Yes, this is E.MK's best case ever mini podcast series, and I'm your host, Dr. Anton Hellman.

In anticipation of our episodes on pediatric fever and pediatric sepsis, we have with us, Dr. Sarah Reed, an old friend of mine from my

medical school days in Ottawa, who is now the CME director of the Department of Pediatrics

at the University of Ottawa, who's going to tell us her best case ever when it comes to pediatric

patients with fever. Dr. Reed, let it rip.

So my best case ever was a nine-year-old previously healthy girl who presented to a family

physician's office in the suburban area of Ottawa with a history of having vomiting and diarrhea for a couple of days.

She lived at home with her teenage brother and her dad, and the dad had gone off to work that

morning and leaving the adolescent brother to look after her.

She had fairly insignificant losses in terms of vomiting and

diarrhea. But when he got home from work that afternoon, she was really sick. So she looked

very unwell. He was quite worried about her. So bundled her up into the car and took her to the

family doctor's office. The family doctor assessed her. He did a full set of

vital signs and wrote a note that stated that her heart rate, remember she was nine years of age,

her heart rate was at 140, and her blood pressure was 77 on 40. Her respiratory rate was 36,

no oxygen saturation was done, and he wrote a note saying that he was worried that

she looked sick and he sent her by car to the emergency department with the note with the vital

signs listed. So unfortunately, the doctor's office was a bit far away. So it took them some time

to get to the emergency department, let's say 45 minutes. By the time she

arrived on our doorstep, she was gray, she was shut down, she looked like she was pre-arrest.

So she was whisked into the resuscitation room, immediately put on oxygen, two lines were started,

fluid was started in terms of bolsting saying she actually was not febrile when

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