Talk To Me, Kid.

I declare: I LOATHE STUBBORN KIDS! Only because I wasn't when I was little. I wasn't afraid of needles, of people wearing white, i.e., nurses and/or doctors, and most importantly, I was easily talked to! I still am, by the way. Why do kids nowadays are so maarte like they are trying to act like an adult and they wanted their whims and caprices to be followed? BRATS! You know what, parents and older sibs out there, these kids MUST know who takes the lead and who is the follower. Right? 

We had a patient last night, 9 year old male, brought in at around 9:00 pm and was complaining of right lower quadrant abdominal pain. He was s/p appendectomy last year so we were contemplating on bowel obstruction secondary to adhesions. In other words, he will be transported to the OR as soon as possible to prevent further compromise. The Pedia-Surg resident asked us (Suzie and I) to insert a foley catheter and nasogastric tube. I was the one who inserted his IV line so I knew he was so inquisitive like he asks too many questions and since you cannot lie to a child, I had to explain tiny details including why I need to place leukoplast all over the IV cannula. Then comes foley cath insertion, we had to explain ALL the details that need to be done. The parents were there to console and assure him. So we thought everything's okay. When Suzie was about to enter the tip of the tube, he shrieked and closed his thighs together which made it impossible for us to perform the procedure. We talked him down in our most soothing voice, said all the things that would probably make him comfortable. Epic fail. We left and decided to return when he's ready.

Two hours later, we came back with another set of foley cath. Still wearing our baby voice, we talked to him as if he's an adult hoping to alleviate his apprehension. Yet, no effect. We called a resident, who did a lot consoling. The kid was shouting: "Hindi niyo kasi alam ang pakiramdam!", and the resident answered: "Naku hijo, pinagdaanan ko na ang lahat. Lahat na ng klase ng tubo nagawa na sa'kin..Kaya sige na please, mabilis lang naman eh. Please?" in her most begging look.We even mixed lidocaine with the lubricant to make him a little numb. Still, no effect.

Five hours passed and he was still throwing tantrums. We called the Pedia-Surg resident to help us out who did a lot of bargaining with the boy until she almost lost her patience. He was so whimsical he wanted everything he says to be followed. We were initially giving in to him, until the Pedia-Surg resident noticed how stubborn he is. So much talking on our part and so much yelling and shouting on the boy's part. He's 9 years old and difficult to restrain. He doesn't listen to anyone, not even to hisparents. We gave him midazolam which sedated him for like a few minutes, but when he felt the NGT poking on his nose, he struggled again and regained his energy!! Aaaaack! This time, we had other watchers help us restrain him until we successfully inserted both the NGT and the foley cath at around 3:00 am! The worst part is, when I pushed 10cc of water on the catheter for inflation, he squeaked and struggled so the needle passed through my skin! That was my second prick last night. On the positive note, both needles were not used for blood extraction...otherwise, I need to panic!

It was a long 24-hour duty. We bagged almost whole day, two of which expired. :(
Conducting patients who doesn't respond to midazolam to the CT-Scan room.
Suzie and I had "The Phenobarbital Incident".
And, THAT BOY.
We left the ER this morning with the preduties bagging again. *Sigh*

Bagging Tina

Triage Area. 

Adult Triage. Sitting and looking from the Pedia Triage, parang ayoko mag-duty diyan!

Finally, na-sedate na rin ang patient na ayn!

L-R: Tina, Ai and Suzie! :)