CCS- aspirating some peanuts

[usmle0713]

Hey guys. I was having this discussion with someone. There's a CCS case in which a baby (completely normal before) suddenly develops cough and stridor, and there were peanuts nearby. Baby can't breathe and is brought to the ER. No fever, unremarkable Hx.

So, now in emergency, with oxygen, Iv access, can we straight up order a bronchoscopy? I didn't even do a CBC or CXR. Did broncho right after emergency orders and physical. Baby recovered in a minute and mother was happy. I checked ABG's and they were also fixed. but according to uworld I missed a lot of steps.

My question is, would they take off points if you straight up do a broncho for foreign body asp, instead of CXR, CBC and all that first?

Thank you!!

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[c0pycat]

Hey guys. I was having this discussion with someone. There's a CCS case in which a baby (completely normal before) suddenly develops cough and stridor, and there were peanuts nearby. Baby can't breathe and is brought to the ER. No fever, unremarkable Hx.

So, now in emergency, with oxygen, Iv access, can we straight up order a bronchoscopy? I didn't even do a CBC or CXR. Did broncho right after emergency orders and physical. Baby recovered in a minute and mother was happy. I checked ABG's and they were also fixed. but according to uworld I missed a lot of steps.

My question is, would they take off points if you straight up do a broncho for foreign body asp, instead of CXR, CBC and all that first?

Thank you!!

No one really knows how they score CCS but from my understanding...
You need to act quickly if you suspect foreign body asp based on the initial history and presentation...
You do emergency order and only focused physical, don’t do full physical and jump straight into bronchoscopy.

now, if they mentioned that the kid had peanut allergy...they you won’t even have to do a focused physical. You would put emergency orders first along with Epi intramuscular.

very careful read the history ...