I was on call yesterday (1/9/05), and apparently there are quite a number of ill cases.. (3 ASA 4 cases come for operation). One of them is the 87 years old man, who was very dehydrated with low sodium 114 on admission with poor conscious level, with obstructed inguinal hernia and bronchopneumonia with sepsis and widespread T wave inversion on anterior leads in 12 lead ECG with liver impairment (raised bilirubin, liver enzymes and hypoalbuminaemia). With correction, the sodium raised to 125 and surgery was proceeded under epidural. If do under GA, sure cannot extubate the patient and the patient will be left intubated till the day he expired... and he needs inotropic support intra op..
I know already I have one POMR (peri operative mortality report) to write.. Not regarding the case mentioned above but on another case :(
Well.. not to mention too much about work.. Finish all my cases basically around 3 am in the morning. Receive quite a number of sms to greet me happy birthday after the clock strikes twelve. The first sms was arrived exactly at 12 am :)