Accident & Emergency Posting

Salam semua.
Lama rasanya tak buat new post.pahadal every day bkk blog sbb nk klik kat link sebelah kanan ni ha..

Today nak cerita sket pasal my last posting as a house officer (ED a.k.a casualty a.k.a Accident & Emergency posting).Start posting 29/5/13 tp end on 8/6/13 sbb amik extra 10 days leave for chickenpox.
Ah yes,I got chickenpox during this posting.

Okay..so start mula2 tu actually risau gila okay.rasa macam tak tau apa.Maklumla before this duduk dalam ward ja.So diagnosis dah established and continue plan ja kan.Tp ni semua kita kena clerk balik.Pastu make a diagnosis and our own plan okay,at the same time,our MO akan guide us.

Tapi walaupun takut2 MO ED sangatlah best (ni bukan bodek okay).They will guide us.Specialist best,staff best and paling best mestilah colleague terchentaaa..haha

Kami kat ED ni kena divide into few shifts and zones.Ada 3 zones,Red zone,Yellow zone and Green zone.Ahaa..plus asthma bay and procedure room and Observation room.

Kes2 kecemasan sahaja..sila pahamkan ya..patutnya kecemasan sahaja yg mai A&E ni,tapi hmmm..kes2 mcm jerawat pecah pun ada mai malam2 pkl 4 pagi.cmna tu?xkan nak MC kot eh?hahahaa..macam2 kerenah kan?

Kes red zone - macam kes MVA (motor vehicle accident) with severe head injury,patient with low blood pressure,diabetic ketoacidosis,intubated patients,acute MI (sakit jaunting) and etc yg severe lay

Kes yellow zone- chest pain (acute coronary syndrome), severe pain macam kes renal colic,MVA yg unable to walk,high blood pressure,stroke etc

Kes green zone-macam kes2 xberapa cemas,contohnya demam panas (bukan denggi ya),sesak nafas, dan macam2 kes yg unbelievable

Kes Observation Room-yg awaiting investigation result macam suspect dengue,appendicitis,uncontrolled DM,dehydration ka,hyperventilation syndrome ka

Asthma bay - kes asthma or COPD yg perlukan nebulised medication
Procedure room- kes MVA with abrasion wounds/ laceration wound yg perlukan jahitan,tukar Ryle's tube,tukar CBD,foreign body in eyes/ears

Awal2 masuk tu houseman ada 8 orang.Yg masuk sekali dgn aku ada lg 2 org,so total suma jadi 11 orang la termasuk aku.Fuuhhh..memang mencabar okay.1 zone sorang ja jaga.
1 HO -red zone
1 HO-yellow zone
1 HO-green zone,asthma bay,procedure room and OR

Mmg terkejar2 esp yg jaga the latter tu

My very first night shift java yellow zone dgn sorg ja MO.so basically 2 org kami ja jaga yellow zone.patient came in with chest pain ramai gila ! ntah knapa hari chest pain sedunia kot..haha..maka banyaklah referral to cardiology

Afterwards,dah ramai HO start joining ED.ED makin meriah okay ! Haha..so beban kerja kurang sket.bleh la bahagi HO ramai sket utk jaga satu2 zone tu ..

Pastu masuk ED banyak bleh join course.contohnya macam ACLS (advanced cardiac life support),ATLS (trauma life support),MTLS (malaysian trauma life support) and BLS (basic life support).Aku dapat join BLS and MTLS,pastu ada megacode session (macam ACLS jugakla)

Banyak belajar kat sini.Daripada sekecil2 URTI ke acute myocardial infarction yg perlu Streptokinase and severe head injury.

And on 1/4/13 till 10/4/13 I took leave sbb dapat chickenpox.Mmg seksa betoi kena chickenpox ni,fuhhh xmau dah !

Then on 29/4/13 I had my braces off ,Yay !

Last2 sedar2 dah habis ED.Aku present tajuk Burn and Inhalational injuries.Lepas present trus banyak kes burn aku dapat.Mmg apply betoi lah !

In ED ni jugak belajar buat chest tubes,intubation,central lines,managing amputated limbs and mcm2 lagi.Memang best sgtttt..banyak belajar.

