First day as HO

Most likely you will arrive the allocated ward about 10 am, because you would need to report duty at department office at 8 am, and would be given some briefing. By the time you arrive the ward, it could be ward round still ongoing / finished.

Hence here are some small KPI that could be achieved during 1st day:
1. Introduce yourself to the
- Ward specialist(s) and consultant(s)
- Ward MOs
- Ward sister (wearing light blue attire, not dark blue attire - Matron). Most likely the ward Sister will do some ward orientation.
- Ward SNs
- Other HOs in the ward

(these are all the important people you will work with for the subsequent 4 months)

👉 I me, I would approach the ward specialist / ward Sister first

2. Understanding the layout of the ward:
- How many cubicles? Which one is stable cubicle / subacute cubicle / acute cubicle / isolation room?
- Toilet for patient? Toilet for staff?
- Pantry
- Where to put your belongings?
- Where and how to arrange patient's files?
- How many files one patient will have? (e.g. case notes, investigations, observation, medications)

3. Clerking at least 1 new case
- Follow your senior clerking 1 new case, take note what are the essential information required. If there are more patients later, you can start clerking (with guidance from senior)

4. Doing some basic procedures
- After observing 1 - 2 patients on how blood is taken, and how branula is set, you must attempt on your own on other patients (you are no longer a medical student!)
- You should ask about the commonly used specimen containers for: FBC, LFT, RP, Coag profile, Random blood sugar, therapeutic drug monitoring, ESR, CRP, blood gas, lactate, troponin etc. (it would be the best if your hospital has a list of blood specimen and their respective containers)

5. Others
- Observe how your senior colleagues refer cases (how to get the number, and how to present case)
- How to fill in lab form
- How to fill in GSH form & request GXM
- How to fill in X ray form
- How to fill in prescription slip (inpatient, outpatient)
- How to do discharge
- How to do AM review, PM review, transfer in review
- If your hospital is fully computerised: at least know how to put entry, how to order medication, how to order investigation

6. O&G
If you are in the labour room, PAC, or EPAU the first day, there would be more hands-on things to do e.g. speculum examination, vaginal examination, conducting deliveries, episiotomy, placenta delivery, postnatal review etc. (it could be overwhelming especially the first day because the expectation is high and people are shouting a lot inside) 😂

Most likely your leader will assign you exactly where (which cubicle) to tag starting from the following days or on the first day itself. So before you go back, have a look at the cases, so you can prepare better for yourself the next day.

***Above are just some little tips from me, a former HO. If you can fulfill the checklist above, then you are done for the day.

Time flies. 2 years ago I had just started my HOship 😂

#HO
@nota_perubatan

FINAL CALL for Advance HO Induction tomorrow!

This is the last session of the year,
join #early after graduation & you can join again & again the live session to practice HO task;

👉🏻 clerk & review patients
👉🏻 formulate plan of managemen
👉🏻 referral & request scan
👉🏻 preparing discharge summary

Register here; https://medicorp.onpay.my

Apa beza LITE Advance HO Induction (RM 126) versus FULL Advance HO Induction (RM 249)?

FULL advance participants will get 2 year access to ECG & Medical Emergencies pre-record modules 👍

Enthusiastic participants from Clinical Skills #Workshop today!

Patutnya program habis pukul 8pm, tapi semua semangat nak practice banyak kali sebab masing-masing dah dapat hospital placement.

All the best for HOship soon 👍

Apa beza GSH vs GXM?

GSH if you anticipate bleeding, but you do not need blood product for transfusion yet. So you just send a blood sample.

GXM if you need the blood product for transfusion now (ie patient is bleeding, or during ongoing surgery).
.

You can convert GSH to GXM if patient is bleeding & get the blood product faster.

For this particular hosp, the GSH is keep available for 24 hours. Some hosp keep it available (for conversion to GXM) for a longer period of 2-3 days; you can ask your blood bank about this 👍🏻

Further reading on this;
https://t.me/nota_perubatan/764

Tak pasti nak start #study topic apa lepas grad untuk prepare for HOship?

