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More #excellentHOs at Medicorp's blood taking, branula insertion & blood C+S #workshop today 🥰
Yes we had fun learning & practicing together ✅
Yes we had fun learning & practicing together ✅
#Eventful day at labour room,
But alhamdulillah tolerable sebab HO semua #function ✅
.
‼️ cord prolapse - pushed for EMLSCS
❗ Fetal distress, secondary #arrest - had to open up 2nd EMOT for EMLSCS 😅
❗cord round neck during SVD
.
‼️ Prolonged second stage due to poor maternal effort, delivered by #vacuum but baby not vigarous, attended stat by Paeds MO, alhamdulillah AS 6 at 1 mins, 9 at 5 mins
.
‼️ shoulder #stuck for 1 mins, delivered after suprapubic pressure & McRobert.
Baby 3.8kg, thank God good Apgar, Moro complete B/L 🤲
.
❗PPH due to uterine atony, EBL 1 litre, mother & baby well
.
Alhamdulillah all is well with good team work 💪
.
#HOnowadays #excellentHOs
#WardSimulation & yes, we simulated all these situations in less than 5 hours at Medicorp's Clinical Skills workshop today 🌟
But alhamdulillah tolerable sebab HO semua #function ✅
.
‼️ cord prolapse - pushed for EMLSCS
❗ Fetal distress, secondary #arrest - had to open up 2nd EMOT for EMLSCS 😅
❗cord round neck during SVD
.
‼️ Prolonged second stage due to poor maternal effort, delivered by #vacuum but baby not vigarous, attended stat by Paeds MO, alhamdulillah AS 6 at 1 mins, 9 at 5 mins
.
‼️ shoulder #stuck for 1 mins, delivered after suprapubic pressure & McRobert.
Baby 3.8kg, thank God good Apgar, Moro complete B/L 🤲
.
❗PPH due to uterine atony, EBL 1 litre, mother & baby well
.
Alhamdulillah all is well with good team work 💪
.
#HOnowadays #excellentHOs
#WardSimulation & yes, we simulated all these situations in less than 5 hours at Medicorp's Clinical Skills workshop today 🌟
“Sorry, I dah try poke patient ni dua kali untuk blood C&S, tapi tak dapat. Boleh tolong tak?” 🥹
.
Saya macam nak #menangis dah bila minta tolong senior HO waktu tu!
Joblist lepas round pagi tadi pun banyak lagi nak settlekan,
& semua senior HOs busy sebab ward kami #active ie receiving admission hari tu.
.
Saya yg baru tagging few days ni, first poster pulak tu, terkulat-kulatla try nak ambil blood C&S sendiri for the first time (dah observe senior HO sebelum ni), tapi tak dapat-dapat.
.
#Stress betul! Rasa hopeless sangat sebab tengok senior HO buat sebelum ni nampak senang je, kenapa kita buat tak dapat pulak?
.
“Owh, patient bed 12 yang ada underlying CA (cancer) tu ya?
Patient yg ada CA, memang vein susah nak nampak & very difficult blood taking. Takpe jom I tolong tengokkan” rilek je senior HO tu jawab 😅
.
Saya macam nak #menangis dah bila minta tolong senior HO waktu tu!
Joblist lepas round pagi tadi pun banyak lagi nak settlekan,
& semua senior HOs busy sebab ward kami #active ie receiving admission hari tu.
.
Saya yg baru tagging few days ni, first poster pulak tu, terkulat-kulatla try nak ambil blood C&S sendiri for the first time (dah observe senior HO sebelum ni), tapi tak dapat-dapat.
.
#Stress betul! Rasa hopeless sangat sebab tengok senior HO buat sebelum ni nampak senang je, kenapa kita buat tak dapat pulak?
.
“Owh, patient bed 12 yang ada underlying CA (cancer) tu ya?
