Of EMed (5)...

...and more things. spent some time yesterday reading through old entries and realised that this blog has degenerated into nothing more than a record of my days in medicine. so dry and uninteresting, unlike other blogs out there. anyways.

the madness
these two days in the ed have been madness. even though hotel f.o.u.r. was open, we were swamped with patients. it was patients, patients everywhere - in rows of three between the panels, in the corridors, in wheelchairs because there were no more trolleys... resus was overflowing with up to eight or nine patients squeezed into that tiny area. so what, you might ask, is worse than having many patients? what was worse were the anxious and irritable relatives who entered the p2 area in droves and refused to leave. i saw the poor security guard do many shuttle runs between the two main entrances to the ed trying to stop the relatives from rushing in despite being told to wait outside.

as for those who made it past the guard, they either hovered around their sick relatives and interrupted the consultation or went round demanding that they be seen first. one woman i saw stood in the middle of the sea of patients and yelled at a nurse, saying, "i've been here two hours!" like, has she been to an a&e before? since when was a 2 hour wait considered long? did she think the doctors were hiding in a comfortable room somewhere, sipping tea from porcelain cups and listening to smooth jazz while the a&e overflowed with patients? argh.

and so the sad thing about being a medical student is that we aren't qualified to help. we can't help the doctors see the patients, type in consult notes or examine them - anything to help clear the queue faster. if anything, we probably slowed them down because they had to explain to us certain things and watch us inexperienced blood suckers take blood or set lines. felt really useless, especially when i saw the constant stream of patients wheeled in.

what's amazing, however, is that the docs still took time to teach us. they were all partially crazed, eyeballs bulging, from the nonstop work, but they managed to explain details coherently to us. hats off to them man.

VVIPs or otherwise
cases wise, it's been quite a field day (or rather, days) for us. first thing when i walked into resus yesterday, i had to perform cpr on a patient brought in initially for urosepsis but who subsequently developed a massive anterior infarct. then we handled a standby case of a man with severe sob, who turned out to be the ex - of -. (haha did you think i'd reveal his identity?) mumbler's first brush with a vvip; jaw kinda of dropped when told by dr -. yeesh, not a vip but a very very important person. and to think i was calling him "uncle" the whole time. goodness.

saw a patient with suspected hiv today, who came in for a painful inguinal swelling. ex-ivda who had so badly damaged his veins that they had to set a line in his neck. he was cachexic (with temporalis wasting) despite reporting loa for only four days. white cell count was high (26!!) but lymphocytes within normal limits. still, the suspicion was high so i think they went ahead to test him.

as one doctor said, things always come in twos. an hour later, a man was brought in for a heart attack, and it turned out that he was hiv positive, but hadn't told any of the attending doctors. fortunately for the computerised records, which documented visits to the cdc. whew!

and to round up the day (it was only a 4 hour shift!!) we saw a patient who had a horrific crush injury after a one ton metal bar fell on his hand. there was partial amputation of his hand and various parts of his fingers, so we could see the bones and tendons that tenuously held the two halves of his hand together. it was likely that he would need an amputation of the distal phalange on one of his fingers, but the worst case scenario was having that on 3 of his fingers. hand mo said it'd be long op, so they're probably still operating on him right now. hope it goes fine!

american idol
just because it was andrew lloyd webber night, i decided to watch american idol and sit through it. haven't been able to that the past few seasons and since i knew the material tonight better, i thought i'd enjoy it. was pretty impressed with syesha's and david's rendition of webber's hits, but was absolutely dismayed with jason's "memory" and brooke's "you must love me." since you've made it so far in this competition, surely you'd want to research more on your songs and try and sound better than this?! can't believe they totally destroyed the songs. and i didn't share the judges' enthusiasm about david cook's "music of the night." thought that he actually could sing it well, but the magic wasn't there at all.

to hear what magic is, follow this link. this is a tape of a live performance featuring the original phantom, michael crawford. his voice gives me goosebumps. now that is magic.

so ends my one and only ai post, only because alw is a genius. heh.