I gotta vent....

We got a call for an unresponsive two year old last night.  Usually this is new parents over reacting to a sleepy child, or a child with a common illness like a cold, or flu.  Sometimes, it's a child who just had a seizure from a rapidly rising temperature.  We get there and the sheriff deputies are holding a limp little girl.  We recognized she was breathing right away, but we couldn't wake her no matter what we did.  My partners "T" and "B" went to work on her while I tried to gather some information and history.  A young male who identified himself as the step-father started telling me he took a nap, and when he woke up he found her like this in her bed.  I took him in the truck with me so I could help with care, and ask questions at the same time.  T & B were busy putting some oxygen on her, getting  a temp, checking her blood sugar, starting an IV ( Great job B!!), and running an EKG.  The guy tells me she's been sick for a week with a cold, and she's been taking some pediatric cold meds, but the last time she took them was two days ago.  He denied any type of trauma, or ingestion of adult meds.  I checked her pupils and they were equal and reactive.  We did a complete head to toe and didn't see anything indicative of trauma.  Her temp was 97.8 axillary, ( you add 2 for core temp, making it 99.8) which is pretty normal for a kid with a cold,  not really high enough to make us think it was a fever induced seizure.  Past experiences for all three of us caused us to think it was fever related, even though we all agreed she just didn't feel that hot.  So, I start asking the guy questions like name, date of birth, etc...  He doesn't know her last name, or exactly when she was born.  I ask him just how exactly he's related to her and he repeats that he's her step-father.  

" So,  you're married to her mom?", I asked.

" No man, I talk to her mom" he replied with the attitude thats common in the neighborhood we were in.

" I'm just babysitting her while her mom is out".

No one in their right mind would trust their baby with this guy if they just looked at him, but whatever.  So we transport to the ER, and on arrival mom and some of her friends are waiting by the doors, freaking out.  Mom is about 8 months pregnant, and looks no older that 20.  B&T bring her in to the pediatric ER bed while I asked the charge nurse to call a pediatrician fast.  We usually call on the radio and let them know what we are coming in with, but their radio was down.  As we were taking the child off of our stretcher and getting her onto the hospital bed, she woke up.   She had a daze about her, and didn't react normally when noticing where she was and seeing her mom.  The Pediatrician showed up pretty quick, touched the girl and concluded it was a seizure in about two seconds.  I told her the temp we got, and that she didn't feel hot to us, especially on our arrival to the scene.  She kinda brushed us off, and said that the child looked rigid when she first noticed her, and now she was normal, so it's definitely a seizure.  She did a rectal temp, and it was 99.9 also.  B, T, and I kinda just looked at each other, grabbed our stuff, gave the info to desk nurse and left.  On our way back to the station we talked about it and while we didn't really agree with that, we figured the Dr knew what she was talking about.

About 5 hours later we were back in the ER with another patient, and we inquired with the charge nurse about the little girl.  It turns out that she had a sub-dural head bleed, with a facial fracture.  It showed up on the head CT they did.  I told the RN that we didn't see any trauma at all, and he said that the face bruise didn't show up for about 4 hours, right after they did the head CT.  

T and I went into a silent rage.  That piece of shit had hit her head on something, probably his fist.  And, he sat in my truck and lied over and over to us in our questioning.  Our practice would have been the same, but if I knew for sure there was trauma involved, we could have gave the hospital a heads up and they would have done the CT sooner, being that the Dr. wouldn't have had " Seizure" tunnel vision.  The quicker the CT, the quicker they can relieve the pressure on the brain, preventing even more serious neurological injuries.  That little girl could have permanent disabilities because that selfish, cowardly piece of shit was only worried about himself.  The last time I looked at him, the little girls mom was crying and hugging him because she was scared for her little girl, and he was consoling her.  He had us fooled.  Twice.

That ruined my shift. Up till then, we were having a great shift, playing Wii against the Engine crew for Dunken Donut coffee's, laughing at each others stories, and running routine calls.  I went home so pissed off that that guy had fooled me, and I'm still pissed.  I'd love to bump into that guy some day.  The only consolation I have is the RN told me when they saw the fracture and bleed, they called the police and family services.  If the system works, he'll be put into prison for a long time and gang raped by the worst of the worst.  But, I have little faith in the system.  Maybe the mom will be more careful who she leaves her next 12 babies with.