These Tiny Tubes
October 18, 2020
Poking babies for some blood investigations is not that easy. First, we need to decide if poking them / to insert IV line (branula) is really needed. Then, of course we need to explain to mothers why we need to do that.
I always tell my patients (since housemanship phase) that our blood is like our identity. I think I have mentioned this in previous post too. We can check many things from few drops of blood. :) And I love the facts that we can do so.
In paeds, blood taking procedures are RARELY be done bedside (means most of the time, we will take the babies / kids to the procedure room) and we will ask the parents to stay outside of the procedure room, or simply stay in the patient's room. Why? I don't think people loves to see their kids crying with the pain initiated with poking them. Right? I have witnessed lots of mothers (usually) have tears flowing on their cheeks every time they hear their children crying in procedure room.
And to be honest, kids have really good memories - name it from their eyes and even from their body memories. Huhu. Every time we just hold to check their hands & foots for any possible veins, they usually will start crying. But some others are cool haha. Some will only cry once the needle is inside.
EDTA tube - usually for full blood count, full blood picture
Plain tube - for renal profile, liver function test, serology etc.
Tricking the children with some videos are helpful to be honest. It helps to distract the kids. For babies, I discovered that playing some sleep lullaby can help to calm the babies. :)
I always asked my husband why on earth would he prefer Paediatrics compared to Medical Department. He said that both are busy departments, one handling general medicine for babies & children while the other one for adults. But, at least seeing cute babies sooth his mind to continue working. Lol. He handles kids better than me though we both are the youngest in the family.
And now, both of us are Paediatrics MO. Haha. Life is very funny sometimes.
Anyway, please pray together with us to be blessed with kids ya :)
I still remember I will ask your prayers when I was in medical school & housemanship. Hopefully, you will not mind to keep praying for me too.
May Allah bless your day :)
Cyberjaya
20201018
Open the Book, Seek Help.
October 11, 2020
It is called Frank Shann.
New Life, New Adventure
September 26, 2020
“Dan boleh jadi kamu tidak menyukai kepada sesuatu padahal ia baik bagi kamu, dan boleh jadi kamu menyukai sesuatu padahal ia buruk bagi kamu. Dan Allah mengetahui sedang kamu tidak mengetahui.” Al-Baqarah ayat 216
Last few days, I had a talk with a colleague who is currently in the same boat.
S: Perasan tak, Allah uji kita benda yang kita tak suka.
H: Kan... Lagi kita tak suka, lagi Allah bagi. Memang nak ajar kita kesabaran. Mungkin nak kita overcome perasaan tak suka tu.
And yeah, we are the chosen one to join the Covid team at quarantine centers in November-December. Alhamdulillah tak kena deployed ke Sabah. T_T
Karma by Muharikah | Book Review
June 11, 2020
"Karma - (in Hinduism and Buddhism) the sum of a person's actions in this and previous states of existence, viewed as deciding their fate in future existences." - https://www.lexico.com/en/definition/karma
1. "Let the husband lead the family."
2. "Medical service is about human act and human touch."
- accidents involving patients under 18, especially if they are not wearing helmet and do not even have license!
- accidents involving drunkens!
- patients who came in a worsened condition just because they ARE NOT COMPLIANT TO MEDICATIONS!
- patients who came at 3 o'clock in the morning for something they already have for months and years and they don't even bother to get it checked before.
- yada yada. Hahaha.
3. "Tidak ada karma dalam Islam."
4. Miracles
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Iman is pregnant! |
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https://www.quora.com/Why-do-people-not-wear-a-helmet-while-riding-a-motorcycle |
- Patient able to speak in full sentences, no gurgling or stridor, no foreign bodies in the mouth/ nose, not on cervical collar, range of movement of neck was full.
- Here, we usually use the acronym IPPA - which means Inspection, Percussion, Palpation, Auscultation
- I - breath spontaneous, not tachypneic, chest rise was equal bilaterally, no chest wound
- P - resonant percussion bilaterally
- P - no clavicle tenderness, no chest tenderness, chest spring negative, no subcutaneous emphysema / crepitus
- A - lung was clear, equal air entry
- Don't forget to check the oxygen saturation too (SpO2)
- check other vital signs - blood pressure, pulse rate
- CCTVR - Color of skin, Capillary refill time (CRT), Temperature of extremities (is it warm/cold), pulse Volume, pulse Rate
- for this patient, it was all normal - pink, CRT <2s, warm peripheries, good pulse volume, pulse rate around 60-70.
- then, we checked the abdomen - soft, non tender, not distended, no abdominal wound.
- GCS was full E4 V5 M6, pupils 3mm/3mm equal reactive
- Here, we inspected the whole body from top to bottom, from front to the back.
- This boy has abrasion wound everywhere - shoulder, elbow, hand, shin, foot. But there was no swelling, no limb deformity, no limb tenderness, no limited range of joint movement (means, he can bend all joints normally) - so we don't expect any fractures here.
- There was no spinal tenderness / step deformity during log roll
- But the head was covered with bandage and we could see some blood stain. When we open the bandage, fuhhhhh there was jagged wound, quite big one! the skull was exposed. And there was no skin flap to cover back the skull.
- We gave him antibiotics and painkiller too.
- FAST scan done, no free fluid.
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https://www.slideshare.net/vipinvenugopalnair/free-ld-flap-for-scalp-reconstruction-dr-vipin-v-nair |
To make it easy, generally we can say that this patient was stable clinically, vital signs was okay. Just, if there was no jagged wound on his scalp, he didn't even need to be referred to tertiary hospital.
Biasalah orang accident mesti akan calar balar sana-sini. Takde patah, kira alhamdulillah sangat dah. Tapi untuk dia ni, kulit kepala dah terbukak, tengkorak terdedah camtu. Nak jahit kulit kepala pun tak boleh.
https://www.medicalimages.com/stock-photo-image-image9257585.html |
I am Dreaming of...
May 5, 2020
Dalgona Coffee's Impact
May 2, 2020
- full blood count (FBC) - we can see if there is any low hemoglobin, so it can be a sign that your body does not receive enough oygen.
- renal profile (RP) - to check your baseline for kidney function
- cardiac marker (in my hospital setting, we will take troponin I) - here, it can show if there is any problem with your cardiac (heart) muscles, maybe the muscles also do not receive enough oxygen and start to break down.
- electrocardiogram (ECG) is a must - this can show the rhythm of your heart, is the conduction of impulse okay or not
The Thought That Counts
February 10, 2019
"Dr, patient bed xx tu GCS* drop, SpO2 pun tak boleh pick up, 80% je"
I felt like crying, blessed to have these people. T_T
They even had my meal packed, in case I am too tired to eat outside that night.
*GCS - Glasgow Coma Scale - to rate one's level of consciousness for eye, verbal, movement response. If GCS less than 8, indicate for intubation.
Alhamdulillah.
My 2018 in Alphabets
January 6, 2019
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First time. |
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My version of Doraemon's pocket - baru lepas exchange C&S bottle. |
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First meal of the day at 11pm. |
In need of this. |
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Will share my wall of memories 2.0 later once it fills up with more sweet memories :D |