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Showing posts from April, 2018

ER diaries : Facepalms- Hemodialysis

Heyyyya! There was this 60yr old man . Fever  cough and weight loss history  On hemodialysis history I ask him routine questions... Fever  ? Cough   ? Intermittent ? Body pains  ? Chest pain ? difficulty in breathing  ? Urine me jalan hai kya ? N he is like  Madam , main dialysis pe hu... merko urine Nai aata ! I was in this awkward face palm situation blabbering senselessly like a pet parrot! This made me feel like a fool to be honest. I rush home zero down to hemodialysis . Read about it like it’s the last day on the planet and if I don’t read it today. The death angel will take me nowhere but hell! Because the patients on hemodialysis constituted good number of cases reporting tonER in pulmonary edema and altered sensorium. The only thing that would give respite to them was hemodialysis. Rest all was temporary management. Read about how important asking about fistula is !  It’s like a second heart frankly. You don’t touch it . Yo

ER Diaries : Accidentally finding a Murmur

 Hey all! It’s strange but I find myself in midst of situational comedy most of the time . Here is another funny instance. I examine a patient. Report the findings to my senior to  - Sir , There is a sound net apical lobe. It’s neither a crepitus nor a wheeze. He turned around as asked , what do you think it is? Puzzled , I said , pata nai aisa sound suni nai 😂 kabhi. He asked me to examine again. I did the same . Told the same findings. Are you sure it’s from the lungs? Yes , apical lobe . Sure? He laughed and said. That’s a murmur ! My reaction 🤦‍♀️ What the mind doesn’t know, an ear doesn’t hear.  So far so much

ER Diaries : Hepatitis B cover

Serious stuff Note: Such incidents are a common thing for people from Day 1 of your housejob. You never know what threat you’d be exposed to. Our condition to be honest is worse than soldiers. Soldiers atleast know that they’d die on war . A bomb is expected at the border or a bullet on field. They die an instant death . We are just unaware! Somebody may just knock your door one fine day stating look my mother is really sick , help me out . It’s an emergency. You roll over your sleeves . Manage the case . Only to find the reports stating positivity to viral markers. Better keep yourself vaccinated to hepatitis B atleast . Hep C and HIV we just can’t help! A similar episode happened . An ERPhysician from another hospital walked in to inform us that he was leading an ambulance. A patient is supposed to arrive. He had done CPR on insistence of the family. He was having his meal when the call for help came. He just had to leave everything and go. His resuscitation attempts faile

ER Diaries : Sleeping pills overdose

hey all! Like a blue moon or eclipse I appear . Tell a tale and disappear . Today’s discussion is about the little dilemma book VS practice. Around 60 year old lady presented to ER in a drowsy state . Alleged h/o consumption of 10 tabs of 0.5 Alprazolam and 10 tabs of 500mg PCM 1.5hr back. No Vomiting / seizure / frothing/ sweating/ palpitation/ or any incontinence . KCO DM HTN CAD Depression Hemodynamically stable Patient drowsy  yet aggressive pupils 2mm RL+ Power 5/5 Lungs clear Abdomen soft B.S.+ MLC was registered Treatment wise  Pantoprazole Ondasetron  And Gastric Lavage was done They had affordability issues , they took the patient away. So the twist of the tale was OHEM says no gastric lavage for Benzodiazepines as it’s not fatal except for elderly and COPD cases . Only supportive management. Since pCM was 5g n she was elderly . ( mixed poisoning) It was not a blunder. But the consultants do gastric lavage for benzodiazepines. What t