SOCIAL MEDIA

Monday, November 27, 2017

One Heck of an On Call

Assalammualaikum :)
Every month, I do 6 - 7 oncalls.
Ever since I started doing ICU calls in September, my boss gave me more ICU than OT calls to train me.
So this month, I had only one OT call.

Definition:

"ICU call: On Call and is in charge of the ICU for 24 hours.
OT call: On Call and is in charge of the Operating Theatre for 24 hours."

MOs doing OT call will be giving anaesthesia to all the emergency operations of the day. Operations might be done by several surgeons:

Ortho / Surgical / Obs Gynae but there will be only ONE anaesthetist.

And that single OT call of mine was yesterday; 26th Nov.
And it was such a buuusssyyy day, almost like 6 oncalls being combined into one.



I had an ECT (electro-convulsive therapy) in the morning.
Then EMLSCS for poor progress
Then bleeding PP type IV - under GA!
Then bleeding PP type II
Then WD Fornier's Gangrene - sent to ICU
Then EMLSCS for breech in labour
Then EMLSCS for poor progress
Then acute appendicitis.

My OT went on and on non-stop since 9am and it was already 4am by the time I discharge my acute appendicitis patient and I thought I can sleep until Subuh.

But suddenly at 6am, the staff nurse came knocking at my door and screamed "Doctor!! Ada fetal bradyy!!"

I literally jumped out of my bed, struggling to switch the lights on, open the door, take the phone the staff nurse brought me and listening to what the O&G MO has to say, put on my scrubs, put on my tudung, look for my glasses and shoes - all at the same time.

And as I am having active URTI at the moment, my throat was really hurting when I woke up I can't even talk properly.


Why the panic?

Fetal = unborn baby. Brady = slow.
"Fetal Brady" is the term we use to imply unborn babies with slow heart rates. When an unborn baby has slow heart rate, means the baby is in danger. BIG BIG danger and he/she has to be taken out ASAP or the baby might die in utero. See the reason to panic now?

I went out of my oncall room, didn't even care that I have not brushed my teeth or washed my face.
While preparing my GA drugs, I called Shangker breathlessly, asking him to stand by while I induce the patient; either GA or spinal.

When the patient arrived to OT, baby heart rate was 86bpm. Anything less than 110 beats per minute is low for a baby. And so, I had to GA the mother. Giving general anaesthesia to a pregnant woman is one of the things I fear the most in this field.

Anything can go wrong. And any mistake can cause the lives of two human beings and of course, lots and lots of paperwork ahead.

And in the morning, there was a CME session that I had to attend albeit being very tired and was dozing off midway until suddenly Dr R attacked me with a question: "Akmar! Which GABA receptor does Midazolam bind to?"
*criessss*

Nasib baik her mood was good this morning; x kena marah sebab cannot answer.
Finish lah coretan of one of my worst oncall day.

'til then!

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

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