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EM Clerkship - Round 19 (MW) Tummy Ache in Child with Diabetes

Round 19 (MW) Tummy Ache in Child with Diabetes

04/02/24 • -1 min

EM Clerkship
You are working at Clerkship General when the next patient is put into your rack. It is an 8 year-old male with vomiting Initial Vitals: HR: 119 BP: 104/63 Temp: 98.0F RR: 20 O2: 99% (Room Air) Critical Actions: References: Mellick LB, Sinex JE, Gibson RW, Mears K. A Systematic Review of Testicle Survival Time [...]
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You are working at Clerkship General when the next patient is put into your rack. It is an 8 year-old male with vomiting Initial Vitals: HR: 119 BP: 104/63 Temp: 98.0F RR: 20 O2: 99% (Room Air) Critical Actions: References: Mellick LB, Sinex JE, Gibson RW, Mears K. A Systematic Review of Testicle Survival Time [...]

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* Common during the first year of life as well as during puberty * Presents with nausea/vomiting, abdominal pain, and/or testicular pain * ALWAYS examine a child for signs of torsion who presents with abdominal pain (especially lower abdominal pain) * Look for tenderness, firmness, high riding testicle or testicle with unequal lie, swelling, and the absence of a cremasteric reflex * Consult Urology IMMEDIATELY if you have high suspicion, otherwise proceed to ultrasound * Ultrasound is only 85% sensitive, so clinical gestalt can trump even a negative US * Attempt manual detorsion if there will be a significant delay to surgery

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