discharged from the picu

the scariest report i transcribed today was about a five-year-old boy who was in a car accident. the driver of the car was killed. for some reason shortly before the crash the boy had climbed out of his car seat, so he was completely unrestrained.

his liver and spleen were lacerated. his pelvis, femur, and some ribs were fractured. his most severe injury was a subdural hematoma requiring an emergent hemicraniectomy to relieve the pressure. the boy had cerebral edema, ie his brain was swelling up. he was having spasms of his right upper extremity.

it's easier typing these kinds of things at work than here at home because at work i have all these autocorrects set up to make things go faster. examples:

i type "rue" and "right upper extremity" appears.
i type "fxd" and "fractured" appears.
i type "homa" and "hematoma" appears.

i've made up hundreds of these. that's part of the fun of the job, coming up with these little codes. the number of lines we type in a day is monitored, you see. the faster i type the more i get paid!

i type "poo" and i get "postoperative."
i type "ooo" and i get "salpingooophorectomy," ie surgical removal of a fallopian tube and an ovary.
i type "tp" and i get "the patient."
i type "ass" and i get "assessment."

i can be as scatological as i please. fun times!

not so much for that little boy, though. he's nonverbal and unresponsive but they're talking about discharging him to a rehabilitation facility soon. his parents have to learn how to care for him once he goes home. his prognosis is not so good.

it is horrifying to think of these things, if i stop and think about them. most reports i type are for patients with upper respiratory or urinary tract infections, otitis media, chest pain, pneumonia, or poorly-controlled diabetes. usually pretty benign stuff. the other day i typed up a brief operative note, placement of chest tubes, on a patient in his 20s who'd been shot and ended up dying from his wounds. these things happen. i did type up a delivery note today, the birth of a baby girl. of course, the mother is only 17.

it does make me think about how medically fortunate i have been thus far. i'm a relatively healthy person. touch wood or what have you.