Monday, January 8, 2007

The Circle of Bleccccch

The stomach bug that B and J had last week made its way through me (Friday night/Saturday), then my wife (Saturday night/Sunday). E has been fighting it on and off all week but yesterday Mr. Mom (uh, that would be me) didn't hydrate him enough during the day and he became worse; so Dr. & Mrs. Scott both stayed up all night pushing Pedialyte through a medicine syringe. True oral rehydration therapy in action, and it saved us from a trip to the ER for an IV. But now I'm at home trying to catch up on sleep before I see patients.

Well, not at this very instant. Though I would love to be able to blog in my sleep. It would be a great way to get all these thoughts out of my head.

In the meantime, thank you all for welcoming me to the blogosphere, and I hope not to disappoint. Too much.

8 comments:

Anonymous said...

Ahh yes, avoiding the ER visit. Been there. When my daughter came home from NICU, they sent a bunch of extra NG tubes. So when my she got dehdrayted (just a touch) we happily droped a NGT right in. Don't worry, I'm a med student, even better though, my wife is an RN.

Any evidence that NGTs are better than IV's in pediatrics? My daughter has Downs and is a very tough stick. Just Curious

Anonymous said...

correction: Any evidence that NGT are equivalent to IVs.

Flea said...

Tell your patients your story. ORL works. Not everybody with gastro requires IVF and Zofran (really!)

best,

Flea

Anonymous said...

Hope your hosuehold gets better soon, if not already done.

Take care!

Dr Scott said...

anonymous--Flea is absolutely correct. The latest studies show that po hydration is actually better than IV fluids for gastroenteritis: just as effective, but better tolerated, fewer resultant hospital admissions, and naturally, can be done at home with a motivated and appropriately educated parent. And if your patient (or, in this case, daughter) can get over the initial unpleasantness of having the NGT, even better and more effective. ERs don't use Oral Rehydration Therapy because of (1) habit, and (2) more effort (it's probably easier for an ER to pop in an IV and let it run than to have a nurse take the time to educate at the bedside!). Check out www.pediatrics.org, search "ORT": the top hit should be a small but good study published Feb 2005 from Children's Hospital of Philadelphia.

Dr Scott said...

I also wonder if some ERs might be afraid that parents will tell their friends, "I was in the ER for four hours and all they did was give her Pedialyte through a syringe! No IV or nothing! Heck, I could have done that at home!" IVs are now the expected cure, if not necessarily the best. Hard habit to break for both ERs AND parents, I suspect.

Judy said...

I always love it when the ER calls the NICU for someone to start an IV on the dehydrated gastro patient after they make multiple attempts. When we can't get it........Yup, oral rehydration. If that's even on the list of things you'll consider, DO IT FIRST! /rant off

Bryan said...

Welcome to our world.