all in a day's work/i feel empty

atls mock exercise in the morning.
see our MOs pretend to be paramedics, intubate a trauma-tised mannequin, trauma activate, order xrays/ctscans/e-blood.

auto-pulse run-through.
(really cool device. compressions abit scary though. i think by the time they finish cpr-ing, the poor patient would probably have suffered multiple rib #s and lung contusions, if he hadn't already. the nurse deadpanned that once upon a time blood was seen coming out of a patient's OG tube because the lifeband was positioned too low.)

organophosphate poisoning! (neverevereverever seen that before) from a guy who drank 2 bottles of insecticide and downed 3 bottles of valium. siao.
but the full SLUDGE toxidrome didnt manifest. only urination and bowel sounds +++.
OP smell permeated through the ED and the adjacent lift lobby.

102 year oldman with creps and rhonchi +++ plus bedsores

guy who OD-ed on benzos cos he felt frustrated.

classic ureteric colic writhing-on-bed-vomitting-loin-to-groin-pain presentation.

most exciting last day ever!


my 4 months are up.
electives have been great.
think i learnt the most from the last one.

the doctors have been awesome.
the nurses have been swell.
seriously going to miss them and the hustleandbustle of all my mornings/afternoons.

in this 1 month, i have done/seen/memorised/been patiently brought through:
1) all the symptoms in section 1 of the black book, except for chapters 6,7,9,12 (the kid chapters). so i think i should be able to know what to look out for when i see someone coming in with chestpain/ SOB/ giddiness/ weakness/ diarrhea/ vomitting etc.
2) enough plugs to be fairly confident of not shearing anyone's veins and/or giving them a huge hematoma.
3) glasgow coma scale
4) the ecg changes in a STEMI
5) exciting cardiac dysrhythmias - WPW! R-on-T!
6) VF/pulseless VT/PEA/asystole algorithm (drilled into my thick skull by drtan)
7) many collapse cases (thank god for 6)
8) xrays, abgs, blood cultures, iv drips
9) what cyanosis really looks like
10) 1 clinic session, where i saw delirium at its very best (or worst, depending on which side of the line u perceive it from)
11) quite a few t&s-es. enough to make my hands stop shaking everytime i hold the needle.
12) 1 bier's block and tried (with the help of drgoh) to m&r a colles #.
13) 1 cooper-milch.
14) many psych cases. enough to understand why we need more psychomed trainees.
15) oh, and i forgot, 3 triple-As!!! i only saw like 1 during my AH surg posting.

sip up next!
watch me cry.
(actually quite excited lah, just a leetle apprehensive about the unknown)