Today, I see around 20 odd patients.
One of them is a 50 odd years old lady, came in with a small child (few year old, running around the AED). She looked tired, vomitted a few times, having fever, loin pain, dysuria, hematuria and pissing pus. I had to given her intravenous antibiotics, which will take a few hours if not a few days to bring the disease down. However, she has to take care of the grandson, and I cannot alllow her small child to be running around in the observation ward and I had to let her sleep in the cold corrider in the AED. She could have slept in a proper bed in a proper ward if not for the child to be around.
The child is actually abandon and "sign-off"ed by his parents. His parents divorced, went separate ways and the child was left parentless. It is now up to the sick lady to take care of him, all by herself.
For those who wants to learn more Kidney infection
星期六, 4月 28, 2007
Beyond salvage
Today, I see only around 20 pple. A combination of low attendance rate and busy resuscitation.
1 60 odd years old man comes in with shock and leg pain. The pain is very severe. He has alcoholic liver cirrhosis, DM, HTn, CHF, He was only discharged 10 days ago from our unit for heart failure and pneumonia, and he come back againt. The leg pain, the shock and the fever made up a "classical" picture of necrotising fasciitis. After running a litre of saline, Dopamine, he was still in shock and has gone into fast AF with chest pain. At this point, I let the orthopaedics surgeon take him to the theatre for urgent debridement and the anaesthetist to stablise him. He may need an amputation eventually...
Just think about it, even if we can save him this time, how long can he live more? His condition is so poor, he cannot walk, he need to be bathed. He can only feed himself, but he cannot eat all the tasty food because he has DM, HTn, liver failure and heart failure. Life is a torture for him now, and death would be his savior.
For those who want to learn more: Flesh eating bugs
1 60 odd years old man comes in with shock and leg pain. The pain is very severe. He has alcoholic liver cirrhosis, DM, HTn, CHF, He was only discharged 10 days ago from our unit for heart failure and pneumonia, and he come back againt. The leg pain, the shock and the fever made up a "classical" picture of necrotising fasciitis. After running a litre of saline, Dopamine, he was still in shock and has gone into fast AF with chest pain. At this point, I let the orthopaedics surgeon take him to the theatre for urgent debridement and the anaesthetist to stablise him. He may need an amputation eventually...
Just think about it, even if we can save him this time, how long can he live more? His condition is so poor, he cannot walk, he need to be bathed. He can only feed himself, but he cannot eat all the tasty food because he has DM, HTn, liver failure and heart failure. Life is a torture for him now, and death would be his savior.
For those who want to learn more: Flesh eating bugs
星期五, 4月 27, 2007
Long time no blog
It has been so long since my last blog. I hardly remeber to blog anymore.
Just to recap:
Finished 6 months of busy yet happy life in orthopaedics. Now back to AED to see ~30 to 40 sick pples every day. Sometimes you help them, sometimes you cannot help them, sometimes you dont want to help them.
I have to see as many as possible so pple (and my boss) dont yell at me, yet I am not allow to make any mistakes. The emergency room is like a circus, everyone is shouting, screaming, yelling, scolding and running.
Just to recap:
Finished 6 months of busy yet happy life in orthopaedics. Now back to AED to see ~30 to 40 sick pples every day. Sometimes you help them, sometimes you cannot help them, sometimes you dont want to help them.
I have to see as many as possible so pple (and my boss) dont yell at me, yet I am not allow to make any mistakes. The emergency room is like a circus, everyone is shouting, screaming, yelling, scolding and running.
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