peds question.

[lateness]

just curious about, in most academic hospital er's, if the situation arises, do EP tube neonates,1 month olds,etc, or does it have to legally be a neonatologist or an EP peds doc, or does it just depend on the situation, and timing etc

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[EctopicFetus]

Well IIRC technically "neonates" would rarely be in the ED. Otherwise the EM doc can and does tube the little ones. At places I interviewed they said that they get their practice during their Gas month or PICU month.. Truth is kids are generally healthy and dont require a lot of tubes..

 

[BKN]

just curious about, in most academic hospital er's, if the situation arises, do EP tube neonates,1 month olds,etc, or does it have to legally be a neonatologist or an EP peds doc, or does it just depend on the situation, and timing etc

And actually it's a whole lot easier than the usual 400 lb pickwickian behemouth in the ED.

 

[docB]

And actually it's a whole lot easier than the usual 400 lb pickwickian behemouth in the ED.

True. Two of my hospitals are going to start doing gastric bypass so you know those post op PEs and complications will roll into the ER. I'm not looking forward to it.

 

[Jeff698]

True. Two of my hospitals are going to start doing gastric bypass so you know those post op PEs and complications will roll into the ER. I'm not looking forward to it.

Oh, don't worry. Gastric bypass patients are always the picture of health and never have any complications!

Take care,
Jeff

 

[FoughtFyr]

Well IIRC technically "neonates" would rarely be in the ED. Otherwise the EM doc can and does tube the little ones. At places I interviewed they said that they get their practice during their Gas month or PICU month.. Truth is kids are generally healthy and dont require a lot of tubes..

RSV season here in the midwest. Not infrequent tubes on real little ones. But you are right, a true "neonate" is rare - I did tube a premie last week, 22d old, not even to his expected b-day yet.

To the OP - short answer is we tube them!

- H

 

[Homunculus]

just curious about, in most academic hospital er's, if the situation arises, do EP tube neonates,1 month olds,etc, or does it have to legally be a neonatologist or an EP peds doc, or does it just depend on the situation, and timing etc

i don't "legally" think it has to be a neonatologist, PICU doc, or EP peds doc, but in my experience if those assets are available they are the ones managing the pt once they hit the door. in code situations i've yet to see a PICU doc *not* run things if there is enough lead time. alternatively, if it's a non-emergent intubation (ie one to secure an airway *before* total crumpage) i've seen it go both ways.

if the kid is a train wreck (ex 24 weeker mrcp CLD etc) consultants are usually called. with your run of the mill 7 yo status asthmaticus they usually aren't.

--your friendly neighborhood agrees with BKN caveman