Thursday, May 25, 2006

The missing piece

I just completed my first night shift with a nice bloke who I haven't worked with before. We took over from the day crew and were told it had been a 'reasonable day'. Hmm... was that good? Did that mean it was going to continue to be 'reasonable' or did it mean we were about to have one of those nights?

We had a couple of interesting and challenging jobs fairly early in the night. First up we went on a Signal 1 call to a young girl of about 18 months who was in apparent respiratory distress. We arrived and found a very cute girl with beautiful black curly hair and huge eyes clinging onto her mothers leg in the hallway. I just re-read that and yes, the leg was still attached to her mother.

As with so many of the families where I work - nobody spoke much English. Sometimes there will be a very young family member who has been educated here in Australia who can act as translator for you. This is usually a great way to get answers, although often you need to be very strict with your questions because you will ask "Does your mum have pain in her chest - yes or no?" The kid will turn to mum, there will be a 4 minute long conversation and the answer will come back "she is sick, she doesn't feel well, she doesn't like going to hospital...". Utilising the kids is often your only option and can provide its own curly issues - asking a 7 year old to help ascertain if his mother's waters have broken can require some dexterous verbal gymnastics.

Anyway where was I?... ah the kid and the leg. It turns out she had been "breathing funny" when she was down for sleep. She had been treated with antibiotics about 2 weeks ago for a chest infection but according to family it was gone now. We did a really thorough assessment of the little one and found the only thing amiss was a slightly elevated temperature. She had clear lungs, good heart rate and respiratory rate, she was active, happy and reacting appropriately to mum and everyone around her. But mum was insisting she was sounding strange when she was in bed so we stuck around to observe the girl while my partner did his paperwork. Everything checked out, but as always with kids, we offered mum a trip to hospital for a check up. She declined so we suggested that she take the girl to her local doctor - and she agreed. Hmm... but what were we missing?...

We packed up our stuff and I stopped playing with the kid and helped carry bags out to the car. We were just going through the front gate when there was a single barking sound from the house behind us. Aha! the missing piece of the puzzle. The seal-like barking cough that comes with croup is such a distinctive sound, you only need to hear it once and you have a 99% accurate diagnosis.

We turned around and went back to let mum know what we now thought was going on and to reassure her that croup in its early stages is ok but needs to be watched carefully. Trying to put all the pieces together is one of the things I really enjoy about this job.

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