Thursday, 11 May 2017

A busy paeds day

Well that was a busy day, I finished an hour late and have just eaten a super healthy Burger King, I was so hungry!

I was on the late shift today and from 18:15 to 20:00 I was the only physio working so you have manage alone. 

During this late shift I treated two patients with two seperate consultants, I have never treated with a consultant before it was great learning and a great experience discussing my clinical reasoning with them. 

I had two patients who were very unwell and both needed a lot of help clearing their secretions! Both had lots of additional problems, but not extensive past medical history's and their sudden illnesses had come a little out of left field. 

One had chicken pox, and actually chicken pox can be really scary, we have had two patients on intensive care with chicken pox recently and both have become really unwell, this current one is taking breaths of approximate 2ml/kg, that works out at a total Tidal volume (size of breath) of 30ml of air. A normal tidal breath for this age would be 140-150 ml/kg, a huge loss! This makes getting oxygen in and CO2 out really difficult, obviously a big issue!

The main challenge this presents is remaining positive whilst treating, parents are often at the bed, and when children become unwell, you cannot afford to show any sign that you are worried whilst they have placed their child's  life in your hands. With physiotherapy this is particularly difficult because in respiratory intensive care the techniques you use do not look comfortable or pleasant and they would hurt you as an adult. Often parents have asked me if their ribs will be broken and even when they know they are mainly cartilage and can't really break it is still very upsetting. So I have found looking confident and remaining professional whilst treating really helps the parents to trust you, and as a new band 5 this is really important.

However as a new band 5 it's really important that you are confident of what you are doing and you don't put yourself in a situation that can cause a patient harm, because unlike being a student you are solely responsible. Whenever I am a bit concerned about treating a patient or I'm not confident, I will always ask to see the patient with a senior member of staff, luckily we have a very experienced team which allows us to do this. 

To end I will tell you a little secret of mine. A not so little part of me absolutely loves having to treat an ill patient who really needs my help, I haven't experienced anything quite like it before, you are really changing their life you know!

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