Archive for the ‘Pediatrics’ Category

Would Like to See More Info on This Case

Tuesday, September 27th, 2011

I recently read THIS distressing story about a seven year old boy dying of as asthma attack during an ambulance transfer.   Of course, whenever you read articles like this in the lay press, you shake your head saying “What the heck were they thinking?!”. Why would you transfer a child with really bad asthma to a far away hospital without intubating him first (if you thought that was even a remote possibility)?

Now, thinking like the ER docs involved, I would imagine that child looked much improved before transfer and presumably they had a relationship with the receiving hospital’s PICU (like we have).  Of course you wonder how much of this transfer was because the child had Medicaid.  I do know that we have difficulty transferring uninsured or Medicaid patients to many nearby hospitals. Then generally have to go to larger, state-funded centers which may or may not be the best place for them.

I also have to applaud and criticize the author of the article for the way the story opens.  It nearly made me cry – but pissed me off that they would resort to that just to get the public to side with the family.  Without even considering the actual medical situation (even by just having an unbiased ER MD postulate on possible reasons for the transfer), they succeed in scoring a big victory for the plaintiff.

 

 

Scare Tactics

Monday, September 5th, 2011

Third visit for intoxication for a 15 y/o boy. What to do?
We put him in a large 4 person room with two other drunks- but these guys were your typical stinky, toothless, near cirrhotic drunks. (under constant observation by security) As the teenager sobered up, we showed him the other guys, all urine soaked and filthy.
A simple, “straighten out now or end up like them!!” was all it took to scare the crap out of him. He looked horrified.
Hopefully we won’t see him back.

This is Sad

Thursday, May 26th, 2011

It really knocks you for a loop when you pick up the chart of a 15 year old girl who has been vomiting for a day and you read the history:

S/P Gastric Bypass 1 year ago

Meds: Dilaudid, Reglan, Pepcid, Lexapro

Allergies: NSAIDS, “All Antibiotics”

Holy crap this country is sad.

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