Palmo Anest

Selamat Hari Raya Aidilfitri

2008-10-01T12:26:00.003+08:00

Selamat Hari Raya Aidilfitri to all. Maaf, Zahir & Batin.Enjoy your holidays and godspeed for all your trips.

ISA must go!

2008-09-18T13:42:00.003+08:00

(Photo courtesy of the obnoxious 5xmom)On 15th Sept I went to Cathedral of the Holy Spirit for a mass and candlelight vigil dedicated to Justice, Peace and Truth Prevail in Malaysia.In his opening, Fr Fabian quoted opening words of the Vatican II document “THE PASTORAL CONSTITUTION ON THE CHURCH IN THE MODERN WORLD”: “The joys and the hopes, the griefs and the anxieties of the men of this age,

Pssst! That's Guan Eng on economy class!

2008-05-04T00:15:00.004+08:00

I'm sure by now it would have been all over the internet already. Spotted this in RPK's place. Sourced from Mr Manager's blog.It is very humble of him to fly economy. Anyway, KL-Penang is such a short flight no need to waste taxpayers' money on flying business mar. Well, he walks the talk! He's the man!Some comment in Mr Vernon's blog said seen LGE in business glass in 2 occasions. I'll say

Joy to the world!

2008-03-09T03:11:00.001+08:00

Oh ya! That's what I feel.Makkal Sakthi! People's power!Lets built a better Malaysian for ALL ANAK MALAYSIA!

Let's vote for a better MALAYSIA this coming GE2008

2008-03-06T17:29:00.002+08:00

We all BANGSA ANAK MALAYSIA! Go out and vote for our country, Malaysia on 8th March 2008.

Happy Chinese New Year!

2008-02-07T13:44:00.000+08:00

Gong Xi Fa Chai & Happy New Year!

Don’t Jail Doctors Blog Campaign

2008-01-31T22:25:00.000+08:00

Haven't been blogging for very long time. Following Palmdoc's call, I've put up the 'Don't Jail Doctors' banner on the side bar of this blog in support of 'Don’t Jail Doctors Blog Campaign'.Calling all doctor and student bloggers and anyone who can help. The Government has begun to arrest and jail doctors on a technicality - not registering their clinic with the PHFSA. This act treats doctors

Selamat Hari Raya Aidilfitri

2007-10-13T13:34:00.000+08:00

Wishing all especially Muslim friends a Selamat Hari Raya Aidilfitri!

Too good a deal to miss.

2007-09-06T21:55:00.000+08:00

Palmdoc@MMR host a Special Merdeka Palm Treo promotion for Malaysian doctors and medical students!!A Treo 680 for RM1688complete with foc - 1 Car Charger - 1 extra battery - 1 screen protector - 1 GB SD CardQuick! Go and grab it! Log urslef to this MMR post to find out more!Too bad I'd just got myself a replacement TX for my T5. But I got it real cheap from my friend YeapCH.

Fraser's Hill Part 3

2007-09-04T23:40:00.000+08:00

The clock tower and the Post Office on Fraser's Hill town center.My kids enjoy themselves in this back to nature hill retreat. Hope some of you will enjoy this place as well.To anybody interested to know more about Fraser's Hill, these are a few good read on the web:wikitravelwww.journeymalaysia.com Part 1 and Part 2FHDCWWF

Fraser's Hill Part 2

2007-09-04T22:13:00.000+08:00

Ye Old Smoke House. Unfortunately it was fully booked during the weekend.There's another one at Cameron Highlands by the same owner.Might try this place on the next visit.

Fraser's Hill

2007-09-04T20:53:00.000+08:00

Went to Fraser's Hill during the Merdeka weekend. We left home at about 13:15hr on the 30th and arrived at Freser's Hill about 18:00hr.It was a raining all the way after Tg Malim. Kids were comfortable in the car. The only stop we took was at the Tapah R&R.We stayed in Shahzan Inn at the town center. A 3 stars joint, clean but nothing to shout about. This is the view from my room.After a short

Poor quality devices III

2007-05-25T11:08:00.000+08:00

The NEJM posted a complication of central venous catheterization on the 24th May.I almost had a retained guide wire the other day when I was pulling out the guide wire of a triple lumen I inserted on one of my new case during my last call.The outer coiled part of the guide wire detatched from the inner core of the guide wire as I was pulling it out. Luckily I notice the difference and stop

