C10006977 / invoice 10000

Reason: Ingested A ScrewConsultation time: 2010History:Ryda presented for assessment following suspected ingestion of a screw. The owner witnessed Ryda pick up a screw from the floor during home renovations, run away, and then the screw could not be located in his mouth.BIOP for 1 monthEDUD all WNLNil hx previous major health problemsNil current prescription medicationsUTD with vaccinations and preventatives Subjective: BAR, very wiggly!Objective: Temp    unable   MM  pink, moist   CRT <2   HR  140    FP=HRBCS:   5/9                       Wt:  7.6 kgPain Score (CSU):   0/4Cardiovascular : No arrhythmia or murmur auscultated, FP readily palpable.Respiratory : Normal bronchovesicular sounds in all 4 quadrants, normal respiratory effortGastrointestinal : No pain or discomfort on abdominal palpation. Passed formed faeces > soft faeces with gritty sandy texture, nil blood or mucous Musculoskeletal : Nil discernible lameness, ambulatory Otic: Pupils symmetric, visualLymph nodes : No peripheral lymphadenopathyProblem List:Suspected ingestion of screwAssessment: Potential ingestion of foreign item with potential to cause intestinal fb obstruction/perforation etc. Recommend radiograph to check if visible/has been ingested > O's consent to radiographs + emesis induction if appropriate. Radiographs show no evidence of screw ingestion. Small radiopaque fleck in location of stomach not consistent with screw. Emesis induced. Small bone material retrieved via emesis. Repeat radiograph show no evidence of material post emesis. Nil further complications anticipated. Reasonable to monitor at home with bland diet for few days and transition slowly to normal diet if no GI signs. Options Offered to Client:Recommended radiographs + emesis induction, o consentFollowing rx, discussed emesis, recommend careful monitoring, prevent repeat access. O indicated comfortable with this. Treatment:-apomorphine Plan:Confine and monitor Recheck asap if any further concerns    Vital Signs