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Thursday, February 09, 2006

Cardiac bleep

For once since the time I've had the cardiac bleep (and I've had it for about 6 times in the 2+ months I've been in medicine), yesterday was the only time which the cardiac bleep didn't go off at all. For any arrest or medical emergency. Nothing.

On average, there would be about 2 arrest calls (cardiac/peri-/respiratory) and 2 medical emergencies (people feel faint in the corridor/carpark/someone started having a fit). I remember 2 of the days which I was on the cardiac bleep. For one of those days, the arrest team was called to 3 medical emergencies, the first of which was in the ENT clinic, where the patient had just gone up from the bed, felt faint and laid down on the couch again. Because the porters couldn't come immediately with a trolley to bring the patient to A&E, they called the crash team - (it's like, huh? What? do you expect us to bring a trolley there as well, while we are running??).

There's another where we had a crash call in MAU. Now, my Reg and I had just started the ward round in my ward, and my SHO was in the ward as well. We had thought that when the call came in, it would be a test bleep, as that's the time in the mornings where they carry out the test calls. It was not to be. So the 3 of us ran out of our ward, and up the stairs, down the corridor, towards MAU. Just after reaching there, breathless, we were told by one of the nurses that it was a false alarm (%^$%^$?) Heh. Oh well, we had a good workout that morning anyway. =P

Another time was when we turned up to medical emergency calls, as the patient had felt faint or fell down on the ground, and couldn't get up and had to be taken to A&E. Now that is just silly.

But there are times when the calls are genuine. The first time I held the cardiac bleep. I was terrified, as I didn't know what was expected of me, and I was hoping and praying that it would not go off. Lo and behold, it did. To an elderly ward some more, especially when that was my first week, and I didn't know exactly where the elderly wards were or what the code was on the doors. But I reached there in good time, to come to a patient with a respiratory arrest. Thank goodness the SHO was there already, so I basically did all bloods and ABGs. And that was my extent of work there. Another time, I had a medical emergency where this patient on Wakeley ward was in peri-respiratory arrest. Dev and Kate were there already, so I did the usual of running up the ABG (coz the nurses just stood there and didn't know where the ABG machine was) and doing routine bloods. I went back later and see the patient later that night (and now she's on my ward, btw) and read the notes, and at least, now I know what I have to do and write down, and what kind of follow-up after the arrest I need to do. A rough idea at least.

Yesterday wasn't too bad. The weekend and Friday's on-call wasn't too bad. I was kind of bored (being on the elderly side for Fri and MAU for the weekend), so I went to help out and did the post-take rounds for the elderly wards and fluids and bloods and cannulas for the young adult wards. Not too bad really. Kind of got the hang of it now. =)

Am starting to like medicine, or rather, trying to see the sense behind certain investigations. =)


On another note, I got to do my first paracentesis today! Well, I also did my first ascitic tap on this chap 2 days ago, and when the results came back, I'm quite glad that there weren't that many RBCs int he fluid sent off! Heh. My first successful ascitic drain was draining well, the last time I checked. The patient had drained 4L within the span of 2 hours! I reckon there's a minumum of 10L in the belly, but we shall see.... Hopefully the drain comes out by tonight.


Over the weekend, also watched a chest drain - Seldinger, being put in. Now I've only done a pleuritic tap, and that was when I was doing my shadows at Chichester, and that was more than a year ago. I think the chest drain is more traumatic than the ascitic drain, especially if the patient is fat and you can't feel the ribs to go above it (as the nerves are on the underside of the ribs), or if the patient is too frightened with overly-anxious parents as well. My next aim: to do a chest drain and a central line. =)


On the admin front, it was quite annoying that yesterday morning, someone - a contractor, knocked on my door, saying that he has to paint my room that day. I said, no you can't, as I was not given any notice, and all my stuff was in here, and I wasn't given anywhere to move. And so he went back to Staff Residences to ask what else could be done. Then I receive 3 bleeps (in the span of 1 min!) yesterday morning, ON THE CARDIAC BLEEP. I didn't answer immediately, as I was doing an ascitic tap then. When I called back, it was the person i/c staff residences asking me where was the resident living in the room next to me (WTH?? you call me on the cardiac bleep to ask me this?! #$R^%$ and you bleep me 3 times continuously because of this?!) I had half a mind to be rude down the phone to her and state that the cardiac bleep was not to be used for such purposes (I thought someone was dying somewhere in the hospital!), and I could have been bleeped on my normal bleep. And besides, if they wanted to know where the person in question was, they could have called Medica Staffing to find out. Argh...

Then this morning, I was woken up at 7am was someone sandpapering the room next to mine. Not being able to go back to sleep, I went to take a shower, and shortly after I came back to my room, I get a knock on the door. Trying to dress and get ready for work and this knocking on the door at 8am just irritated me. I opened the door. There was this man, another contractor standing outside, who said that he's come to fix my door. I was like 'what? excuse me? No.... you're not'. 'Well, I told you last week that I was coming on Tues to fix your door'. 'Well, you didn't. Firstly, you came 2 weeks ago. And today is a thursday, not a tuesday. And I expect to have received a letter from staff residences to inform us residents that our rooms will be re-painted or our doors would be fixed,. and none of us received any notice when you guys were coming.' 'Well, sorry, but we have to fix your door today.' 'Well, I'm getting ready to go for work now. Could you give me about 20 mins?' 'Fine'.

Then he knocks on my door about 15 mins later, and got started on it, all the time while I'm in the room. Very very irritated. And so, I left, with my room wide open, without a door. And I came back, to find a new door, nothing gone (so far...), and it being difficult to lock.

Honestly, it's just annoying.


Applications are giving me a headache. And there are so many things to do! Think I might stay in Medway these couple of weekends. Need to get my arse in gear and stop procrastinating and finish up what I have to do!


Before I forget about this, celebrated my 25th ont he day itself with all the Medway PRHOs. Almost all turned up, and we had like 17 of them all around an L-shaped table, at this Singapora restaurant in Rochester. We all had good fun chatting and laughing and Harps was playing around with my camera (lots of funny videos on it!), and I ahd a chat with the boss at the end, where she came me an ang pow! So nice of her to. =)

then celebrated Mary's bday too on the Sat, after my on-call (even though both our birthdays are on the same day, which was uncannily weird), at Grandma Thai's. It was great fun too, coz we were sitting next to Mr Andrews, one of the vascualr consultant, who was absolutely hilarious! It would be quite crazy working for him, I would think.

Okay, time for me to go zzz now. Note to you some time later on.

P.s. btw, it feels really good to be going back to the gym and working out. Haven't done that in a while, till this week. I feel... refreshed. =-)