"Preventable traumatic infection"

My child deeply sliced their leg open, and although we were seen very promptly when I took them to St John of God Midland, I believe the actions and condescending attitude of the treating doctor led to a very serious infection of MRSA which required admission to Perth Children's Hospital for administration of intravenous anti-biotics.

The initial wound was 2cm deep and 1cm wide  with muscle bulging out - my entire kitchen was sprayed with blood. As a young child, they were terrified and it took myself and a nurse to hold them down for treatment.

I requested ketamine to calm them appropriately as they were screaming and thrashing, to which the doctor refused citing that it was their job and not mine. Whilst trying to comfort my child and explain what was happening, the doctor placed their hand on my shoulder and said how about you let me be the doctor and you be the parent. They closed the wound with only 1 stitch, despite my requests for more knowing that they are a very active child and it will not hold.

Less than 24 hours later, the stitch had pulled and the wound re-opened. I immediately took my child to a medical centre, where I believe the poor care of the GP there also catalysed the subsequent infection. They removed the covering bandage to observe the wound, but did not cover it before having us wait for 3 hours to be seen by the treating nurse to glue it. The doctor prescribed the broad spectrum anti-biotic amoxicillin to prevent infection.

All requests the doctor, reception, nurses in the clinic and other staff were met with "you'll be seen straight away, you are the next patient." Meanwhile, several patients presented and were treated while we waited, with an open deep tissue wound exposed. When we were finally seen, the nurse glued the wound shut entirely. Obviously, in my opinion, infection began to set in.

I quickly realised the bacteria were resistant to the amoxicillin so presented back at St John of God. By this time, a slight abscess had developed due to the lack of drainage site, and the staff there removed the stitch to allow drainage, and prescribed cefalexin. 

Resistant to this anti-biotic also, the infection worsened rapidly within 24 hours. My child's entire leg from the knee down was bright red, hot to touch, shiny, and had nearly doubled in size at their calf where the abscess was. I immediately took my child to Perth Children's Hospital.

Our experience here was 2-sided: swift and appropriate with great care, however I only believe this was delivered due to my background (I was studying micro-biology) and had the adequate discourse to explain the history and communicate my requests for my child's treatment. Until I pulled those cards and explained why I thought my child had a multi-drug resistant s. aureus infection, I was, in my opinion, unfortunately judged on my appearance at the time and had been spoken to very condescendingly. 

An orthopaedic surgeon was called in to assess my child, and finally they were admitted and administered intravenous anti-biotics: fluclolaxacillin (which later proved to be ineffective due to bacterial resistance) and vancomycin (the big gun that finally worked). Swabs of the wound confirmed the presence of s. aureus. 

Thankfully, after a few days at PCH my child improved, and we completed the treatment closer to home at St John of God Midland. All up, my child spent a week on high doses of powerful anti-biotics which gave them nausea and diarrhoea. It was incredibly traumatic experience for them, as nearly 2 years on they are still completely terrified of infections, hospitals, and needles. Not to mention the anxiety it caused me, knowing how serious anti-biotic resistance is, and the impact it had on my child's older sibling. They still has a very nasty scar and the site is generally sensitive with possible nerve damage (they complain of tingles down their calf, and won't let anyone touch around the scar). 

All completely preventable, if, I believe, the initial doctor had have just stitched the wound properly in the first place. I genuinely believe that had this happened to another family who were not able to advocate for their child as I was able to, that it would have been catastrophic.