::: Saturday, April 12, 2003 :::
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I don't know what happened to my No Codes post.
Kanina, mas mahaba yan eh.
Lecheng blogger to.
::: posted by
Chel at 4/12/2003 04:08:00 AM | |
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Tara, lunch. :)
::: posted by
Chel at 4/12/2003 01:58:00 AM | |
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No Codes
It's called Emergency Room, but my patients stayed for, say, three hours average.
No, it wasn't because they were toxic and they needed close monitoring. Nor was it because they found me incredibly gorgeous they couldn't force themselves to leave. Well, my first patient probably did (either that, or masyado na naman akong feeling) but because I still have some shame left, let's not get into that.
It was because of the damn laziness of the people in the records section. Oh, and the hopeless inefficiency of the central laboratory staff.
Logged in at exactly 6 am. And no, this time, I woke up really early - didn't have to bring my blower and shamelessly dry my hair in the intern's quarter, which, by the way, I was told was the gutsiest thing ever done by a JI in the ER. My ambu surgeon saw me, and, well, just, laughed. Anyway, my friend, who was on duty the night before, immediately endorsed her patient - a 22 y/o male who was suffering from pain in his abdomen which could not be relieved by antacid. Friend handed me the extraction kit, told me she's finished with history and PE, and all that was left for me to do was extract blood. I went to the DTU where he was staying, and asked him a bit about himself and his illness. He was nice, told me he's scheduled to graduate with a degree of BS Computer Science on Saturday (today). Told him my boyfriend took Com Sci too in college. While we were doing small talk, I nonchalantly inserted the needle - he didn't notice. It was only when I asked him if it hurt that he realized it was inside him already.
So I submitted the blood sample to the central lab., and when I came back, the resident on duty asked me about my patient. I told him everything my friend told me, which was actually complete except for one very important thing: she forgot to do rectal exam, which is mandatory in patients with abdominal complaint.
And since she already endorsed the patient to me, I couldn't tell the doctor she didn't do it. Mas boljak if I reasoned out that I just arrived, and the patient was just endorsed to me.
So I took the blame, and told the doctor next time I will do rectal exam on all patients presenting with abdominal problem.
Boljak.
Anyway, the doctor did the rectal exam on the patient, and then he asked her to remove his underwear. He was, like, doc, ayoko, nahihiya ako, all the while looking at me. Anyway, doctor checked him for hernia. Negative. He was asked to call his parents because he had to be admitted for observation for possible appendicitis.
He called his parents at 7 am. At 11 am, parents still haven't arrived. I asked him why.
Taga-Infanta Quezon pala kasi siya.
So, I took another patient. This time, a patient for admission, stent removal, who was just instructed to go to the ER before he'd be brought to the charity ward. Akala ko madali lang.
Turned out the patient has had ureteral stone removal, right kidney stenting, was a known hypertensive and diabetic with retinopathies and hemorrhages, and who has gone under three laser eye surgeries. Ang haba ng history! And when I brought his blood sample to the central lab, they refused to accept it because he had no charge ticket yet. Went there thrice, was refused thrice, and when I brought the sample with the charge ticket three hours later, they had the nerve to ask me why it took so long for me to submit the specimen.
Anyway, the parents of my first patient already arrived, and I had to bring him to his hospital room, and endorse him to a JI in charge of Surgery pay 4 South. Then when I came back, I endorsed my second patient to the JI in charge of him in the charity ward. Mga alas kwatro na yun ng hapon, nakakadalawang pasyente pa lang ako.
Third patient was a 20 y/o female who came in with her boyfriend, complaining of right ear numbness. When I looked inside her ear, it was 80% occluded with cerumen, so the ambu surgeon asked me to go to ENT and ask if someone can suction the wax. Even if I haven't done the history and PE yet, I immediately followed him. Syempre ER, we had to finish non-toxic patient
::: posted by
Chel at 4/12/2003 01:19:00 AM | |
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::: Tuesday, April 08, 2003 :::
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Two months.
::: posted by
Chel at 4/08/2003 04:45:00 PM | |
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ER Queen
If Pex has EB queens, you are the ER queen. All hail!
Text from my boyfriend this afternoon. And no, I did not singlehandedly revive a coding patient. I just achieved the impossible (well, almost) - have six hours of uninterrupted sleep in a stretcher inside the Minor Surgery Room.
May dalawang oras na nap pa sa DTU nung hapon.
I know. Ang kapal ko.
But I think I deserve that. I may have had only three "decked" patients in the ER yesterday, but two of them were, hmn, challenging. The third and the last only a case of upper respiratory tract infection in a 6 month old infant who did not even need antibiotic.
By the way, I specified three "decked" because I had two I did not have the stomach to log. Both of them were rabies cases, and both the most I did was instruct them how to go to San Lazaro to have their anti-rabies shots. What's amusing was, both were foreigners, one was Taiwanese I think, and the other was Korean. The Taiwanese was a 33 y/o tall guy who was bitten by a stray dog while walking in a sidewalk. I wonder why - he went to the ER wearing bright red shiny spandex matching jacket and jogging pants. Palagay ko pati aso nainitan kaya siya kinagat. The Korean was a bubbly teenager who seemed to genuinely like me, despite the language barrier. Basta, like niya ko sobra.
Me, the Korean magnet.
Anyway, my first patient came in at around 8 in the morning: a 33 y/o female who was brought in because of behavioral changes. She wouldn't talk to me, and would insist that she was ugly, and looked horrible. 1989, patient was admitted at Mental Hospital; 2001, she stayed for a week in our psych ward and was diagnosed with major depressive episode. She was released, prescribed meds, but stopped taking them a month after. When I asked the sister where the patient is working, she said, "tumutulong tulong siya sa mga telenovela saka nag-aalaga sa mga anak ni Jackielou."
Huh? Pasyente ka din, miss?
Apparently, the patient works for, yeah, Jackielou the actress. They had nothing but praises for her, and they told me she even offered to shoulder the patient's hospital bills.
And while looking at my nameplate, the patient suddenly blurted, "Eh lalake siya eh."
The psych JI told her no, I'm a girl. To stress the point, she pointed out that I was wearing a skirt. But the patient looked at my nameplate (or, yes, Rhome, my chest area) and insisted that no, "lalake talaga siya". When I told Roy about this, he said I should have discharged the patient at once because "okaypa ang judgment niya." Leche, bastos.
Now I always say I don't want to get a toxic patient. I mean, who does, right?
My second patient was 63 years old, hypotensive (low BP), bradychardic (decreased heart rate), has had hypotensive bleed July 2000 and almost all the complications of the surgical procedure done on him, with tracheostomy tube, PEG, foley catheter...in short, the works.
At tatay pa siya ng doktor sa min. Pag sinuswerte ka nga naman. If ever I screwed up, lagot, SP na sa ER, SP pa tiyak pag nag-rotate ako sa kanila.
Toxic. The pulse was so weak I had a hard time monitoring the pulse rate and the blood pressure. I couldn't even hear the heartrate upon auscultation. Akala ko sira steth ko. I was instructed to take the vitals Q10, which meant, every 10 minutes. When he was finally admitted to the pay ward and I endorsed him to a neuro JI, para kong nabunutan ng tinik.
After this, I crashed in the DTU bed and, well, took an unplanned nap. Early today, I was in the OPD and saw a fellow JI (sinc
::: posted by
Chel at 4/08/2003 07:30:00 AM | |
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