Patient yg ada CA, memang vein susah nak nampak & very difficult blood taking. Takpe jom I tolong tengokkan” rilek je senior HO tu jawab 😅
Owh memang #difficult venous access ya! Patutla tak dapat 😅
.
Lagipun memang tak berapa pandai sangat pun ambil darah waktu tu, sebab baru je start HO beberapa hari 😷
.
Alhamdulillah, tak down sangat lepas dah tahu memang ada pesakit yg kita anticipate difficult venous access;
.
Lagipun memang tak berapa pandai sangat pun ambil darah waktu tu, sebab baru je start HO beberapa hari 😷
.
Alhamdulillah, tak down sangat lepas dah tahu memang ada pesakit yg kita anticipate difficult venous access;
💉obese/#edematous patients (fluid overload, severe hypoproteinemia, long intubated & sedated patients esp in HDU/ICU)
.
💉cancer patients, especially those who has started #chemotherapy
.
- patients with #CKD ie chronic kidney diseases (be careful, most of them need to spare their left arm for AVF, so can try blood taking & branula at right arm only)
.
- patient with history of intravenous drug user (#IVDU).
.
So kalau kita HO baru, bila encounter patients macam ni, lebih baik minta #tolong senior HOs untuk ambilkan darah & ajarkan macam mana nak locate & detect vein patient tu.
Sebab kalau kita yg baru ni try jugak sendiri, chances nak dapat tu rendah, patients akan #sakit & kita end up bumpkan vein yg ada, jadi nanti orang lain akan lagi susah nak tolong ambilkan darah lepas tu!
.
Thank you semua senior HOs yang sanggup ajar & guide saya dulu 😇
Mula-mula start tagging dulu memang #struggle sangat bab procedure ni sebab dekat Rusia mana ada peluang nak ambil darah, pasang branula, masuk Ryle’s tube & CBD semua.
Jadi sangat #takut nak belajar & try procedures atas real patients 😣
.
💉cancer patients, especially those who has started #chemotherapy
.
- patients with #CKD ie chronic kidney diseases (be careful, most of them need to spare their left arm for AVF, so can try blood taking & branula at right arm only)
.
- patient with history of intravenous drug user (#IVDU).
.
So kalau kita HO baru, bila encounter patients macam ni, lebih baik minta #tolong senior HOs untuk ambilkan darah & ajarkan macam mana nak locate & detect vein patient tu.
Sebab kalau kita yg baru ni try jugak sendiri, chances nak dapat tu rendah, patients akan #sakit & kita end up bumpkan vein yg ada, jadi nanti orang lain akan lagi susah nak tolong ambilkan darah lepas tu!
.
Thank you semua senior HOs yang sanggup ajar & guide saya dulu 😇
Mula-mula start tagging dulu memang #struggle sangat bab procedure ni sebab dekat Rusia mana ada peluang nak ambil darah, pasang branula, masuk Ryle’s tube & CBD semua.
Jadi sangat #takut nak belajar & try procedures atas real patients 😣
Audio
👆🏻more guide on difficult venous access ie blood taking 💉🩸 (I was in anaest posting, not ED sorry)
For working HOs, please aim to be branulogist (our informal term for expert in branula insertion😂 ) at 3rd posting, or after your Medical posting 💪🏻
For working HOs, please aim to be branulogist (our informal term for expert in branula insertion😂 ) at 3rd posting, or after your Medical posting 💪🏻
Pahang Obstetrics Manual & Labour Room Protocol.pdf
28.2 MB
Share Pahang Obstetrics Manual & Labour Room Protocol.pdf
Forwarded from Nota Perubatan
"Doktor, ini chest X ray post intubation patient katil 2 tadi"
What to look for in post intubation CXR?
- To look for complication, especially pneumothorax
- To confirm placement of endotracheal tube
The position of tip of ETT should be 5-7 cm above the carina in the neutral position of neck. When the carina is not visible, the tip of the ET tube should lie over the second to fourth thoracic vertebrae (T2-T4) or at the level of medial ends of the clavicles as carina is located between T5 and T7.
