aquinasprime: (Men in Tights/huh)
Since I decided to participate in the giant non-fandom friending meme (see post below) I decided I should actually publish some content.

Not that I've been practicing pediatric anesthesia for a really long time (I only finished fellowship a this past October) but I've already started seeing certain patterns.

I've noticed what I've decided to call the "positive clothing sign". What does this mean, you may be asking. I'll enlighten you. In my hospital, the patients for same day surgery patients get admitted on a different floor than the one the OR is on. They come down to our floor immediately before their surgery. They are supposed to come down wearing two hospital gowns, hospital socks, +/- hospital pajama pants. Not all children come down in these clothes. Some come down in various states of (un)dress. I have come to realize that the level of cooperation I am going to get from a child (and the level of help their parent is likely to be) is inversely proportional to the amount of street clothing they are wearing. Generally a child who comes to the holding area in street clothes is one who could not be convinced to change upstairs. This also generally means that their parents have a difficult time controlling them.

Case in point, my single most un-cooperative, mentally normal (I exclude autistic, mentally retarted, etc patients from this rule) patient came to the holding area wearing a tee shirt, sweatpants, sweatshirt, jacket, hat, socks and child work boots. After I gave the child an oral sedative (using the plug the nose and squirt in the mouth method that I absolutely hate using), the child induced vomiting and brought up all the medicine I had just administered. I've never seen anything like it before, but I truly understood why the child needed to come to the operating room to get their teeth cleaned.

Thankfully, children with a positive clothing sign are pretty rare. And I've gotten immune to being kicked, hit, having my hair pulled, loud screaming in my ear and I'm good at dodging bites. In these children, oral midazolam is my friend (if I can get them to drink it).

May 2014

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