Atypical anaesthetist

2007-05-25T00:56:00.000+08:00

They said anaesthtists have OCD (Obcessive Compulsive Disorder). I always consider myself atypical in this case coz I am much relax and less organised.This is my GA trolly when I started a day.Anfter an emergency paeds surgery, this is how it usually looks like. Messy.Lo and hebold, the other day I met my match! Look at his trolly after an elective case! Welcome to the club! Dr G :) Hope you

Doing some good to the Earth

2007-05-10T23:15:00.000+08:00

There's a lot of Negative energy in the ortho OT yesterday! The ortho surgeons already over worked, post called, was hand picked by their boss to perform a difficult elective trauma case. The wound is bad. The whole process was quite bad so there's a lot of shouting, to the scrub nurses, circulating and MOs and HOs who assisted the surgery.I decided to do some good for our earth to balance up the

Poor quality devices II

2007-05-10T02:08:00.000+08:00

I wrote about poor quality medical supplies we got in MOH's Hospitals nowadays. This is the other products which bugs me all the time.The three ways connectors.So someone decided to change to the above sets reacently. The problems? It doesn't connect well, the luer locks doesn't lock properly so it leaks very offen.So what we did? We complained and someone up there decided to give it a try on

Problem solved - ePOCRATE

2007-05-07T23:13:00.000+08:00

I'm impressed with ePOCRATES support team! Erica from ePOCRATES emailed me the 2nd day after I write to them regarding my problem with the product. I'm impressed, even though I'm using the free version, their response is fast.Here is what she said:I spoke with customer support and they said you most likely have "Scrabbled data". You just need to delete one file, then sync again. The file is

Having problem with epocrates

2007-05-03T14:03:00.000+08:00

I use MedCal and ePocrates very offen during my ICU rounds. Recently, the data in my palm epocrates seems to gone bizarre. This is one of the example:When I look for renal dose of Cefepime, this is what came out:Try using the ePocrates Online, and we got this (the correct data):I wonder anyone else having same kind of problems?Currently, for antibiotic, I'm sticking to ABXGuide.I'm waiting for

It's official

2007-04-24T23:01:00.000+08:00

Today MOHE puplished the final status of all applications to the local uni clinical master programmes on their website.Check out this link below:Glad that I'm going back to my hometown hospital for the next 2 years. Thanks to all of you out there along my paths to this day.God bless and all the best to all who are going for their primary and final exams.Congratulation and all the best to those

WoooooHoooooo!

2007-04-21T20:36:00.000+08:00

I've found the right place for the info i need.For those who apply for UM, USM Postgraduate degree, clik on the images above to check ur application status.Finally I'll be joining UM this coming intake. :)

Life after spine injury

2007-04-12T23:22:00.000+08:00

I had a patient, 50 yr old gentleman. MVA few months ago, cervicle spine fracture at C5 & C6 level. Plating done but still quadriplegia (paralysis of both arms and both legs) and dependent on ventilator (breathing support by a mechine) and minimal inotrope to maintain his BP. He is conscious and alert.A month after his injury. The other hospital which he initially admitted to (in another state)

2007-04-12T21:55:00.000+08:00

On day, in OT reception area.Ortho MO: (on the phone) ....... oh ok, .... thank you.Orothopod Surgeon: (sitting beside) what happen?Ortho MO: bla bla bla... (it's a referal from other dept.)Orthopod: what? ppl refering case to u, u still say thank you ar? I'd have answered 'what? what u want?'... bla bla bla....Few days later inside OR.Orthopod: Lower the table. (nothing happen, no ppk around and

Back from vacation

2007-04-07T23:46:00.000+08:00

Boy, had been very long while since I last make an entry here.Just came back from a short break with my family in Bali. It's a bit of rushing n tiring with the kids tagging along though.Back to EOD call this weekend.All the best for all those who r sitting for comming exam. :)

Happy Chinese New Year!

2007-02-21T14:55:00.000+08:00

Gong Xi Fa Chai! Happy CNY to all.

Looks what's in a 10 months old's throat!

2007-02-16T16:20:00.000+08:00

Recently we have a 10 months old came in with foreign body airway obstruction. This is what we got out from his throut! Gosh...

Who is responsible of getting poor quality device into MOH Hospital?

2007-02-16T15:12:00.000+08:00

Look at this drip set.After pucture the Y-connector a few times, it started to become a 'real drip set'. Drpping and leacking away.And it is supposed to be a Blood Transfusion set! Imagine that!We have made a few complaints to the central store and now they no longer supply us with this inferior product but it still came with the patient from the ward... the fights for better healthcare continue.

