Seen while working as a fly on the wall ED medical scribe at a level one pediatric trauma center
The following are in no specific order, and the list is not conclusive, but these are all patients that I have seen over the last couple of years in the ED. I was so fortunate to have had the opportunity to work as a medical scribe in such a busy and advanced trauma center as Children's (I was constantly talking to people smarter than me in so many ways). I almost always learned something new or see a new diagnosis with every shift I worked!
Orthopedic injuries (supracondylar fractures, femur fractures, tib/fib fractures, radius/ulna fractures, clavicle fractures, shoulder dislocations, patella dislocations, spinal fractures/subluxations, ligamentous injuries, sprains/strains)
Traumatic Telecanthus
Amputations
Spontaneous/Traumatic Pneumothorax
Pneumonia
Intussusception
Pyloric stenosis
Small bowel obstructions
Pyelonephritis
Nephrolithiasis (kidney stones)
Cholelithiasis and Cholecystitis
Lacerations (one time I saw this kid ejected from his 4wheeler headfirst into a barbed wire fence, had this gnarly deep 6 cm forehead laceration)
Conjunctivitis
Ear infections (otitis media, otitis externa)
New onset diabetics in DKA (Diabetic Ketoacidosis)
SVT (Supraventricular Tachycardia, fasted HR I've seen has was 302 bpm before finally cardioverting with multiple doses of Adenosine)
Vanishing white matter disease, in status epilepticus for 2 days prior to arrival in the ED
Complex cardiology patients with installed VAD in cardiac arrest (how do you perform CPR on a machine? Get that kid on ECMO!)
Anaphylaxis
Nephrotic syndrome
Plastic bronchitis with respiratory distress
Acute asthma exacerbations
Pulmonary Embolism
Myocardial Infarction
Submersion injury (drownings)
I've seen two successful baby deliveries in the ED, both within 3 hours of each other...on Labor Day
Croup
Epilepsy with breakthrough seizures
Cellulitis
Abscesses (Pilonidal I&Ds smell terrible)
Eye injuries (globe rupture, chemical exposure, superglued shut, corneal abrasions)
One time this girl came in for persistent abdominal pain for months, CT A/P showed massive teratoma
Neonatal meningitis/sepsis
Neonatal jaundice
Appendicitis
Pancreatitis
Intracranial hemorrhages
Skull fractures
Toxic ingestions (intentional drug overdoses, hydrocarbon ingestions, accidental stuff like an infant getting into grandma's Glipizide)
Self injuries (cutting, hanging, mutilation)
So, so , so, soooo much constipation
Sickle Cell vaso-occulsive pain crises and complications (neutropenia with fever, Acute chest syndrome, Splenic sequestration, severe anemia requiring pRBC transfusions)
Hemophilia complications (One time saw a CBC drawn that legit showed a Platelet count of "0")
COVID-19/other viral URI
Foreign body ingestion/swallowed/ingestion (coins, lego, button batteries, magnets, jewelry, etc. )
Penetrating wounds ( to the soft palate s/p falling with a pen in the mouth; to the arm s/p falling on a metal fence, etc)
Gunshot wounds
Motor vehicle accidents/ATV accidents/dirt bike/bicycle
Testicular/Ovarian torsion
Sexual assault/Physical abuse, Non-accidental trauma
Rashes of all different etiologies (hives, purpura, erythema multiforme, viral exanthem, roseola, petechiae, sandpaper like, etc.)
Oncology with neutropenia and fever (Retinoblastomas, Neuroblastomas, teratomas, Pre-B cell ALL, anaplastic astrocytoma, etc.)
Ruptured cerebellar AVM with altered mental status