Reference no: EM133444788

Lucas, 5 months old /male, is brought into Casualty by his parents. Lucas has had some "very runny poos" over the last day and a half. His mother is still breast feeding and for the last day he has had difficulty feeding. The principal reason his parents have brought him is that he seemed "too quiet...like he was very tired". He has been "running a temperature" for the last day which the parents were managing with Panadol. They last gave him Panadol at 7 pm it is now 9 pm and he "still feels very hot". He is crying but not with many tears.

Presentation

Lucas is irritable, he is crying but with few tears. The top of his head is somewhat sunken and he is warm on touch.

Vital signs

• Heart rate 180 beats/min

• Respiratory rate 49 breaths/min

• Systolic Blood pressure 60 mm Hg

• Body temperature 38.9oC

Physical Examination

The inside of his mouth is dry. If you press onto the back of his hand the region stays pale for more than a few seconds after you withdraw your fingers.

1. Pathophysiology - Make an assessment that explains the patient's presentation. You will be assessed on the likelihood/accuracy of your conclusions and the quality of your reasoning.