Kids, Kids, everywhere

Today I worked in the pediatric ER. It was a good shift despite the fact that I do not like the pediatric patient as much as I do some of the other patients. I like patients that are old enough to understand that we are trying to help them and not kill them. Suturing little kids is always hard because it is like a moving target and they get mad. I enjoyed the shift and it was busy and hectic.

Common things seen in the pediatric ER = appendicitis, febrile seizures, intussusception (intestines fold in on itself), lacerations, overdoses, pneumonia, fevers, pharyngitis, stange rashes, burns, allergic reactions, traumas.

A sample of some of today's patients:

We had a 2 year old who had acute hepatitis from a tylenol overdose. Evidently the mother had been treating his fever with tylenol for the past couple of days. We administered an antidote; N-acetylcysteine. The child was put into the pediatric ICU and hopefully will not have long term liver damage.  I am not sure why this product is still on the market. The ped. ER doctor says that she this is a common case for her to see and that many times the patients are within the regular dosing amounts.

I was working with a pediatric emergency physician who did a residency in emergency medicine and a residency in pediatrics. She has been working in pediatric ER's for 15+ years. It was amazing how much she knows.

We had 2 cases of appendicitis that I saw and diagnosed and sent off for surgery. Then we also had a handful of scared parent syndrome, which is usually a child with a completely benign issue that the parent is worried about and rushes them into the ER. Today we saw a bee sting case (not allergic), 5 year old with a 100.1 fever, vomiting 8 year old, and a couple of other not so serious illnesses. 

The most exciting case was a 6 month old infant in respiratory arrest. This infant had cerebral anoxia at birth which led to developmental delays and seizures. The child is a very sick baby and has been in and out of the hospital since birth and this morning stopped breathing. We quickly intubated the baby and were able to keep the baby alive. The case was touch and go. I realized how hard it is to put IV's in infants. Generally everything is harder on infants. It was rewarding to see the baby's  vitals return to normal.