I wasn’t supposed to work the day today because I now have to start working nights since there is a few days’ gap in the night pediatric physician coverage. But after a good night’s sleep, and with two intubated patients in the pediatric tents with no other intensivist on site, I felt like I should go for morning rounds, set a plan for the day and then sleep on the hospital grounds to rest up for the night. …
There was a buzz around the hospital this morning that Hillary Clinton might visit, though it did not turn out to be true. It was an interesting process to consider what would be my answer to her obvious question: What one thing could the US do to make things better? My own answer would have been: nurses. Despite my tendency to focus on the physician side of the equation, it is nurses that make a hospital run. And HUEH needs more. They need more of 5,000 things, but mostly they need more nurses.
Nobody yet knows exactly how many staff were killed in the earthquake. But it’s absolutely clear what percentage had their lives destroyed in one way or another: 100%. During an informal moment with a half dozen pediatrics residents, they shared with me that all but one of them is sleeping in a tent or their car. Showering, washing clothes, finding clothes, commuting and eating all became hardships on January 12. As if residency is not difficult enough. And yet several of them came to the hospital today for the sole purpose of hearing a talk on DKA by some foreign doctor.
After the DKA talk, several opted to stay for an additional teaching session at the bedside of an intubated adolescent in the adult ICU tent. A couple of others took advantage of the mentoring by placing lines and intubating a patient in the Pediatrics tent for their first time since the quake. In fairness, even as the residents were using me for backup, I was doing the same by sharing rapid fire emails back and forth with my Children’s Hospital Respiratory Therapy colleagues. …
Here’s a quick look at what Thrive was up to last week:
Sleep deprivation affects how we interpret emotional cues. The FDA is tired of misleading food labels. Second hand smoke has deadly consequences. Children’s launches a new stem cell website. One mother tells her story of finding out her daughter has celiac disease. Do you know what disease sounds like? Children’s Facebook fan page reaches 100,000 fans. Ray Tye, a noted children’s philanthropist, dies. Michael Agus, MD, reports back from Haiti – twice. Should you take your kids to see Alice in Wonderland?
The day started with a proud smile and high five from the HUEH resident who wryly bragged, “I told you I wouldn’t need all that airway equipment.” The child had been safely transported and the surgeon had successfully removed the pebble from her trachea.
The routine has begun to set in at this point, but admissions were few on this Sunday. The weather, which had until now been in the 70s with scattered rain, hit the 80s with strong sun. With this change, the temperature in the interior of the medical tents rose to above 100F with extremely high humidity. Slight fevers are no longer clinically significant, standard intravenous fluid calculations no longer apply. Thanks to the NGOs, drinking water is plentiful and those patients, who are capable, work hard to maintain adequate hydration. The rest are dependent upon IVs or attentive family members to keep them hydrated. …