Tetralogy of Fallot with Hypercyanotic Spell

The patient is a 2 week-old baby boy with prenatal diagnosis of Tetralogy of Fallot. An IV was placed when the patient was in the triage area and the saturations since the arrival to the ED have been in the 60s. This scenario begins with a notably cyanotic infant with a saturation of 55% who is tachycardic with a normal blood pressure. Learners must assess the patient, evaluate the situation, recognize abnormal findings, and respond with appropriate interventions. The goals of this scenario are to perform the objectives below, call the cardiology fellow, and have the infant admitted to the CICU.

Learning Objectives

– Place baby in knees-to-chest position
– Start nasal cannula O2
– Give appropriate treatment and medication
– Call CICU for admission