Tag Archives: Pediatrics

Semper Paratus

For pediatric residents little compares to the anxiety that comes with hearing a call to respond to a code blue for a child in extreme distress. I was no exception. In my hospital the code was announced in stark terms by an overhead page. On hearing that call, every resident on service immediately responded. The first physician to arrive at the patient’s side automatically assumed the role of code leader. That’s really where the anxiety came from. If you were first, every eye in the room looked to you for direction. With every glance you knew they were asking you, “how, exactly, are we going to help this child?” In general I had no idea the answer to that question.

The fear that grips you upon suddenly realizing this fact further cripples you. I knew this all too well. Early in my residency I decided that those first crucial moments in a code were vital for several reasons. First, in the early moments you must make it very clear to everyone in the room that you own the code. It’s yours and no one else’s. Additionally, many codes go poorly for the most avoidable reasons: an oxygen tube inadvertently attached to air instead of oxygen, horribly inefficient chest compressions that result from forgetting to stabilize the child with a backboard, inadequate or excessive medication dosing that occurs with lax documentation. Primarily though, you need time, time to collect your thoughts and take a deep, calming breath. Having figured this out I came up with a list of five or six things that I pledged I would do at the beginning of every code. They were simple things like definitively stating my role as code captain, tasking someone to fetch the aforementioned backboard and having the person most in the know tell me a few things about the child. They were certainly important for the child but mainly they gave everyone in the room a job to do for a few moments; it was just enough time to convince myself that I could actually do the thing that needed to be done.

I hardly ever stray into the territory of photography lessons. I’m a complete dilettante; I have no business telling anyone how to take pictures. I’m not going to start now. I will say this though; I think that preparation plays a huge part in most successful photography. The lessons I learned as a resident apply to a good many of life’s challenges and photography is no exception. In general I’ve moved toward setting out on a specific photographic task rather than just wandering aimlessly looking for purpose…and images. Setting out, for instance, to shoot a bird in flight means I’ll prepare differently than I would for yet another shot of my kids or those ubiquitous lampposts I seem to adore. I focus on the equipment I need and always setup the camera in advance with settings that will maximize the likelihood of capturing a good shot. I got this shot of a snowy egret by being prepared. I set my camera up for 5 fps, switched to a balance of settings that would largely freeze action yet give me some depth of field to play with and converted focus to continuous mode for better motion tracking. It was only then that I got out of the car and set out looking for the shot. Preparation in this case got me a shot I really like.

See, this wasn’t a lesson. It was just a common sense discussion on the importance of preparation in life–handy if you ever find yourself running a pediatric code blue or searching for a decent shot of a snowy egret in flight. Don’t worry, I won’t venture here again any time soon.

Update 10/27/12–I’m really pleased that this image was named a noteworthy image by photofriday.com

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