All in all,rindulah ED.Best ooohh..esp when our referral got accepted and when diagnosis that we made as first liners is correct ! Alhamdulillah :)

I really3 love ED.Thanks to all great colleagues and bosses

End Of Posting Holiday

Holiday.Ermm..what defines holiday?

CUTIIIIII..I just love cuti.Who doesn't kan?

So this end of posting holiday,i decided to spend it in KL-JB-Spore.

Yup,Singapore.Tak penah jejak kaki lagi kat Singapore.Hihik

Went to KL for my dental appt.Went to Melia Hotel utk lunch buffet.Beli kat groupon ja pun,y'all.Hihi..

Tgk ada banyakkkk makanan sedap2.Meh jamu mata meh2.Food addict sgt.

 

Abis menjamu mata? (aku menjamu selera),kami pun betolak ke JB.Tido kat Hotel Sentral JB.Sat ja g JB.Dalam 3 jam+ from KL.Tp disebabkan tak tau location Hotel Sentral tu,sesat skit la,padahal dah dekat dah pun dgn hotel.Nasib baik ada mak cik kastam bagi pinjam plug utk charge HP Nora yg dah abis bateri.Hampeh btoi,HP nora ja bleh online.HP aku takbleh.Ceh..

So.tido and breakfast kat hotel tu,ditemani Chip yg dtg jauh dari Kuantan Pahang.Esok pagi,bertolak ke S'pore naik bas dari Stesen bas Larkin.Murah ja RM3 ja weh.Hehe..

Dah sampai Singapore,brenti kat checkpoint imigresen tu,pastu kena naik bas rm3 a.k.a Causeway Link yg mana ada kat bawah tu.Kat checkpoint tu,bas tu akan brentikan kita kat situ,pastu kita kena cepat2 check-out from Msia ni,and g tgk kat bwh stesen bas tu ada x bas kita.Kadang2 dia jalan ja,tak tunggu pun.So kena naik bas lain yg sama company.-point no1 aku xsuka g Spore,boleh? Hehe..

Sampai sana,bas berhenti kat Queen Street,dekat dgn MRT Bugis.Kat sini la ada restoran murtabak femes tu,Restoran Zam Zam,ada jual murtabak ayam tersedap penah aku makan.Hehe..

Actually awal2 kami sampai,kami g Orchard Road,orang ramaiiiiii gila tak tau nak cakap.Crowded sgt.Tak sure sbb hari tu public holiday (Thaipusam Day) or sbb mmg population dia yg overcrowded.Mmg mcm sardin kat dlm MRT.Siap tolak2 n rude lagi.Plis la,MRT dia selang 2 minit pun ada,kenapa nak push jugak masuk,pdhl bleh tggu next train kot klu train tu dah penuh.Common sense la-point ke2 Singapore tak syok.

Pastu kat Orchard road ada la tempat bleh beli souvenir skit.Pastu kami g Bugis balik,sbb nak g smyg Zohor and makan2 kat restoran Zam Zam kat Bugis.Afterwards,g Little India sat.Hah,crowded kot Little India,p pun time Thaipusam Day kot.

Lepas penah bersusah payah melepaskan diri dari crowd dalam MRT,kami baru g jalan2 area Marina Bay Sands.Yup,mmg kami x g USS.Malas,xterasa nak g lagi.Maybe later.Dahla org ramai kan..After seharian di Spore,balik JB balik.Oh,God knows how much I love Malaysia !! <3 p="">

Pastu tido macam tak tido 100 tahun,esok tu bgn breakfast,then tido balik.Check out pkl12 p.m.Then off we go to JPO.Johor Premium Outlet.Sempat la grab a few things.Hihi..Then balik ke KL.Tido umah Nora.Esok tu balik Kedah.

Weee..penat..esok tu plak masuk posting baru,casualty a.k.a Accident & Emergency Posting.Weehuuuuu..terbaik ! Kepenatan tak berbelah bahagi.Haha..

Orthopaedic Posting a.k.a Posting Tulang

Hehe..ada ka patut posting tulang?Or posting curi tulang? Hakhak..

