I start on Peds... advice anyone?

[Foxxy Cleopatra]

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Hi to all-

Just got word that I start on peds surgery. It sounds interesting, however I have never done a rotation in it (outside of my general peds 3rd year.)

I have saved my Harriet Lane handbook but other than that do not have any peds-specific pocket books. I am particularly unfamiliar with the NICU- I've never rotated in one.

Any advice on things that are particularly helpful for an intern in peds surgery? All help is appreciated!

-f.c.

 

[apma77]

circumcisions galore!

 

[Skylizard]

Originally posted by Foxxy Cleopatra
Just got word that I start on peds surgery...I am particularly unfamiliar with the NICU- I've never rotated in one.

Any advice on things that are particularly helpful for an intern in peds surgery?

Your experience will largely depend on the type of program you are training. A few points my experience in Pede-surge rotations have taught me:

1. Some programs will not allow the intern to do anything in the OR, if they let you into the OR you may not be allowed to do anything except "hold hook". Sometimes, the non-operating nature of intern experience is blamed on the "you don't have loupes" argument.
2. NICU is almost always run by the neonatology team and their NPs. This has in my experience always been a battle. The neonatology nurses will try to pressure you to NOT WAKE UP THE BABIES. Do not fall for this. You need to examine your patients before rounds and that will invariably cause the little one to wake up and cry...that is too bad, do it!
3. F/E/N is generally managed differently by the NICU medicine team then by the surgical team. You will see alot of things treated with bicarb by the NICU team & pediatric residents. You will also see high calorie/volume TPN. In my experience, the pede surgeons want the babies to grow but not as fast as the NICU team wants. It is a difference in philosophy & experience. The surgeons are concerned with biliary stasis secondary to TPN. The NICU wants them to grow.

I actually met a colleague at orientation and she asked the same exact question. She will also be starting pede-surgery.

 

[njbmd]

Originally posted by Foxxy Cleopatra
Hi to all-

Just got word that I start on peds surgery. It sounds interesting, however I have never done a rotation in it (outside of my general peds 3rd year.)

I have saved my Harriet Lane handbook but other than that do not have any peds-specific pocket books. I am particularly unfamiliar with the NICU- I've never rotated in one.

Any advice on things that are particularly helpful for an intern in peds surgery? All help is appreciated!

-f.c.

Hey fc,
It is good that you saved you Harriet Lane because it will come in handy for peds surgery. (Review fluid needs and nutrition now)You should also review your major pediatric stuff like T-E fistulas, pyloric stenosis, the atresias, malrotation, nec and the like. Peds surg is a good starter because most pediatric surgeons are pretty "hands on". I got to do lots of operating on peds surgery; most of the time as surgeon junior. There are lots of intern-level cases like hernias and the like. Also, got plenty of practice putting in IV lines and chest tubes. I also did quite a few lap appys on peds. Here at UVA, the pediatric intern is the consult resident for peds surgery and the pediatric trauma resident too. These are great opportunities for getting into the consultant role.

You can get enough preliminary reading in Surgical Recall and Advanced Surgical Recall. I used Greenfield and Sabiston for my major presentations.

Enjoy your rotation and enjoy the kiddies!

njbmd 😎

 

[Foxxy Cleopatra]

thanks for the advice 😀

So far, they have given me floor patients, which luckily, have not been very sick. Tonight I take my first call (which is actually home call), so pretty much my first exposure to many of the unit patients. I'm hoping to sneak over to the library and do some reading for some of the more common cases.