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Monday, January 03, 2005
It is getting depressing. CPR doesn't seem to work. Then again, maybe it's becoz the patients come in 'collapsed', therefore their prognosis is worse. Doesn't help that my patient who didn't make it today was in his early 60s, which is considerably younger than those who are more likely to come in in that state.
On the upside, saw another shoulder dislocation using a different method of ext. rotation, then traction - 1) Kocher's manoeuvre(?).
2) Learnt that there's a proper name for the Y-view - transcapsular, and it is used to tell posterior dislocations, compared with the AP view.
Had a number of interesting cases too. 3) Had ?inferior MI, which could also be a probable dissection. esp with his BP dropping way low even though 2 bags were pumped in (risk of ruptured dissection though).
4) Observed the useful properties of tissue glue, which apparently is difficult to remove after putting it on the scalp for an occipital laceration.
5) Taught the 4 most common local causes of LOW (loss of weight) - cancer, TB, thyroxtoxicosis, AIDS, oh yeah, and add anorexia for females. (then again, I'm wondering, isn't it similar in UK as well?)
6) 2 most common local causes of jaundice - HCC, pancreatic Ca, stomach Ca (less), cholangiocarcinoma (supposedly called Clark's-skin cancer? sounds weird though. Beep. Was corrected by a friend, who said it's Klat, not Clarks. Oops)).
One of the female MOs almost got assaulted by this NSF person this morning. Gf came in with a broken wrist, bruises on her face, but claims to have cut herself on a glass bottle accidentally. Bf, on the other hand, was fine, apart from close-cluster lacerations on his forearm. Didn't report for duty this morning, was abusive to staff, so much so that the police had to come in. Even when given a letter to explain where he had been that morning (for the army), he crumpled the documents immediately and self-discharged, was rude and just whined away. Poor MO though. Must have had a shock of her life. These people should be shot.
Supervisor is lleaving for medical relief efforts for the Tsunamis-hit countries in a day or 2/ Up till now, I haven't talked about the tidal waves at all. Much has been reported on the news - too much money but no channel coz of bureacracy, sanitation and food problems, people losing their loved ones, whole families being wiped out, homes destroyed, areas devastated, countries trying to outbid one another for donation of money for relief effort. Although I was in thailand, I'm thankful the area i was in wasn't hit. Saddened by the catastrophy. Even as a medical student, wondering what I can do, which isn't much really. Yet feeling a bit relieved that is is so near yet so far, and people still go about their normal lives over here. Sure, people do talk about it, but it's kind of surreal, dun you think?
Early shift from 8am starting tmr. More later, if I can remember and find the time. A bti worried about applications. How?