So I took some time off from the NaBloPoMo. I loved to blog every day but it's also nice to have a few days off.
Had a crazy situation the other day.. We had a 21 month old come in with the complaint of vomiting for three days. This patient should never have come to us, it's not "Fast Track". Fast track means in and out. Not someone who is so sick they may need to be admitted to the hospital. But sometimes it happens. The doctor was upset that this patient came to us, especially because we are not a pediatric hospital. When we get pediatrics that are sick enough to be admitted we have to transfer them to a pediatric hospital. But it is hard to be a community hospital because people don't know this, they take their sick child to the closest hospital they can find. I don't blame them.
We had to start an IV on the poor little guy. Starting an IV on a child is always difficult. We have to basically hold them down while we stick a needle in their arm. They don't understand why we are hurting them. We are under the constant scrutiny of their parents who pay strict attention to everything we do.
A nurse from the ER who had experience in pediatrics came over to start the IV. At the bedside was the little guys mom and his 18 year old sister. We asked them to help. We told mom to stay near his face to talk and reassure him. We asked the sister to hold his legs so he wouldn't kick us. We have the kids arm and are attempting to access a vein. The poor kid is howling and twisting away from us. (I don't blame him). The nurse gets blood return from her needle and all of a sudden, the other nurse helping yells, "She's going down! She's going down!" I'm not really sure what she means and I turn my head just in time to watch the 18 year old sister faint. She falls backwards from the guerney and hits her head so hard on the floor that I'm still haunted by it.
I immediately crouch next to the sister (I find out later her name is Anna) and try to assess the situation. I stand up and open the door and yell, "We need some help in here!" I crouch back down and realize that she's not really breathing, the color of her face is yellowish/gray. I start rubbing her sternum with my knuckles. It's called a "sternal rub" and it's very painful. (Try to rub your sternum now. It's painful. I was digging into her.) One of the physician assistants came in and crouches down with me. Anna's color comes back in her face and her eyes open. She's confused and tries to sit up. We look at the back of her head and see a gigantic lump forming. Meanwhile, her mother is freaking out. "Ayyayeeayaayeeyayyeee!" Unfortunately, we still haven't gained IV access to the kid.
I grab a gurney and push it into the room. The other nurses get Anna up and into the guerney. She complains of a headache (I don't blame her). We order a head CT and give her pain meds and an ice pack for her goose egg. I can relate to her predicament, I fainted the day after Easter and ended up with a huge hematoma on my head. I know it hurts. I have to push the doc to give her stronger pain meds. He had originally ordered Advil until I pushed for something stronger. Sometimes I think doctors have never been hurt before.
We finally gain IV access to the little kid and get a CT on his sister. Nothing wrong with her except the hematoma on her head. We eventually sent the kid home after we gave him fluids and anti emetics. We sent the girl home as well.
Amazing what the body can do after seeing something crazy. I'm very careful now about making the family member sit down if we need to do something. These poor people, this is going to go down as one of the worst days of their lives...