Sunday, January 23, 2011
Saturday, January 15, 2011
I know this to be true, and mostly use it as a defence, to protect my fragile mind, but sometimes, sometimes, things leak through. No man is an island, and this man certainly isn't a rock.
The Christmas period was as horrendously busy as I've ever seen it, and I've worked a few Christmases. The rest of the hospital seems to operate a fingers-in-ears policy; interestingly, a few weeks after Christmas, when all the patients we'd seen had been admitted, and the burden of care was shifted up a level, 'they' sat up and took notice.
Suddenly we were flooded with extra staff, and, as is so often the way, they came on a day when we had precious little to do, having admitted all the sick patients in the area.
Until, of course, after 6 p.m., when everyone goes home.
We've seen a lot of very sick folks in their 20s and 30s, with awful, awful pneumonias. At first I though it was all 'flu related; the histories seemed to fit, and indeed some of them tested positive, but more of them are testing positive for strep. pneumoniae, which I haven't seen before.
Tuesday, January 11, 2011
Do you ever regret choosing Emergency Medicine? Does the quiet life of a GP ever seem more appealing?
Never; I wanted to be a General Surgeon (or a trauma surgeon) but since the K doesn't really have dedicated trauma surgeons, and general surgery is effectively an historical speciality, EM was the obvious next choice for me.
I'm not clever enough to be a GP
Toxic epidermal necrolysis, probably. Though I have, of course, seen the usual complement of objects lodged in body cavities
Tuesday, January 04, 2011
Of course, this, at least in part, depends on your definition of unusual.
Sounds pretty unusual, but in the UK, that might be as many as 60 times a day...
So maybe it just seems unusual; or maybe, as a great philosopher once wrote, "It's not unusual"
Nonetheless, it is a truth universally acknowledged that patients collapsing in Radiology have,usually, just fainted, sometimes as badly as Gillian McKeith. (Or, "Gillian McKeith" to give her her full medical title.)
So, today, when the Resus doors banged open and he was wheeled in I was not unduly concerned.
Shows what I know.
To be fair, he did look worse than the usual fainter, and his thready pulse and agonal respiration pattern did little to reassure us. Even that meagre effort didn't last long, and his light went out. There was surprisingly little fanfare.
His history, gleaned in shouted snatches between the requests for adrenaline and flushes, demands for pads and tubes, added little. But we did get him back, and after a prodigious bout of vomiting, he declared himself better.
Well, he didn't know he just survived a VF cardiac arrest brought in by a substantial STEMI.
In fact, one almost wonders how he'd have fared if he HADN'T gone to the pub and fallen over.
But he came back. I still don't know how long he'll stay this time, but he came.