Friday, August 26, 2011

Pediatric neurology: Tools of the trade

Because little kids are afraid of doctors, and doctors are associated with white coats, I suddenly found myself with five fewer pockets to carry my tools and other miscellany that are vitally important to the survival of the third-year medical student. The situation is even more grave because neurology uses a lot more tools than most other specialties, and pediatric neurology even moreso. This is my solution:

It's an elephant-shaped lunch bag! So far, it contains:
  • Ophthalmoscope and otoscope (borrowed from a classmate): For the eye and ear exams. All of the exam rooms are fully equipped, though, so I don't really need to carry these around in clinic.
  • Tuning forks (128 Hz): For vibration and warm/cold sensation. My attending calls it the tickler. "Tell me if you feel it tickling your toe!"
  • Reflex hammer: For reflexes, obviously, but it's also a great stand-in toy and distractor.
  • Safety pins and paper clips: For sharp/dull sensation. But I hardly use them because poking kids with sharp objects is not a good idea.
  • Measuring tape: My attending says, "The only head circumference measurement I trust is my own."
  • Tennis ball: To play catch! And fetch! Easy way to assess coordination and running gait. I take the kid out in the hall, throw the ball, and observe the kid as he or she runs after it.
  • Crayons: To draw on the exam table paper and examine ability to draw various shapes.
  • Finger puppets: A frog and a pink rabbit. Pure distraction for the little kiddos, helps with assessing eye movements and tracking.
  • Bell: To test hearing; also a great distractor.
  • Wooden blocks: Six of them. Ask the kid to stack them up to test fine motor development.
  • A bottle and raisins: Ask the kid to put a raisin in the bottle to test grasping (whole hand versus three-finger pincer versus thumb and index finger).

I'm already running out of room in my spiffy new tool bag.

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