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Monday, November 22, 2010

A&E

Assalamualaikum wbt

Hehehe..Emergency Medicine..Sebelum nih rasa macam kurang jer semangat nak wat Emegerncy Medicine. Tambah-tambah bila bukak buku cuba baca sumthing utk prepare before start rotation, it is very medicine like..saya kurang minat bab2 medicine sebaba x suka hafal management dan nama drugs..

But first day turned out to be very interesting..hehehehe..seronot2..first time rasa ambik history medicine rasa seronok dan excited..tau sebab apa??hehehe..meh nak cita...

Sorang Consultant suh kitaorg gi amik history, then present kat dia..Bila present tuh, dia mmg 'diagnosis oriented ' betul..hehe..present nye bab Presenting COmplaint and History of Presenting COmplaint jer..Pastuh bila dah sudah, dia mula tanya DIfferential Diagnosis.

"Come on, give me differentials"

Erkkkk...bg laa beberapa..kemudian dia cakap lagi..

" Come on, that's not what i want "

Hohoho..dipaksa memberikan Differentials arinih..Pastuh dia ajar, how to make differentials and break it down into relevant system, and rule out irrelevant system..Lepas first session tuh dia suruh gi amik History lagi n present lg kat dia..and benda sama gak dia nk history tuh mmg dinarrow down kepada differentials..

Menariknya adalah sebab selama nih pergi amik History tak bother n susah2 nk pikir diagnosis pun sebab lepas tuh boleh tgk chart patient tuh saket apa, symptoms apa, n differentials apa..haha..

Tapi kalo dah kat A&E, sah2 laa x der lg differentials suma..kalo patient baru dtg, kena wat differentials sendirik laa kan..Hohoho..Td bila amik history, dalam kepala, differentials2 jer yg diingati..hehe..mengambil history sambil comeout with differentials..itu pun yg patut dibuat selama nih, tp x terbuat sebab habit sebelum jumpa patient gi tgk chart dia dulu..then dah tau saket apa..haha..x mencabar lgsung utk wat differentialss..

And hari nih, terasa macam doktor kejap..Registrar tuh suh panggil patient kt Waiting room, then amik history patient tuh, then present kat dia utk dia tau apa saket patient tuh tanpa dia sendiri perlu amik history patient tuh..so dia rely on history aku laa..kalo aku kelentong cam selalu kelentong wat case report, mati laa patient tuh..haha..

Yang bestnyer, td patient tuh dtg ngan severe back pain..pastuh bila examine, palpate abdomen, Registrar tuh rasa pulsating mass..Differentials adalah AAA (Abdominal Aortic Aneurysm) laa kan..hoho..cuak jap sbb takut bg history salah td, kang tetiba patient tuh collapse sbb rupture rasa bersalah plak..haha..tp lepas xray, aorta dia normal, sbb dia kurus cam aku kot so boleh rasa pulsatile..*aku pun boleh rasa pulsation kt perut aku..tmabah2 time lapar...hehe..*

Ok, panjang plak..hopefully, Emergency medicine is sumthing to enjoy..hehehe

Semoga Allah permudahkan juga, sbb kena wat shift malam seminggu..malas betul nk balek2 tgh malam..Cuak gak bila td ada patient yg lebam biji mata sebab kena attack ngan anak dol weekend arituh..aiyyyoooo...Semoga selamat semuanya..:D

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