Macam banyak je list of compulsory topics dalam logbook HO ni 😅, nak fokus yang mana dulu? 🤔

👇👇👇👇

Shortlist of common disease & emergencies you need to as HO;

👉🏻 All posting (esp medicine, surgical & ortho)

- hypertensive urgency & emergency
- hyper & hypoglycaemia
- hyper & hypokalaemia
- fluid resuscitation in unstable/patient with shock

👉🏻 medicine; AEBA (asthma), COPD, dengue, ACS

👉🏻 surgery; acute abdomen (appendicitis, choledocholithiasis, PGU), sepsis, UGIB, LGIB

👉🏻 ortho; open fracture, DFU, fat embolism, compartment sindrom

👉🏻 O&G; intarpartum management & complications (1st, 2nd & 3rd phase of labour), GDM, PIH

👉🏻 gen paeds; AEBA, dengue, AGE, febrile fit

👉🏻 neonatology; NNJ, neonatal sepsis, IDM & hypoglycaemia, respiratory distress in newborn

Reference; any book you already have, yang penting baca 😂
.

Kalau rasa2 nervous sgt tak masuk dah kalau baca buku, atau nak input baru,

bolehla tengok online course Medicorp ❤️, insyaAllah lebih mudah faham & ingat sebab MO/ specialist yg explain & ada case discussion sekali.

Semua video team dah edit pendek2, jadi mudah nak tengok trus specific topic 👍
.

Alhamdulillah ramai senior HOs bagi feedback online course ni membantu mereka utk prepare & pass both off offtag & end of posting assessment 👍🏻


Boleh tengok more info here; https://medicorp.onpay.my/order/form/3in1combo

Senang kan boleh study tanpa buka buku 😆, lebih mudah faham & ingat sebab tengok video + slides yg MO & specialist explain 👍🏻

How to intubate patients?

https://m.facebook.com/story.php?story_fbid=3439008259450758&id=100000248545939&sfnsn=mo

One of the most important traits for any clinician, esp new HOs - is resilience.

Let’s learn from the expert tomorrow night!

https://academy.locumnet.com.my/resilience-live-webinar-by-dr-rostam

Nota Perubatan
After some time I've been working with HOs, I realized few of them were not able to complete the offtag assessment because they are still lacking of some basic knowledge. Hence, the specialist gave them another date for re-assessment.

Some of the important questions / basic knowledge (especially for internal medicine):
1. ECG: inferior MI, anterior MI, lateral MI, anterolateral MI, reciprocal changes of ECG in MI

2. ACS
- Medications for ACS (including doses)
- How to classify ACS?

3. DKA
- Criteria (must know the exact value / cutoff point for each)
- Principle of management - what to start

4. Hypo & hyperkalaemia
- ECG changes for each
- Definition for each
- Treatment for each
- Formula for calculation of potassium deficit (during assessment, you can only use a simple calculator 😂)

5. Hypoglycaemia
- Definition
- Treatment

6. Dengue
- Warning signs
- Features of compensated shock VS decompensated shock
- How to monitor dengue? (haemodynamic and what blood parameters?)

7. Tension pneumothorax
- Clinical finding (chest examination)
- CXR of tension pneumothorax
- Treatment

Others
- If you are HO in the ward, patient complaining of chest pain / SOB, what would you do?

#GIM
@nota_perubatan
https://t.me/nota_perubatan/774

Spot diagnosis. What is this?

What you should do as HO when you encounter this?

#quiz-HOmustknow

Semalam, saya sempat follow up HOs yg baru start tagging last week (intake Bil 5/2022).

Jom tengok apa feedback diaorang lepas start #tagging beberapa hari;

👇👇👇👇

1st day as taggers dah kena buat ward work, procedures semua💉

So tagging bukan masa utk #shadow senior HOs atau tengok2 saja ya. Jadi sebelum start HO, dah kena ambil tahu & practice macam mana nak buat semua ward work & procedures ni semua 💪🏼