Thursday, January 25, 2007

Hospital education

We had an adventure in medicine yesterday. One of the kids from school got whacked in the face which then forced him to fall on the back of his head. He never lost conciousness as far as I understand, but all his muscles went out...he was unable to stand and could barely bring his finger to his nose. After a quick evaluation and a few unclear head X-Rays at the local clinic, it was decided that we needed to see what was happening with a head CT and to check out his neck for possible reasons as to why he had almost no function of his arms and legs. An IV was placed before we left, and 3 of us carried him to the van for a ride down the mountain where there is a "clinic" with the equipment we needed. No hospital transfer via ambulance, no HIPPA forms to sign, we just packed him up, rigged up his IV bottle to the back seat, and tried to immoblize him the best we could...and prayed! Halfway down the mountain he really needed to go to the bathroom, and after a failed attempt to go while tilting over a bottle, he all the sudden was on his knees in the van, his muscles were back! He was then able to stand outside the van, after a few questioning looks between Leslie an me as to whether this "spinal/head fracture" pt should actually be walking around! We made it to the hospital where we were sent to get the CT, never having received an exam or evaluation. The transfer from bed to CT table was horrendous, with the staff pulling him by leg and arm to the table. Thank God that he was cleared from any spinal injury, but we didn't know it at the time and it was HARD to watch. He then had a neck X-ray and was not only lifted in a similar fashion to the bed, but was then flipped on his tummy,neck brace removed, and his neck turned to the side (!!!!!!!!!!!) for the picture. I couldn't actually believe what I was seeing. If he had truly had a neck injury, this could have caused further damage or even paralysis.

After the CT, we were sent back to the ER to wait, and wait, and wait. The trauma doctor who was to review the scans wasn't quite in yet, so we waited some more for the pictures to be printed and then were able to transfer to another clinic...where the trauma doctor was going to be to read the results.

The other clinic was (of course) just around the corner and across the street, so our little pt (who still hasn't technically been cleared of any head or spinal injury) was put in a wheelchair and wheeled down the street, around cars and motorcycles to the next clinic!
When we got to that clinic, we were told that the doctor was out and didn't even arrive for another hour and we were the 3rd in line. Leslie (she's a pediatrician with training in emergency medicine) had a look over the films that we had with us of his scans...and we left! It was a decision based on his coming around and having full functioning and having looked over all the results. He still had his IV in and we were had stopped at a little store/restaurant, so I took it out while we waited for the pastelitos to heat up. It was truly and I am glad to have done to see how it works, but am thankful to have had Leslie with me and that the results were all great.
So for all those nurses and doctors, enjoy your transport teams, backboards, hallways, and on-call MD that is in-house!

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