A 2 year old infant with a small laceration to the left side of her forehead presented, with her parents and young brother, to the Emergency Department. Just one hour prior to evaluation, the patient’s five-year-old brother accidentally dropped a toy dump-truck on her cute little face. Luckily, by the time she was evaluated by the medical provider, the wound had closed and did not require any sort of repair. The doctor asked the necessary questions, including: Did the patient lose consciousness? Has her behavior changed from baseline? Did she vomit? According to the rules et out by the Pediatric Emergency Care Applied Research Network (PECARN), these questions were necessary to evaluate the need for Computed Tomography (CT) imaging of the head.  A CT would reveal any intracranial pathology. Fortunately, the answers to these questions were ‘no,’ and the patient was saved from unnecessary radiation exposure. I busily jotted these responses down in her medical chart, as all scribes do. No workup or testing was needed, so the provider began discussing the patient’s diagnosis, her prognosis, and the signs and symptoms that would warrant her return to the ED.

As discharge instructions were recited to the patient’s mother, the patient’s young brother began to demand attention. The father, therefore, escorted the culprit, dressed conspicuously in black armor and yellow cape as The Dark Knight, out of the examination room. I followed, noting the anxiety of maternal separation overwhelm the boy. He cries for his mother, and so I quickly distract Bruce Wayne incognito.

Image

“Hey! Are you Batman?!”
“Hey!!!”
“Are you Batman??”

I chuckle and smile. I use my computer to search for a Batman episode on Youtube. Aha! Batman versus Superman. Click. The video calms the distressed boy immediately and he becomes fixated on a reflection of his own image. He is not a treacherous villain deserving of guilt. Rather, he is a brave superhero celebrating health and well-being. His little sister is going to be just fine. The medical provider then leaves the room, and we are off to see our next patient. I say my goodbye, and the father thanks me for a moment of peace.

A day in the life of a current EPPA Scribe.

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