1) We were dealing with a nail avulsion that extended to the nail bed, coupled with a complex finger laceration. And let's not forget the petite proportions of a toddler's finger adding an extra layer of complexity! This signaled the need for X-rays to check for a fracture, as well as stitches for the laceration and nail bed repair. All this meant that for the best outcomes we needed the skilled hands of a specialist in pediatric emergencies, and a setting equipped to deal with a tiny, squirmy patient. Because, as we know, toddler wrangling is an Olympic sport in its own right!
2) We were dealing with a bleeder - despite applying pressure, the bleeding refused to call it a day. This suggested there could be a deeper injury, potentially involving a blood vessel.
3) She was going to need assistance in managing pain and, let's face it, the wiggles. Now, there are a couple of options. You could go for conscious sedation, where the child is lulled into a sleep-like state for a peaceful and cooperative procedure. Parents typically are asked to wait outside of the door during the procedure, the doctor weaves their magic, and parents return to the scene before their little one wakes up. Alternatively, you could opt for local anesthetics and add some giggly meds (perhaps a little liquid courage or laughing gas) or other comfort measures. The child is awake and parents hold/play the comforting role.
For these three reasons, I knew the ER was our best bet. Of course, as a parent, you're not expected to figure this out on the fly! As a pediatrician, I deduced this within a few minutes of my mental assessment, even as my husband was considering urgent care, and I was blurting out 'ER, now!' When it comes to injuries in my practice, I often find myself on speed dial for families. As they regale me with the tale of their latest adventure in the land of bumps and scrapes, my mind is running a marathon, assessing various factors to plot the best course of action. Funnily enough, it turns out that 80% of the time, the journey doesn't lead us to the bustling corridors of the ER.
Nothing! We bolted out the door. Even our trusty diaper bag was left behind. I stepped out in my morning glory, with my nightgown, bedhead, and a pregnant belly filled only with a few slices of kiwi...
However, we didn't forget her beloved stuffy, thank heavens!
And props to our foresight of always stashing a spare diaper in the car. It came to our rescue when our little one needed a change amidst the ER chaos.
People often ask how I, as a pediatrician mom, deal with such situations. I tend to be a "go-with-the-flow" mom when it comes to minor scrapes and bruises. But believe me, when your child's piercing cries fill the air and blood paints a grim picture, it's nothing short of terrifying. This was our first serious injury, and until that moment, I wasn't certain how I'd respond.
Enter what my husband likes to call "Doctor-mode" - my laser-focused, problem-solving mindset. My thoughts race through countless scenarios, seeking solutions at warp speed. I become swift, decisive, and according to my hubby, rather directive. I'm not usually elaborative about my thought process in these time-critical situations, but I'm always ready to answer any "why" that comes my way and adapt to the evolving situation. You would witness this side of me when I'm handling emergencies at the hospital or responding to urgent concerns - quite the contrast to my typically sunny demeanor. This mode only kicks in when I'm under high stress or intensely focused on a task.
So, with a shrieking child, blood everywhere, and a horrifying finger injury, I flipped the "doc mode" switch. I knew we needed to head to the ER. The situation wasn't life-threatening, but I had to ensure my little one felt secure and comforted. And what's the best way to do that? Modeling a calm demeanor, using a soothing voice, and dispensing lots of snuggles. And that's precisely what I did.
Fast forward to 12am that night- The adrenaline rush subsided and the waves of mom guilt crashed over me, along with tears and concerns for my baby. There I was, lying by her side, planting kisses on her, and whispering promises that mommy would strive to do better, all while she slept peacefully. I then had to give myself a gentle reminder - we do the best we can! So here's a shout-out to all parents, remember, we're doing our utmost, our kids are dearly loved and cared for, and they're incredibly fortunate to have us in their corner!