Further reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173625
https://www.radiologymasterclass.co.uk/tutorials/chest/chest_tubes/chest_xray_et_tubes_anatomy#top_2nd_img
#ED
@nota_perubatan
What to look for in post intubation CXR?
- To look for complication, especially pneumothorax
- To confirm placement of endotracheal tube
The position of tip of ETT should be 5-7 cm above the carina in the neutral position of neck. When the carina is not visible, the tip of the ET tube should lie over the second to fourth thoracic vertebrae (T2-T4) or at the level of medial ends of the clavicles as carina is located between T5 and T7.
Further reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173625
https://www.radiologymasterclass.co.uk/tutorials/chest/chest_tubes/chest_xray_et_tubes_anatomy#top_2nd_img
#ED
@nota_perubatan
Forwarded from Dr Iliana9
Intubation CSW version.pdf
1.2 MB
7Ps for #Intubation.
Kalau korang nak intubate patient, biasanya MO akan tanya fasal 7Ps ni.
Kalau tak tahu, melepaslah peluang nak intubate patient sebab kita tak tahu details about that procedures 😅
Nak belajar lebih lanjut tentang #intubation & post intubation care?
Jom praktis sama-sama di Clinical Skills #Workshop Medicorp; 17+3 procedures in 1 day ❤️
Kalau korang nak intubate patient, biasanya MO akan tanya fasal 7Ps ni.
Kalau tak tahu, melepaslah peluang nak intubate patient sebab kita tak tahu details about that procedures 😅
Nak belajar lebih lanjut tentang #intubation & post intubation care?
Jom praktis sama-sama di Clinical Skills #Workshop Medicorp; 17+3 procedures in 1 day ❤️
Forwarded from Dr Iliana9
Episiotomy workshop.pdf
7.7 MB
Slides for Episiotomy workshop ✅
More info on this #workshop;
https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
More info on this #workshop;
https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
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"Dr patient collapsed, on going CPR" - HO
"Ok I'm coming - please prepare for #intubation!" - MO
.
What to prepare for intubation?
Remember MALES;
M 👉🏻 mask ie BVM
A 👉🏻 airway adjuncts; OPA etc
L 👉🏻 laryngoscope
E 👉🏻 ETT (correct size & type)
S 👉🏻 stylet, syringe, stethoscope 🩺
.
Learn more #procedure for HO with Medicorp's Clinical Skills Guidebook;
.
Or get this book for 🆓 when you register for Clinical Skills #workshop;
https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
"Ok I'm coming - please prepare for #intubation!" - MO
.
What to prepare for intubation?
Remember MALES;
M 👉🏻 mask ie BVM
A 👉🏻 airway adjuncts; OPA etc
L 👉🏻 laryngoscope
E 👉🏻 ETT (correct size & type)
S 👉🏻 stylet, syringe, stethoscope 🩺
.
Learn more #procedure for HO with Medicorp's Clinical Skills Guidebook;
.
Or get this book for 🆓 when you register for Clinical Skills #workshop;
https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
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More QR codes for #procedure demonstration included in Medicorp's Clinical Skills Guidebook,
Get your copy here https://medicorp.onpay.my/order/form/bookstore ✅
Get your copy here https://medicorp.onpay.my/order/form/bookstore ✅
Forwarded from Nota Perubatan
A 30-year-old woman presents with weight loss, heat intolerance, palpitations, and tremors. On examination, her thyroid gland is diffusely enlarged, and a bruit is heard over the gland. What is the most likely diagnosis?
Anonymous Quiz
8%
Hashimoto's Thyroiditis
27%
Toxic Multinodular Goiter
63%
Graves' Disease
2%
Subacute Thyroiditis
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 😂
👉🏻 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 😂
Let's revise some important topics at SCN (special care nursery) ie #Neonates posting ✅
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