# data[].attributes.body
hydration status, urine output
pain abdomen and blood in stool

# data[].attributes.body
- in depth patient history: are the Child's vaccines up to date? yes. UTD. Any recent exposure to other sick children or friends? no recent travel? no. Is this the first time the patient has presented with seizures? yes
- how has she been eating? does she ever consume any unpasteurized products on the farm? No.
-what is the home environment like? They live comfortably
-pain assessment She is very irritable or very lethargic.
-recent lab values
-diagnostic tests: lumbar puncture, culture and sensitivity, CT scan
-any signs of increased cranial pressure?

Sadie

# data[].attributes.body
BP (95/65), pulses (strong and palpable x4) , hx, Bm (2-3 times per day for 3 days), Palpation of abd?, descriptive pain assessment (abd tender but you can assess. She is uncomfortable and doesn't like it)

# data[].attributes.headline
Missing information for the Wilson Case:

# data[].attributes.subject
Missing information for the Wilson Case:

# data[].attributes.body
-health hx? previously healthy
-past/current medical conditions
-allergies? NKA
-has this happened before? No
-any recent hospitalizations? No
-pain? thorough pain assessment- as above
-head to toe assessment
-focused assessment on the GI system
-what triggered the onset? (Did she eat/drink anything,? Fast food?) nothing mom can recall
-recent travel? No.
-what are their living conditions?
-labs/diagnostics/cultures?
-characteristics of emesis and BMs (blood present?) - no blood
-major changes in weight (decrease?) - no
-CWMS - intact
-vaccination hx - fully immunized

-Arianne

# data[].attributes.body
Are her vaccinations up to date?
What is the family history? Is there a history of meningitis?
Has she ever experienced any of these symptoms before?
Has she been traveling around anywhere?
Does she have any allergies or has she had a serious reaction to something in the past?
What is her pain like? is it the pain somatic or visceral?
Lumbar puncture test? Has it been done yet?
More detailed labs drawn? kidney function, BUN, BNP. With that being said. her trend needs to be looked at. has it improved or is getting worse?
Has she been around anything that could have poisoned her. (a little dramatic but you never know). - She does live on a farm so its a good thought! But no... it doesn't appear to be poisoning.

Emma

# data[].attributes.body
What caused it? Good question! We're waiting for results.
Are her vaccines up to date? Does she have her vaccines?
What is the family history here?
What is her living environment like?
What is her personal health history? Does she have allergies?
CT scan potentially? Lumbar puncture?
How was she eating and drinking before this? She had a fever for 6 hours prior but was normal before this
When was her last BM/pee? had a wet diaper on arrival to ER
-Rae-Anne

# data[].attributes.body
Environmental hazards like exposure to second-hand smoke or poor living conditions? They are lower income so it is possible. Dad smokes

Medications taken at home? Has used an MDI in the past but not regularly

Pain? Just from the coughing

ABGS? Not ordered

Chest X-ray ordered? Yes. Normal results

Allergies? no allergies

Family history? 8 year old brother has asthma

What has exacerbated her resp health in the past? (Exercise at recess?) respiratory illness. This this is first time this has happened at school

Assess mom’s knowledge of the use and action of Jill’s puffer

Vaccine hx?

Rest of lab work results? nothing ordered

-Sabrina

# data[].attributes.body
-How are the fontanels presenting? Remember shes 2 so they would be closed.
-Is anyone else in the family presenting with symptoms? no
-Does she have nuchal rigidity? She's super irritable when moved.
-Does she have the MenC vaccine? yes. fully vaccinated
-Was there a head CT?
-What is the causative organism? waiting on results
-History of upper resp. infections? no
-How are mom and dad coping? They are very, very, very worried and appear distressed
-Are symptoms improving with fluids and antibiotic treatment? not yet
-Growth and behavior prior to infection- normal growth and development

Samantha
-
-

# data[].attributes.body
Prior medical/surgical history; temperature/?elevated WBC/CRP to indicate infection; risk factors at home; CXR

Simran

# data[].attributes.body
Any recent travel?
LP - what was the fluid pressure? increased? we got gram stain, blood count, and protein, but whats glucose content?
What is the causative organism???!!!
Is she showing any signs of ICP, like papilledema or a bulging fontanelle? Is the head CT part of whats pending???
What we doing about BP? Just monitoring?We have to limit fluids to prevent increased ICP.. so we're running hypertonic soln to pull the fluid into the bv?

