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Showing posts with the label Random

ER Diaries: Horny Patient

Hey all, Sharing a Rather funny incident today!  A 20 something girl walked into the ER with 45 something man . Both seemed healthy and fit. I enquired who the patient was.She asked me if Gynaecologist was available. I was replied No, am an ER physician. Tell me your problem . May be I can help you with it if it’s acute ? You won't find a Gynaecologist at this hour. She starts, See I have itchy vagina. For a few days now. I enquired about the discharge,  Odour ,Blood and all. All had a negative answer .Meanwhile the man looked like a father figure to her , but you never know . So I asked her who he was. She was burping out anything and everything without hesitation which is VERY RARE irrespective of your race and nationality, whatever be your religion or culture to talk about your personal details in your parents presence. She continues Whenever I itch I am feeling horny. I thought I heard it wrong, I asked her twice , thrice . HORNY she says loudly.  Um

ER Diaries : Being a Zombie doc!

Hey people! I talk about Emergency medicine and my life around it much, and that’s on purpose. Here’s why :  My life is wonderful. I really love it. Is it perfect? No. Is anyone’s life perfect? Definitely not. I would never wish to portray my life in a negative fashion and certainly not to wish for sympathy. I would talk about it in an informative way, but even doing that, to be comprehensive, you must hit the low points because all careers have them, and again, just doing that can come off as complaining. I always end up thinking. I’m exhausted physically. All I have had to eat is a protein bar on my one washroom break in the middle of a 12hour shift .and sometimes not even that. And sometimes partied like crazy. The concoction of being hungry like a pauper or partying like a king makes it all worth living! I haven’t had quality sleep in days, and I feel like no matter what time I leave the hospital, I have left work undone. I miss feeling normal. No matter

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

ER Diaries : Managing First Arrhythmia

Hey people The case was amazing. It must be a normal presentation for SVT but the first time I got to manage. Around 60/F kco HTn on treatment came with complains of chest discomfort  since morning associated with palpitations , blurring of vision , headache .  I thought MI first . Asked her to repeat the history and tried asking her chest pain hai Kya . She still insisted its chest discomfort . I asked the staff for BP and ECG . While I connected her to the monitor .  The heart rate was 210 ! Spo2 was 93. Ecg showed SVT pattern . BP was not recordable . Shifted her to priority area . Connected fluid ( later realised that it was unnecessary ). Sent the ecg to cardiologist . He came down. We were doing vagal manoeuvre and adenosine. He came n told to give 100 J synchronised shock . ( tab yaad aaya ! Arey warning signs🤦‍♀️ shock directly) sedated gave shock. She said aah 😅. (sedation didnt act even after 2 min I guess ). ACLS guides you to sedate but doesn’t teach you t

ER Diaries : Why Emergency Medicine

Hey all! The most impatient Doctor speaking up! Confessing ! Why Emergency Medicine ? For a person who wants hand on everything , a person who can’t choose a best friend among a group of friends , a person who can’t pick a favourite cuisine instead wishes to have it all!  I just couldn’t have asked for a better place. I love dynamic things! I love the way things in emergency come to conclusion , like you treat / stabilise / just send him home ( live / dead ). I love the way the heart restarts for every shot of adrenaline! I love the way the Glasgow Coma Scale improves . I love the way entire team works endlessly turn by turn to resuscitate . I like going h ome tired , unaware of the surroundings , only to hit the sac. People often asked me which specialty you liked the most ... medicine / surgery / gynaecology ? I would respond all of them but only on the duty days (Emergency Days). I hated the way physicians wait for weeks together for medic

ER Diaries : Emergency Medicine

Emergency medicine plays the most important part in caring for the acutely ill and injured patients. Also it is surrounded by so much drama, tragedy, and media interest The department and specialty are a rich subject for debates and criticism . The initial assessment and early treatment in resuscitation, trauma, medical and paediatric emergency will remain the “core” role of the ER physician. What will be the changes to our specialty in the next 10–15 years? Demands will continue to increase. There will be more patients, with more serious illness and higher expectations. There is an emerging vacuum in acute care and it is for our specialty to choose paths to develop. We should start to identify some specific gaps in training and perhaps to restructure training programmes to ensure the necessary skills are obtained. So far so much

ER Diaries : Falling sick

Hey all It's when you're sick you realise , you are important . The one who needs your attention the most is yourself.There were days when I thought about career , people but now I only think about the body I plan to live in till the end of my life.  It’s then when you realise you need your time , you want the time to slow down a bit so that you can heal your tired body. It’s then you realise you need care and attention from your loved ones. You know it’s viral fever , you know it will have its own course , you know it’s benign ... still you seek some empathy and attention. That’s human . That’s us . So far so much