I have to cover the emergency room and hospital consults periodically at the hospital. It’s really a pain. Most consults aren’t really “emergency,” but that’s how it goes. When it comes to kids, though, the findings are usually pretty grave and I am only too happy to see them.
I saw a young baby yesterday at the request of the pediatric service. There were concerns about the baby’s change in mental status. I determined that she had a vitreous hemorrhage and retinal hemorrhages in one eye. Unfortunately, there is really only one cause for these hemorrhages in an infant. It is known as shaken baby syndrome, or, more subtlely non-accidental trauma. Usually only the eye findings are sufficient to launch an investigation.
An MRI also found some bleeding near the brain and some fractured ribs. The case will now be reviewed by Child Protective Services. The bleeding in the eye was not too bad and probably doesn’t need any treatment as it should resolve on its own. Obviously, not this child’s biggest obstacle.
Many of you may know I have 5 kids. I wasn’t feeling too well while writing my report. A nurse sitting next to me said, “Be happy for this one, she is in the system. It’s the one’s we don’t see that are the saddest.”
There is always a silver lining.
Randall V. Wong, M.D.