Neurology has been 1 of my sore spots in medicine, but my 3-month neurosurgical rotation in Australia has been fun. Somehow, 2 calls in neurosurgery has completely ruined my impression of it :p lolz
After finishing work at 6.50pm during a long surgical day, was just about to grab some dinner and have a rest, when neurosurgical male ward called at 7pm. They needed somebody to call Kluang hospital's MO to accept a patient due to be transferred. It's funny how the person who wrote the referral letter earlier did not call them up as well.
Going through the case files, before I could figure out what to do or say, rushed to the Neuro HDU - 1 patient has asystole. Upon arrival and jumping onto the bed to commence CPR, the heart monitor reveals the rhythm to be ventricular fibrillation (this would be a very good time to try and remember what was practised during SIM centre).. The MO allowed me to play with the defibrillator (different from the one we used in Monash / Australia), so I delivered 3 shocks to the patient. Adrenaline and atropine given. No response. The MO told me to go do rounds since nothing much could be done.
Going back up, managed to call up Kluang hospital and push through the referral, only to be told that the Kluang ambulance people could not wait and had already left. So the patient is staying with us, whether we like it or not. Returning to the HDU, had the unenviable task of filling up the death certification and documentation, as well as informing the friends who arrived and family over the phone. So unprepared.. I think I did fine, but if 1 thing bothers me, CPR attempt was documented as 30 minutes in duration, when in actual fact I don't remember anybody bothering to go on even more than 10 minutes..
Was in the process of taking ABGs when the OT called to run for blood at the blood bank. An 8-year old boy whom we saw earlier when he came to HDU was undergoing craniotomy, but upon arrival at the blood bank with the patient's info, they denied receiving any forms for blood request. It turned out that of all the bloods taken, the nurse forgot the GXM cross-match, and knowing how difficult it is to take blood from kids in the middle of surgery, the anaesthetist literally blew up in the OT..
It's already midnight, and I have been running up and down, and up again to the paediatric surgery ward. New case for admission, as the poor little girl fell forward off her bicycle and hit her head on the handle bar. You know what was the best part of clerking her? Dozing off in front of her mum.. and to add another moment of laughter, when I drew the diagram of the haematoma, I was actually extremely tired and sleepy, so for some unknown reason I labeled the wound 'For bowel prep'. By the time I was done, started TDS rounds at some weird time in the morning - 2am at male ward, and 3.30am at female ward.
At the female ward, I was greeted to the sight of a patient who appeared tachypnoeic, which was being ignored by the staff nurse to my annoyance. Suddenly, she began hyperventilating / gasping, and you could hear wheezes from her tracheostomy. ABG: respiratory alkalosis. Gave her some nebuliser and trachymask oxygen. Sent down to neuroHDU.
My colleague, who came into NeuroHDU as I left, was greeted to a sight of 10 patients, and turned towards me and griped, "Why in the world did you fill up my ward??!"
Call ended around 6.45am. No time to shower / eat / sleep also.. start surgical rounds.
No comments:
Post a Comment