Merry Christmas!

2006-12-25T12:42:00.000+08:00

Merry Christmas to all!Have yourself a merry little Christmas,Let your heart be lightFrom now on, our troubles will be out of sightHave yourself a merry little Christmas,Make the Yule-tide gay,From now on, our troubles will be miles awayHere were are as in olden days,Happy golden days of yore.Faithful friends who are dear to usGather near to us once more.Through the years we all will be

Flu Shot

2006-11-27T19:58:00.000+08:00

MOH gives free influenza vaccination to it's staffs. Those who haven't get theirs can check with your hospital pharmacy or sister in-charge of your ward. I found a letter from our pharmacy in the file unattended last few weeks ago and asked our ICU sister to contact our hospital pharmacy. In bolehland, almost nobody will going to give u anything (even if it is their job to do so) if we dun ask

Traditional/ Complementary Medicine in Public Hospital

2006-11-26T17:18:00.000+08:00

Recently MOH called for a meeting in Hospital Kepala Batas (the integrated hospital in the north) to shed more light to us regarding the MOH's vision and it's plan of rolling out T/CM service in public hospital.Coincidentally, Bernard and Malaysia Medical Resources blog about this issue too.MOH is really serious about integrate T/CM into public hospital system and they really want it to work.RMK-

More on AACA2006

2006-11-18T22:42:00.000+08:00

Who is this gentleman?He is Prof Ronald D Miller, the towering man in anaesthesia. I'm sure everybody who r in anaesthesia knows him but probably dun regconise him.He delivered the 1st plenary talk about the future of anaesthesiology in the 12th AACA. The photo below is an endoscopic appendisectomy done by a robot. There is no surgeon and scrub nurses in the OT except the anaesthetist. There are

Challenges in PAIN Management

2006-11-17T23:49:00.000+08:00

Challenges in PAIN Management. This is a seminar on chronic pain organise by Hospital Ipoh and Malaysia Association for the Study of Pain (MASP) which will be held on 8th-10th Dec 2006 in Hospital Ipoh.Click on this link to download the registration form. Closing is on 28/Nov.If I get some locum in the next 2 weeks to cover the rm200 registration and the extra for accomodation, I'll see u guys

AACA 2006 - The Art & Science of Anaesthesialogy

2006-11-10T18:56:00.000+08:00

Just came back from the 12th Asian Australasian Congress of Anaesthesiologists, Singapore.Presented a poster at the conference and the 'kembang moment' was when the editor-in-cheif of Acute Pain invited us to publish the paper in his Journal. Well, it is not a high impact journal like Aesthesia & Analgesia, Anaesthesiology, BJA and Anaesthesia etc because it is only 2nd year in publication. Our

Difficult Airway II

2006-10-23T23:54:00.000+08:00

The other day, while I was running elective list, my colleague running the emergency OT called me. Went out to the reception area to see what's going on... Lo and behold, this is what we have (I have the patient's permission to use his photo as education material). His ThyroMental Distance is only 1 finger breadth. We proceed with caution.We explained to him his risk and also our options if we

Selamat Hari Raya Aidilfitri

2006-10-23T23:39:00.000+08:00

Selamat Menyambut Hari Raya Aidilfitri!Maaf zahir dan batin.

Lets celebrate DeepaRaya!

2006-10-21T23:02:00.000+08:00

Happy Deepavali and Selamat Hari Raya to all!!

2006-10-21T13:23:00.000+08:00

Difficult AirwayRecently we received a distress call from a private maternity centre for help.A young lady going for elective LSCS for a so called big baby. After induction of anaesthesia, she was not intubatable, some problem of ventilation too, SpO2 remained about 80% while they tried repeatedly for almost an hour, manually ventilate the patient.Our team, an anaesthetist, an anaest MO and an O

Master Program

2006-10-19T20:17:00.000+08:00

Have waited for this for a long time. Finally I've been confimed in service thus eligible to apply for my master program.Sent in my application today. It's either make it or break it. If I got it, I'll still stay in service,otherwise it'd be off to private practice next year.No point staying as chronic MO any further if not getting into master program.I like my current job. I like anaesthetic, I

Little Napoleon

2006-10-16T18:40:00.000+08:00

Today I have met our local little napoleon in the hospital. She is our administrative clerk who had been very notorious. I finally got my confirmation in service (Pengesahan dalam jawatn) after completing 5 years of service. (no thanks to the little napoleon, if I didn't went down to Putrajaya last year, untill today still don't know what went wrong). Anyway, that's another story.Since I'm

