Hello and welcome to Medical Mondays! Truth be told, I was kindasorta dreading this rotation because I’d heard so many comments about it from two fellow residents who were on this right before my friend and I started, but it actually ended up being a really cool rotation!
Day in the Life: Pediatric Emergency
Our shifts were split into 6 12-hour blocks throughout the month and we’d spend the other time at our regular office seeing patients. We did either Monday or Wednesday blocks from 12pm to 12 am, and also did a full weekend double-block.
As Family Medicine residents, we were technically responsible for “Peds Fast Track,” which are the patients labeled either a 4 or a 5 in acuity (1 = the worst/most acute + emergent), but we ended up seeing basically anyone that walked in anyway, and splitting up the patients with our attending and the other resident (either from Peds or Emergency Medicine).
While I was on, perhaps because it was summer and everyone was gone for vacation and the like, it didn’t get tooooo too crazy down in the Peds ED. The attendings I worked with were all really cool, and you always knew when the hours were starting to drag when one of our attendings would start sitting in his seat with a blanket wrapped around his head (kinda like Obi-Wan Kenobi). (For the record, it’s freezing cold down in the ER. :[ )
We’d assign ourselves to the patients that came in. For the emergency room, our main goal is not necessarily to find out what exactly is going on with a patient–it’s to determine whether or not the patient has something life-threatening, and what to do if it is. Otherwise, if it’s at least somewhat severe, we admit them to the hospital, and if it’s something that can be followed by their primary care doctor, we discharge them to go follow up there instead.
Some of the cases I took care of include:
- Allergic reactions
- Fracture of the ulna + radius
- Gastroenteritis (stomach virus)
- URI/Upper respiratory infection (aka [common] cold)
- Second-degree burns
- Psychiatric evaluations
- 5th metacarpal fracture (I can relate :'( )
- Neutropenic fever
- Cellulitis
- Abscess
- Constipation
- Abdominal pain
- Otitis externa (ear infection)
- Asthma exacerbation
- Animal bites/scratches
- Vasoocclusive crisis (sickle cell)
- Motor vehicle accidents
- 3-day history of left arm swelling that turned out to be leukemia :[
Muffin has been hanging out with me a lot. <3
One thing I’ve definitely noticed (in this and in past ER rotations) is that a lottttt of people come in for completely non-life-threatening issues. I think a lot of them would probably come less if they had a regular doctor to see.
- Have you ever been to the ER? I got sent there once when I was in college because they thought I had a blood clot in my leg.
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You saw a lot of different conditions. I know the non-emergency ER visits are a big issue. I would think the growth of walk-in clinics would help with that. Last year I finally found a new GP
I liked but then she quit for a new career and the practice is now focused on geriatrics — and I’m not there yet!
I think they definitely do help–I can’t imagine how busy the ER would be without their existence, but I think a lot of people still end up going straight to the ER.
I’m sorry to hear that! :[ I hope you find another GP that you like soon!
I have been to the ER, but yeah, it’s best to avoid it but I think a lot of people don’t have a regular doctor like you said, so they feel like the ER is their only option. I’m glad it wasn’t too bad of a rotation!
-Lauren
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Agreed! I wish I knew what to do to remedy that–ER visits are so, so expensive for people! I’m pretty sure that’s a huge part of why health care costs in the US has been driven up so much!
I went to the ER probably 10ish years ago because I thought I had strep – it was the only place open on Saturday and I didn’t want to go 2 days without treating it! It seems like more urgent care clinics have evening/weekend hours now
That’s definitely understandable! I’m really glad they have more urgent care clinics around now–I think they’ve definitely made things better!
Farrah recently posted…Day in the Life: Pediatric Emergency
I know more and more people in my area are going to the ER for non life threatening things. I have actually been told by my doctor to go to the ER for simple things. The reason being that it’s impossible to get an appointment with my normal doctor. I call to make an appointment for a sinus infection or cold and they won’t be able to get me an appointment until the following week so they tell me to go to the ER. It is really frustrating.
I would think it must be frustrating for the people working at the ER as well.
Ahh! I’m so sorry to hear that! :[ Do you have any urgent care clinics near you? That’d probably be more helpful for non-emergent acute things that you need to be seen for!
I feel like this would be a difficult rotation because you have the parents to deal with too! And parents go into mama/papa bear mode when there’s something wrong with their kiddos!
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Forreals! That’s one of the reasons I knew I wouldn’t want to do straight up pediatrics!
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