Teen patient presents by ambulance from school for severe shortness of breath, headache, fatigue and neck/upper chest urticaria. Breathing was worsening and he began developing wheezes, so we placed him on 4 L nasal cannula and a trial of aerosolized Albuterol, which stabilized his breathing and decreased his RR to approximately 22 from 38. ABG demonstrates respiratory alkalosis without adequate renal compensation. I ordered a stat CXR, He didn’t say too much during this time due to severe distress so the patient was a poor historian. Mother arrived approximately 25 minutes later. Patient has no allergies to food or environment. School nurse was the one who notified emergency services so I gave her a call. She stated that his friends dared him to snort crushed up flamin’ hot Cheetos, upon doing so he immediately began vomiting and coughing tremendously. CXR Demonstrated ground glass densities in the middle right and lower left lobes. Patient admitted to snorting the Cheetos. After explaining the risk and benefits of therapy, patient and his mother decided a short term course of steroids would be best given the patients past history of atopy.
Moral of the story: it’s always the friends…
Source: Original link