ACUPUNCTURE IN COMPLEMENTARY MEDICAL PRACTICE - Workshop in KL

2006-08-03T21:44:00.000+08:00

A workshop titled ACUPUNCTURE IN COMPLEMENTARY MEDICAL PRACTICE will be held on 18 - 19 August 2006 (Friday - Saturday)@ The Saujana, KL.It's 9am - 5:30pm for both the days. Registration fee is rm200 for M'sian. Those who are interested can contact Academy of Medicine of Malaysia:Ms Kong,19 Jalan Folly Barat, 50480 Kuala LumpurTel: +603 2093 0100, 2093, 0200Fax: +603 2093 0900Email: acadmed@

Is Dr. Anna Pou and her nurses murderers?

2006-07-28T23:43:00.000+08:00

CNN has this report: 'They pretended they were God'Doctor, 2 nurses allegedly killed patients with lethal drug doseThe alleged killings taking place in the desperate days after hurricane Katrina struck, at New Orleans Memorial Medical Center. Louisiana's Attorney General Charles C. Foti Jr. announcing second-degree murder allegations against Dr. Anna Pou, Lori L. Budo and Cheri Landry.An

In an emergency, where should we go?

2006-07-15T14:21:00.000+08:00

IML asked in her comment for this post:In an emergency, which A&E should one rush to for immediate attention? I.e. a stroke or a heart attack. To the local GH or a private hospital?I thought this should be shared to others too. Let me try to answer this difficult question.IMHO, in an event such like a stroke or heart attack, few things can help us decide which hospital to go to for the benefit of

An article to share with fellow medical friends

2006-07-05T00:55:00.000+08:00

Read this from TSUBASA, share it with those colleagues who understand mandarin.It's about an expirience of a doctor as a patient's family when his mother got admitted. It reminded us about our attitute towards the patient and family.

Private practice II

2006-07-02T01:56:00.000+08:00

Talk about private hospital care again.Don't get me wrong... I'm not against private practice. And I'm not hinting that public health care is any better too.One thing I can't stand when working in private hospital is all patients needed to be cleared by the customer service guys before treatments or investigations is given ecept the very basic life support. Either a deposit, insurance or GL from

So England is going back home...

2006-07-02T01:49:00.000+08:00

Well.. they lost! Bye bye.

Private practice I

2006-07-01T22:19:00.000+08:00

Yesterday I was the same Singaporean own Private Hospital again. I was there locum for it's Emergency Department (ED).At one time, there is a 'kuai-lo' came for URTI, he wish to see a physician. At that moment the physician on-call is actually there in the ED reviewing another patient who I reffer to him for admission earlier. So after he (the physician) is done with the referal case, I spoken

Damn BZ to blog!

2006-06-17T12:18:00.000+08:00

Hey there!It has been very bz at work and at home! 4 of my colleagues left for master at work... At home, Amos had been admitted to Paeds ward for Dengue! Very bz, no time to blog or read blogs... The only blog I still read daily is the MMR.

are we tidak apa?

2006-05-16T16:49:00.000+08:00

I've always regard myself as a laid back, easy going kind of guy. Even 'close one eye' on a lot of the so called regulations. But when it comes to patient safety, there is no way I'm going to tolerate 'tidak apa' attitute.Last saturday when I was oncall, the 1st case in the morning was an exploration and repair of a tendon cut on the forearm due to a deep laceration wound.I explained brachial

US Marine Corps Rules for Gun Fighting Vs Anaesthsia Rules for Engagement

2006-05-16T01:00:00.000+08:00

I have a good laugh on this, I'm sure other anes buddy will too... Read this from 4F Rant. It's a good one!Marine Corps Rules for Gun Fighting:1.Bring a gun. Preferably, bring at least two guns. Bring all of your friends who have guns.2. Anything worth shooting is worth shooting twice. Ammo is cheap. Life is expensive3. Only hits count. The only thing worse than a miss is a slow miss.4. If your

Full load of the Kangoo

2006-05-13T00:07:00.000+08:00

Went to Melaka for MSAASM 2006 in March. Those of u who follows GASMAN's blog may know that we went down together. Both Gasman and I presented a paper there. On our way back, there are 5 of us in the Kangoo. These were the photos taken on our way back after stopping over at Tapah R&R for some fruits... Luckily our boss decided not to follows...

