Friday, September 23, 2005

On Call again..

Was doing EOD (every other day) on call... really tiring and exhausting ..
Nowadays I prefer quite and simple life instead of thrilling, exciting, nerve wracking and sweat drenching moments.. Frankly speaking, I feel very tired...

My friend LT just mentioned in his blog that he had a busy day during his last on call whereby he had lotsa laparatomy cases...

The moment I stepped into the Operating Theatre yesterday morning at 7:45 am, I was told that there was a post op case with bleeding problem for Re-thoractomy, and patient was on the way already to the OT.. Aiyk... What a case to start my day :( The patient was intubated with Double Lumen Tube (DLT). Intra-op, we transfused several pints of blood & Fresh Frozen Plasma as well as DIVC regime. Problem to maintain oxygenation when he was put on One Lung Ventilation (OLV) and have to resort to giving him 100% oxygen instead with PEEP.. Manage to maintain SpO2 97% with FiO2 1.0. Otherwise, his other vital signs are stable. The surgeon manage to find the bleeder and identify the source of bleeding.

The next case I did was a young girl with abscess in the pinna(ear) which developed after she pierced several holes at her ear not long ago.. for I&D.. All these results from unsteril & unhygienic instruments during the ear piercing process...

Then I continued my day with EVD insertion for 5 months old ex-prem baby with chronic hydrocephalus. When I called the case, the neurosurgical MO informed me that there's another case on the way from the other hospital with Extra Dural Haematoma (EDH) which might required craniotomy & evacuation of haematoma.

The patient with EDH finally arrived. She didn't require craniotomy cos the EDH was small but she had multiple deep laceration wound, including deep inverted Y shaped laceration wound on the scalp, and severely injured lips (being torn into pieces) & tongue (almost cut into two, causing massive bleeding... cos tongue is a very vascular organ) and multiple facial bone fractures as well... Another bleeding case... The surgeon managed to secure the bleeding after the identifying the bleeder.. Even though it's just Toilet & Suturing (T&S), the whole surgery took almost 5 hours cos it involved meticulous stitching & suturing ... Few pints of blood was transfused as well. The plastic surgeon really did very good and fantastic job.. Good cosmetic effect despite the severe injury..

I had many many other cases as well and I'm not going to list down each of the cases cos it will take me ages to do so ;) ...

Doing the last case of my day at 6 am in the early morning, which finished around 7:30 am..

Received a sms from Gasman while half way doing the last case..

9 comments:

LT said...

Nowadays seems like all the calls are pretty bad... I wonder does it reflects on the poor economy that more ppl are coming into govt hosp??

Jellyfish said...

ooOOo... EOD stands for Every Other Day.... I tot Email-On-Demand :P

Jellyfish said...

blur liao at this hour, almost ter-see EOS as in digicam, kekekeke...

glutton rabbit said...

Doc, the EDH case sounds very severe, what happened to the patient? Must be really painfull.

I used to have a negative perception of plastic surgeons because of MJ hehe..) but, I think everything has a good and bad. In this case it's really helpful...

Chen said...

LT,
lately the on calls here are very busy & bad ....
Don't know why lah.. Luckily I manage to get some time off next week..
going for a short vacation & getaway from hospital ;)

Jellyfish,
3 am in the early morning u are still online? so late liao... Go to sleep lah..
It's proven u r too tired already, till see the wrong wordings :)

Glutton Rabbit,
yep, she suffers from severe injuries & now being taken good care of under expert hands :)

Btw, regarding the plastic surgeons, there's misconceptions about their scopes of work..
Those who work in private centre for "purely cosmetic surgery" I have no comments ...
I have written a post on this topic regarding Plastic Surgery sometime ago...
http://chen22.blogspot.com/2005/06/plastic-surgery.html

U can go there to have a look if u are interested in this topic :)

glutton rabbit said...

Doc, yes I read it already. Thanks... Plastic surgeons are really really helpful...

Chen said...

glutton rabbit,
yeap, plastic surgeon are fantastic..
but their operating hours are mostly quite "long" ...

izchan said...

I sometimes wonder, when doctors are working so badly, is it even safe to allow them into the OR?

I mean, I trust them to their job, but when a person is stretch so thinly and fatigue comes to play, begin tired is only natural. But their small mistakes might cause a person their life.

So how does a doctor react under these kind of conditions. Do you say .. "I'm sorry but I am just too tired?" or keep quiet and hope that someone else in your team will catch the mistake that you might or might not introduct to the operation because of the fatigue?

Oh ... and thank you for being there when people need you most.

Chen said...

izchan,
Well, there's a limitation to everything.. And one should know what's their limit :)
I will definitely take a rest if my limit is reached.. or when I'm extremely exhausted & tired...
Not only for others' safety, but for my own safety as well..
We are just mere human.