We have all had it on multiple occasions. Some days we choose to ignore it and other days we can not act fast enough. This was my day yesterday! I am so glad I went with my gut!!!!
Student walks in mid morning. His first words are "Hey!", (first red flag! This kid is never not polite), proceeds after a few minutes with, "UMMMM, I need this (pointing at his arm) there is an ummm you know an umm bite. Can you fix it? OK!! This kid is more mature than most seniors I know and hes is 7 and he can't explain to me what is wrong. Red Flag again!!
I cover his bite and send him to class and call his teacher ASAP. She states she has not really started doing much with them yet but will watch him. Great! Maybe I am overthinking this?? (my thoughts at that point)
Give it maybe 25 minutes. Teacher calls me and at that moment I knew!! YES!!! something is not right.
Mom is an employee here and of course she gone on a field trip today!!
I do an exam. Can not walk a toe toe line without watching, unsteady and bumping into things, unable to really say what he wants without deep thoughts on what it is(confused), dropping things, and his pupils are dilated. VS good, low grade temp (99.5).
I call mom and inform her of what I see and my urge that he needs seen now! Dad arrives in 5 minutes and notes an issue 5 minutes into the drive to ER.
Mom updates with ER doc being phenomenal!! Ran numerous test and did a CT(which showed no masses up that high). No real answer as of this morning. He is set up to see Neuro today for an MRI of the brain stem to rule out a tumor there (which is where the doctor feels there may be). Labs associated with tumors are on the high end of normal. He has a strong H/O migraines and had one Sunday which left him asleep for over 16 hours.
Parents and Doctor did notice an improvement as the night went on, but his doctor was convinced something is wrong. Pupils remained dilated!
I have not spoken to her yet this morning.
My gut said something was not right and for a brief moment I doubted myself!! WHY do we do that!! LOL!!
I knew there was something off!!!! FOLLOW YOUR GUT!!!!!! 9/10 times it wont fail you!!!!
My inner saying goes more like this "Back up, or rule out all hunches with objective data ASAP" Gut feelings are usually very informed by training and experience, it's just that it comes through as a gut feeling or hunch that needs to be verified or ruled out. (or sent on to someone/somewhere that can)
HEY everyone!! Update on my kiddo!! It is a seizure disorder triggered by migraines. Currently taking meds and so far he is better. Still having daily spells but not nearly as severe.
tining, BSN, RN
1,071 Posts
THIS is why we are such a valuable member of the school. Keep us updated on this unique case.