By: Megan McCallum

# data[].attributes.body
-Stool & emesis characteristics

-Any allergies?

-Weight prior to admission - same 16.5

-What’s her BP?

-Pain assessment

-Previous medical history

-Is she on any medications?no
-Labs (CBC/lytes)

Amanda

# data[].attributes.body
-Hx of respiratory illness - frequent colds with cough
-Birth Hx - normal delivery at term
-CBC and sputum culture test - not ordered
-chest x-ray
-exposure to smoke/allergens
-allergies
-prior asthma management plan and adherence to it

Naur Padda

# data[].attributes.body
Patient history (allergies, has this episode occurred before)

More info on coughing/SOB episodes (has occurred before, when?, does resting help?)

More info about phrase “does not use a puffer regularly” does that mean child has asthma but manages well w/o puffer? Has been prescribed puffers in the past but does not use regularly.

Did salbutamol in ER help with opening airways? When was the last dose? Is it safe to give another dose? Salbutamol did help but minimally. She had the 3 "back to backs" and can have more. Good question.... Salbutamol is a drug that is given to effect.

Lab values (is this an infection or?)

Temp (is there elevated temp that could indicate infection) Temp is normal
-Sumjana :)

# data[].attributes.body
- Hx: has anyone else in the family had meningitis before? has the child been vaccinated? has the family recently travelled?
- Pain assessments: is the child in any pain
- Labs: EGFR (what is the kidney function)
- Lumbar puncture or CT scan
- PCR amplification - was this test done to determine specific cause and treatment

Halle

# data[].attributes.body
- Health and medical history
- Vaccination history
- Potential source of illness: contaminated food or water? other family members with sx?
- Characteristics of emesis and stool - is vomiting bile now. Can't keep anything down. no blood in stool - diarrhea
- Dehydration sx: low BP? skin turgor and mucous membranes? current bowel and
urine patterns?
- CWMS
- weight loss?
- Focused abdominal and pain assessment
- Lab work
- Allergies

Olivia

# data[].attributes.body
- Patient story (what was she doing at recess? was she running/exercising?) She was playing on the playground and was quite active (normal kindergarten behavior!)
- history of RSV and colds (other visits? what interventions were put in place then?)
- allergies (testing could be done, is it an indoor/outdoor allergen) - no known allergies
- Home environment (and ways to decrease risk/humidifier)
- Any other medications she might be on?
- vaccination status - up to date
- seasonal? (was it cold out/ changing seasons/ weather changes)
- Labs (to see if there is an active infection)
- chest x-ray

-Melissa

# data[].attributes.body
-       Vaccination Hx

-       Background info needed: Recent travel? (Untreated water), Visits to animal farm?

-       Consistency of stool

-       Cap refill (3 seconds), BP, allergies, pain Ax

-       Any other medical conditions?

Alden

# data[].attributes.body
Pt hx (asthma, previous admits, etc.)
Work of breathing (supraclavicular and substernal indrawing with tracheal tug (TT)
Allergies
Temperature - afebrile
Labs (CBC, WBC, etc.)

- Dani

# data[].attributes.body
- Vaccination hx
- ABGs, CBC
- Have they been in the hospital before?
- Living conditions, allergies, anyone in household smoke? Any pets?
- Temp, BP, any other signs of infection? BP normal
- Sputum culture - not ordered
- How was the respiratory assessment post medication? see above
- How is the work of breathing? Any retractions?
- Urine output--> dehydration? HNV (has not voided) since admission

# data[].attributes.body
Medical history
Characteristic of stool and emesis
Pain assessment
Labs/diagnostic
Allergies
Blood pressure (assess dehydration)
Weight (difference between weight prior and after hospital admission)

-Ruth Juliana

# data[].attributes.body
Hx. of RSV & how frequent colds with cough occur. Family hx.

Allergy test.

