Ped's is medical slang for pediatrics. Ped's are a whole new ball game.They are SO much more than just "little people." Their anatomy is different, and it changes everything.Their heads are so much bigger, that it almost resembles a big ole ball on a little stick. For example, to open an adult's airway, all you can just tilt their forehead, and lift the chin, and bingo. But with a kiddo, you will be need to lift the body to help offset their huge head.... Sometimes, a rolled towel, or pillow under the body will suffice. But that's just an example.
I worked an OT shift on Monday for the bonus money. When the schedule has a lot of openings, the boss man will offer a $200 bonus just to get people to fill the schedule. It's really not bad, considering that you get your time and a half hourly rate on top of all of it.
Anyway. I got to work with TCB, the big BBFE... For those of you who don't know, that means "That Chris Boy" which is what my family calls my boyfriend, Chris. BBFE is Best BoyFriend Ever. Chris is the Best BoyFriend Ever... but that is all another story for another day.
We worked the normal NH (Nursing Home) stuff. We ran all the normal Drama Queens, and MVA's (Motor Vehicle Accidents.) The one that scared me actually came from a NH... I'm sure you are wondering why I'm telling you that this call came from a NH, because this is titled something to do with ped's... Usually when you are called to the NH's you are never ushered from the door to the actual pt. Usually they just tell the dispatcher which room the pt is in, and let us play marco-polo until we get to where we need to be. But not this time. There was a frantic CNA that met us at the door, who led us to the administrators office.... Super strange. Just beyond the door, I see another CNA or Medication admin lady or something, completly frantic, sobbing, and people are comforting her. A firefighter, steps outside the door, to tell us that our pt is a 2y/o M who had a seizure. Whaa?? Ok, well stuff is starting to make sense, but 2!? not 82!!!
I stepped inside the room to see a group of people huddled around a little boy, shirt off, and washcloths and ice all over him. Well... They are dropping his temp? But this is a little extreme. I step in, and start trying to calm everyone down. When it's a kid, it seems like people freak out even more, and I understand why, it's just keeping people calmed down is the hardest part. I roll him onto his back, then take his little sweatpants and shoes off. Alot of times, just stripping them nude will do the trick, the ice is a little much.
I ask a FF (firefighter) to attach the monitor and get some vitals. Plus, with protocols (rules,) we have to have the pt on the cardiac monitor before we start any invasive procedures. We get the monitor on, and all goes well.. I am getting ready to start the IV, and all the FF can tell. I'm terrified that the tackle box looking thing that I keep my IV stuff in is about to explode when the 2-3 very eager to help FF get ahold of it. Somehow, it doesn't. We place the IV, a 20g, which is an acceptable size for an adult, is placed in the AC (inside elbow.)
I call the mother in to explain everything that was going on. She was hysterical, and I can imagine why. I try to explain that sometimes when little kids get too warm, this happens. Everything he is going through right now is normal, and he will come out of it. I tell her that I want her to sit down, then we will put baby on her chest, to keep baby warm with her body heat. She sits down, we get baby settled, then get the monitor back on him, and everything else settled. We buckle baby up, and I start telling mom what to expect on the way there. Just then, I notice baby's eyes are beginning to look like they are starting to seize.
We are in the hall way, Chris is in the office, cleaning up after me. (Still wonder why he is the best?) I say in the sweetest, calmest voice that I can muster, "Chris, may I please have some valium?" Just then, I hear a FF scream, "CHRIS! VALIUM!!! NOW!!!!!!!!!" I'm fairly certain at this time, I might have said something like, "whoa, cowboy," But I could be wrong... Chris puts a vial of valium into my hand and I get it ready.
