My Last Day in Paediatrics

My last day in paediatrics can be considered as the most exciting and memorable one.

I was doing my last night on call for paeds. The night kicked off busy, with 4 waiting to be seen and 2 awaited. So I cracked on and started to see one after another. Halfway through them, my registrar's page did not stop bleeping. She added more names to the admission sheet.

I really could not believe how busy the night was going to be. I hardly slept the whole day. Well, I tried, but couldn't. I had to go back to the hospital to meet my supervisor at 2 pm. After the handover in the morning, I had to attend a teaching. So by the time I left the hospital, it was 10.30am. Got home an hour later due to bad traffic, washed up and sat down for awhile to rest....before needing to leave at 1 pm. After the meeting with my supervisor, I met up with my friend, Laura, who just found out that the guy she loved, as been having a relationship with another girl! I went over to make sure she was alright....I mean, it is pretty obvious she wasn't going to be ok. I chatted with her till nearly 6pm. Now, by that time, my eyes were so painful, and I could feel a headache starting to build up. The only sleep I managed was 3 hours the night before. With hardly any sleep, I was really slow at work.

Not too long after that, she received an urgent call to go down to resus in A&E to see a 26 day old baby with sats in the 80s. So off she went, and continued to see all these patients. The only good thing about working in the last day is I have experience...well, 4 months worth of experience. Therefore, once I have seen a patient, I feel confident enough to make a decision as to whether or not to admit, or observe the patient for a few hours. My registrar came back an hour later from resus with a small little baby that has been stabilised.

The rest of the night was spent revieweing one patient after another. Some patients, in my opinion, should not even be seen by us, because the child was absolutely well, except for a cold. This could be easily sorted out by their GP. One of the babies that I saw needed a full septic screen, which included a lumbar puncture. It took awhile to sort that baby out as he was pretty sick. Anyway, while I was busy seeing another patient, I heard my registrar shouting, "I need help here!"

I dropped what I was doing and ran over to see what was happening. I found a dusky coloured baby lying down on the cot. *Yikes!

The baby's saturations were dropping to about 70% despite having 10 L of oxygen, with a heart rate of only 90 bpm. To be honest, I have never really seen a baby in a periarrest situation. I have certainly very sick children with DKA or severe asthma exacerbation. My adrenaline started to kick in. We took the baby (who is only 10 days old) to the treatment room, because our resus trolley was there.

I felt nervous but excited. We worked through the basic ABCs....the only thing we really struggled was the circulation part. My registrar tried like nearly 8 times to cannulate her, but failed. In the end, we had to seek help from the neonatal registrar to set up an IV Access. He got it after 5 attempts too. We decided that the baby was septic....so we started to prepare antibiotics. The baby was really not doing great. She kept running into apnoeic episodes with colour changes, her Hydrogen ions were 50 and potassium was 6.1!

We worked on that baby for a good 2 hours, and had to call the consultant on call to come in. It was 9 am (which is handover time) by then. Being the SHO, I had to ensure the handover sheet was updated and of course, I had to go back and complete my examination on that child that I was seeing initially. As so many things happened overnight, I became really confused as to which patient came in with what particular problem. It was 9.30 am before us, the night team, did the handover.

*phew, what a night! Filled with sick children...and a periarrest! Before I left, I heard that the wee baby girl needed to be transferred to the bigger children's hospital in Glasgow city. They would need to intubate her as well, because she simply wasnt really coping with her breathing.

I was glad the night was over...it was exciting though. My last day in paeds certainly ended with a bang! Next up, would be psychiatry for me....something which I absolutely dislike.