Environmental assessment at home e.g. dust or smoke exposure.
Pain asmt.

Chest Xray.

Other labs like CBC, CP6.

ABGs as O2 demands are increasing & pt. requires Salbutamol Q1H.

Education regarding puffer usage as pt. does not use puffer regularly... to prevent worsening of asthma which may require hospitalization?

-Shubhneet

# data[].attributes.body
Has the patient had this before? Is this the first time this patient presents with seizures?

How has the patient appetite been lately?

How has she been growing?

What vaccinations did this child have?

Is there a family history of autoimmune diseases? (ex. lupus)

Family history of herpes simplex virus? Was mom screened prenatally for this?

Has there been recent Travel- possible malaria??

Any birth complications (birthing injuries, was she a large baby, skull fracture at birth causing spot of weakness for pathogens to get to brain?) Normal birth and delivery

Any congenital anomalies in family history? no.

What are the results of a CT?

A Polymerase Chain reaction (PCR) to look for specific causes (HIV, enterovirus, HSV, tuberculosis)

_Larissa_

# data[].attributes.body
-Medical history, vaccination history, a bit more background info as to what may have caused the gastro
-Stool characteristics
-Labs/diagnostics
-Pain assessment
-Cap refill
-BP
-Allergies

# data[].attributes.body
Allergies
History of asthma?
What is the patients baseline?
Is is well-controlled?
What meds does patient take at home?
What causes exacerbation of symptoms?
Pt's weight? 15 kg
X-ray to r/o other respiratory infections
ABG's if patient worsening?
CBC, lytes

# data[].attributes.body
vaccination history, allergies, pre admission wt.
Thorough pain assessment
BP
urinary output/ characteristics
Lab work- full CBC, creatinine, BUN. ABGs
Urine specific gravity, ELISA test,

-Natalie

# data[].attributes.body
- How was her delivery? normal? instrumental delivery? any injuries during delivery?
- Any previous hx of seizure? any previous medical/surgical hx?
- Did she got any medication for fever?
- Family history?
- How was her developmental milestone?

Niraja

# data[].attributes.body
Patient history
Allergies
Lab Work
Previous treatments - how did she react? any side effects from medications?
Duration of infection/how long did it take her to recover
Family hx /anyone around her smoking?
Any birth complications or SGA/trauma/preterm that predisposes her to lung insufficiency? born at term
-Anna D

# data[].attributes.body
Patient history: Family history of meningitis, comorbidities, does the patient have a weak immune system? Is the patient vaccinated against meningitis? (i.e. H influenzae type b vaccine)

Lab values: Monitor CBCs/leukocytes closely to see if it improves/trends down

-Lumbar puncture
-CT scan
-Pain assessment

Linda

# data[].attributes.body
What is on the farm? Animals? Pesticides?
Are vaccinations all up to date?
Any recent travel?
Any recent sickness?
Was she born to term or was she preterm?
Was pregnancy healthy?
Allergies?
What is her diet like?
What is the home like? Mold? Water?
How big is the house? Is she sharing a room?
Anyone else in the house sick? Any recent abx? Any change in diet?
Debbie

# data[].attributes.body
Medical History
Number of hospital admissions
Characteristic of stool (If there is blood)
Stool sent for CDIFF/culture/O&P - yes. Good thought. This is ordered
Weight prior to coming to ER to assess if there is a significant weight loss
Allergies
-Rochelle

# data[].attributes.body
-Patient history (has she gotten vaccinated for meningitis/ had something similar/ family history of meningitis/ any other comorbidities)

-What is the patient trend for lab values (are the continuing to rise or trend down)

-Any known allergies

-Pain assessment for child (FLACC scale) - Good point! We would need to use FLACC as she is lethargic or irritable

Paige

# data[].attributes.body
Allergies
Patient Hx (how many times has she been in hospital, for what?)
labs (WBC, CRP)
Chest Xray
-fallon

# data[].attributes.body
Pt hx: Causes of infection? Why has she suddenly developed meningitis. Was she sick with something else beforehand? What has her early childhood health looked like, any comorbidities?

Lab values: Kidney function?

Lumbar puncture? Pain assessment?