Do/Did your Peds rotations suck?

[chartmonkey]

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My peds rotation sucks as.s All boring minor stuff on healthy kids. Does my rotation just suck or is it just as bad everywhere?

 

[jennyboo]

My peds rotation sucks as.s All boring minor stuff on healthy kids. Does my rotation just suck or is it just as bad everywhere?

My peds experience charted up to something like:

Dozens of general anesthesia for MRI, endoscopy/colonoscopy, radiation treatment and line placement cases for kids from birth to age 65
A bunch of inguinal hernia repairs
A bunch of circumcisions
A couple dozen reconstructive surgeries for burns (age 2-20)
A couple of emergent cranis (age 2-10)
One thoracotomy for lung biopsy (6 months)
One pyloric stenosis (35 week preemie just born)

In other words, when I added things up, the majority of my cases were bread and butter and included stuff like "general anesthesia for IV placement."

Things I have yet to see: TEF, gastroschisis, congenital diaphragmatic hernia, congenital heart malformations (they go to our cardiac service)

 

[urge]

Do/Did your Peds rotations suck?

They usually do, unless you are in a big mofo tertiary center where there are no fellows.

 

[pgg]

My peds rotation sucks as.s All boring minor stuff on healthy kids. Does my rotation just suck or is it just as bad everywhere?

I'm assuming you're a CA-1 (else you'd have done peds before, wouldn't be using the singular "rotation" and wouldn't be asking this question). Four months into residency, of course you're only going to get boring minor stuff on healthy kids. What'd you expect?

My program has an unusually large amount of peds for the CA-1s to do, and I did a handful of NICU kids or other nontrivial cases, but it still wasn't until my CA-2 peds months that I did more. Even then, it was still mostly B&B peds. I've got a CA-3 elective coming up at the pediatric hospital, and while I'll do more sick & tiny kids than before, I still expect most of it to be healthy youngsters, because that's what pediatric anesthesia IS.

Boring minor stuff on healthy kids is, in fact, the huge majority of pediatric anesthesia. Don't be so impatient and eager for the 2 kg preemies ... wait'll you nearly bump off your first healthy kid during a boring minor procedure ... little monsters are wannabe self-assassins, don't trust 'em for an instant.

 

[chartmonkey]

I'm assuming you're a CA-1 (else you'd have done peds before, wouldn't be using the singular "rotation" and wouldn't be asking this question). Four months into residency, of course you're only going to get boring minor stuff on healthy kids. What'd you expect?

My program has an unusually large amount of peds for the CA-1s to do, and I did a handful of NICU kids or other nontrivial cases, but it still wasn't until my CA-2 peds months that I did more. Even then, it was still mostly B&B peds. I've got a CA-3 elective coming up at the pediatric hospital, and while I'll do more sick & tiny kids than before, I still expect most of it to be healthy youngsters, because that's what pediatric anesthesia IS.

Boring minor stuff on healthy kids is, in fact, the huge majority of pediatric anesthesia. Don't be so impatient and eager for the 2 kg preemies ... wait'll you nearly bump off your first healthy kid during a boring minor procedure ... little monsters are wannabe self-assassins, don't trust 'em for an instant.

I'm a CA-2. We didn't do CA1 peds, but I've done 2 as a CA2. I use the singular because it's the same rotation both times. Good for 2 days then boring as anything.

Anyway, I'd be interested to hear about other people's peds rotations too so keep em coming and thanks.

 

[Arch Guillotti]

I find your attitude and experience very unusual. My sphincter tone was pretty tight the first month not just because of the pts. but also the anesthesia and surgery attendings. I did a lot of healthy kids but also some pretty darn small ones too.

When you have your first laryngospasm when the attending isn't in the room and you don't have an IV and the pulse ox sounds like a fog horn you may get a bit more stimulated.

Some of the biggest cases that I did in residency were peds such as secondary scoliosis repairs and craniofacial stuff.

 

[KungPOWChicken]

My program is affiliated with a children's hospital. We do a 5-6 months of peds at a minimum at my program. We don't rotate through there until our late ca1 or early ca-2 year depending on our schedule. My first block I did a lot of asa 3-4 cases. This included rare disorders such as hunter's syndrome(difficult intubation), mitochondrial disorders, immune deficiencies. There is tons of cp spines, pelvic osteotomies. I had one total volume blood loss in a craniosynistosis. Tons of spina bifida, vp shunts. Cranis. Lots of cf bronchs. Lots of premies. I did one gastrostomy tube placement in a TEF. One omphalocele repair. Several lap pylorics. Necrotizing fasciitis cases. Peds Trauma. The list goes on and on. It's a very busy hospital with sick kids. And I do agree that it would get boring after awhile doing healthy peds, but i did appreciate days where I wasn't ****ting in my pants with some of these sick kidos.

 

[coprolalia]

Too many sick peds cases. Come to my place. You can have 'em.

-copro

 

[jwk]

C'mon you weanies - kids are easy nowadays. When I was in school 30 years ago, your indication your SaO2 was low was either

1) Heart rate of 30
2) Surgeon calmly saying "the bloods a little dark, son".

I got lucky - I did 10 weeks of peds at tertiary peds hospitals. No offense to you residents, but by chance only, no resident was there when I was so I got to do it all. Kiddie hearts and heads, temporal A-lines, taking an anesthetized kid for a ride on a stretcher pulled by a golf cart through the tunnel from Emory back to Egleston because Emory had the only CT scanner, and of course my personal favorite, "wake up tests" on Harrington rods for scoliosis - turn off the agents, reverse the NMB's, DOPRAM IV, shout "wiggle your feet" and push the pentothal. Wild stuff.

 

[TheSandMan]

C'mon you weanies - kids are easy nowadays. When I was in school 30 years ago, your indication your SaO2 was low was either

1) Heart rate of 30
2) Surgeon calmly saying "the bloods a little dark, son".

I got lucky - I did 10 weeks of peds at tertiary peds hospitals. No offense to you residents, but by chance only, no resident was there when I was so I got to do it all. Kiddie hearts and heads, temporal A-lines, taking an anesthetized kid for a ride on a stretcher pulled by a golf cart through the tunnel from Emory back to Egleston because Emory had the only CT scanner, and of course my personal favorite, "wake up tests" on Harrington rods for scoliosis - turn off the agents, reverse the NMB's, DOPRAM IV, shout "wiggle your feet" and push the pentothal. Wild stuff.

Never heard of dopram before. Quick search online says it is a "respiratory stimulant". Is this a drug that is still used in humans or is it now just vetinary? Anyone know how it works?

 

[Arch Guillotti]

We have a couple of dinosaurs that give it once in a blue moon.