Paediatric scenario- a 9 month old baby with suspected intracranial sepsis
A previously healthy nine month old child has been brought in to the emergency department by his parents because he is ''unwell".He was initially very irritable, but is now lethargic and not feeding well.
His vital signs are : BP 95/35, HR 175, Respiratory rate 50 / min
He is lethargic.
Temp 38.2, His capillary refill is 4 seconds
Heart sounds are normal, chest sounds clear.He has a full fontanelle.
Interpret these findings.
Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.