Authors: Jude Okoye / Editor: Fiona Mendes / Codes: / Published: 09/09/2020
A 3-week-old infant male presents to your emergency department (ED) with a history of recurrent episodes of respiratory distress and blue discolouration of his skin.
His mother tells you that he was born at term with an uneventful delivery. The episodes started after 2 weeks of age. They occur when he is distressed. He becomes floppy and his skin become mottled and turns blue in colour. The episodes are not associated with feeding. There is no fever, cough or coryzal symptoms. He recovers fully after administration of wafting oxygen in the ED.
On examination, during this episode, he appeared mottled and had an audible stridor, tracheal tug, and sternal recession.
Observations showed:
- Oxygen saturations: 98% on room air
- Respiratory rate 55 breaths per minute.
- Heart rate 142 beats per minute
- Blood pressure 105/56mmHg
- Good bilateral air-entry
- Normal peripheral pulses and normal heart sounds.
- Alert (A) on AVPU scale Temperature 36.6 degrees Celsius.
