The Effectiveness of Advertising

A cute little 6 year old boy was brought from home. He had autism and didn’t communicate much. His mother stated that he would occasionally just stop eating and drinking. Then he would get dehydrated. Then he’d get constipated. Then it would be a big problem to attempt to get him un-constipated. He had to be hospitalized for dehydration a couple of times and he had to be manually disimpacted once. The mom estimated that he had gotten significantly dehydrated 4-5 times in the past few years. So the patient’s pediatrician sent him to the emergency department to get some IV fluids in order to attempt to avoid the progression of events. I examined the boy and he did seem behind on his fluids. He hadn’t urinated since he had woken that morning and his mucous membranes were tacky. I asked him “Won’t you drink some juice for me?” He said “Dehydrated. Need fluids.” OK. Interesting vocabulary for a six year old. “I know you need fluids. Could you drink some fluids to make you feel better?” “No. Dehydrated. Need fluids.” The nurse brought him some juice. He turned his head away and got upset when it was offered to him. “Dehydrated. Need fluids.” “We’ll have to stick you with a needle to give you fluids if you won’t drink.” “Dehydrated. Need fluids.” His mom interjected. “He’s really good about IVs.” Difficult situation. On one hand, the kid di...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Authors: Tags: Patient Encounters Press Ganey Source Type: blogs