more unamazing tales from the ER

First, I have to say pedi ER nurses are amazing. They do the hard part of medicine, in my opinion. The drawing of blood from angry sick children.
I got to suture up a 16 yr old who got cut punching a window. She was cussing in spanish when she found out we had to numb her up with a needle. “You don’t understand, I hate needles..Oh MY GOD!” She had a tattoo. “Um, you realize tattoos are done with needles…right?” “yeah, but that’s different. It was worth getting.”
Turns out the tattoo had a sad story behind it, a sibling lost before he was born. She told us how she had lied and said she was going to church, but when to get the tattoo instead. Her brother asked if we could suture her mouth shut. Overall, that family was great to talk to and we got her patched up.
I missed a diagnosis last night, and what kicks me in the butt is that it was a thing I had been waiting to diagnose for awhile. For some reason, I was obsessed with finding a herpetic whitlow while I was rotating through dermatology. I even checked for it on one of my coma patients. It’s basically herpes on your finger, a bunch of tiny vesicles that coalesce into a bigger bump, contagious especially if you pop it open. Herpes everywhere.
So i got a chart, and it states that the girl was sent here by her doctor for draining an abscess under sedation, because he felt she was too hyper for him to do it. Send it to the ER…nice. FYI, we don’t sedate kids to drain small abscesses. Sadly, already in my mind I thought that was it-she had an abcess. I didn’t even question her primary care guy. Now, I might have caught on if I had gotten a real good look at it. Unfortunately, that patient was the MOST HYPER thing ever. And she got her little sis to be hyper too. They were hitting the nurse call button several times, pulling stuff out of whatever they could. I was finally looking at her finger when the mom and I looked up and realized the little sister was playing in the trashcan. I get her out of the trashcan so the girl takes the opportunity to climb in the sink. The girl tried to kick me when I got near, crawled under the bed, little sis was back in the trash…it was crazy. Mom did not spank them for any of this, just scolded. So I got a quick glance, got an estimate of the measurement, of where else it was spread to, then left the room. The nurse was standing out there looking at me sympathetically. “That was something, eh?” We hear an angry scream from the girl coming out of the room. Still no spanking noise.
I report to Dr. Sparkman, who is an excellent doc. She walks into the room, is friendly and all to mom, takes the girl’s thumb and just holds on, like a rodeo rider on a bull. The girl’s thumb, from being squeezed a bit, turns a little bit redder, and the discoloration causes more vesicles to be visible. “Herpetic whitlow- you don’t want to drain that.”

Oh and last night as I moved in to examine a patient’s mouth he coughed on me. And today I feel sick as a dog. Baby germs…grr.

Published in: on July 4, 2008 at 3:51 pm  Comments (3)  

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3 CommentsLeave a comment

  1. Your dog emits a foul smell.

  2. As does the cat.

  3. I always thought Addy smelled like Fritos.

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