Some of mine for the groups entertainment.
1. The teenager brought in by ambulance (with lights and sirens on)
found by the side of the road totally unresponsive.
As he was being wheeled in he literally jumped off the trolly and ran
out of the ED discarding bits of equipment.
Turns out he lived next to the hospital and thought this would be a
good way to get a free ride home (at least once!).
2. The non-toxic two year old with with URTI and intermittent
stridor, treated as, but not responding like croup.
A background of choking on a "cake" on the same day. Stridor was very
unusual in it came on and off very quickly.
Eventually taken to theatre sitting up, with anaesthetist and ORL
present for a gas induction (?tracheiitis/epiglottitis/FB)
Laryngoscopy revealed what appeared to be a mid-line third vocal cord!
I kid you not. Same colour and width.
Anaesthetist grabbed with McGills and it came out. It was a flipper
from a scuba diving doll.
It was just big enough to fit between the cords (heel side to lungs)
but would go no further as distal end was wider.
Every time it got blown back a bit he would be fine until it went down
3. Speaking of linear dermatography, I was once asked by a medical
student about an unusual black linear rash on both lateral sides of a
It was, of course, food! To be precise Vegemite or Marmite (a dark
yeast extract) commonly taken on bread or toast in NZ and Australia.
I must admit in all fairness to the student it was actually not that
obvious until the rash was wiped off (I did not taste test).
Dr David Herd BSc MBChB FRACP
Paediatric Emergency Medicine Specialist
Mater Children's Hospital
South Brisbane, Queensland
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On 27/08/2009, at 7:30 AM, Brown, Julie C. wrote:
> I can't help but add to the list:
> 1. The baby rushed back by a nurse for omphalitis and mottled
> skin. I
> washed off the gentian violet around the umbi stump, which was healing
> normally, and noted the normal if slightly reticulated skin with brisk
> capillary refill. The tough part was what to give as a diagnosis for
> this beautiful perfectly healthy newborn.
> 2. The 3-year-old with a small splinter brought in for streaking
> redness. The resident told me she felt it was cellulitis with
> lymphangitic spread and suggested antibiotics. On exam, it was such a
> linear streak leading away from the splinter, I asked if I could try
> wipe it off, even though Dad had already tried. It came off with
> alcohol, after which Dad remembered that the child's preschool had
> served popsicles that day. At least I could diagnose and remove the
> Julie Brown
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