Hi All
I have had a little 'partner' trouble recently (no not the recurrence of
that rash ;-)
I had a lad brought in (cottage hospital) - 8 yoa, 12ft (confirmed) fall
onto concrete - initial LOC - I won't go into detail except to say that
when I saw him he was inconsolable and not making much sense - then he
became quiet with GCS 12-13 (E-3 (with repeated and loud voice - then
would re-close and be difficult to rouse again), V-4, M-5) - this was
fluctuating somewhat. His Left pupil dilated but responsive to light
(and local bruising and I think was traumatic aetiology)
He was haemodynamically stable with no signs of other injury except
slight swelling R wrist.
The decision is ?50 minutes to DGH with scanner but no neurosurgery/paed
surg/paed ITU - and a v long trip from here to further care
or fly - 30 mins airtime but delay in getting aircraft to site etc -
total time to hosp likely to be doubled c.f. DGH
I spoke to the consultant surgeon at the DGH - long chat - felt probably
better to go elsewhere - this was my initial feeling and I guess I may
have pushed him this way a little
My decision was to fly to centre with facilities - and this was in the
event.....uneventful. I accompanied the child and spent 2.5 hours in a
taxi coming back (22:00 by this time). Aircraft was large, stable -
with coffee machine! and full monitoring and extended trained aircrew.
The major bit of this trauma has been my partner's (GP not bed)
reaction. He was v v displeased (although I managed to get my
receptionist make the 14 'sick' folk waiting to see me 'disappear' (to
slots with me starting work early for the next 2 days) - and all my
partner had to do was to cover the on-call until I returned (with me
volunteering to do the whole following night (his) in return for the few
hours cover for me.
He seems to think it was unnecessary to make this trip - and quite
frankly I am quite upset about it. I disagree with him but am
infuriated by my unpreparedness to quote the evidence at him. I am now
on my 3rd night on call and am convinced that someone has switched off
the light at the end of the tunnel - so can anyone point me towards the
stuff I need to read and quote.......or does anyone support my partners
view and can provide me with info to stop me needing to 'create' this
problem in the future?
Many thanks all ;)
Cheers
PS (it is all made worse because our asst GP flew a 2 month old out just
a few weeks ago - had HI and was unresponsive for 20 mins - partner also
felt that this was the wrong thing to do)
--
Jel Coward
..take a look at the Wilderness Emergency Medicine and Command Physician courses
http://www.wildmedic.org
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'There's no such thing as bad weather - just bad clothing"
Anon Norwegia
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