The EMS for Children Innovation & Improvement Center recently reached out to the Texas Pediatric Society Foundation (TPSF) to request that they set up an Emergency Relief/Recovery giving category targeting the special needs of children post disaster. The mission of the TPSF is to enhance the well-being of Texas children by supporting efforts to help improve their health, safety and education and to make a positive impact on their lives and futures.
The funds collected by the TPSF for Emergency Relief/Recovery will be provided in the form of grants to emergency relief and recovery efforts conducted by physicians, community advocates and other child advocacy organizations in Texas during times of a natural disaster such as a hurricane, flood, fire, earthquake and other emergency events. To find out more about the TPSF visit their website at https://txpeds.org/tps-foundation. To make a donation to the TPSF Emergency Relief/Recovery giving category use the online form.
6-day-old term Haitian male presented to the Emergency Department (ED) for abdominal distension. Per mother, the patient was born at home and delivery was uncomplicated. History revealed the patient was able to pass stool and urinate in the first day of life. He tolerated frequent breastfeeding until day of life 3 when he developed increased fussiness, feeding intolerance, and constipation without emesis. Abdominal distension developed and increasingly worsened over the next 48 hours. Although there were no prenatal medical visits, mother stated that there were no fevers or known infections during pregnancy.
A three month old male born at 39 weeks gestation, with a history of a possible seizure disorder, presents two hours after a large fluid-filled lesion developed on his left forearm. Immediately before he developed this lesion his entire body became red and flushed for 15 minutes then spontaneously resolved. The fluid-filled lesion shown developed on top of a skin lesion that had previously been present since 1 week of life. At 2 months of age he experienced these exact symptoms for which he was hospitalized overnight at another institution. During that admission, the bulla’s fluid was cultured for bacteria but was negative for growth. He completed a 10 day course of oral clindamycin and topical mupirocin without resolution of the lesion. Family denies any fever, purulence from the lesion, sick contacts, burns, pets or changes in the patient’s behavior.
A three-day-old term female infant presented to the emergency department with a two-day history of rash to the back of her right leg. The family noticed the rash shortly after hospital discharge and described the rash first as just a few red spots. However, the following day, the rash spread on her right leg and was now described by the family as multiple red and fluid filled spots. No maternal history of herpes simplex virus (HSV) or varicella at time of delivery. The infant was otherwise well, afebrile with appropriate waking, alertness, appetite, voiding and stooling. On physical examination, she appeared well, active and in no acute distress. A linear, vesicular rash with surrounding erythema extended from right posterior mid shin to upper thigh (Image 1 and 2). Pediatric dermatology was consulted and a full neonatal sepsis evaluation including urine, blood and cerebrospinal fluid (CSF) was performed.
“I would like to tell you that you have inspired me to change my career goal from being a cardiologist, to an ER doctor. I want to help people when they need it most urgently. When I grow up, I want to be just like you.” –Kashika Bharol
In the summer of 2016, I was approached with an opportunity to do something completely out my scope of practice and I said yes.
No, I was not asked to initiate ECMO on an emergency department patient.