Re: Emerence - Standing orders??

[Guest guest]

Unfrickin believable!!!! , I can not believe you went through

all this? I have a question for you. OUr pediatrician wrote

standing orders that are on file at our local hospital that if for

any reason can not eat food (either vomiting or strep

throat, etc), then she is to be immediately admitted and an IV with

D10 started. (The pattern is that she stays on D10 until she can

begin to eat broth with noodles or toast; at that point the IV is

turned down to D5 and we move to more normal food -- spaghetti or

other soft carbos. If after 5 hours there is no vomiting and she

seems to want to eat, then the IV is turned off and we wait another

couple of hours and monitor her BSL; if all stays good, we go home)

Do you think your pediatrician would write this type of order that

could be kept at the local hospital?? (and would the ER accept it).

I guess this goes to all of you. Dr. Harbison is the one who told

us about this, and our pediatrician talked to Dr. H and then wrote

the orders. It has helped many times in the middle of the night.

> Hi,

>

> This has been long weekend...Sat at the ER and we went back on

> Sunday and they felt that she was hydrated and doing okay. Then

she

> woke up crying and threw up. She had cocksackie (hand foot &

mouth)

> in her throat and already has a real big gag reflex. She already

> throws up while crying even when not sick.

>

> Anyway, the hospital has a pedi ER and the dr who discharges us

Sun

> at 7:30 pm said if she wasn't better on Sun to come back and she

> would be admitted. Well, as I said she got sick so I called her

dr

> office and the backup (Children's Hospital Boston) called and

agreed

> with me taht since she threw up with a blood sugar of 85 it was

only

> going to go down overnight. They said to take her to South Shore

> Hospital and she would be admitted

>

> So, I get there at 10;45 pm, they won't admit b/c they say she

has

> to be seen first. NOr will they call the pedi dr. who dismissed

her

> (he was still on) nor will they call the pediatrics dr. on call on

> the pedi floor. Oh, and the pedi ER closes to new patients at

10pm

> so I was going to have to wait until a reg ER dr. saw her. AT

this

> point I debated driving to Boston to Children's but thought it

would

> only be a couple of hrs and by the time I got her to Boston it

would

> be the same...so....2:30 am nothing and they told me not to feed

> her. I

>

> call the endo on call from Children's who called right back and

> said to give her sugar immediately followed by complex carbs if

> possible. I bought oj from the vending machine and already had

> wheat pretzels. She drank one oz and took 2 bites. I look up and

> there is a friend's husband - father is having a heart attack. I

> then take Emme to the bathroom and there is the handyman from her

> daycare (also a former coworker of my mother) whose daughter has

> just been brought in after being in a bad car accident (was

> broadsided while driving his Suburban, over a stone wall and hit a

> house - car is totalled).

>

> 3:30 am taken inside the emergency room. 4 am ask for the nurse

> twice (no on has come to our room since we were left there). 4:15

> nurse comes and says dr. very busy because of overdoes, heart

> failure, heart atatcks and car accident - I say I know because I

> know 2 of the people but someone has to at least look at my

daughter-

> get another ER dr. if not please call the pedi upstairs.

>

> 4:30 am see my friend's mother in law on her way out - husband

going

> to Boston hospital, then 5 minutes later see Dan with his family

and

> daughter - bruised cut but okay. 5 am I call the endo at

Children's

> frantic, no one has come at all. He has me check her blood and

says

> anything 70 or under needs immediate attention. It is 70 and I go

> find the nurse.

>

> 5:20 I call Children's because no one comes and am asking him if

he

> can see us directly if I leave and drive into him in Boston. Just

> then the nurse comes in and he says he was able to get scribbled

> orders for a IV with D5. I hand over my cell and the endo urges

the

> placement of the IV with D5.

>

> 5:30 the dr comes in and tries to politely apologize while also

> trying to make me feel guilty about being persistent, he gets

called

> away as the 85 year old guy whose relatives have been fighting

> oustide my door about rescucitating him or not, goes into cardiac

> arrestr. As he leaves he tells me he asked the pedi on call to

look

> at Emerence - my response is that since 10:45 pm I have been

asking

> the same thing.

