Night Emergency Duty

so yesterday night was my night ER (emergency room) with samiyah saeed ahmed.

she is one of the hard workers, so i was pretty relaxed about it.

it wasn't very rush-rush in the beginning, around 8pm there were like 3-4 cases at max.

there was an old hemiplegic guy with bedsores! samiyah taught me how to do dressing on that, she's been through surgery posting and i havent yet.

some middle aged lady came with chest pain and breathlessness. had to rule out heart attack and pneumothorax. apparently she was just exhausted coz her relative was delivering a baby in the OBG ward and she was running around a lot for a few days without rest.

her condition was pretty stable and her ECG was normal. yet i just sent cardiac enzymes to rule it out further. according to the consultant, i shouldnt have as it costs NPR 500. not cheap!

some guy from Bhopal, India was touring muktinath in nepal, when he felt dizzy and fell unconscious, was brought later at night. his fellows thinking it was a heart attack, gave him sorbitrate . which was a smart move as a layman, in my opinion! but here, he apparently wasnt having a heart attack and it just lowered his BP and heart rate further! making him even dizzier and faint! :P

he was later shifted to the ICU. i was awake till 4 am and i couldnt take it anymore, so i left to sleep. the doctor's room in the ER is a shit hole! smells constantly of smoke! i dunno how they sleep there!

anyway i left my number and came to my room. next thing i know, i woke up at 12pm next morning :P

i just hope samiyah, who went to sleep earlier handled the morning well.

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short stint in the ER

yesterday i learned to suture a scalp laceration!!
yehhhhhhh. did alright.

poor lady fell and hit her head against something and on her forehead she got a nasty 7-9cm long cut and the skull below could be seen! it was that deep!

she got 7 stitches!
prolene 000 suture material.

in the ER

started the community medicine ER shift. so basically i along with rashika, prashanna and anindita go to the ER in the morning and stay till the afternoon.
today i learned how to use that ECG machine they have at our hospital. sadly, these people dont keep any training sessions for new doctors, and neither can you find any instruction manuals anywhere. so its a chore to actually get yourself to learn anything new. but i did it and went around taking the ecgs of 3 patients in the ER today. :) so happy overall for learning something new today.

a day at the emergency room

yesterday was my ER duty along with sambhav, from 8 am to 8 pm.

totally unready for what to do and what are the expectations from interns in ER, we just left after having breakfast.

sambhav was there earlier, coz thats him, he likes to be present everywhere earlier than the others. so when i got there there were a few cases only, some old man with COPD on nebulisation and a lady with abdominal pain who was waiting for the surgical consultant to arrive.

we started chitchatting and introduced us to the nurses and the MO on call.

then some patients started to come.

what we realised by evening is that patients come in hoards, and when its empty its empty, you hardly have one or two patients ever, its either 6 or none! :P weird isnt it ?

and all we had to do is do the forms, follow instructions from the MO / consults.

we had to make calls to the dept.s to send consults. we had to collect lab reports. we had to take history and do general examination and fill up the file with relevant data.

we could help the nurses with procedures but we were new, so they let us watch first.

i did my first PR exam on this old guy with urinary retention (big prostate felt!!)

(PR = per rectal exam, basically shoving your finger up the anus)

tried to cannulate a patient but didnt get the vein, so the nurse took over. next time might get it right! :)

by the time it was 7.30pm a load of patients arrived! one guy with serious head injury and bleeding came in moribund condition. i checked his pulse, carotid pulse was palpable, i checked his pupils , non-reactive !!

rushed to fill his forms, ran with him to CT scan his head. he had a big fracture and hematoma.

his brainstem had bleeding so when the neurosurgeon arrived he said, this patient will not survive!

we had to leave coz our time was over, when we left we hadn't seen anyone die under us! thank god!

we heard that this patient didnt survive as expected.

there was another patient yesterday, she was suspected of heart attack / acute pancreatitis. she was shifted to ICU, heard today that she died too!

sad!

got to learn so much in emergency duty!

this woman came with 3 kids. the girl in pink held in the mother's arms had a greenstick fracture to her right forearm .

assisted in her plastering.

sanumaya sister from the OBG ward. time passing down here with us early in the morning when the load was less.

she is a very nice fun lady. very helpful, very knowledgeable, knows who are keen and who arent and helps those who are to learn a lot.

sambhav was really good in handling the phone calls and taking the history and all.

didnt expect so much, impressed me to some level.

we might be able to do more and do better in our next ER duty i hope.