Tuesday, July 1, 2014

My grandson survives a visit to the ED

Last weekend, my 16-month-old grandson was at a backyard barbecue with his parents. He had been eating some potato chips when he suddenly stopped breathing and turned blue.

Having had CPR training, my son started rescue breathing and suspecting aspiration, performed toddler airway clearance maneuvers. No obstruction was found. The child slowly awakened but was very drowsy.

Because of the concern for aspiration, an ambulance was called and the child was taken to the nearest hospital.

My son called and told me what happened. My wife and I drove to the hospital, which was 15 minutes from my home, but not one where I knew any staff.

By the time we arrived, child had been in the ED for about 10 minutes. Two nurses were trying to start an IV in his chubby arm, he was crying loudly. We took that to be a very good sign. He had already been examined by a doctor.

After successfully starting the IV, the nurses secured it and calmed down my daughter-in-law. She asked where she could buy a bottle of water. One of the nurses said not to bother and brought her a glass of ice water.

The nurses were gentle and professional, so much so that my wife, who is a former ED nurse, didn't mention that fact until nearly 5 minutes after we got there.

The initial vital signs taken were remarkable for a temperature of 104° F, prompting the emergency physician to suggest that the child probably had suffered a febrile seizure. He ordered a chest x-ray because of the history of possible aspiration.

The boy stopped crying and began to watch a cartoon on his father's iPhone. Soon he was smiling and laughing.

The x-ray was negative, and the fever came down with ibuprofen. I resisted the strong urge to point out that lowering a child's temperature has never been shown to prevent a febrile seizure.

We were all relieved that he was okay.

If you were expecting a tale of mistakes, sloppy nurses, and arrogant doctors, I am sorry to disappoint you.

Several essays, blog posts, and media articles about poor care received by doctors or their family members have recently appeared.

This is not one of them.

PS: The nurses complimented us for not trying to run the show.


Libby said...

Glad your grandson is fine & the staff was professional.

In my experience (as parent, patient, friend, family, & volunteer) most ED staff are professional. I know some people who believe that laughter doesn't belong there but I do believe that it can be a tremendous coping strategy for both sides. I see it as showing compassion and humaneness. Of course there is dark humour that gets some people all twisted in a knot (hear me social workers?) and there has been some discussion on it's therapeutic affect for medical/emergency professionals. That's a whole different ball of wax. I see light banter between staff and /or patient as positive. Of course patient should buy into it (some will some won't and sometimes you don't find out until something is said. Oh well. Happens). I like it and lets me know if anything I say will be taken seriously. When I was in Pheonix I needed to go to a ED so I could get a note to say that 1. I was fit to fly & 2. that I was ill and needed to go home sooner than planned. Turns out I was dehydrated (comes with tossing cookies all night). Anyways, the ED chief happened to be taking care of me and I mentioned to the nurses that he was the splitting image of Dr. Cox on "Scrubs". The nurses laughed, agreed and said that he was nicer though than Dr. Cox. They also said that they tease him about it and he takes it goodheartedly. Too much said? I don't think so, some may (about the teasing of him or even acknowledging the similarities between the two). That quick interaction helped me feel less alone (I was at a conference so no friends/family with me) and comfortable telling them if something went sideways with the IV or even that it was finished. I have had some nurses that I'd rather leave with the IV bag empty and attached than say anything to them!

Again, glad things are ok with the little tyke and that you showed great restraint. I know it's hard with what knowledge I have & so I'm sure it's really hard when you actually know a lot!

JEN said...

Scary! Glad you had a good experience and the wee one is okay!

Skeptical Scalpel said...

Libby, thanks for commenting. I agree laughter is necessary to help break the tension sometimes. Thanks to you and Jen for the good wishes too.

Anonymous said...

I'm glad that things turned out well for your grandson.

I agree totally. There are a number of excellent interactions I've had with staff. Just today ... well maybe ... at one of the top ranked teaching hospitals, the gentleman made sure his "thoroughness" lasted thru 2 hours with another exam scheduled down here close to home.

Its just that the followup is due to a doctor who botched it. As are many of my other appointments. Its easy to forget a mistaken cold for the flu. When it leads to some $$$ and work time lost, and major events missed in your life, totally different story.

I think we can all excuse things. I have. Just not one that will impact me negatively for the rest of my life.

Skeptical Scalpel said...

Anon, thank you. I am fully aware that some doctors do not measure up. I have blogged about a number of them myself. I wrote this post as a reminder that contrary to what you may read, sometimes things go very well.

Unknown said...

You're right - things do go well. My husband went to ED with a persistent run of A-fib. Within 10 minutes, he had two IV's in, pads for defibrillation in place, consent in hand and plan of care explained - mostly care from nurses, tho the attending and resident were in and out.
We're both nurses -- and I didn't have to mention that we were ---it was the ED in the hospital where we both practice. The one plus was that they let me stay when when attempted cardioversion. (We both do better if we can stay together.)
I'm finally writing the thank you notes to the nurses that cared for him (and have already written their Director) They did a great job --and were really patient advocates.
And -- I have to admit it -- I really expect to receive the same level of nursing care that I provide to my patients. That level is pretty high -- but these nurses met it.

Skeptical Scalpel said...

Melissa, thanks. I'm glad it turned out well.

William Reichert said...

Let me tell you my favorite story of a very satisfied patient visit to the ER. One afternoon, I was on call for admissions to the ER. The ER doc called me to admit a 37yo woman because of a rapid heart beat. I looked at the rhythm and determined it was Paroxysmal atrial tach.
The woman looked healthy, was on no drugs but I learned she had had a cold lately and was taking regular doses of "cold tablets".
I knew that one could convert PAT to normal rhythm with carotid massage but it had never worked for me. But
I thought, "what the hell, "let's give this a try". SO I applied pressure and to my amazement her heart stopped for 2 seconds and then started up again with NSR. I informed her of this .and she could sense the improvement . At that moment, her husband entered the room. She looked up at him and said,"Honey,guess what?This doctor cured me by just touching me?".

Skeptical Scalpel said...

Great story. Next up "Reiki."

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