Saturday, December 1

Shock

Shock 1:
Surgical house officer on-call was called to see a 60 year old lady who had profuse PR/PV bleeding and I was following him around for the day. That was quite an experience. I know I have another 3 years before qualifying, but the thought of being expected to do something to prevent the patient in front of me from dying is just scary. 'So what are you going to do when a lady presents like this?' 'umm... find out the cause of the bleeding, or um.. take a history, give some fluids maybe..' WRONG! I must have read about management of hypovolaemic shock for at least 10 times yet I couldn't give confident answer. It's really alarming to recall how badly I hesitated while the lady's BP dropped by the minute. And it was also really impressive to see the house officer managing the situation so calmly. Bags of fluids and bloods going into the lady via three cannulas, blood pressure checked frequently, oxygen mask on, ECG, ABG, urgent bloods test ordered, reviewing results and sending more sample and prescribing more fluids and bloods, calling anaesthetists and seniors, writing clinical notes, assessing patient, talking to relative, asking nurses for help, teaching me, briefing the registrar - how could anyone ever manage so much at a time? Anyway the lady was sent to theatre as an emergency to have an endoscopy and colonoscopy for further management. I hope she is alright now. I have definitely learnt from this experience, and hopefully when I see another one of these shocks, I won't be as hesitant.

Shock 2:
My winning entry for the Shine award 2007 was published in the Student BMA news. Caught me by COMPLETE SURPRISE - can't say that it's a pleasant one though. Why couldn't someone have the courtesy to inform me about it before they actually publish it? I'm not mad or anything... it's just really not funny to suddenly come across my name and my essay on a medical student newspaper circulated countrywide.

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