ok, here's a scenario ...see if you have the same suspicions i have (or any reasonable person would have smile emoticon )
13 month old comes into urgent care with reported "seizures", somnolent. Hospitalist decides he has increased ICP, so he gets mannnitol and 3% saline in our PICU. (now usually it is necessary to actually determine what the cause is before treating this way, usually needs invasive monitoring,multiple head ct's, not just : "he must have increased intracranial pressure" before using these treatments.
No tox screen done on admission because it 'isn't necessary".
2 days of nurses pushing for more eval, and a CT scan and bone scan shows a parietal skull fracture.
In the mean time, Mom insists on only feeding him the formula from home,("he hates eating food, he only eats this formula") and nurses continue to report very odd interactions with family and family with baby.
CYFD and police are finally involved. Dad skips just before they arrive thanks to a cousin who works in another unit who has been accessing the electronic record and probably warned him.
Picking up all the possessions left in room, we discover bags full of boxes of nonsterile gloves, boxes of face masks, a bag of syringes, and two boxes of aluminum foil from the cafeteria.
Pediatrician agrees that hair analysis for drugs or toxins "might" be worthwhile.
In the meantime, kid wakes up, eats real food, begins to smile and interact with staff.
DUH
13 month old comes into urgent care with reported "seizures", somnolent. Hospitalist decides he has increased ICP, so he gets mannnitol and 3% saline in our PICU. (now usually it is necessary to actually determine what the cause is before treating this way, usually needs invasive monitoring,multiple head ct's, not just : "he must have increased intracranial pressure" before using these treatments.
No tox screen done on admission because it 'isn't necessary".
2 days of nurses pushing for more eval, and a CT scan and bone scan shows a parietal skull fracture.
In the mean time, Mom insists on only feeding him the formula from home,("he hates eating food, he only eats this formula") and nurses continue to report very odd interactions with family and family with baby.
CYFD and police are finally involved. Dad skips just before they arrive thanks to a cousin who works in another unit who has been accessing the electronic record and probably warned him.
Picking up all the possessions left in room, we discover bags full of boxes of nonsterile gloves, boxes of face masks, a bag of syringes, and two boxes of aluminum foil from the cafeteria.
Pediatrician agrees that hair analysis for drugs or toxins "might" be worthwhile.
In the meantime, kid wakes up, eats real food, begins to smile and interact with staff.
DUH
