ah.... finally back in the ER. Its like I forget everytime I'm away how awesome the ER is. The pediatric ER is a bit different than the adult ER. Most kids who come in are assumed well until proven otherwise-- the exact opposite mentality of the adult ER. This is because the reality of kids is MOST of the TIME if it looks bad, its not. That said there are plenty of really sick kids out there- so don't use that as explicit medical advice. Most of why kids come into the ER are in 3 categories: 1) they shouldn't be there (cough, flu, runny nose, etc) 2) traumatic some kind of accident (broken leg, swallowed a quarter, abuse, etc) 3) congenital/genetic problems - these can be catastrophic and/or change the bodies abilities at a cellular level. This last category is every doctors nightmare (or at least mine) because all the rules are changed, what would make a normal person better can often make them worse or even kill them inadvertantly.
That said, 90% of the patients belong to category one which means we see maybe 3 times the patients as compared to the adult ER. That means twice as many stories and way way busier. I spent many a shift so busy I could not pee for the full 12 hours. Anyhow down to the stories and the pictures, all of which were taken with parents and patients permission.
This kid has a machine sewing needle through a finger. I took it out no worries. :)
The tongue below is a classic exam question and often not seen so
textbook-perfect. It is what is known as "strawberry tongue" and when
accompanied with a rash, fever, sometimes sore throat is also apart of
scarlet fever. Scarlet fever isn't as scary as it was before
antibiotics- it can be treated. It doesn't cause as many heart
infections now.
Another story is one that caused quite a mystery in the department. A
girl who came in with purple skin from her bra line to her panty line.
Although I didn't think to take a picture of it until it started fading
you can see the distinction if you look... It was crazy. It was so
distinct and we couldn't figure it out. It was obviously venous pooling
but we couldnt' figure out why.
Last but not least. A diabetic type 1 (juvenille) and its a very distinct foot infection of the skin also known as cellulitis. This girl wanted to go back to school, she had been in the hospital and ended up having to skip a grade. Since she didn't want to have that happen again, she has been walking around on these until they started turning purple (look at her ankles).... What can I say some kids really like school... way more than I ever did.
