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Friday, February 24, 2012

Berehat jap

Dah hampir seminggu aku berehat from bersenaman & study. Maka beratku yg dah elok-elok turun tetiba naik hampir 2kg, simply coz no senaman & sedentary life in a week termasuk kat spital. Aku rasa mcm each time aku period sure size seluar & baju naik 1 size. Angin satu badan, physically & mentally. Hahah. Blame it on my menstruation: Dysmenorrhoea & menorrhagia.
Letih jadi pompuan ni kan. =P

Alhamdulillah aku tak kena panggil masa aku oncall over the weekends. Got the day off on Monday as well. Then was working a.m. shift Tuesday & Wednesday. Not bad coz patients banyak tapi doctors & nurses pon banyak. So patient flow memang fluent. Then the doctors that I was working with over the 2 days were the cool ones. Termasuk my ED physician/ Intensivist boss who is my idol. Hehehhee. So memang mood baik je kot, despite sakit-sakit badan.

Ada category 1 patient datang on Tuesday, out of hospital cardiac arrest with long down time. Wasnt my patient but I was the procedure doctor. Was happy with my arterial line, didnt get to do the CVC because family & medical team decided to withdraw treatment, mainly coz long down time & patient was showing terminal signs already. Selamat, coz I was sooo sleepy that morning that I almost confident that if I proceeded with the CVC, sure miss & bazir au$300 for the CVC kit. So this patient went to ICU to pass away.

Some other interesting cases I saw during those 2 days: Acute appendicitis yg aku diagnosed clinically despite the odd history & findings (it takes guts to confidently diagnose something yg tak ikut black & white of medical textbooks). Compound crush fractures of a hand. Sepsis 2° to severe cellulitis, that we managed to exclude necrotising fasciitis.


Semalam pegi registrars' teaching kat spital. Cool gila kami ada this new fibreoptic camera laryngeoscope for intubation. We had a briefing by the rep on that stuff. I personally have used this to intubate a severely overdosed patient 2 weeks ago during my night shift, and I found that it was significantly easier & quicker using this. Great. Not much strength & lifting needed, and the screen to observe the airways is excellent. This gadget is great for difficult airways, trauma intubation, cervical spine precaution & to remove upper airway foreign body.
Tapi aku still rasa we still need the traditional intubation skills using the old metal laryngeoscope. Which needs a lot of left arm muscles, di mana aku punye memang flabby & lembek. :P

I think yesterday's registrars' teaching was one of the most comprehensive ones. Lepas glidescope briefing & practicals, kami blaja new guidelines on procedural sedation for children, in particular using ketamine & nitrous oxide. Most of the registrars dah guna these great 2 sedatives either in ED, ICU, theatre. Tapi yesterday, we had the briefings on the new guidelines & also ada practical stations.
Then my idol boss refreshed us on the details & hardcore stuff of acid-base/ blood gasses use in sick patients. Best la. But by the time abis glidescope briefing tu aku dah ngantuks & tepu. So tak tau brapa byk the rest of the tutes masuk dlm otak aku smlm.

All in all teaching smlm memang best. Hopefully I get to see these stuff in the near future for real life practice. Ntah ngapa now rasa cam semangat nak kerja plak with all these refreshments. Selain dp new cool doctors to work with in ED & ICU, my plate is full of work stuff. I'm going to this APLS course in a month's time (advanced paediatrics life support), then the primary exams in August/ Sept (InsyaAllah pass, then boleh maju ke advanced ED/ ICU training.. yay!), on top of the many presentations during registrars' teaching & mengajar for the medical students/ interns/ residents. Banyak this ongoing lifelong professional development stuff. Seems positive & hopefully stays positive & smooth. InsyaAllah.

Aku kerja arvo shifts this weekends, then straight to weekday nights Monday until Thursday night, abis pagi Friday, again with awesome docs. =)
Now kena sambung study.

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