Epocrates Online

Thursday, March 30, 2006

Lokun-wanna-be

The Star reported that all the 1,800 PSC medical scholarship hopefuls will now undergo a mandatory three-day course at hospitals, including visits to the mortuary and operating theatre.

Yesterday, 3 such groups came to my OT. Some of them are extra enthu, stayed till 9pm to watch the op done in oT. I openly invite them to tag with any of the house officer to really get a hang of what's going on in real life. None do so.

I dun think whatever we said now will deter these students from taking medicine. They are all ‘berkobar-kobar’ (burning), want to be a doctor.

One of my colleague told me he heard from someone who ask why are the doctors trying to deter us from taking medicine? Why are we trying to scared them away? (to protect them or ourself?) I don't think we really wants to stop all of them from doing medicine.

We just wants them to know the reality. It is a tough life ahead. I just wish I can show them enough reality of life as a doctor in m’sia context esp. in govt settings (3 days is not enough but it’s a good start). Try arrange them in smaller groups and ask them to tag EOD next time, please.

Today I'm not in OT but I heard some negative comments from my colleague regarding these lokun-wanna-be. I hope they will change their attitutes other wise their life will be very very tough ahead even if they are not a doctor later.

For those already know what’s the hardship ahead of them and still choose to persuit medicine, I wish them all the best.

Wednesday, March 22, 2006

Super fast Palm service

I sent my Palm T5 back for service and I'm so glad that Palm's service is still supper fast.

Here's the tracing of the Palm from DHL's site:

Detailed Report

Date Time Location Service Area Checkpoint Details
March 21, 2006 15:14 Singapore - Singapore Shipment picked up

March 21, 2006 20:06 Singapore - Singapore Departed from DHL facility in Singapore - Singapore

March 21, 2006 20:42 Singapore - Hub - Singapore Arrived at DHL facility in Singapore - Hub - Singapore

March 21, 2006 21:26 Singapore - Hub - Singapore Departed from DHL facility in Singapore - Hub - Singapore

March 22, 2006 02:13 Hong Kong - Hub - Hong Kong Arrived at DHL facility in Hong Kong - Hub - Hong Kong

March 22, 2006 09:00 Penang - Malaysia Processed for clearance at Penang - Malaysia

March 22, 2006 12:15 Penang - Malaysia Arrived at DHL Facility

March 22, 2006 13:05 Penang - Malaysia With delivery courier

March 22, 2006 13:21 Penang - Malaysia Departed from DHL facility in Penang - Malaysia

March 22, 2006 14:55 Penang - Malaysia Shipment delivered


I sent it in at 14:10 21/3/06 and I get my replacement on 15:00 22/3/06!

Monday, March 20, 2006

How to tell if you are a Medical or Surgical patient?

Heard this joke from an Australian anaesthetist in the MSAASM 2006:-

In a paediatric ward, there are two patient in a room. One is a Surgical patient and another Medical patient.

The Medical patient ask: what is this medical and surgical patient thingy? How do u tell who is surgical and who is medical?

Surgical patient: It's easy... If u are sick, admitted to the hospital and your doctor make u well, u r Medical. But is u were well but admitted to the hospital and ur doctor did something to u that make u feel sick, u r Surgical!

Cheers!

Saturday, March 11, 2006

Annual Scientific Meeting of Anaesthesiology




Going to Melaka Next week.
Any friends here going to the MSAASM too?

Surgical Consent

I wonder how does this done in other hospital.

In my hospital, it is usually done by the house officer who sometimes have no clue what the said surgical procedure is or how it is suppose to be done and also the risk involved.

The usual way a house officer takes the consent is like e.g.:

HO: Pakcik, besok nak operate kan?

Pakcik: Ya kot...

HO: Sign sini pakcik, untuk operation.

(Consent taken from patient)

When the anest doc does his/her premed round, if he is a lil chatty, the patient will starts asking a lot of questions that the surgical team would have answered to the patient's satisfaction in the first place...

We have an incident recently.

A 18 y.o. young man was admitted for appendisectomy. The consent was taken from the 'sister' of the patient. The surgical went on with some complication, the patient had to be admitted to ICU for post op care.

In the ICU, patient's family is very furious, not about the complication, but the said 'patient's sister' was actually not their family member! Although the patient and the lady who sign the consent had lead the HO to believe that she is the sister, it is still very important that the HO knows for a fact that the patient being a 18 y.o. adult, should sign for his own consent.

We have been bring up the issues of surgical consent to respective head of different surgical base units for as long as i can remember but it was never really taken seriously.

HO who made a mistake comes and goes. The issues remain years after years. I think it is an important issue to be discussed in the new HO's induction course rather then keep stressing on how to dress and what to dress and some other nonsense they are imposing in the current induction.

Guess what is the usual knee-jerk-reaction of the bosses whenever there is a mistake done by the lower ranking officer? Simple, strike it off. If HO make a mistake, HO cannot perform the said procedure anymore without MO's supervision. When a ward nurse made a mistake, they too don't have to perform the task anymore, call the HO for the said task... Bottom line is, don't create issues... then the bosses can have good life sitting on top of the food chain.

I have seen a senior consultant taking a very detail consent from the patient and the fortunate MOs can really learn and felt shameful of how a proper consent supposed to be taken.

That reminded me that very soon, we in m'sia public hospital would needs to take a separate written anaesthetic consent in detail from every patient coming in for surgery. That would add another 10-15 minutes to every patient when we do our premed rounds.

counter create hit