After two days at NICU, it was back to the ER today for me. The first case of the morning: a teenage girl with what looked like a cellulitis on her elbow, except when Dr. C touched her arm she started crying. Turns out her entire arm was tender to the touch, and Dr. C called it a "cellulitis, lymphangitis, and abscess all in one." Yikes. She was supposed to see her PCP tomorrow but Dr. C said, "This can't wait that long." The girl had to be admitted and receive IV antibiotics (clindamycin) for her infection, but the veins in her hand kept rolling so they had to insert the IV in her cubital fossa. Thank goodness my veins never give me trouble. Getting pricked once is bad enough; getting pricked twice is torture.
We had two lectures today: the first was at lunchtime and covered different types of anemias, and the second one at 4:00 pm covered fluids (which I still have trouble with). Right before the fluid lecture, a 4 year old boy came in with a Nike-shaped laceration to his knee. Yesterday Arash got to assist in doing subQ stitches in one girl's leg in the ER (the girl had needed 70 stitches total), so when Gina said she'd let me put in a few stitches of my own, I was excited. However, when it was my turn to do a stitch, the boy's grandmother told Gina to keep going. "He's the one who's going to have to live with it. I don't want to put him in any more pain than he's already in," was what she said. Meaning, of course, that she did not want a lowly medical student to suture her grandson's leg. I was disappointed, but I understood her reasoning perfectly.
Later an infant was brought in with a history of general seizures. He was crying bigtime as the nurses tried to find a vein in his leg to insert an IV, and then he went into another seizure. It lasted about 45 minutes, and all the while, his mother was holding his shoulders and crying, "Mijo, mijo..." I felt so bad for her; it cannot be easy for any mother to watch their child have a seizure and be helpless to do anything about it. The pediatric neurologist, Dr. D, was called to the ER for a consult. I had to leave around then, but had I stayed around, maybe I would have seen the docs do an IO on the baby. And so concludes my time in the ER. Next stop: PICU
2 comments:
what's an IO?
IO = intraosseous access. Remember the week before rotations when we practiced drilling into a bone? That's an IO; it's used to deliver medicine directly into the vascular system when IVs fail.
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