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Case Study 2 : A 6-week-old infant presents to the emergency department with complaints of color changes with a choking and coughing episode

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Case Study 2 :

A 6-week-old infant presents to the emergency department with complaints of color changes with a choking and coughing episode. The mother reported that the child had a bluish discoloration of his face with the episode. Upon presentation, the infant appeared alert and in no distress. Vital signs are as follows: heart rate 122 beats per minute, respiratory rate 30 breaths per minute, blood pressure 90/54 mm Hg, SpO2 100% on room air. The patient was triaged and placed on a cardiorespiratory monitor. The infant's mother stated that the event occurred about 10 minutes after she had finished breastfeeding and had placed him on his back in his crib. She said that she had heard him making choking and gurgling sounds and had gone back to his room to check on him, where she noticed that his face had turned bluish purple. She further noted that when she picked her son up, he was limp and did not seem to be breathing. She immediately shouted for her husband while she "blew air into his mouth." After about 10 seconds, she said her infant responded and seemed to be back to his normal self. A chest radiograph was ordered and results were unremarkable. The infant was admitted to pediatric services for overnight evaluation with impedance pneumography with pH by an esophageal monitoring catheter. The patient had no further apneic episodes during admission but did have reflux after most feeds. No further interventions were required during the hospital stay, and the infant was discharged home the following day after parental education on home management of infantile

gastroesophageal reflux disease.

1. What does impedance pneumography monitor?
2. Could this type of monitoring be performed with a home device?
3. What are the limitations to using an impedance pneumography monitor on the patient in this case study?