8 y/o with brain injury

[DemonWings]

Hi there PICU nurses!! I have a question that I have googled serveral different times and have yet to find an answer. I wish I had a PICU course in nursing school! Well my 8 y/o cousin was hit by a car last summer, was in a coma for 3 weeks (at valley childrens in Madera Ca). He had several subdermal hematomas, but luckily he woke up and was basically back to normal. However, ever since the accident he has been blinking alot, and he spaces out, gets headaches with vomiting a few times a month. I have told my aunt time and time again to take him to the neurologist, but she says medical denied her. I feel like its my responsibility as a nurse and as a person in general to do something but Im lost as to what I can actually do. The parents are not motivated to get him checked out, and they seem to think it will go away and its just the aftermath of the accident. The blinking is almost constant, I was thinking they may be mini seizures or something. Have you PICU nurses seen anything like this related to a brain injury? And can you think of anything that I can do? I feel helpless:confused:

Oh and 2 weeks after being discharged he was jumping on the trampoline, playing roughly with his brothers, riding bikes with NO restrictions, my kid would have been in a bubble but thats just my opinion

[NotReady4PrimeTime, RN]

We're not permitted to provide what amounts to medical advice, other than to consult a phsician. Having said that, in a purely hypothetical situation, I would not be surprised to learn that a patient exhibiting those symptoms would be diagnosed with complex partial seizures. Is there any way you could convince the primary caregivers to take this boy to a pediatrician, at least?

[caliotter3]

This scares me and concerns me for the child. I would hate to have something serious happen to him that could have been avoided, had the parents taken your advice to have the boy checked. I hope they can be convinced to change their minds and take him to a doctor. Best wishes.

[traumaRUs, MSN, APRN]

You can appeal Medicaid decisions also.

[DemonWings]

Thanks guys, I know that there can be no medical diagnosis, I really didnt know where else to turn, the parents said the PCP requested a neurology consult and so did the optometrist, both got denied, Ill have to tell her that she needs to appeal the decision. I was surprised that medical actually denied the claim, I would think that one visit to the neurologist would be cheaper then him having something awful happen and him spending more time in the PICU.

[JeanettePNP, MSN, RN, NP]

That's so strange. Wouldn't a child who had a brain injury and was in a coma for 3 weeks be followed up by a neurologist as a matter of course?

[sharpeimom]

are you near a medical school? often they or an attached children's hospital are able to see kids who have been denied and appeals have been refused. good luck.

[umcRN, BSN, RN]

That's so strange. Wouldn't a child who had a brain injury and was in a coma for 3 weeks be followed up by a neurologist as a matter of course?

That's what I was thinking...

[DemonWings]

I believe the insurence did authorize a follow up with the neurologist, but it was a few weeks after the accident (which was in june or july of last year)