Week 3 at KCMC

We just finished our third week at KCMC.  Like most weeks here, it had its ups and downs.  And unfortunately didn't end on the happiest note.  We're glad to have a couple more days left before we leave next week.

This week the medical students were back from their vacation, which meant a much bigger crowd on rounds, but also a few more on-the-fly teaching opportunities.  The patients continue to be very sick, and we are somewhat limited in the treatments we can offer them.  I was happy to see my favorite heart failure patient discharged at the end of the week, even though we have no cure for her she was so excited to be going back home after 3 long weeks in the hospital.  We also have quite a few cute babies admitted for antibiotics for one infection or another, and all of them are doing pretty well.

Friday was a tough day on the wards.  We have several sick patients who need things like g-tubes (semi-permanent feeding tubes inserted directly into the stomach) to prevent the recurrent aspiration pneumonias they will get due to their inability to swallow food safely.  And that just isn't available here. 

We also saw our first code on Friday, although several patients have died in the last 3 weeks this was the first one we were on hand for.  Tricia was called over by a grandmother who noticed the patient slumped over, not responsive and not breathing.  She started giving breaths with the bag-mask and called for help for almost 5 minutes before someone came to get our team from rounds.  We did about 10 minutes of CPR, with lots of chaos and less than ideal equipment, and after 1 round of epinephrine we did get a heart rate back.  Eventually she started breathing on her own too, but was not responding to pain and there is a good chance the injury to her brain from so many minutes without oxygen is just too severe.  It made us acutely aware of how great the nurses, respiratory therapists, and other members of the Children's code team really are.

We also had another baby with respiratory distress and likely congenital heart disease who wasn't looking so good this afternoon, but thankfully by the time we left she was looking better.  Her mother fainted onto Tricia while we were at bedside, probably a vasovagal episode related to the stress of having such a sick baby and not eating anything all day.

After a sad and eventful day, we had a laid back dinner at the Impala Hotel and called it a night early.