Instructions
You are a medical student on placement in the emergency department at Perth Children's Hospital. Your next patient is Ivy Ng, 3 months, brought in by her mother, Rebecca, after five hours of inconsolable crying.
Perform a full examination
Outline to the examiner:
- Your most likely diagnosis and differentials
- Next steps in management, including relevant investigations
- You do not need to take a further history or summarise your findings
- Please verbalise your examination; findings will be provided on request
- Ivy is represented by a doll; her mother is with her
Triage nurse: history from mother
Crying since about 2 pm; not settled by a feed, rocking, a dummy or a drive in the car. No fever at home. Only short breastfeeds since. No vomiting; normal stool this morning; nappies a little drier. No cough, cold, rash or unwell contacts. No known falls or injuries. No medicines given.
Child health record
First baby; born at 39 weeks by normal vaginal delivery, no neonatal problems; 6-week check normal; 2-month immunisations given; exclusively breastfed and growing along the 50th centile.