Monday, 5 October 2009

The pinched


Alhamdulillah. My 3rd week in HTF. Being a newbie houseman in surgical dept really challenging, plus the systems were really different compared to Moscow. But that was not a major problem, learning as time goes by.

As i told before, i will share a bit of my experience since my 3rd week there. Through out 3 weeks there, ive been exposed to a lots of major cases. One of it was the motor vehicle excident (MVA) with cerebral concussion plus the extradural haemorrhage.

My specialist always remind us, "If u can detect and do not make any delay in extradural haemorrahage, the patient soon after the craniotomy will go home healthy as nothing happened to them"..ya that was true..

Last Friday, i've been busy to complete all my pt review and my watch was already showed 9.15pm. And after that there was a new admission. A 17 years old boy alleged fall on stairs with cerebral concussion. Im telling myself to attend him the next 5 minutes after completing my review. Continuing my work and suddenly my instinct feels not good about that newly admitted boy. Stop my review and i went to his bed. The standard procedure is accessing his GCS. He seems like in a deep sleep, a usual sleep i guess and after all shouting his name to wake him up, he still not responsive. I pull the curtain and with the attendant accessing him again. Using the pain stimulant on his chest i really made him to wake up. He answered all my question except the location orientation which his answer was in a petrol station instead of in a hospital! and after that continue his sleep. A wierdo behaviour! I feel something. Straight away inform my MO.

My MO came and re-accessing his GCS again. But now he was not responding even the pain stimulus applied on his chest. I decided to pinch him on his leg. Straight away i pinched him. He woke up and answered all of our questions. We were surprised. My Mo decided to put his GCS less than 15 and wanted to do a CT scan.

Taken all the consent and the pt did a CT scan. The result was an extradural haemorrhage which involved the left frontal lobe and it was very related to his weird behaviour. The specialist has been informed and the craniotomy has been carried out. The operation took only 1 H and the pt condition was stable. Less than 48 Hours in ICU and after that transferred to my ward for further observation. The next day, was Sunday, 2 drainage tube from his scalp has been off and the pt was fully stable and can allow orally with a normal diet. Praised Great be to Allah for the chance had been given to that boy to live his life back.

Doing my review as usual in the evening at 7 pm and im approaching that boy and i asked "adik, adik sedar tak siapa yang cubit adik time adik sampai dulu kat sini?" He answered no, he did not realize. And i replied " sebenarnya abg yg cubit adik time adik sampai hari tu sbb abg ingat adik mcm tidur je, abg mintak maaf ye"
He smiled to me.

Day by day getting me stronger to challenge the real situation. The situation far from 6 years ago only i read in the books.. Allahu Yassir wa la tu'assir ya Kareem


nataliaku said...
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Anonymous said...

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