is compromised by a foreign object, listen to his chest/back for rales/rhonchi.
However, your job as an EMT is to stabilize this patient for transport to the ER, where they will obtain a comprehensive medical history and begin epidemiological testing. IV fluids and antibiotics will commence at their earliest opportunity as well. The infant may also receive oxygen.
At first glance, many would suspect the little boy has bacterial meningitis. Because of the facial paralysis (Bell's palsy), I believe he has late Lyme disease. Symptoms of Lyme disease typically begin 7-10 days after receiving an infected tick's bite.
The patient's attending physician will always have the hospital lab run tests in the hopes of confirming a diagnosis.

Answer 3

possibly respiratory syncytial virus (RSV) found only in very young children and highly contagious among them. it doesn't affect adults at all but makes the very young extremely ill. i saw many cases of this in the ER and the child was always listless, usually dehydrated. being a virus the child was treated with fluids and isolation but RSV can be lethal.

Answer 4

Botulism. Toxin would have to be diagnosed through the state lab or the CDC.

Answer 5

encephalitis,,west nile virus,head trauma, neck/cervical trauma ,apply brace to neck immobilize spine.;was fed narcotic or other med ?color of skin.nails presence of bites on skin?,,,,make sure hes breathing,good heart sound,not aspirating,no seizures, lungsounds clear? ,take to hospital,,,,lettem do the rest,administer nothing if stable,,condition u/k,,,

Answer 6

My suspicion is that if you ever become an EMT, and come to my house, you'd better know what the heck you're doing, and getting other people to do your homework is not the way to learn.

Do your own homework.