Coarctation of the Aorta

2-week-old baby girl otherwise healthy, born at 38 weeks presenting with respiratory distress. Her parents have noted that she has been breathing faster and feeding less. She has an older brother (3-year-old who is in daycare). Symptoms have been getting worse over the last couple days. She was seen at urgent care and was ultimately referred to the ED after albuterol and suctioning were unhelpful. On exam, the patient is in obvious respiratory distress. If pulse is placed on the upper extremity, saturations are low 90s with adequate blood pressure (lower extremities unable to detect BP or get a good saturation reading). Overall goal is to recognize CoA, start PGE, and call ICU for admission.

Learning Objectives

‘- Learner applies monitors.

– Learner assess both lower and upper extremity blood pressures/saturations.

– Learner starts PGE.

– Learner obtains and reviews arterial blood gas.

– Learner obtains and reviews CXR.

– Learner calls ICU for admission.