In the ED, their vitals/exam are as above. Patient’s presentation is consistent with prior episodes of storming with this episode likely being in the setting of constipation (vs. pain vs. infection) as detailed above. We will obtain labs/CXR to rule out infectious processes driving etiology. We will also treat pain given its potential as an inciting etiology. Hence, will proceed as below.
– Labs/Tests: CBC, CMP, UA w/ reflex UCx, BCx, PRO
– Imaging: CXR
– Treatments: IN versed +/- ketamine 1-1.5 mg/kg to facilitate IV access, Propofol gtt once IV access obtained, Rapid initiation of patient’s home medications
– Consults: RT
– Dispo: Admission to PICU