Posting tulang pun tulang lah..posting ni besttttttt gila.ntahla..ada org cakap 'hang ni semua posting best'..so xtau cmna nak cakap which one is the best kan.sbb i really enjoyed all of my postings as a houseman.Bersusah2 dahulu,bersenang2 kemudian kan.Just be optimistic and you'll enjoy ur life to the max.

Ok.Back to this posting.
I started this posting on 30/9/12 till 29/1/13.4 months cam biasa.Doing routines such as seeing patients in clinic,assisting surgeries in OT (operating theatre),clerking new cases in casualty dept,doing ward works and all.

1st - Seeing patients in clinic.I really enjoyed seeing patients actually,esp in clinic setting.Sepanjang jadi doktor ni rasa2nya kalau stress,nak bg destress aku akan sembang dgn patients.Dulu time blajar kat HUKM,ada subjeck PPD (personal & professional development),dia akan ajar ethics,medicolegal issues and etc.Slalu jugak diajar utk treat patient as a person+disease.Not just seeing a patient and concentrate on the disease alone.So,time2 kat clinic ni la I take my time to give some advice and tell some info regarding their respective diseases,so that their insights are better,kan?? That's what I enjoyed being in clinic.Tapi ada gak time patient ramai sgt sampai xlarat nak tgk pun.haha..nak buat cmna kan..Enjoy gak !



                                                                 *In OT assisting cases*

2nd- Assisting surgeries in OT.Aku mmg xbrapa suka masuk OT just due to 1 reason.Sejuk !! sejuk gila oooo..Aku mmg xsuka sejuk walaupun takla kurus mana.Cukup ja lemak sebagai penebat haba (eh?).Tapi aku suka benda2 hands on ni.Utk buat procedure mmg rasa best ! Tambah2 bila ada MOs yg bagi kita buat sendiri OT.You know who you are ,Thanks a lot Boss :)
Tapi sepanjang aku ortho,tak la byk sgt masuk OT.Hihi..takpala dah naseb badan.Ikut ja la jadual khenn..

3rd-Clerking new cases .Selalunya akan ada 2 houseman allocated to be in-charged in casualty,more precisely in OR (observation room).Kes2 macam MVA (accident),jatuh tangga,jatuh stage,jatuh motor semua ada.Jatuh cinta ja takdak.Hikhik..So kena la tengok kes2 ni and decide whether require admission or tak.Awal2 masuk ada 3 HO jaga OR,just nice kot 3 org.Tp lepas xcukup HO,tggl la dua org ja.Agak penat la jaga 2 org bg aku,sbb kadang2 time byk kes,1 org nak clerk new case,1org nak buat procedure e.g I&D,Ray's amputation and all,ada plak nak bg sedation utk CMR (closed manipulative reduction).So pretty busy kat situ.

4th-Doing ward works.Jaga ward mmg best sbb byk procedure bleh buat.I really miss doing procedures but not the reviews.Hehe..Dulu2 time aku awal2 masuk,mmg heaven.1 ward ada 10-12 HO.Jaga 2-3 patients ja.But that was for a short duration only.Lps tu,makin ramai left,so jaga la satu cubicle cam biasa.Time jaga peripheries pun ada time kena review 10 patients in the morning.Mind u,that's a lot in Ortho.Hehe..plg tak larat kena buat wound desloughing.But hey,everyone went through that so xkesah la kan.Amik pengalaman katakan.

5th- ada ka 5th? Adaaaa...enjoying time wt friends.Best kat ortho sbb ada kawan2 yg best,sekepala,rock n gila2.Hehe..keluar makan2.Sembang and buat keja sambil gelak2.Support each other kalau kena marah and all.Sukaaaaa..







Thanks everyone who made my orthopaedic posting a memorable posting.Thanks to my lovely,supernice MOs esp those who were in 3D (you know who they are).Best gilaaaaa ! Stay cool,surgeons :))

Jamuan ortho :P



Lots of love from your ex-HO.Zoizoi (that's what they called me-I mean,my friends la yg pggl camni)