>

> The pedi dr admitted her without seeing her since he felt she

should

> have been there. We had to wait a bit for a bed and the IV was

> finally started. Emerence did not eat at all Monday but did drink

a

> bit. her throat was so very sore...However she did run around,

> insited on pushing her IV pole and was energetic which of course

> prompted the why are you here questions...however, her blood sugar

> rose because of the IV and she was hydrated at least. The floor

dr

> was very good, not knowledgeable about RSS so he asked for the

name

> and number of the endo at Children's who was on call and he called

> ans asked for his advice (yea fr this doc admitting he didn't know

> and asking for help!). On top of this, the dr. dcovering for the

> practice we go to (and there are about 15 pedis!!!) was the ONE

dr.

> I refuse to see. So we signed her care over to the floor dr.

>

> She got up and took IV out, ate breakfast, snack and lunch and

> maintained blood sugars on her own...so we left at 2 pm.

>

> And we are home!

>

> I now have to pay 3 $50 ER visits plus a $250 admissoin...and next

> week our insruance copays for the same jump to $75 and $500.

YIKES.

>

>

>

> Today she slept late and

[Guest guest]

OH MY G*D!! Do you ever wonder how hospitals function!!!!! I am sooo sorry you

had to go thru that nightmare!! I am glad Emme is now home and doing better.

We too have standing orders after a similiar scenario began,(Though it did not

continue).

Standing orders will make your life sooooo much easier. I hope your ped. can

help you out!

Good Luck, Dayna

[Guest guest]

,

We have sort of the same thing for Max. It sort of happened just

because Max is in the hospital at least twice a year, or more, for

vomiting, ketones, etc. Once the ped. and GI realized that this is a

more chronic thing, they put the standing orders in. Unfortunately,

it's never a couple of day stay for Max. It's always a minimum of 5

days. They leave it up to him and how he feels.

Jodi Z

[Guest guest]

Unfortunately she is not back in the office until next week

(vacation) but I think I can get her to do this. She has always

been very supportive and ackowledges that I as a parent know more

than she does. Anything I want she will refer me to etc. I also

wrote a 2.5 page letter to the " Advocacy " department and cc'd my

daughter pedi, endo, genetics and ENT. We'll see if that shakes

anything up.

Now, for the most fun news of all...my kids go to my mom's on Wed

(she has Wed off) and I went to work. Went to pick up the kids and

, my 5 y ear old, has had a headache all day and was running

a temp of 100.7 at 5 pm...well by 7 that was up to 103.4 even after

a bath. So, off we went to the dr. thinking he had the same thing.

WEll, no cocksackie and the rapid strep was negative. So I'll be

home tomorrow. Emerence is now bright and chipper and will go to

daycare and I will work as I am covering for several others,

including a good friend whose husband's brain tumor might have

returned (they have to go for the cat scan results tomorrow).

SIGH. My husband will be the next to fall and we wives/moms know

that is the worst of all

, mom to 5 and Emerence 2.5 22lbs and losing 32.5

> OH MY G*D!! Do you ever wonder how hospitals function!!!!! I am

sooo sorry you had to go thru that nightmare!! I am glad Emme is

now home and doing better. We too have standing orders after a

similiar scenario began,(Though it did not continue).

>

> Standing orders will make your life sooooo much easier. I hope

your ped. can help you out!

>

> Good Luck, Dayna

>

>

>

[Guest guest]

Thankfully the cocksackie lesions were clearing uup and she wanted to

eat - and didn't cough too much (so her gag reflex didn't kick in).

Her drs and I will be having chats as she has a specialist a week

starting next week!

> ,

>

> We have sort of the same thing for Max. It sort of happened just

> because Max is in the hospital at least twice a year, or more, for

> vomiting, ketones, etc. Once the ped. and GI realized that this is

a

> more chronic thing, they put the standing orders in. Unfortunately,

> it's never a couple of day stay for Max. It's always a minimum of 5

> days. They leave it up to him and how he feels.

>

> Jodi Z