House keeping

2006-05-10T23:49:00.000+08:00

Did some house keeping tonight.1) Due to reason unknown to me and many others, MyKangooClub had been shut down by it's founder and there a new forum setting up by some of the exmembers in MyKangoo Club which the calle it Kangoo Club Malaysia. The forum link at the side bar had been changed accordingly to Kangoo Club Malaysia Community.2) Added to my link.3) Added

DrugDoses (Frank Shann) Update

2006-05-08T23:40:00.000+08:00

I blogged about PDA version of Drug Doses by Frank Shann back in May 2005. They have updated the PDA database recently. This is the email I received the other day: Dear Colleague, We are proud to announce that we have updated our database. You'll find lots of new drugs, corrections, and new informations. All these changes will only appear in the next booklet, that will not be

A near miss encounter

2006-05-07T22:00:00.000+08:00

Cases of near miss happens on and off in both public and private hospitals. Resently I met one, this time my wife is the 'victim'.My wife when to a foreign own private hospital in penang for delivery of our new born kid. Our 1st and 2nd was delivered in public hospital, very good obs care but the nursing care as usual is NOT desirable at all. That is another story, lets go back to this

IRB's e-Filing

2006-05-04T08:50:00.000+08:00

The Star running a story claimed success of the IRB's e-filing system. I welcome the move but had story to tell regarding its implementation.Back in Feb 2006 when the IRB announce to the public the launching of e-filing, they said public can register for the digital cert in their brunch. It is also stated so on IRB's website. I when to the IRB brunch in Bandar Perda, Seberang Prai in Feb twice to

Medical Acupuncture

2006-04-16T18:47:00.000+08:00

Attended a one day Workshop On Medical Acupuncture organised by Penang Medical Practitioners' Society today.Kind of interesting on how much it can help/compliment the 'modern' medical practice. Would like to take a full course of medical acupuncture or even the TCM's acupucture course one day.Did a google search and these are the 2 institute found locally:1. Research Institute Of Medical

Long crazy day

2006-04-13T01:28:00.000+08:00

I was oncall the other day, it was a public holiday. When I arrived in OT at 7:55am, there's already a patient waiting to be pushed into OR for ortho surgery. So I started the case with my post-call colleague passing over in OR and then do a quick ICU passing over rounds with him and the rest of the on-call/post-call team.My OT has been going on and on case after case non stop till about 9:40pm.

House Call

2006-04-09T17:29:00.000+08:00

I'm locuming today. Just attended a house call to certified death of an old lady who had just AOR discharged from a private hospital in town.I wonder what is the going standard of attending house call by local GP nowadays... Any official/unofficial guideline? (will google for it later at home) What's the going rate I or the clinic should charge the party?Any input from our colleague out there is

Lokun-wanna-be

2006-03-30T21:55:00.000+08:00

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

Super fast Palm service

2006-03-22T22:41:00.000+08:00

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 ReportDate Time Location Service Area Checkpoint DetailsMarch 21, 2006 15:14 Singapore - Singapore Shipment picked upMarch 21, 2006 20:06 Singapore - Singapore Departed from DHL facility in Singapore -

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

2006-03-20T22:59:00.000+08:00

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

Annual Scientific Meeting of Anaesthesiology

2006-03-11T12:54:00.000+08:00

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

Surgical Consent

2006-03-11T00:49:00.000+08:00

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.

A morale boost

2006-02-25T11:42:00.000+08:00

Mr F that I bolgged last month Is back to the common general surgical ward and is in a very positive mood and relatively in good shape. Congratulates to all helth care workers who involved in taking care of him! He was transfered back from plastic surgical. The plastic team had done a marvelous job. He last a lower limb, injured his genitalia, losses part of his bowel, losses more then 20kg but

To wear (white coat) or not to wear?

2006-02-24T01:38:00.000+08:00

This white coat thingy has been dragging too long... I blogged about this earlier here and here... Recently MMR also blogged about this issue again.Noted this piece of news tonight: "BMA to doctors: abandon bug-spreading ties". LONDON (Reuters) - Doctors should stop wearing ties and traditional white coats to work because they might be responsible for spreading deadly hospital superbugs,

Kek Lok Shi at night during CNY

2006-02-15T01:05:00.000+08:00

Kek Lok Shi at night. Isn't this a great view?

weirdo

2006-02-14T01:02:00.000+08:00

I was covering a private hospital's emergency dept (ed) few days back. At 5 am in the morning, a 30ish lady came in, ask for antibiotic for her 'going to come' UTI... Well, this lady said she had recurrent UTI before, so she knows that when 'it is coming'. At that time, she had no UTI symptoms yet, on examination there was nothing to suggest any infections going on from head to toe. Urine FEME is

Happy Chinese New Year

2006-01-29T22:48:00.000+08:00

Gong Xi Fa Chai!

