My week off.....

It was supposed to be a week off work, doing nothing, just relaxing.....well, that has not been the case. Usually, it would take 3 days to recover from a week night duty to get back to a day routine. Unfortunately, this time I didn't get a chance to recover that quickly as on Wednesday I had to attend basic paediatric life support course, which was a day course, being held at Children University Hospital, Temple Street about half an hour by Luas and a short distance of walking from the nearest Luas station.



It was an intensive course starting from 8am, finished at 6pm. There were about 20 of us from different specialities, whose job involving children, including nurses and doctors from emergency medicine, paediatric medicine, intensive care unit, orthopaedic and anaesthetic. We all were taught how to do a proper basic life support to a child in an emergency situation. Later that day after lunch each one of us had to perform in front of a small group of people, of what we had been taught. Although I deal with this nearly everyday with adult, it was quite nerve wrecking to lead the team when I was being judged and criticised. Overall, I enjoyed it, and I passed the practical test which was done at the end of the course. It was a simple test but I am proud with myself for being able to do it calmly and systematically. One of my principles in life is to enjoy every success, and to learn from each mistake, no matter how small it is. Having passed the test, I am in a better prospect to get a job in Jan 2009.



After the course, I went straight to the gym for nearly 2 hrs and by the time I got back, I was so exhausted that i went to bed early. The next day, thank god, I had the all day for myself, so I went to city centre and had my hair cut.



Friday, yesterday, I had to be at work starting at 8am. I was not supposed to but Samuel asked me to do his shift for a day as he had to go for a driving test. So there I was, got up early in the morning and drove for 1 hr to get there on time. The morning started with 2 hours teaching Session which occurs on friday morning only. Dr. Kelly, one of the AE consultant was there. Irene (a south african doctor), Esosa (a nigerian doctor) were also there. We were taught how to detect fractures or broken bones from xray. For adult, it can be quite easy, but in children, it can be quite tricky, because their bones are still developing, and certain fracture can be easly missed particularly on the hands, wrist or ankles/feet. At the end of the session we were shown by two representatives from a company which produces fibre layered backslab.



There are two common types of material used in AE to stabilise broken limbs before further review by the orthopaedic team. One is plaster of paris which application is quite messy and the other is fiber material which is much easier to apply. During the session we were taught how to apply the material properly.



It was fairly quiet afternoon in AE yesterday. Nothing interesting. One patient, he cut his upper lip after falling. The thing with a cut on the lips, I have to be careful in stitching it, otherwise it will leave a scar that could affect their social lives later. The wound needs to be closed precisely, and the patient needs to be warned about the comestic complications including the scar. With this young man I was quite happy with the result.



The other patient, came in with severe vertigo, which is a sensation that the room spinning around. It was so bad that she could not stand up or walk properly. Poor sod!. In vertigo, first of all we need to determine if there is a peripheral cause which is not that serious, or central cause, which means from the brain, which can be serious and needs urgent attention. With this lady, with previous similar episode and elevated lymphocytes, it seemed she had viral labyrinthitis, inflammation of the inner ear caused by a virus, which is self limiting. Considering the age and the severity i decided that she needed medical admission. Off she went under a medical team.



The last patient I saw yesterday was an elderly guy with non insulin dependent diabetes mellitus (NIDDM) or Diabetes type 2, came in referred by the hospital chiropodist, who is a person who is looking after toes and nails particularly in diabetic patients or in patients with peripheral neuropathy. The patient, apparently had developed peripheral neuropathy or loss of sensation, on his feet. It is quite common for a diabetic patient to have peripheral neuropathy as a late complication. The other complication is foot ulcer because of poor blood circulation. The combination of the two (peripheral neuropathy and foot ulcer) is disastrous. Because of he had loss sensation of the foot, he became less aware of the ulcer on the foot and he kept the pressure on the ulcer which made the ulcer worse. On examination the foot was swollen and red - signs of infection - and there was a small ulcer on the sole just near the big toe. It was oozing with pus, producing foul smelling. According to him, it had been there for 6 month. Just imagine how bad it was! It appeared that he had chronic ulcer with peripheral neuropathy and cellulitis which is infection of skin. I was worried about the bone which also might have been infected (osteomyelitis) and if so it is a serious condition. Regardless, he needed admission...



After work, I was rushing home with a plan to go to the gym and later to have a dinner with a group of friend to say goodbye to Liam who is moving to Australia. When I got back, I was too tired to go to the gym, but I managed to bring myself to the dinner. It was in Tante Zoe's restaurant, an american food restaurant in Temple Bar. It was ok. Nothing spectacular about the meal. Funny enough, Liam who is leaving, who organised the dinner had to leave the table even before the food was serve after he fell ill. We toasted, saying goodbye to Liam without his presence.