Lawton, B. American College of Emergency Physicians #ACEP Part 1, Don't Forget the Bubbles, 2013. Available at:
An 8 yr old boy presents after three vomits at home. He has a background of spastic diplegic cerebral palsy and has a ventriculo-peritoneal (VP) shunt. He is usually ambulatory and attends mainstream school. What goes wrong with VP shunts? How can we assess them for failure or infection?
A previously well 3 year old girl presented to your ED with a history of fever. You have confidently diagnosed otitis media and are just about to discharge the child when the nurse mentions a urine was requested at triage and has come back positive for blood.