Inpatient Pediatrics

This week I was on inpatient pediatrics. The patients at Moffitt-Long Hospital are complicated and hardly representative of pediatric inpatients in general. Each team has a service of about 20 patients but most patients are managed by subspecialty consult services. On our service, we have patients ranging from acute stroke in a 5 year old (arterio-venous malformation) to girl who had a repaired double outlet right ventricle on coumadin for artificial heart valves and admitted with an INR of 14 (therapeutic is 2.5-3.5). We have an eight month old admitted for EEG to characterize seizures and a boy with a first diagnosis of type I diabetes and a teenager with disseminated coccidiomycosis. The patient population spans from wealthy families to recent immigrants with very little means. Some have chronic debilitating diseases and are well known to the pediatricians here; others are referred from outside hospitals for complex conditions; and a minority are admitted from the emergency room for common pediatric problems. Like a regular inpatient service, we take call every fourth day and follow a handful of patients through their hospital stay.