Welcome to my blog! Hope you enjoy reading it and do feel free to comment.

Monday, April 27, 2009

A Night in Casualty

Night-shifts were a part of our EMR (emergency medicine registrar) posting and we thoroughly enjoyed them. We liked the kind of work that was assigned to us and were also able to understand how patients should actually be managed in an emergency setup. Besides, it was one month of legal 'night-outs' - with very little or no work after 3 am. After 3, it was five hours of complete non-specific gossip and nonstop laughter. Missing those days [:(]

A night in the Casualty is never like that in the EMR. You feel like a hermit trapped in a forest from where you can’t escape. You are doing nothing, just issuing ‘case papers’ and not even remotely concerned with the patient management. This was how life was in the last week:

After a long OPD in the morning where at least five multi-drug resistant tuberculosis (MDR TB) patients coughed on my face, Casualty was next on the list. There are usually two interns at night in the Casualty, unless of course one decides to escape. Luckily, that didn’t happen. We were two of us; the Casualty Officer allowed us to divide and my co-intern went off to sleep at 12 midnight. He was told to relieve me at 4.00 am.

Soon after he left, the horrid exodus began. One after the other, patients arrived and demanded immediate attention. I was examining a kid who was down with fever. Since he was really young, I was dealing with him first as you can never take chances with paediatric patients in the casualty.

There was no looking back – entered a lady with a breathless kid in her arm. The kid was only 3 months old. Rush! A woman with severe giddiness was brought by four relatives. Each relative was holding a limb – they didn’t even care to arrange for a wheelchair. A young married girl entered with a deep cut on her wrist, exposing her tendons. Obviously, I realised that it was a suicide attempt; her scared husband was dangling behind. Hesitation marks around the cut were confirmatory. It was a police case and the Casualty Officer was busy noting down the details thereafter (I had to wake him up!).

A hefty middle-aged man arrived with a towel covering his ear. The towel was soaked in blood. He had a fight with a guy in his neighbourhood sometime back. The fellow with whom he fought took a knife and chopped off half his ear. A lady in her forties came with a deep gash on her palm. She claimed that she cut herself while peeling an onion. I couldn’t believe her story because I did not find any reason why a female should peel an onion at 2.00am. Anyways, there was no time to argue with her.

There was a loud noise outside. It was the siren of an ambulance. Correction – there were three ambulances carrying accident patients. Within seconds, there was a flurry of footsteps and wheels of a trolley were heard clearly. A man was brought with multiple fractures on his left leg and a head injury. As I got up to examine him, another trolley was brought in, with a woman in a really bad position. She was trolley no. 1’s wife. As soon as I saw her vomiting blood, I handed the police ‘pink slip’ and she was immediately escorted to ESR (emergency surgery registrar).

‘Pink slip’ is given by the Casualty doctor to any patient needing immediate attention. For patients who are really critical, where one can’t waste time issuing a ‘case paper’, pink slips are used.

Next second, another wheelchair was dragged in the casualty. It was the third accident patient, involved in the same mishap. He was bleeding profusely from his skull. A young boy, around 17 came with his friends. He had fallen from a staircase and an iron rod made a 3 – 4cm hole in his lower back. A girl hurt her eye while playing with her friends. Her friends threw a stone that hit her left eye causing a grievous injury.

At 4.15am, I couldn’t sleep. I was in the hostel room with darkness all around…

[…looking forward to ESR where I’ll play a role in patient management. I hope I get the same (/kind of) co-interns like in EMR.]

Friday, April 17, 2009

The last Laugh

Some people can really get on your nerves. They can be so uncooperative and selfish that you feel like digging a hole in the ground and pushing their heads into it. Worse still, you feel like giving them an injection of rabies virus intracranially.

I was good with them initially. They started taking undue advantage. Now begins the fun. Some people deserve a taste of their own medicine. It’s going to be a nice week ahead, with six of us hell-bent on making their life miserable. Heh heh… you uncivilised asses, you’ve had it.

Don’t trouble trouble, till trouble troubles you.

Monday, April 6, 2009

Few Good Things…

This week in EMS was better than the last.
1. I managed to put an intravenous cannula in almost all patients in one prick. Even in a person who was convulsing.

2. I almost put a central line. Of course I needed help.

3. I managed to avoid needle stick injuries. That reminds me – I’m yet to take my booster for hepatitis B. Shit.

4. I’m lucky I have good co-interns. We divided the work and so that each one of us could sleep for at least an hour every night in the side room of EMS.

5. There was a huge raada in the casualty one night. The next day, there was a fight amongst the interns posted in paediatrics and EPR. Its fun to watch people fight.

6. I learnt (read: memorised) few sentences in Marathi. “Arre gap bas. Ek sui lavaychi aahe.”

7. We agreed to teach a police security guard how to collect blood. In return, he promised to save us in case an angry relative decides to wring our necks. However, the deal didn’t materialise.

8. We learnt how to use the police walkie-talkie. It’s a fun thing.

9. I’ve had at least a kilo of ice-cream this week. EMS is cool!

10. A friend of mine agreed to pole dance on my funeral, whenever it happens. According to her, that will attract at least some people to attend the ritual.