Rafidia Hospital

  Tuesday, day 3 of surgeries. 10 am and the team is deep into the first case, 3 month old with a tethered cord to be released.
  We start the hospital day with rounding the previous cases. Most are doing well. The most ill is Riyad who was 13 or 15 days old (conflicting information) who arrived at clinic altered level of consciousness cyanotic, bulging fontenell, heart rate of 70.
  We did an emergent VP shunt for hydrocephalus. Pt. was an IV nightmare.  Severely dehydrated.  Probably 10 IV attempts, including the one that was pulled out by mistake along with the ET tube. Oops, big feet.
Pt. Survived surgery, came to me, HR 90, cap refill 4 seconds, gave a fourth bolus an sent to NICU.
  The following am we were met by a very angry head of pediatrics. Loud yelling, short of tears i the hall. In short she was upset that they weren't notifed about such an ill baby. I have spent the last day and today doing damage control. She was right. We just don't know the system and thought protocol was being followed. The ball was dropped.
  Thankfully baby is recovering from sepsis, and dehydration he had before surgery.