skip to main content

Drowning with mild respiratory symptoms — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardEnvironmental emergenciesDrowning with mild respiratory symptomsRCPSC EM

A 10-month-old has intermittent screaming episodes with pallor and vomiting. Point-of-care ultrasound is indeterminate, but the child is currently perfused and has no peritonitis. What is the next diagnostic action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Obtain formal ultrasound and arrange pediatric referral if unavailable

The best answer is “Obtain formal ultrasound and arrange pediatric referral if unavailable”. The presentation is concerning for intussusception. Canadian pediatric emergency guidance identifies formal ultrasound as the diagnostic test of choice when trained point-of-care ultrasound is negative or indeterminate but suspicion remains; transfer is appropriate if it is unavailable. Abdominal radiography lacks adequate sensitivity, and absence of currant-jelly stool does not exclude the diagnosis.

Reference: TREKK: Intussusception bottom-line recommendations: https://cms.trekk.ca/wp-content/uploads/2023/11/2024_11_13-Intussusception-BLR-v3.1-Final.pdf