Wistleblowing?

2006-01-22T08:20:00.000+08:00

Read this post in Waking Up Costs. In advocating for patient safety, be forceful but not 'disruptive' together with this article 'Is whistleblowing worth it?' from Medical Economics. What would you do if you discovered that conditions at your hospital posed a threat to patient safety? Let's say you reported the problem to your supervisor, and got no response. Would you then go to the hospital's

New Year, new post.

2006-01-19T23:36:00.000+08:00

Well, it has been very long while I didn't post.I think I need to clarify sometime here to do some justice to govt medical service. Those of you who are not 'insider' in medical services might get very anxious as peppermint energy posted here. But I'm not telling the truth and the whole truth...Basically, things that creat much emotional stress that I need to vent out are usually some negative

Update: ICUmath for PalmOS

2006-01-12T01:06:00.000+08:00

This handy PalmOS freeware created by Terry Fagan has been updated on January 7, 2006. Can download from Palmgear at this link.

Finally, online again.

2006-01-06T22:35:00.000+08:00

Hi friends, I've been offline for about 2 weeks since the Christmas. So, Happy New Year to all of u out there.My network card got rosted somehow and my Palm T5 also 'kaputed' so I have no online access till today. Get myself a new network card from PCDepot for rm16. Palm's support is still very good. Called them up, told them the problem and they allow me for a swap, drop my unit at High Point in

Merry Christmas!

2005-12-24T23:50:00.000+08:00

Here to wish everyone a Merry Christmas and a Happy New Year!!!

Sick Attitute

2005-12-18T23:48:00.000+08:00

Doing quite some locum lately. I'm sick of some patients' attitute.Those who come in and tell you what drugs they want (but they don't really have a clue what they are taking). "Give me the yellow colour and the green colour one..."Those who just want a 'quick fix', forget about patient education and following up to this group of patients. (even frequent asthmatic who just want nebuliser and oral

American Vs The rest of the world again???

2005-12-11T01:14:00.000+08:00

Well, I posted earlier that the new resuscitation guideline by both AHA and ERC is out on 28th Nov 2005.As usual, there's some difference in both the guidelines. Let's have a look at the algorithm:For the Adult BLS, the European said: If he is not breathing normally, send someone for help or, if you are on your own, leave the victim and alert the ambulance service; return and start chest

Sugammadex

2005-12-03T23:31:00.000+08:00

In May 2005, Chen, Gasman and I have a short discussion about use of esmeron and suxamethonium in the post I blogged about the new reversal agent of Esmeron (a neuromascular bloking agant): the Org 25969, which is now called Sugammadex. If this Org 25969 gets to the market, we can all dump Sux away and use Esmeron for all the emergency airway right? Wonder how is the cost like?At 5/23/2005 3:21

14th ASEAN Congress of Anaesthesiologist, Hanoi, Vietnam

2005-11-29T22:34:00.000+08:00

"Narrowing the gaps in Anaesthesia" - 23rd - 25th Nov 2005. Hanoi, Veitnam.People there are friendly although english is a problem for them. Most of the educated one knows french but few knows english.We had a good time there. That's the closing night. Malaysian brought them our mini fashion show of the nation at the closing night.I think I've drank more beer in those 4 days then the combination

New 2005 Guidelines for CPR & ECC

2005-11-29T00:59:00.000+08:00

Today, 28th of Nov 2005 is the day that the new guidelines of CPR (Cardiopulmonary Resuscitation) & ECC (Emergemcy Cardiovascula Care) officially published by members of International Liaison Committee on Resuscitation (ILCOR). The AHA (American Heart Association) published it's guidelines in their juornal Circulation. The ERC (European Resuscitation Council) published the european guidelines in

Been bz with my new ride - The Kangoo!

2005-11-19T18:44:00.000+08:00

Haven't been posting for some time. Coz 1st I was bz searching the net to gather info about this new ride of mine, Renault Kangoo. Later after I've gathered enough info, went ahead and bought the car/mpv/van from TC Euro Prai branch. After getting the car I was just all over it.. hahaa... Looking for accessories, waxing the car etc etc... I was looking for a 7 sitter due to my family size getting

Pityriasis Rosea Part II

2005-11-06T23:30:00.000+08:00

I'm no longer spotty as I mention in previous post. The rashes, fading away as they should be. Although study suggest that there is no association with stress but my personal experience told me there might just be! Every post call day the rashes seems more erythematous (redness) the normal day. So I think it does associate with stress (yes anaesthsia call is very high stress). The other possible

One fine day in surgical ward...

