A 12-year-old female has had a sore throat for four days, cl…
A 12-year-old female has had a sore throat for four days, clear nasal discharge, and a low-grade fever. For the past few hours, her fever has increased, and she has had difficulty swallowing even saliva. On physical examination, the patient is leaning forward with her hands on her knees, and her posterior pharynx is erythematous with asymmetrical bulging and fluctuance. A lateral neck plain film x-ray shows thickening of the prevertebral space. Select the appropriate management.
Read DetailsA 9-year-old child presents after being struck in the face b…
A 9-year-old child presents after being struck in the face by a baseball traveling at high velocity. The child did not lose consciousness and is speaking in full sentences. Vital signs: HR 122, BP 104/62, RR 24, SpO2 98% on room air Physical exam: Significant midface swelling and ecchymosis, epistaxis that has slowed but not completely resolved, malocclusion with difficulty closing the jaw, hypesthesia over the right cheek and upper lip, no stridor or respiratory distress, neuro exam is normal Which of the following is the most appropriate next step in management? a) Obtain CT of the head only to evaluate intracranial injury b) Perform immediate closed reduction of suspected facial fractures c) Secure the airway preemptively due to risk of delayed swelling *d) Obtain CT maxillofacial imaging with IV contrast and consult specialists e) Apply nasal packing and discharge with outpatient follow up
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