The Emergency Department. What can I say? A haphazard blend of the sickest of the sick, the accident prone, the unlucky, and the stupid. Yup, the stupid. I am not trying to be mean, but how else do you explain the mom who brings her kid in at one in the morning with a chief complaint of "crying for two hours" and then sits in the room watching "Wizards of Waverly Place" while I try to examine her (sleeping) child? Or the parents whose kids are running around in the dark at ten o'clock at night who just happen to run face first into a pole and bite through their lip? Put your children to bed!
I don't mean to be (that) cynical. In fact, though we complain a lot about people bringing in their kids for the most random and bizarre of reasons, the truth is that many (I don't know if I would go so far as to say a majority, though) of the kids do need to be there. And it's a little terrifying and a little thrilling to be able to be their doctor while we figure out what is wrong and, hopefully, fix them.
The ED is an interesting place, at the same time one of the highest stress and most laid back places (probably because they LIKE being high stress). On the high stress end, yesterday we had a cardiac kid come in with fast breathing and suddenly they're doing chest compressions and intubating and bed-side chest tube and central line. But on the other hand, there's always plenty of chocolate (think giant donut-shaped cakes and huge bags of assorted miniatures) and teasing to go around ("I just called you another bad name in my head"), and the camaraderie there is unmatched. The nurses and pharmacists are way on top of their game, which is super helpful to fledgling doctors like myself. And they let nearly-completely-untrained people stitch up kids' faces and stick needles in people. It's great! (Okay, don't be too worried, I am trained...ish)
I had a lot of firsts this month--first LP, first sickle cell crisis, first rule out child abuse, first homicidal ideation, first I&D, first (second third fourth fifth etc) doing stitches on an awake patient. And I have a lot still left to see (no codes, no major traumas, no deaths), but overall a very good month.
Next up...Gold Team!
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