Our First Major Kid Injury: A Day In The Pedi E.R.

It was to be a relaxed family Sunday….

Hubby had just walked in the door from a weekend work trip yesterday morning, and we were all upstairs… Hubby and I were chatting and catching up, as Babyboy ran circles around Daddy, and I dug through Babygirl’s dresser looking for a cute outfit. She toddled over to her bookcase, and the next thing I knew there was a crash and a long wail.

I ran over– she had pulled a pile of wooden Melissa and Doug puzzles down from a shelf just above her head, and they seemed to have fallen onto her somewhere. She screamed and screamed, shaking her head, swatting at her face, even wailing “NOOO-OOOO”, which is new for her, and that was scary.

I looked and looked, was it her feet? Her head? I realized she was bleeding all over the place, blood was on her face, in her hair, what? Grab a towel, she’s bleeding, I yelled to Hubby.

She was shaking out her right hand, and then I realized it was coming from her hand, her right middle finger. I blotted it and could see, the fingernail was crushed and distorted, and there was a flap of skin in the pulp of her finger… Ugh. Very painful. She was breathless with screaming.

We managed to call the pediatrician, who verified that this would mean a visit to the ER. I called my mom to take care of Babyboy, and she was there within five minutes. Hubby and I grabbed Babygirl diapers, a change of clothes, a bottle, a binky… and somehow stuffed her into her jacket and loaded her up into the car. The highways and roads were nearly empty, and we were at the big fancy Children’s Hospital in minutes. Hubby dropped me off at the ER and I carried a now exhausted Babygirl into the ER.

Triage was wide open. We were seen and registered right away. Don’t give her anything to eat or drink, we were instructed. Then, we waited in the waiting room. A trauma copter came in. We waited. More people came into the waiting area. It filled up. We waited.

Time is distorted in emergency rooms. It goes both slow and fast. You feel like you’re waiting forever for everything… and you are, but then you’re amazed when you see what time it is. How did it get so late?

Our name was called and we were ushered into the medical area, into our own room. Babygirl started to get hungry, thirsty. We waited. A nurse came, took vitals, we waited. A resident came, examined, we waited. Babygirl was a trooper: every time she started to whine with hunger and thirst, we wet her binky and gave it back and distracted her with whatever we had (the worn-out books in the room, our keys, the lights) and she went happy again. For awhile. At some point a Volunteer magically appeared with age-appropriate toys and more books. A fairy book. That worked wonders for a few more hours.

In between her brief fussy periods, and even with a crushed finger, Babygirl was her usual social butterfly self. She wanted to toddle about the ER, visiting. She smiled at the nurses. She laughed and giggled with tickles. Amazing.

The kid in the room next to us started having seizures. Ugh. Time passed. We saw the ER fellow. The ER attending. X rays were ordered. We waited for those. We had to don leaded aprons and hold her down for the xrays. She screamed. We waited for the results. A fracture! The tip of her middle finger-bone was crushed. The fragments had likely pierced the skin under the nail and that was what caused to laceration. Ugh.

Now we waited for the orthopods- the hand service needed to see all Pedi hand fractures. They came, discussed the plan. She was to be sedated. Nasal Benzos! This was new to me. Then the finger was to be numbed, and the nail removed. I figured that. She would have stitches, in the nail bed and along the side of her finger. That tiny little 14-month old finger! And then they would replace the nail, back into the nail bed, to encourage a new nail to grow. They would sew it back on. Crazy!

Early on in all of this, Hubby had encouraged me to let them know I was a doctor, that I had done a med/peds residency. I said no, mostly because I have NO IDEA what they were going to do and didn’t want to pretend that I did. I was here as a concerned parent, nothing more! But it came out, as I asked questions that were kinda medical, and they picked up on it.  I think.. the attitude shifted a bit, people were, I sensed, a bit more… careful, if not deferential…

They encouraged us to be in the room helping when they did “the procedure”. They gathered a team, the equipment and supplies, and, best of all, the Child Life specialist, who appeared with Curious George on an Ipad. We waited. Finally a nurse came with the intranasal Midazolam. We were given fair warning that “it will sting bad for a minute, then she’ll go all loopy”. Squirt, squirt, then screaming, for 30 seconds, and then: “OOOOh. AAAh.” Babygirl looked around with all the fascination of a college kid enjoying really good weed for the first time. She pointed at Curious George, at the lights, at the MA’s nose, smiling and laughing a slow, cute laugh: Heee. Hee Hee. Heh.

Once “the procedure” got underway, it went fairly fast. An hour of intensely directed activity. Hubby and I and the Child Life lady with the Ipad on one side of the gurney, Babygirl laid out on the middle, and the Team on the other side, with all the sterile stuff. They jabbed and cut and sutured and cut and talked. We watched a hilariously high Babygirl.

And then it was over. There was a quick lesson in bandaging, some paperwork, a prescription (antibiotics, as it was an open fracture, technically) and we were free. About 7 hours total. Leaving just in time for dinnertime. Child Life lady brought us a bottle with cold apple juice for poor hungry, thirsty Babygirl, who sucked the whole thing down immediately.

And Hubby and I still had the wherewithal to order pizza on the way home.

Babygirl fell asleep in the car, thankfully. She needed Tylenol overnight, and the whole bandage had to be redone today, but overall, she is great. We’re also impressed: She was so, so good that whole time, with nothing to eat or drink from 8 am until 6 pm. Amazing.

It’s definitely weird to be a doctor- parent in the ER. In this case I’d say my doctorness had little to do with the whole proceeding, as, even for someone who did a Peds residency, I have no experience with this type of injury in a toddler. Also, I don’t remember much of my whole Peds residency. What I do remember is none too pleasant… I was having some PTSD flashbacks during Babygirl’s procedure. Hence, I never practiced Peds.

And we all survived. Thanks to having family close by to watch Babyboy for the whole day. Thanks to living this close to a first-rate Children’s Hospital.

And thanks to a beautiful, adorable, trooper Babygirl.