2005-11-04T09:47:00.000+08:00

One day, I was doing my pre-medication round for the next day surgical elective list. Eavesdropping over 2 housemen's conversation...New HO: Eh.. the new case BP drop! How ah? Few months old HO: Err.. Issue DIL!I don't really know what's going on in the wards nowadays... The next thing ppl do when a patient collapsed would be calling the anest team. They don't seems to willing to learn how to

Happy DeepaRaya!

2005-11-01T23:15:00.000+08:00

Happy DeepaRaya to all of us! :) As Malaysian, we all celebrate together! Happy Deepavali to Hindus and non-hindus.Selamat Hari Raya to Muslims and non-muslims.And for all of us who had to do EOD calls and hold the fort while our friends balik kampung to celebrate, all the best and God bless.Cheers!

Part 2 from yesterday...

2005-11-01T17:46:00.000+08:00

Cont. from last post...We brought the pt up to OT, I can assured everybody that we did give our best for him on the table (started at 6:45am), trying hard to maintain his vital, Struggled for 2 hrs in OT. Surgeons finally complete their task but my pt finally past away in ICU 1hr post operatively. I have pitty this pt for we acted late, missed the diagnosis in A&E level. If someone notice or even

Stop disgrace us in the service... buckle up your act!

2005-10-30T23:10:00.000+08:00

[sorry for the long rambling..]When we the government doctors complaining about our over work, under paid working condition... There are certainly some of us in the fold really don't deserve any pay raise... They can continue to endure in their slackiness instead.This is not new, it happens very frequently... hope the local A&E ppl notice and change... a big hope.. Have seen many A&E MOs comes

2005-10-30T01:07:00.000+08:00

Please tell the whole truth, not just the truth...Few days ago in CCU...A 70+ years old gentleman, known case of 1st degree heart block with Ischemic Heart Disease admitted from A&E (Department of Accident & Emergency) for MI (heart attack).On arrival to CCU, patient was found Asystole (heart no longer pumping) secondary to complete heart block, CPR (Cardiopulmonary Resuscitation) and ACLS (

Puasa month associated injury

2005-10-17T23:38:00.000+08:00

Well, it's Rhamadan again and wish all my muslim friends selamat berpuasa.Today, I'll present to you what I called Puasa month associated injury. Every year, we'd seen this type of injury during puasa month over and over again. Yesterday, we had 2 such cases in back to back.Crush injury of hands by sugar cane machine.Many peoples are making extra money during the Rhamadan by selling foods in

Where is my on call allowences?

2005-10-15T23:31:00.000+08:00

My friend GASMAN wrote about empty promises by the Malaysian Government back in July 2005 to it's doctors in public service.Months passed by since then, and we have a confirmation that the call claims are indeed increased to the new rate. I've received my June call claims. But that's all I've got so far. It is already mid Oct 2005 and I haven't been getting my on call allowences of July, August

I became Spotty! (Pityriasis Rosea)

2005-10-14T01:10:00.000+08:00

Damn! Lots of rashes and lots of scratching before I finally get the diagnosis right...More then a week or so ago, I suddenly developed few rashes on my body. These later become more and more serious. the 1st 2 days it looks like some eczema (I do have sensitive skin that easily developed rashes), so I didn't really bother about it. One fine day when I was oncall, it suddenly became full blown!

Clowning around in OT

2005-10-08T22:39:00.000+08:00

In BBC News lately, An Italian study shows having clowns in the operating room can ease anxiety - at least among child patients.Clowns from the Theodora Foundation are active in 89 hospitals around the world, including eight in the UK.These Patch Adam wannabe is said been successfully distracted children aged five to 12 years while they were put under anaesthesia for surgery.Distraction helps,

Anesthesia can give rise to sex illusion

2005-10-08T21:49:00.000+08:00

We heard about this bizzare but real phenomenon, but has anyone experienced it or their patients experienced it locally? I did my litle 'research'...I asked my patients did they dream when they are under anaesthesia? When they are in light anaesthesia for procedures like ERPOC etc which I use Propofol for induction and sometimes the only agent without inhalation gas as in TIVA. Most of this

Master programmes open for registration now

2005-10-07T19:35:00.000+08:00

Local U's master programmes open for application now. Wish all the best to all the would be candidates.Click here for online application.

