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Friday, January 17, 2014

Trauma and Emergency Elective~ #2


We come into red zone where patients with needs of urgent treatment come in. A patient with chest pain is in one of the cubicles. I'm there watching a Chinese HO doing an ECG. Some doctors there are asking that HO to confirm the area of infarction by doing posterior and right ECG. It's the first time I heard about the posterior one and yesterday I accidentally found about the right ECG when I read Master The Board. So I reach the patient's posterior ECG paper and try to interpret it. But it's look the same as the usual ECG. No difference.

While the Chinese HO is typing the patient's info I asked him about it.
"Doktor.. Nak tanya boleh?"
"Em. Iya?"
"Posterior ECG tu macamana?"
"Oh.. Lebih kurang je macam ECG biasa."
"Kenapa kita kena buat posterior ECG tu?"
"Em sebab nak confirmkan area of infarction. Is it really posterior or no."
"Oh.. Tak boleh ke confirm by usual ECG?"
"Kalau usual ECG tak jelas, then kita buat posterior and right ECG tu."
"Oh. Ok. Thank you!"

A few minutes later, an old man is pushed into one of the cubicles. He got stroke.

"Hah. Korang students final year kan? Apalagi? Pergilah buat apa yang patut. Cucuk branula ke.. Pasang ECG semua." said one of the female doctors there. I'm not sure whether she's HO or MO.

I quickly grab the chance as I have been longed to do the branula. I put on gloves and get the green branula. I'm a bit nervous as the patient is an old man. Some people said that it's quite difficult to do branula on old people and children. But actually the old man's vein is quite obvious.

I put on a tourniquet. Try to find obvious vein. Wipe some alcohol over the patient's right dorsal hand. I found my target and poke. But there's no blood flow in the branula. Means I'm not in. Oh my!

Quickly, I pull out the branula without having cotton on it. And blood is coming out from the punctured area onto my gloves! Oh no...
In a meanwhile, someone has come to save me! Or actually save the patient. =p It's the same Chinese HO that I asked him the question about posterior ECG.
He takes some cotton ball and press on the area where the blood is flowing and take off the tourniquet. I take a glance at his nametag. It's written Dr. K. I back off from the patient's hand and pull out my bloody gloves. Dr. K wipes and clean the blood from the patient's hand while he still pressing the cotton ball. I take another green branula and give it to him.

"No. You do it again."
"Huh? Me?" *stunt face*
"Yes. You try it again."

I clenched my teeth take a deep breath and put on gloves. This time under supervision.
He helps me putting the tourniquet and finding a suitable vein. He sees my hand is in tremor. Me too. Zulaikha too.

"Nervous ke? Jangan nervous." I heard his voice.

I poke the vein. And... there's backflow! I'm happy! Then I try to put in all the needle part of branula after pulling out a little bit the needle leaving behind the small size straw to stay in the vein. And... it's bunk! Failed! Hmpphh..

"Hmm.. take out the needle." asked Dr. K and he gives a cotton ball to press on that area.
"Kenapa nervous..? Jangan nervous..." he asked me with a bit disappointment in his voice.
"Sebab dia orang tuaa....." I spontaneously and childishly answered him back.
I put on an innocent face.
Meanwhile a female Malay HO already put on branula at the patient's left hand.

"Nak try buat ECG?" One of Cyberjaya medical students asked Zulaikha.
"Eh.. Tak pelah. Awak buatlah." Zulaikha refused.
"Kita dah banyak kali buat. Nak bagilah peluang kat orang lain pulak.."
"Izzah nak buat?" Zulaikha offered the offer she has refused to me.
I smile and nod enthusiastically. I start putting on the leads.

After confirming it's on the right place, I try to print it out. But... I don't actually familiar with the machine. So I just press on some buttons randomly that I think it might print the ECG out. Unfortunately, the machine doesn't want to work with my randomly pressed buttons.
Here comes the hero of the day, Dr K!

He presses some buttons and the ECG printed out! I put on a palm face.
He smiles and teaches how to use it step by step.

Oh what a day with Dr. K!~