Case presentation A 2-day-old patient is referred to the emergency department for failure to pass meconium. He was born at home and had prenatal care, although this was not consistent, as the mother had missed some of her appointments. The delivery was at term (38 weeks gestation), vaginal, and apparently uncomplicated. The infant was vigorous and did not require resuscitation other than standard drying and stimulation.…

Case presentation A 12-hour-old infant presents “looking blue” and with poor feeding per the mother. The child was delivered at home and the mother had no prenatal care. She describes her pregnancy as uneventful. The physical examination reveals an overall well-appearing infant who is afebrile. There is a heart rate of 150 beats per minute, a respiratory rate of 60 breaths per minute, a blood pressure…

Case presentation A 4-day-old patient presents to the emergency department with forceful emesis associated with every feed. The emesis is described as nonbloody, slightly green in color. The child has decreased feeding and activity over the past 24 hours. There has been no fever, diarrhea, cough, or congestion. There is no report of trauma. The child was the product of an uncomplicated term spontaneous vaginal delivery…

Case presentation A 5-day-old male infant presents with decreased feeding and activity for the past 24 hours. The parents report emesis that initially looked like infant formula but over the past 12 hours has become “yellow-green” and the last several episodes have been “green.” The emesis has occurred whenever the child attempts to feed, which was typically every 3 hours, but the parents have been attempting…

Case presentation An 8-month-old male presents with 2 months of cough and intermittent rhinorrhea. He has been seen multiple times by his primary care provider and has been diagnosed at various times with viral upper respiratory tract infection and acute otitis media, for which he has been prescribed oral antibiotics. He has had some intermittent fevers as well, all of which have resolved after several days.…

Most pediatric imaging procedures do not require sedation. There are patients, though, who will require some level of sedation in order to obtain a meaningful imaging study. The reasons for sedation are many but include anxiety, painful condition (such as fracture), age of the child (younger children tend to be less cooperative), or study length. Lengthy studies (e.g., extensive magnetic resonance imaging of the brain or…