PEDIATRICS

PEDIATRIC

“These are the tiny humans. These are children. They believe in magic. They play pretend. There is fairy dust in their IV bags. They hope, and they cross their fingers, and they make wishes, and that makes them more resilient than adults. They recover faster, survive worse. They believe.

Dr. Arizona Robbins, Grey’s Anatomy

                Pediatric was my third rotation as a clinical clerk. I was assigned first in non-wards rotation which they said the most difficult rotation in pediatrics. I was first assigned to Neonatal Intensive Care Unit/Nursery with my partner Yvonne. Unlike other groups, they are usually composed of 3 members but unfortunately, we are only two. During our first duty in NICU, we were taught on how to prepare what they called “pajero” for catching newborn babies, they taught us how to perform newborn care and how to assess the maturity of the newborn by Ballard scoring. It was very busy that time because October was birthing month. In one of the duty, we had 16 baby catch and we were only two on duty. We also had 8 sick babies admitted that we need to monitor every one hour. However, I enjoyed my duty because babies were really cute and really tiny. However, also during our 10 days rotation when there was an outbreak of Candida in the NICU. Two of our admitted babies died because of Candida. The resuscitation of newborn babies were different in adults. We don’t exert too much force in giving basic life support and the dosage of ACLS drugs were also different. However, even with our effort to revive the two babies, they were not able to survive. The nurses and the staff in the NICU were also kind as they also taught us how to care and handle newborn babies with care. Nursery is a place in the hospital where you will think that you were in heaven.

                My next rotation in pedia was 10 days in OPD department. However, during Sunday or Holiday, we need to report as skeletal duty in ER. OPD department is fun since we only have 30 patients a day. We handled common cases like pediatric community acquired pneumonia, bronchial asthma, acute gastroenteritis and other cases. There was also a special day for well-baby check-up wherein we were checking for the length and weight of the newborn if they were appropriate for their age and giving immunization and vitamins. During Friday, we have Neurodevelopmental day and Cardiology day were we handle cases of children with Cardio and Neurodevelopment delay. We learned also how to compute and dispense medications for children as they were not the same in adults.  Also, we had a lot of time to study since we can go home by 5pm. I had a lot of time studying for the common complaint in the pedia since it was a nice specialization in the future.

                My third rotation in pedia was emergency room. The cases in emergency room where almost the same as the cases in OPD however, some of the cases were critical. We had multiple encounter with febrile seizures, seizure disorder, poisoning, and PCAP D patients that we need to revive. However, majority of the patients were manageable and we can manage by giving home medications. The most memorable case that we handled in ER was a case of a 7 years old female who came in with high grade fever, difficulty of breathing and hypotension. We perform several attempt of cardiorespiratory resuscitation to her however she didn’t survive. Since it was an emergency case, we forgot to wear mask while reviving the patient. Upon examination of the patient, patient was a suspected case of diphtheria and all the health care personnel who handled her needs to have IM injection of penicillin. Since we were not employee of the hospital, we bought our medications individually. That time, I promise to myself that I will always wear a protective equipment whenever I will handle patients.

                The last month of my rotation was in pediatric wards. We were assigned per group A, B and C with respective consultants per group. I was first assigned to team B, the most benign team. Most of the patients we handles in the wards were cases of dengue, pediatric pneumonia, acute gastroenteritis and typhoid fever. Most of the cases were benign and patients usually admitted 2-3 days and then they were discharged. Unlike in non-wards rotation, it was good to be in pedia wards since we experienced going to rounds with other consultant and they taught us about the cases of each patients. When our interns were pulled-out, we’re in charged with the patients in pediatric ICU. During that time, we had a case of TB meningitis in a 5 years old girl and the saddened thing about it is that she died after many rounds of resuscitation and she hadn’t seen her biological father. It was hard for me not to cry since at young age she died of a preventable and curable disease. During our tour of duty in the wards, we also experienced and assisted performing lumbar tap and phlebotomy to other patients. We also see cases of ventricular septal defects, atrial septal defect and tetralogy of fallot. Although their murmurs were almost the same for me, we were thought that we need to time the murmur to identify if it is systolic or diastolic murmurs. Also, aside from duties, we had 2 case presentation with Dr. Espos which he lectured us on how to be effective and good doctor. We also had CMC with Dr. Pacifico which taught us about management and approach to febrile seizures and bronchial asthma in acute exacerbation. In overall, I enjoyed my rotation in pediatrics. It is a little bit tiring but I learned a lot of things about infants and children.