Two months in IJN posting in KL were not enough for me... everyday woke up at 6am, got everything really and by 630am I will be in IJN to begin the hectic work schedule of IJN. Drugs dilution and preparing for the cases and blar blar blar... i always remember this line by one of the consultant cardiac anesthetist... 'slow is smooth, smooth is fast, so slow is fast...' which i later on found the same line in the movie Shooter, minus the last part of slow is fast... i guess what he said is correct... everything should be planned and carrying it out smoothly... when the patient arrived to OT, I will greeted the patient and make sure the patient is the one on the list... check the name tag on patient's wrist and on the patient's folder... and the check list is going on and on.... all for the patient's safety...
The first case will be started around 830am and ended around 1230pm, of course, it all depends on the Surgeon. There are a few who did Valves Replacement faster than Lap appendectomy! wow, u can say that again....
Then, the Consultant will come and relief you for lunch... and then back to the OT to transfer the patient to CICU. and the cycle starts again for the second case... drug preparation, identification of the patient, setting the peripherals line for induction and arterial line for IBP monitoring... and then asked the patient to say their respective prayers before putting them to zzzzz... yes... it is important part for the patient to say their respective prayer so that their minds will be calm and relax... (to anesthetist also) and then gently holding mask in assisting them to breath and wait for few minutes before putting the endotracheal tube into their trachea... secured the tube, put in the nasal probe into one of the nostril to monitoring the body temp... and tape the eyes... and then scrub for the neck line.... and femoral arterial line... all have to be done in less than 30mins... yeap.. less than 30mins...
Good training for speed....
One of the Consultant does tell me this, 'learn to smell the artery and insert the cannula!' too bad till now, my nose is always blocked and unable to smell... :P
then put up the infusion line for inotropes... put the TEE probe into the mouth... wow... lots of thingy on the patient.. no holes are left... nasal, mouth...
then prepare to disconnect the ventilator for awhile when the 'great' surgeon said out 'lungs down' and you reply back 'lungs down' don't you like it?! and after the chest is being sawed open, he will say lungs back up...
then watch out the blood pressure... and then pay attention to the word HEPARIN in... yes and then count down for 3mins for checking the ACT time... before the surgeon goes on pump.... and things continue on till around 6pm.... chest closed and sent the patient to CICU, do the blood gases and settle the ventilator... and then review the next day patients, minimum 2cases... and if not lucky, being caught by this indian SR by the name of Dr Raja, he will ask you to do his premed and do all kinds of dog jobs... really exploiting...
By the time all premed seen, it will be around 8pm and then hurry to the car park and out of IJN and landed yourself in traffic jam of KL... sigh! by the time i reached home, it was 930pm and luckily wife prepared the dinner. Shower and dinner and eyes are already half shut and dozeeee off...
The alarm went off... and the cycle continue on... for two months...
1 comment:
is that our foc dinner courtesy of ling & wife? :)
oh ya, could u please send me the other pics taken with ur other half? (thru email)
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