we get difficult calls sometime that we were forced to face.
calls which is difficult for us and for the patient's relatives.
there was this one particular time of the day, where this patient suddenly desaturated, and then collapsed.
we attempted intubation and infused inotropes to keep the heart beating and keep the blood flow good.
That patient, lasted through the day.. but when night came by, fate turned around.
His peripheries suddenly became cold and blue, he desaturated even on high oxygen flow.
His heart slowed, his pressure went haywire and we attempted CPR and maximised the inotropes.
After 20minutes of CPR, he did not revived but his heart showed electrical activity. His eyes were fully dilated.
He had pulse which were very very feeble , that some of us thought it was just our imagination as it was too difficult to palpate.
We continued CPR for another 20minutes, and one of us stopped the inotropes.
Formally, CPR is commenced for 20 minutes before we confirmed death.
After another 20minutes CPR, he did not revived and electrical activity to the heart started faded and later, went flat lined.
Question is, are we at fault for stopping the inotropes? in most cases, they never revived after 20minutes of CPR even on maximised inotropes.
In my view, we are not wrong. We could just let inotropes run and stop CPR, and the heart will eventually stop too. Eyes were dilated is already a sign of brain death. A brain death is as good as death. And it is normal for a heart to show some activity after a person already dead because organ died at different time. and by continuing inotropes, will just make the process longer.
tough call huh?
Friday, February 24, 2012
cook. .
have i ever told u how worried i was previously in terms of satisfying my hubs tummy...? Well, ,not anymore..
alhamdulillah after few months of marriage, i acquired cooking skills which are ppppprrrretty satisfying *chin up*
I always believe that when your 'nawaitu' is right, which is to please your husband, insyaAllah everything goes purfectly.. (God knows how many time I recited "bismillah" while cooking, ehehehe)
and of course, a great cook comes from a great food eater/taster/critisizer !
what surprised me even more is that HE CAN COOK and a BETTER COOK ..
hushfully, thank god . hehehehe..
xoxo
alhamdulillah after few months of marriage, i acquired cooking skills which are ppppprrrretty satisfying *chin up*
I always believe that when your 'nawaitu' is right, which is to please your husband, insyaAllah everything goes purfectly.. (God knows how many time I recited "bismillah" while cooking, ehehehe)
and of course, a great cook comes from a great food eater/taster/critisizer !
what surprised me even more is that HE CAN COOK and a BETTER COOK ..
hushfully, thank god . hehehehe..
xoxo
Saturday, February 11, 2012
work is yay
I'm entering my 5th month of housemanship. Just ended surgery, and now in medical department.
Initially, I was a lil skeptical of work and how I would perform and how my life would be once work started.
But Alhamdulillah, it has been smooth sailing and have been unexpectedly good.
New cases to see, new people to meet, understanding colleagues and bosses and how to work with and around them and etc etc. The downside of my work is how my biological clock has never been normal and we all knew that from start of medical school.
My working hours were 7am-6pm most of the days but some days were 11am-11pm and 10am to 10pm. Government has imposed this new work schedule for housemen in order to accomodate the high medical graduates and to ensure everyone gets equal opportunity to the workload and experiences.
and the time when we were supposed to go back is the minimum time.If there were cases to see, patients to treat or to settle their discharges, pending works, patient collapsed , reports to write etc etc etc... then we had to go back later than we were supposed to.
I seldom complained of how nasty my work or how terrible my schedules are. And i think, none of us should. If those who complained a lot, probably they had chosen the wrong road to begin with. Except for when I had a terrible day, I do let some grumbling out. Not everyday is perfect.
I love medical. I have prefer medical since I start learning medicine.
For those who might be confused, doctors have so many fields to choose from. Surgery is when they deal with blades and sutures, abscess and ass-es. Surgery and Medicine might co-incides but they deal differently. Medicine does not deal with operating theaters like surgeons do.
For example , kidney. If you have kidney failure , it is under medicine. but if you have stones in the kidneys or kidney cancer- those are under surgical. Heart- if you have problem with heart, valve or hypertension, those are under medicine but if u need to do bypass surgery - that would be under surgery.
and we have other fields too eg, paediatric (which i fancy too) , orthopedic - bones , obstetric and gynaecologist - mainly babies and vaginas , and whoa! so much to put in a list.
Medicine itself are already big. we have nephrology, cardiology, neurology, gastroenterology, dermatology, hematology etc etc etc.. Basically, if you aim to be a consultant and see patients and not cut them , then medical is the field you should aim for and I am aiming for that =)
and just few days ago, my specialist compliment me in front of my colleagues for my good performance =D it surely would sound unfair to the others since that was my 5th day of work in medical dept but it surely made me feel great and much more motivated in this field.
MRCP, wait up ! ;)
Initially, I was a lil skeptical of work and how I would perform and how my life would be once work started.
But Alhamdulillah, it has been smooth sailing and have been unexpectedly good.
New cases to see, new people to meet, understanding colleagues and bosses and how to work with and around them and etc etc. The downside of my work is how my biological clock has never been normal and we all knew that from start of medical school.
My working hours were 7am-6pm most of the days but some days were 11am-11pm and 10am to 10pm. Government has imposed this new work schedule for housemen in order to accomodate the high medical graduates and to ensure everyone gets equal opportunity to the workload and experiences.
and the time when we were supposed to go back is the minimum time.If there were cases to see, patients to treat or to settle their discharges, pending works, patient collapsed , reports to write etc etc etc... then we had to go back later than we were supposed to.
I seldom complained of how nasty my work or how terrible my schedules are. And i think, none of us should. If those who complained a lot, probably they had chosen the wrong road to begin with. Except for when I had a terrible day, I do let some grumbling out. Not everyday is perfect.
I love medical. I have prefer medical since I start learning medicine.
For those who might be confused, doctors have so many fields to choose from. Surgery is when they deal with blades and sutures, abscess and ass-es. Surgery and Medicine might co-incides but they deal differently. Medicine does not deal with operating theaters like surgeons do.
For example , kidney. If you have kidney failure , it is under medicine. but if you have stones in the kidneys or kidney cancer- those are under surgical. Heart- if you have problem with heart, valve or hypertension, those are under medicine but if u need to do bypass surgery - that would be under surgery.
and we have other fields too eg, paediatric (which i fancy too) , orthopedic - bones , obstetric and gynaecologist - mainly babies and vaginas , and whoa! so much to put in a list.
Medicine itself are already big. we have nephrology, cardiology, neurology, gastroenterology, dermatology, hematology etc etc etc.. Basically, if you aim to be a consultant and see patients and not cut them , then medical is the field you should aim for and I am aiming for that =)
and just few days ago, my specialist compliment me in front of my colleagues for my good performance =D it surely would sound unfair to the others since that was my 5th day of work in medical dept but it surely made me feel great and much more motivated in this field.
MRCP, wait up ! ;)
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