It is an interesting phenomenon to see the two different kinds of parents that exist out there: The one calls their pediatrician...scratch that...goes straight to the ER for the slightest little cough. The other has a crazy sick kid at home and doesn't take them into their pediatricians office until they are blue...in which case they needed to stay at home at call 9.1.1!
So here's my best Thursday PICU nursing advice if you fall into the latter category: if your child has asthma and you are giving albuterol nebs every 3-4 hours a day....call your pediatrician.
If your child has asthma and you are giving albuterol nebs every 3-4 hours for FOUR days.....PLEASE GO to your pediatrician.
However, know that once you get there, your poor little man may need way more albuterol than they can safely give in the office.
SO, he will be admitted to the PICU....most likely b/c he needs continuous albuterol!!
This is the interesting cycle I was able to witness having clinicals in the pediatricians office, and then working in the PICU. While the kid didn't get sent to my PICU, he was sent to the local one nonetheless.
Despite education and re-education from the pediatrician, this mom has brought her 3 year old in too late several times in the past 2 years...requiring 6 hospital admissions!!
While it was a great office clinical experience....and while I love taking care of cute little asthmatic kiddos (see previous post for another asthma cutie!) this is NOT the path kids should have to go down.
So for parents in category 1: Your childs cough (that he did ONCE, without ANY other symptoms) does not mean that he has swine flu or a horrible pneumonia or is dying of some terrible disease that warrants a trip to the ER....he probably swallowed the wrong way, or licked something dusty off the floor, or did one of the other insanely gross things that toddlers do that you would die (but not them!) if you knew about! : )
And for parents in category 2: for the love, yes, when your child has a cough that is not stopping...and you know they have asthma....and you are giving tons of albuterol....YUP, take them in to see the office Nurse Practitioner....otherwise you'll be having an unwanted adventure with the nurse in the PICU!!!