Friday 25 May 2012

ed - procedure done

attachment at ed was superb compare to now at medical dep. bohhhsannnnn. huhu =(

sepanjang 6minggu tu i've given chances to do certain procedure. mula2 mmg xberani buat but i need to do it now or later kn.. at least i'm trying. 

1) insert branula

                                              types of branula. different colors different size.

insert branula or doc orders to 'set line'. fx to push in fluid n medicine in line.

2) taking blood

taking blood for lab investigation

3) wound dressing

wound dressing or 'cuci luka'.
 this is bed sore of pt with diabetes mellitus. pic from google. but i do it real. 

after dressing the wound then cover it with bandage.
luka dicuci dgn sterile water/ normal saline/ iodine. 

4) given ATT injection

ATT- anti toxoid tetanus. 
given to pt that exposed to wound. this is to provide immunity protection n prevent them from 'kancing gigi' or lockjaw.

5) eye irrigation

procedure done to remove foreign bodies in eyes. 

6) ear syringe

procedure done to remove foreign bodies in ears. such as ear wax blockage.

7) T&S (toilet n suture)

suture the open laceration wound. need a very technical creativity. 

8) intubation

this procedureis as an alternative way of correcting pt airway n breathing. 
usually done for critical pt in resussitation. i practically learn on doing it but not in real pt. 


masa mula2 attach dkt ed ni suma procedure ni xtau n ada xpnah dgar pn. tp skrg dh tauuuu.. ramai yg sudi mmbntu n ajar buat all the procedure. thanks. 




Wednesday 23 May 2012

emergency department (ed) -intro

assalamualaikum.

here i am ! 
lama xmenjengah my page nih. nk update about my new activity kt spital pn xsmpat. and i do read my frens update their intern life. suma hepy n best dpt buat something new kn.. n now rasa ada time sket blhlah nk sharing2 . 


my first day went well =) di pg isnin 2hb april. jam 8 lg dh kt spital n my first time get into HSAH. haha
mcm biasa la kn kna lapor diri dkt mngement, n ada bbrapa org houseman baru lapor diri jg. smpat la kenal2. ms tu dlm ht ckp 'bestnyaa depa ni dh jd doctor dh'. suma freshie lg. 

then, pg dekat ED untuk lapor diri dekat HOD, Dr Zainal Effendy. his quite buzy. but then he ask another doc to show me around, jmpa staff2 n kasi briefing skit2. memandangkan i'm alone there doc tu ckp ni anak sedara dia. hehe. thank doc. appreciate it. =) lepas tu mula lah pengembaraan sorang2. but after few hours rmai dh kawan. bnyak bnda yg xtau. hhuhu. then i keep asking all the instrument usually used. penuh buku for 1day. student2 nurse, houseman, ppp bnyak mmbntu. xkurang jg ada yg usik2 gatal kn.

dekat ED ni system laen skit. there got primary triage, secondary triage, green zone, yellow zone, and red zone or resussitation. usually walk in patient yg dtg akan di 'triage' kn dulu oleh ppp or pem peg perubatan. they will take notes n group kn patient ni ikut severity of pain or disease. then they call in into the secondary triage for ppp and nurse to check all the vital sign n condition of patient. ada jg yg skit nya xda pn tp buat2 skit untuk amik mc je. kt cni la dpt di buktikan penipuannya, hehe. org mcm ni akn di suruh balik je. n xkasi pnya nk enter next room jmpa doc. nnt doc yg mrh kt org yg incharge triage tu. after secondary triage tu baru blh msuk jmpa doc at GREEN zone. yg enter green zone yg skit biasa2 je mcm demam btuk slsema pening2 skt perut. takes time jg lah unt govern hosp kn. patient rmai n they keep waiting. n 1 think i realize org yg dtg cni mostly yg berpendapatan rendah. yg mampu msti rasanya dh pg clinic, hosp swasta or bli ubat kt pharmacy instead of waiting for too long kn. kt cni blh dpt treatment n ubat for just RM 1. sgt murahhhhh.

YELLOW zone. most interesting case i'd seen here. patient yg enter this zone usually semi-critical cases n bring in by stretcher or wheeelchair. here patient will got immediate treatment. all the vital sign recorded, take history from patient or from family, do physical examination to know the disease or pain  that the patient complain of. then doc will give medication n monitor pt for several hours before they allow to discharge. if pt condition worsening they will send them to ward according to the disease diagnose.

enter the RED zone only the critical cases. usually motor-vehicle accident (mva) or having polytrauma injury, heart disease such as myocardial infarction, stroke, and shock. they need a very2 fast treatment n all procedure done here must be done in group. pt smpai je siren pn bbunyi and suma doctors akn dtg merawat.

ok. continue nnt pulak ehhhh...
sgt bnyak pengalaman dikumpul kt ED. rasa mcm suma xtau. tp mgkin jg sbb xstart clinical years lg n blum di exposekn dgn dunia reality yg sbenar lg. so bnyaklaa yg xtau. the happiest thing is bnyak procedure dapat buat dgn jayanya. besttt. next entry i'll story k.

take care.