Decided to drop in at 8am with Jules and Ali today, to gauge how things "tick" at ED.
First on the agenda, handovers, which were pretty quick as ED was only 20% full at that time.
Hmmmm.... one quiet morning, perhaps?
Not quite.
While Ali went to triage and Jules got himself a patient to clerk, I shadowed Martin for a period, who happens to be an ED registrar (really nice fellow, btw ^^). Got to do about two focused case-histories for him before the department became "chaotic". By that, I meant sudden influx of patients with a host of acute medical conditions imaginable. It wasn't long before every cubicle at ED was occupied.....and there were more patients waiting at triage, with paramedics and the lot. swt.
Out of the variety of conditions I saw this morning, the two most memorable ones (ie: most shocking for me) were:
1. A work-place accident, where a young male construction worker had both his lower limbs crushed by some concrete slab. Significant haemorrhage - the pillows beneath his legs were soaked, and we had to get towels to mop-up all the blood on the floor. Jules had the honour (albeit "coerced" by Tony =P) of "fashioning" the plaster backslabs. He did a good job, I have to say. XD
2. Cardiogenic shock(?) - patient was resting in a cubicle when his nurse noticed a sudden drop in BP and bradycardia. When he was whisked off to the resuscitation cubicles, what caught our attention were his facial expression (he looked stunned - mouth gaping, eyes wide-opened) and his complexion (completely white, just like those clean, white bedsheets at ED). CPR was successfully performed, after which he regained consciousness, became confused, and had some sort of a transient "seizure". I still don't know what to make of the latter. It was atypical; bizarre.
What I really liked about ED today were the procedural skills I could do. Good practice, really, considering we've been doing them on dummies all this while. =) Had a go at a diagnostic ascitic tap and urinary catheterisation, while my colleagues (ie: Jules and Jeanne) went for arterial lines, IV cannulations and plaster backslabs.
Overall, a fairly productive day, although I tend to get "very lost" in the midst of chaos. There were so many occasions where I didn't know where to stand (so I could get out of the way) or what I could do to help. =P Nevertheless, the ED staff are superbly nice - and they do make you part of their team.
More updates after I finish my homework. XD Lots of reading-up to do!!!
PS: Piece of advice while at ED - wear casually, and by that I mean T-shirts, jeans, comfortable trainers, and where possible.... scrubs attire. It can get really messy in there.
Labels: Medicine/Hospitals/Medics