When working with kids, I'm sure that you have seen a few 3 year olds that are as big as 6 year olds... That's why we use a color coded system that categorizes, not by age, but approx sieze and weight. This kid was a red. ok, 10mg in 2mL, this little guy needs 1.7mg. You do the math. I pushed super slow until the seizure stopped. I flushed it intermittently, and he stopped seizing, and went limp again. This might sound callus, but that's the desired effect. We got him to the hospital, and all is well... Except, "mom" is actually grandma, and she is in her EARLY 30's.
The next day......
We got called to a medical clinic for a 1 month old, who tested positive for RSV, (a Viral infection) and looks like he was developing pneumonia. Mom is 16. She doesn't seem to care about her sick baby, or even know basic things about this baby. Breaks my heart. I wanted to throw her cell phone out the window. Doesn't she see the angel in front of her? The baby that SHE brought into this world? Just because you can have babies, doesn't mean that you should....
The last day.....
Get called for a 10mos old little boy, Mom says he is short of breath. mmmk... easy enough. We are arriving on scene, don't even have the truck in park, and FF are running out of the house, carrying a pale, limp, lethargic (super tired) looking baby. FML. I jump in the back, and throw the bags off the of cot, We put the baby on the cot and a FF who is also a Paramedic jumps on with me, and we get to work. I failed an IV in the AC (inside elbow,) the FF gets started on trying to get another IV option. I quiz mom on what's been going on lately with baby, mom, stress, ect. Nothing out of the ordinary.
I ask my partner to stand in between mom and me so mom can't see me stick a tube down baby's throat. It fails because baby pukes, the puke clogs the little tube. The FF fails his IV attempt. I suction baby, and his head falls to the right, and I see a huge vein down the side of baby's head. I don't miss the opportunity. I get a 20g and they check a blood sugar with the blood from the IV start. Baby's blood looks watered down, strange.... Blood comes back a little low on sugar, we will give him some in a second. He is getting more and more tired, we need to secure an airway, he has been breathing ok up to now, but, he really needs a tube. I try to tube him again. He pukes again. damn. 2 tries and I'm done.
We just go. his vitals are good enough to handle transport, and his airway is doing well. I have a BVM (the bag that they hold over their face and squeeze) if things get worse, and we can always flip the lights and go really fast.... but the danger of driving that fast through traffic, when it's unnecessary is just that. Dangerous and un-necessary. We give him the sugar, and it doesn't do a thing. I was hoping it would perk him up a bit... but no go. We give him some fluid to see if he is dehydrated, no go... The FF and I are tossing ideas back and forth. We are thinking RSV.
We get to the hospital and all is well. The Dr. bad mouths me and says I can't do anything right, I try not to let it get to me, but it does... I worked hard, but I guess I'm not good enough. Its ok, can't please everyone.
Doc gets labs ordered and I go do my report. I come back in to see what they have found, and hand my report over. A Critical Care pediatrician is in the room and is ordering tests and asking questions. Doc is still bad mouthing me, the Nurse backs me up and the Critical Care doc doesn't seem to share her passion for tearing me down. Which, makes me feel a little better. The first set of labs comes back on the baby. His WBC (white blood cell, infection fighters,) are through the roof. His hemoglobin, (on each Red Blood Cell, RBC, is a substance that carries oxygen around the body.) was incredibly low. 1.3, instead of 11-13. Baby is positive for RSV, and prescription sedatives. hmm... baby isn't breast feeding anymore... Where did those come from. It might be morbid, but I keep checking the obituaries for his name, just praying that I don't see it. So far, so good.
Thursday, March 10, 2011
Thursday, March 3, 2011
Wednesday, March 2, 2011
ESI
I just had my second Epidural Steroid Injection (ESI) yesterday. They went closer to L3-L4 this time. Last time it was the facet joint around L5-S1. I am SO much more sore this time. Last time, I was sore, but only with certain movements, and prolonged standing. This time, I can hardly even lay flat, or sit upright in a chair, or stand at all. If I am too long in a slouchy position, it is almost impossible to get up on my own.
But, after the last injection, I do feel that there is hope.
But, after the last injection, I do feel that there is hope.
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