It was such a struggle to wake up this morning at 6:30am for a ward round in a rotation that I don't particularly feel enthusiastic about.

It didn't help that it was so cold that my car was covered by a layer of ice.

*sigh* Five weeks to go :(

Gone are the days of Frankston. Here I am in my room in Bendigo. Feels just like halls actually, minus the fact that I'm waking up alone. And also it gets quite a bit colder at night than it does in Clayton.

Hopefully things stay nice and quiet for the next 6 weeks =)

Patient with GI bleed.

Hb unstable.

Bowel prep charted last night. Colonoscopy planned for today am.

Bowel prep given by nursing staff last night.

Nursing staff gave "light breakfast" this morning.

Patient had to be pushed back to pm list.

Why? Why would you bowelprep someone then give them a "light breakfast"? Use your brain!

Today I had a needlestick.

Sigh.

First one.

Won't be the last one.

My ED rotation is coming to the end. I can't say that these 6 weeks has convinced me to become an ED physician as a career but it has been enjoyable. Highlights?

1. Going in an ambulance ride-along with a patient who had a leaking AAA.
2. Finally performing CPR on a real person - much more tiring than on a manequinn and realised that you have to push much harder to get a good femoral pulse.
3. Putting in a 16G IV into a patient - don't think I'll ever get to do that on the ward without good reason.
4. Diagnosing a patient with diabetes - hard to miss given he had acanthosis nigricans, polydipsia nad polyuria.
5. Watched a patient go from conscious VT to unconscious sinus with IV lignocaine - cue a mad rush for all doctors to secure her airway.
6. Saw an atrial myxoma flapping back and forth on a TTE monitor.
7. Saw a dendritic ulcer - OMG, they actually exist in real life!
8. Got to sit in a new Jeep Grand Cherokee - cost the registrar her whole year's salary!
9. Heard the best wheeze ever in a young asthmatic woman.
10. Cutting off a boot from a patient with a nail in his foot and then trying to remove said nail.
11. Watched a woman walk through the ambulance doors with full thickness facial burns - subsequently had to be tubed and sent to Alfred.
12. Saw a man with subcutaneous emphysema - his face was like a drum to tap.

Frankston gastroenterology, here I come!

In case you haven't been reading the news, the following news article was in the age today:

TIGER Airways could be grounded for at least a month and be forced out of business in Australia altogether after the Civil Aviation Safety Authority revoked its permission to fly, saying the airline posed ‘‘a serious and imminent risk to air safety’’.

Interesting...and I remembered all the experiences we had with Tiger and I'm not surprised actually. But hey, they're a budget airline, what would you expect?

Another patient tonight with PV bleeding. She is meant to be pregnant, self diagnosed with a urine pregnancy test at home. Couple of weird things in this case:

1) Her quantitative BhCG today was <1, non-detectable. Even for a missed miscarriage, this is a bit unusual.

2) She claims that her blood group is B-ve. We thought she would need some anti-D. Today's blood group and hold revealed: B+ve.

3) She also claims that she delivered her three children at Southern Health - 1 at Dandenong and 2 at MMC. No records of this on our system at all.

In the end, the patient discharged herself against medical advice because her kids were crying and her husband has to go to work tomorrow morning.

Something strange...

Patient presented tonight with his girlfriend. The couple were having sex this morning when the boy experienced sudden onset of penile pain and they noticed large amounts of PV bleeding from the girl. The boy withdrew and discovered he had a tear on his penis at the attachment of his foreskin - the source of the pain and blood.

So, the large amounts of PV blood...bleeding from him? Or bleeding from her?

Haven't written anything in ages...job applications and ED have kept me so busy T.T And it's such a shame because I've seen so many interesting things that I haven't had time to reflect upon...

Ever wonder how likely patients are going to survive when we ship them out of ED? Last week I heard the phrase "this patient is going to Gen Med for a trial of life". The poor lady was being admitted for IV anibiotics in a last ditch attempt to treat her raging pneumonia. "Trial of life" is a common phrase used in ED, but probably reflects how stark the reality is for these patients. To these patients, the hope of surviving this admission is probably close to zero...and yet doctors still try. Perseverence or stupidity? I guess we just do whatever the family wants...

Our strategic and tactical officer is actually a world champion =D