Saturday, March 15, 2008
I am back in the Pediatric Emergency Department. While things at the Veteran's hospital went smoothly (It is nice having computer access to records of primary care and specialist visits.), the patient volume was so much lower than it is at my hospital. While I miss the luxury of actually being able to leave on time with all of my charts dictated, time passes much more quickly when you are busy.
Over the past few shifts I have had some pretty sick children, mixed in with all of the usual fever and vomiting cases. The other morning started with a child hit by a car. She came in already intubated, so there wasn't too much to do, but the poor thing had fractured three out of four of her extremities. She'd been hit so hard that she had huge gashes across her chest, and her liver was lacerated. She's still in the ICU fighting for her life, but she came through surgery ok, and hopefully will come of the vent soon. Then there's been the gauntlet of medical stuff... asthma, sepsis, scarlet fever, meningitis exposure (!), appendicitis, etc.
And perhaps my favorite, the accident-prone: lacerations, shoulder dislocations, finger amputations, nailbed injuries to repair, all requiring lots of sedations. I have said this before, but I really like the straight-forward stuff: clean it, sew it, pop it back in place. As long as the rest of the department is settled down, it is really satisfying to have a quiet 20 minutes of irrigating, prepping and doing a quick suture job.
It's good to be back.