Sunday, January 16, 2011

Foreign bodies and head injuries

Working in an ER means you get to see some pretty crazy things.  Working in a pediatric ER you get to see some unique things and you start to notice some patterns.  Like whenever the weather changes drastically (cold front moves in, storm blows through, windy weather arrives, etc) all the "breathers" come in - aka the asthma kids.  Or when icy/snowy weather arrives the arm and ankle injuries follow shortly after. 

One thing I've noticed is that when kids injure themselves, especially when they get lacerations, its located on the head.  Every single laceration I've repaired has been on the head, and I'd venture to say 80-90% of those are on the forehead.  The thing about head lacerations is you have two concerns to deal with.  First and foremost, the head injury.  Have to make sure that they don't have any underlying brain trauma requiring a CT head (which most don't, thankfully).  Then, the laceration must be repaired.  It's a little unnerving to be stitching up a kid's face knowing that if you don't do a good job they are going to have a big nasty scar front and center for the rest of their life.  No pressure, right?

The other things you don't see with adults, foreign body ingestion.  In my short tenure I've seen cereal up the nose, beads up the nose and a swallowed coin.  In fact last night we had a patient who swallowed a dime.  Yep, they went to surgery on a Friday night to remove that sucker.  If my child ever swallows something and needs surgery to retrieve it, I'll be ticked!  Well, after its removed and all is okay.

Here's a picture of what the x-ray looked like (not the actual XR because I'm not into violating federal privacy laws, just found this on another site):

Those are just a few of the joys of working with kids.  There are many more, like getting popsicle juice stained smiles, grimy hands grabbing at your dog badge-holder, and nearly getting peed on my baby boys.  I love my job ;o)

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