Pediatric tips

Don't trust them! I have one little cutie who, as I'm in the kitchen washing syringes, etc. come to me, trach in hand and says "I found this!". Yeah, in your neck you found it. Little stinker! Seriously, you cannot predict what they will think of next.

Oh, and kids (almost) never have primary cardiac emergencies as adults do. They nearly always start out with respiratory distress and progress downwards. They can go south in a hurry, to be sure, but there are usually warning signs.

Thanks for responding maryjean. I also have 11 years experience as an EMT, so I guess I do know a couple things about sick kids. I am just scared that the parents are going to want me off the case because of the NGT removal at 2 this morning. It only happened once and they seem like nice people, but I feel awful about it. I tend to be very critical of myself, which is probably at least half the problem. Nothing super bad happened after it came out. Just crying (baby, not me although I felt like it), no bleeding or resp distress, etc. Mom got the tube replaced pretty easily. I just want to give these kids the very best care possible and make the families' lives as easy as possible. Stress, my old nemesis, had found me again! Grrrrr!

I've had to wake parents up (mostly because kid decannulates himself and I couldn't get it back in). Trust me, they're grateful you woke them per their instructions. You'll adjust. I actually work PDN as a stress-reliever from my peds ICU job. Two nights each place every week. It's just the right balance.

The thing I love about PDN is that you get to watch your kid make progress. My current little guy came home from a 15 month NICU stay six months ago. I had him his first night home. He was on a fair amount of O2, couldn't hold his head up, constant vent alarms, just touchy in a lot of ways. Fast forward to this week, he learned to crawl AND say 'mama'! Oh, and he's been on room air for months and we're weaning his vent rate!

My former patient (single ventricle, vent dependent) I also acquired right out of NICU. Now? No nursing care and she rides the bus to kindergarten every day. You rarely get that type of follow up in the ICU environment.