A simplified approach to the initial assessment and management of sick patients with VP shunts in the emergency department
Case
A 4 year old presented to the ED with a mild headache, nausea, and vomiting, and was triaged to the sub-acute area of the department. You are called to the room stat, as the child is now unresponsive with a HR of 55, a BP of 167/65, and a sat of 96% on room air. His mom mentions that he had a VP shunt placed when he was younger, but now has no medical problems. The closest neurosurgeon is 45 minutes away, if everything goes perfectly…
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