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teenager is brought in by nervous family after noticing the her arms were
turning blue. her face and legs were fine. No history of heart disease, no
vascualr issues, no ingestions, and clinically felt fine.
 Long story short, she was in a gown when I examined her. I noticed that
when the nurse prepped her for an IV the "blue" or cyanosis resolved. Guess
what? She had been wearing a two tone long sleeve shift earlier in the day
that had blue arms and a grey chest . Turns out she had gotten hot and
changed shirts. I presume what happened was the blue dye discolored her
arms.  Mother noticed the "cyanosis after kid changed shirts and put on a
short sleeve shirt!

Marty




On Wed, Aug 26, 2009 at 8:42 AM, Dave Smith <[log in to unmask]> wrote:

> 16 year old h
> Yes, this is a fun topic...one of my all-time favorites:
>
> 16 year old healthy male presents with the chief complaint "Stepped on a
> nail."  I came into the room and of course, he had both his shoes and socks
> on (why this is always true, I don't know).  So I asked him to remove the
> shoe/sock from the affected foot and examined it.  I had trouble finding the
> puncture wound.
>
> "This is the foot?"
>
> "Yeah"
>
> "I don't see a mark from the nail."
>
> "Oh, it didn't go through my shoe."
>
> (Long pause as I straighten up from my bent over position and stare at
> him...confused look comes across my face.)
>
> "So, you're saying the nail didn't go into your foot."
>
> "No man, just went into my shoe."
>
> (Cross my arms, shift one leg forward with my weight back on the other leg)
>
> "Then *why* are you here?"
>
> "My mom said if ya step on a nail, ya gotta go to the doctor."
>
> (Shake my head, begin leaving the room, as I exit, I say to him...)
>
> "Only if it hits your foot, big guy!"
>
>
>
>
> ________________________________
> From: Amy Baxter <[log in to unmask]>
> To: [log in to unmask]
> Sent: Tuesday, August 25, 2009 9:54:11 PM
> Subject: Re: Odd visits
>
> Oh, this is always such a fun topic!  It leavens the intensity of
> flu/respiratory volume we're seeing.
>
> OK, my favorite chief complaint also involved a perfectly well looking
> five year old with the chief complaint of "missing testicles".  Quoth the
> mom, who came in one cold winter morning in Cincinnati, "I gave him a
> bath, so I know they were there last night!"
>
> Jay Fisher <[log in to unmask]> writes:
> >Back in the Mesozoic Period I helped start up a Peds ED in a suburban
> >community. I was a little nervous about it's viability and became even
> >more
> >so when I the first patient in the dept's history.
> >
> >It was a diaper.
> >
> >A father brought in his child's diaper for me to examine (child at home
> >sleeping comfortably).
> >
> >It was urate crystals.
> >
> >Talk about an inauspicious beginning.
> >
> >Jay
> >
> >Jay D. Fisher MD FAAP
> >Director of Pediatric Emergency Services
> >Emergency Physicians Medical Group
> >University Medical Center, Las Vegas NV
> >St. Rose Sienna Hospital, Henderson NV
> >
> >For more information, send mail to [log in to unmask] with the
> >message: info PED-EM-L
> >The URL for the PED-EM-L Web Page is:
> >                http://listserv.brown.edu/ped-em-l.html
> >
>
>
>
> Amy Baxter MD
> Pediatric Emergency Medicine Associates
> 404 371-1190
>
>
> For more information, send mail to [log in to unmask] with the
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                 http://listserv.brown.edu/ped-em-l.html
>
>
>
>
>
> For more information, send mail to [log in to unmask] with the
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                 http://listserv.brown.edu/ped-em-l.html
>



-- 
Marty
Martin Herman, M.D.
Pediatric Emergency Specialists, P.C.
Lebonheur Children's Medical Center
Memphis Tn 38103
901 405 1407 ( office)
901 219 9202 ( cell)
901 287 5986 ( ED office)
901 287 6226 ( ED fax)

Help fight blindness. Support the Memphis VisionWalk 2009. Go to
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find the Memphis TN chapter and follow the prompts to make a donation to my
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Thanks!
Marty and Lynette, Vision Walk Event CHairs for 2009..

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html