Paediatric A&E

A&E has always been an area of medicine I have wanted to look into purely because it always seems so exciting and diverse. One of the reasons I love the idea of becoming a doctor is that I know I will never be bored and A&E has always appealed to me because of the need for quick and efficient problem solving and the ability to work under pressure. Some people might view this as scary or unpleasant but I love situations like that. So, when I was offered some time with a consultant in paediatric A&E at my local hospital, I jumped at the opportunity. I arrived and was sent straight to the staff room area which was full of doctors at computers typing away, with a big TV screen on the wall with names and DOBs and injuries on. I was introduced to a few doctors and told to just shadow anyone I liked. Great.

As soon as someone picked up a card to leave the room, I jumped up too and followed. A finger injury on a young boy following an incident with a folding chair… Oh dear! It was definitely difficult seeing the child so upset but it was nice to watch the way the doctor interacted with both the child and the parent. Reassurance, support and professionalism with the parent, and care, patience and compassion with the young child. 

After seeing the patient, I followed the doc to go and fill out a multitude of online forms to allow the boy to be discharged. That area of medicine is something which is definitely not well known among wannabe doctors, but it didn't bother me too much. I saw it as a pleasant break from patient contact to consolidate the things I'd seen and reset myself to go back to see more patients. 

I saw lots of chest infections but one which stands out was a young boy who was covered in a rash. I went into this consultation with a medical student who was doing a placement and after taking the history and conducting the physical examination, she suspected scarlet fever, but was unsure, and so didn't mention anything to anyone before relaying her findings to the consultant. By doing so, she avoided panic and ensured that no unnecessary concern was caused. The consultant then went to do her own exam and ruled this possibility out and diagnosed a chest infection. However, the medical student was still applauded for her efforts, despite her initial diagnosis being incorrect, because she was able to seek help and reassurance. This highlighted another, less obvious quality of a good doctor, and that is being able to check your work and recognise areas of weakness, asking for help where necessary, especially when the welfare of others is in question. 

Because I quickly got on really well with the medical student, she taught me how to take patient histories and taught me a method she had recently learnt called BINDS used when taking the histories of young children. B stands for birth, as in was the birth normal? Natural or Csection? I- Immunisations, are they up to date? N- nutrition, are they eating normally, enough, still have an appetite, drinking enough, less/more than usual? D- development, are they developing the way you would expect, do they act in similar ways to other children their age? S- social background, who do they live with? Do they live with any pets? 

Overall, I loved A&E experience :)