Day 10 of 20
Had the management of a multiply-injured patient course yesterday. It was pretty interesting and learnt loads of stuff in the flesh, which makes all the difference. We can read all about primary and secondary surveys but it's really doing it that hammered the stuff in! The victim extrication and helmet removal was a little far-fetched - isn't that what paramedics do best? - but at least now we have a bit of an idea how's it's really done. Of course, learning to apply the Donway splint was good!
Then, we had an extra tutorial by Dr. Palam on ECGs and ABGs - he really konked me out for ECG, with stuff like how to differentiate between supraventricular tachycardia with aberrancy vs ventricular tachycardia (erm ... they look EXACTLY the same), and introduced new stuff like fusion and capture beats in a VT. Crap ... I really need to brush the ECGs up. ABG was surprisingly easy, he kinda comforted us by saying that in the viva test, they usually ask straightforward cases like respiratory alkalosis/acidosis and metabolic alk/acid. None of that scary respiratory alkalosis on metabolic acidosis mixed-picture horrors.
Now, delice didn't want to take my cases, and now I feel like a huge leech! We were supposed to exchange! Hah .. alright then ... free cases! =D Now to get down to writing. I suppose I'm better-off than a few in my group; apparently it's really difficult to do 10 writeups in 7 days. It's trying to find cases that sucked.
Well since it's the weekend and I have absolutely nothing to do at home, have to wait till 10pm for yx to get online, I decided to stay on and see if I can get anything more exciting than stuff like syncope, anxiety syndromes and PUD. Alas, no .. there were so FEW patients!! Like 5 P2 patients in 30 minutes? Which is hmmmmmmm. Where did all of them go? It must have been the VRE.
Anyway, there was a minor trauma case of a motorcyclist being flung off his bike and sustaining a suspected pelvic fracture - the very, very nice surgical MO gave me and another guy a mini-tutorial! Of course it's nothing surgical - just a recap on primary and secondary surveys and chest tubes etc. Then, while I was clerking this gigantic man with supposed chest pain and dyspnoea, Dr. Oh came in and great!! You really just gotta love this woman - she *relishes* teaching. She was quite perturbed by the fact that the gigantic man was giving inconsistent history. At first I was suspecting (and evilly hoping) for an MI or at least angina - usual medical student fashion, but well. He fell ASLEEP and SNORED (thundered, more like) while OJJ and us were talking! SO. I was thinking, was he here just for the bed? These people ... Anyway, OJJ went through the different cardiac markers with us and things like caveats in Trop T measurement. The nice thing about her is that she shares a lot of personally-experienced things, stuff that aren't in the texts. Like the imporance of the relative measurement of CK vs CK-MB.
Was almost 8 by the time I was done .. drats. A&E really should consider having windows that can be seen from the critical care area. It's a nasty shock to find out it's black when you step out, and even worse .. the darned carpark was so creepy.... ok, no more staying till nightfall. It's just too creepy.
Then, we had an extra tutorial by Dr. Palam on ECGs and ABGs - he really konked me out for ECG, with stuff like how to differentiate between supraventricular tachycardia with aberrancy vs ventricular tachycardia (erm ... they look EXACTLY the same), and introduced new stuff like fusion and capture beats in a VT. Crap ... I really need to brush the ECGs up. ABG was surprisingly easy, he kinda comforted us by saying that in the viva test, they usually ask straightforward cases like respiratory alkalosis/acidosis and metabolic alk/acid. None of that scary respiratory alkalosis on metabolic acidosis mixed-picture horrors.
Now, delice didn't want to take my cases, and now I feel like a huge leech! We were supposed to exchange! Hah .. alright then ... free cases! =D Now to get down to writing. I suppose I'm better-off than a few in my group; apparently it's really difficult to do 10 writeups in 7 days. It's trying to find cases that sucked.
Well since it's the weekend and I have absolutely nothing to do at home, have to wait till 10pm for yx to get online, I decided to stay on and see if I can get anything more exciting than stuff like syncope, anxiety syndromes and PUD. Alas, no .. there were so FEW patients!! Like 5 P2 patients in 30 minutes? Which is hmmmmmmm. Where did all of them go? It must have been the VRE.
Anyway, there was a minor trauma case of a motorcyclist being flung off his bike and sustaining a suspected pelvic fracture - the very, very nice surgical MO gave me and another guy a mini-tutorial! Of course it's nothing surgical - just a recap on primary and secondary surveys and chest tubes etc. Then, while I was clerking this gigantic man with supposed chest pain and dyspnoea, Dr. Oh came in and great!! You really just gotta love this woman - she *relishes* teaching. She was quite perturbed by the fact that the gigantic man was giving inconsistent history. At first I was suspecting (and evilly hoping) for an MI or at least angina - usual medical student fashion, but well. He fell ASLEEP and SNORED (thundered, more like) while OJJ and us were talking! SO. I was thinking, was he here just for the bed? These people ... Anyway, OJJ went through the different cardiac markers with us and things like caveats in Trop T measurement. The nice thing about her is that she shares a lot of personally-experienced things, stuff that aren't in the texts. Like the imporance of the relative measurement of CK vs CK-MB.
Was almost 8 by the time I was done .. drats. A&E really should consider having windows that can be seen from the critical care area. It's a nasty shock to find out it's black when you step out, and even worse .. the darned carpark was so creepy.... ok, no more staying till nightfall. It's just too creepy.
posted by R. at 2:21 PM
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