Monday, August 15

Gerak Khas Attachment: Day 6


So, I'm back people! After 2 days off from the ward, I'm back to K14. Today is active day which means all admission is to this particular ward. Before I went up to the ward I saw a group of student presumably from USIM. I asked them, they are 4th year student. Then, obviously I will have sorta 'gang' in here. I came up then see on of the HO but they all rushing to morning prayer/TO. I waited there with another HO and waiting for them to finish. It took almost one hour for them to finish.

When they came back, I joined the MO supervising HO doing rounds. I joined them until the second cubicle. After then, the specialist arrived. She said to me "Oh, Ibrahem da ada kawan eh sekarang". We were doing round and the specialist asking the USIM student to interpret the ECG. I was sorta 'kantoi' over there while interpreting it. The patient have first degree heart block most likely due to septal MI reflected on V1 ST segment elevation. Then we were met by a CVA pt. The specialist asks the USIM student to assess patient's GCS. I had been seeing it for the past 5 days. I'm not saying I know everything about GCS, but assessing GCS for a patient is not really hard actually once you know how. Practice makes perfect, folks! We continue on rounds until the specialist was instructing a patient to receive PD stat. Then we joined the procedure as observer. It runs smoothly, until a USIM student asks the MO assisting the procedure what is indication for PD/HD. She straightly direct that question to me owing to my short experience following ward rounds.

I stammered while answering that, since I never thought about it. So here's the list!

i) Uremic syndrome (RP)
ii)Persistent Hyper K+ (RP)
iii) Severe metabolic acidosis (VBG)
iv) Fluid overload
v) Drug toxicity
vi) Anuria

I felt relieved, at least I can think at least 3 of it. That means my last 5 days tiredness worth it! Then we continue the round until almost 3pm. We all excused for Zohor prayer. And I promised the USIM students to teach them GCS. Well we assessed 1 patient but stop after that because of inappropriate timing (unfortunately it is time for evening snack!) Those student also went to clerk a patient. Luckily, I reviewed her last week and I told them to hear course crept. It was fun though, chasing for the very low frequency sound.

After that, I encountered this very nice HO. He asked me to withdraw blood from a patient. I nervously tried it. I MADE IT! YEAY!!!! I managed to take blood from an old patient. He is CVA patient, so as patient courtesy, we took blood from the affected side so that he won't feel very much pain. I just wandering around the ward looking for anything to do. Then the same HO asked me to take blood once more but from another patient which is young. He said "patient muda ni senang sikit nak ambik darah, tapi kalau kantoi kena marah teruk sikit la". I smiled while my heart skips beats. I made it once again. Alhamdulillah. I would like to thank the HO to allow me to withdraw blood from his patient. I'm now addicted. Until next time folks!


USIM- universiti sains islam malaysia
morning TO- morning take-over
MI- myocardial infarcts
GCS- glasgow coma scale
CVA- cerebro-vascular stroke (a vague word for stroke)
PD- peritoneal dialysis
stat- immediately
PD/HD- peritoneal dialysis/hemodialysis
RP- renal profile
VBG- venous blood gas

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