Night of Lacerations

We had a Night of Lacerations recently in the ER. I was working in the Pediatric area. It's a bit more complicated when the kids come in because they have a hard reconciling "sewing your head closed is a good thing" with "AAGH! Needle in my head!!" Sometimes the kids are really good and just sit there with wide eyes. Other times they scream their little heads off.

One night there was a boy about eight who was quite accomplished at delaying the proceedings. After the doctor calmly explained that she was going to deaden the area, he had lots of questions. Why was this necessary again? Are you absolutely sure that needles must be involved? What are your qualifications to make this judgement?

Despite his tactics, the needle eventually went in and he was stitched up. There was some shrieking, though he saved the best for last. Afterwards, when the doctor asked him how he was, he narrowed his eyes, shot her a look of pure hate, and tossed his head contemptuously.

Another time, a kid of about six had a nice gash between her eyes. It was deep, so the plastics doctor was called in to do it. They did a conscious sedation on the little girl. The patient is still able to communicate, but there's no pain and often no memory of the procedure.

I had it when my wisdom teeth were removed. I have only one brief memory, "waking up" and seeing spatters of blood on the face guards of the people around me. I distinctly remember thinking, "Oh. Not done yet. Okay, back to sleep," before sinking back into amnesia. I'd love a videotape of the procedure. My teeth were still mostly covered by my gums so I presume they had lots of cutting and teeth cracking to remove them. I do have two polaroids of myself spitting out a mouthful of blood when I got home. So there's that.

Anyway, when kids are likely to fight back (something that can still happen with conscious sedation), they get strapped down. The door to her treatment room was closed, but you could hear her screaming all the way down the hall. Seriously, you'd think they were torturing her in there.

The mom had to leave and sat in the hall with tears in her eyes. I and a fellow employee felt much worse for the mom. The kid was just scared and being ornery; she was pain-free and likely to forget the whole experience. The mom had to see and listen to her daughter freaking out.


Technorati tags: Laceration, conscious sedation, screaming children