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FLAOrthoPT -> Re: CASE 1 (January 10, 2006 3:19:00 PM)
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well ignoring this is a child, an ortho screen would be AROM vs PROM to see if the joint is involved or musculature involved. You could do neuro tests to rule out peripheral or chord symptoms. Motor control tests to see if CNS invloved. Functional task to see if fear avoidance etc. Palpation, sensory exam, and rule out C-spine, T-spine, rib fxs.
Now since this a kid and a bit before the real talking ages, you cannot simply ask them what happened. So you are going solely based on mom's interpretation, and you have no reason to believe mom to be deceiving you at this time. you also need to make sure no primitive reflexes are active, look for signs of trauma and or abuse, have the child attempt activities appropriate for 16 month old including walking and pushing a ball perhaps, throwing and catching you can try, climbing/crawling up a step, etc.
Now since this is hard to do in this format, let's try to figure out why heartbeat so high, check BP, check temperature, check all over for wounds including exit wound in toes perhaps from electric shock. Try to rule out a brachial plexus injury by looking for peripheral patterns of weakness. Hopefully this all takes WAY less time than it did to write!
When in doubt, I think the person was standing on the block of ice which is now a puddle of water and that's how they hung themselves...sorry reminds me of one of those conundromes.
Ben (no peds exp. whatsoever by the way)
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