ER trip and Temp taking
I'm kind of disappointed there are other publishings about my pooh theory. (see below) But I guess it was too obvious a thing to go un-noticed before this nursing student came along. Hey, I enjoyed writing it anyway.
I was searching for a basic "ER" logo pic and couldn't find one, This one of "Dr. Kovac" is way easier on the eyes anyway....he's yummy.
My last clinical day of pediatrics was yesterday and I got the privilege of spending it all by my lonesome (was the only student) in the children's ER. I really thought it was going to be more exciting then it was. I didn't realize that the children involved in traumas went to the Adult "crash" dept. The department I was in saw mainly level 3-5s. My layman interpretation of the levels are Level 1 is "dying" ie internal bleeding, Level 2 is "could die very soon" ie severe asthma attack, Level 3 is "chronic or serious problem that needs to be dealt with in 2 hours max with about 2 interventions" ie. a child with urinary tract infection. Level 4 is "can wait for up to 8 hours, 1 intervention needed" ie ear infection or rash, Level 5 is "patient could probably get better on their own and the problem is in no way fatal but since they are here...." ie. sprain or a cold. I got to help in triage all day so I got familiar with the level system the nurses explained to me. The worst I saw all morning was an infant with RSV who was in mild respiratory distress. I had never seen the nasal flaring, high resp rate, and subcostal and intercostal retractions before. The good thing was they took the baby straight back and the had about 2 MDs, an RT, and 5 nurses surrounding him in minutes. He's gonna be fine. He probably went to the NICU after I left. It was fun but not what I thought it was going to be.
I'm also anti-rectal temp taking if there is another accurate way available. Axillary (underarm) can be off but Tympanic (ear) has been proven to be the most accurate if done right. I read an article not too long ago that said rectal temps are sometimes up to two degrees higher then core temp. (think of where you are looking, you want to monitor brain temp but you are monitoring all the way down there in the rectum.)
I asked why they weren't using Tympanic and the nurse told me the doctors think rectal is more accurate in babies (under 2 is what they were doing) That may be, but why traumatize the child anymore if you don't have to? Every baby screamed when they did vitals.
I say get the Tympanics and train staff how to use them appropriately (which they should know anyway)
Md Anderson in Houston
We finally have some hope. Mom's taking Jerry to the MD Anderson cancer center in Houston on Tuesday. If anyone can help him, they can. I am relieved they are at least seeking a second opinion. I am also relieved that My step-brother Shane and my sister Jamie both live in that area so my Mom and Jerry have family support there.