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EM@3AM: Pink Baby

A 3-month-old male is brought in for increased work of breathing for the last 4 days. The patient has had no fevers or sick contacts. He was born full term without complications, is fully vaccinated, and has no familial medical history. Triage vital signs (VS): BP 85/50, HR 152, RR 56, SpO2 92% on room air, oral temp 99.9. The patient is tachypneic with weak cry, but has normal pink color. There is a 4/6 holosystolic murmur, with 2+ femoral and brachial pulses. He has suprasternal and intercostal retractions with wheezes. There is also palpable hepatomegaly. What are your next steps?

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EM@3AM: Heat Stroke

A 72-year-old female is brought to the ED during a heat wave. Her daughter found her confused in her home. She believes the power has been out for several days. The patient appears lethargic and is intermittently confused. A rectal temperature reads 105.1F. The patient’s skin is warm and dry. She is confused, but the rest of her exam is unremarkable. What is the patient’s diagnosis? What’s the next step in your evaluation and treatment?

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