What do I get from Budget 2006?

2005-10-02T14:25:00.000+08:00

Well, I was on call on the Budget day. The radio in my Operation Room (OR) tune into budget speach at 15:30hr. Everyone, including the patient on table was listening and anticipating goodies from Pak Lah. Looking at our current economy status, I personally think that the small goodies that we are receiving is 'good enough'. Although of coz there will never be enough when it comes to goodies...

14th ASEAN Congress of Anaesthesiologist

2005-09-30T01:19:00.000+08:00

Yesterday I officially registered for the 14th ACA which will be held in Hanoi, Vietnam. This will cost me a boomshell if my Hospital doesn't approve my application for subsidise.Looking forward to go there for this eye opening experience. This will be my 1st regional congress. Before this all the conference and congress I attended were national levels. What is more excited is all the 3 papers we

Laparotomy day

2005-09-22T18:15:00.000+08:00

Was on call yesterday. Very bad day indeed. Early in the morning at 8am soon after taking over from post call colleagues, we have the 1st emergency, A young lady with 2 previous LSCS 36 weeks pregnancy. Coming in for bleeding placenta previa type 4 accreta.She bleds ~4000ml of blood intra operatively. Was in DIVC, we ventilate her in ICU post op but able to correct her DIVC very soon with

Kedah Govt Hospitals To Set Up Complaints Bureau - Another knee jerk raction??

2005-09-20T23:21:00.000+08:00

Kedah Govt Hospitals To Set Up Complaints Bureau.I'm glad that Kedah Health Department has finally being serious about the public complaints. this was reported by Bernama in this report.Kedah Deputy Director of Health Dr Hasnah Ismail said: "We will try to solve any complaints of cases or problems faced by customers and patients within three days and if we fail to do so, customers can make public

Simply rambling...

2005-09-20T22:44:00.000+08:00

The other day, Uncle Lim bloged: "...that the national integrity campaign launched by Pak Lah is being used to waste more public funds, making a complete mockery of the national integrity plan with no impact whatsoever in creating a new culture of zero-tolerance for corruption in the public service." Indeed, can anyone help me to recall any campaign launch by BN which is a real success and have a

2 singaporean doctors

2005-09-20T00:11:00.000+08:00

Added two Singaporean doctors' blogs into my link.Angry Doctor and A Doc's Life.Enjoy and Happy reading!

Airway emergency

2005-09-15T20:26:00.000+08:00

The other day my friend Chen had a Bleeding day in their OT, today, I have an airway day. 1st of all, the Capnograph not working on our philip monitor, had to change to an old side stream capnograph.I'm running Dental/Maxillofacial OT. My 1st patient is an obese lady with BMI of 40. Well, I was anticipating some problem but it was a smooth take off and landing (induction and extubation). I've

National Health Financing Scheme (NHFS)

2005-09-06T21:11:00.000+08:00

How much do you guys/gals know about this NHFS thingy which suppose to take over the current health financing scheme (which is just minimal token fees in the government clinics/hospitals for all Malaysian) from year 2006? A major change which will affact almost all Malaysian.Untill now, Sept. 2005, we are all still in the dark. There are a few articles regarding this which may shown some light:

Great help for Penang Bridge user - Live cam feeding.

2005-09-06T17:57:00.000+08:00

Well, while I was browsing thru Malaysian Medical Blog Aggregator, I went to Dr. Liew's blog, and after a few links, came across this on mybabybay.com. Wow, I think it's a great discovery and sharing of resources. I wouldn't have gone to UEM's website to search for the cam feed (both still and vedio feeds) if not because of this post. :) Thank you, whoever you are for the pointer.

New fans?

2005-09-05T00:14:00.000+08:00

There has been quite a number of spams in the comments lately.. Just received this one:" Hi, you have a great blog here! I'm definitely going to bookmark you!"Wah.. I thought I've got a fan! But wait a minute! Here's how it goes..."I have a make money online site/blog. It pretty much covers make money online related stuff.Come and check it out if you get time :-) "Aiks... it's a spam!! Damn!I'm

1st Call of the month.

2005-09-04T22:21:00.000+08:00

I was oncall on the 3rd of Sept. This is the 1st time in 2-3 months that I actually see empty beds (2 of it!) in our 7 beds ICU. However after my colleague passing to me, I know it was not as relieving as it seems to be. We have 3 very very ill patients in the ICU which is enough to torture me till next morning. One of the patient, Mr. T an old man who had just transfered into our ICU erly in the