Monday, October 4, 2010

A Piece of Knowledge in A&E

40 years old gentleman known case of diabetes came with breathlessness. Dextrostik showed glucose was 20 mmol/L. He was initially diagnosed as diabetic ketoacidosis until ECG was done and found that he had NSTEMI (click here to read for more info regarding myocardial infarction).

Oxygen was given, sublingual GTN was given....IV morphine plus maxolon... all the emergency treatment was done...but patient restless & suddenly collapsed.

CPR was done, intubation was done & atropine with adrenaline was given but patient succumbed to the illness.

Moral of the Story

1. Myocardial infarction (MI) is a number one killer in Malaysia.

Before this accident I've never seen patient with myocardial infarction died...so I thought that may be most of them died years after having MI...come on Afif, wake up! Be more attentive & observant...another few months to go before becoming HO.
So, here some advice for all of us..watch what you eat, take care of your health... even if you have hypertension, diabetes or previous MI, never & never stop taking care of your health because it is the amanah from ALLAH

2. To all medical students, know your stuffs well before becoming doctor...!!

First & foremost your theory must be good... as our doctors always said the eyes never see what the brain never know, which is 200% true. As in this patient he had no angina pain due to his diabetes...so let us start study ok!
Secondly practice & practice all your clinical works during your study especially when it comes to resuscitation. Because when we, medical students do CPR on that day for me it was terrible especially myself. It was asynchronous & shallow in short it produce irregularly irregular rhythm...which is totally opposite to what the medical assistants did..and never hesitant to learn from anyone including your own patient.

3. A&E can be tiring & full of frustration

So be mentally prepared ok! Always remember that doctors are human..even with the best treatment, only ALLAH can save a soul. For those who aim for A&E specialist...gud luck & may ALLAH bless you.


Hope this entry benefit all of us...

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