Medical ICU day 4/ER

Woke up at the usual time. Headed in with Emma this time as she has been assigned to internal medicine with me so I don’t have to be on my own! We went to handover and then headed to medical ICU for a bit. Lots of the patients were the same as previously although one of the previous ones now had a tracheostomy in rather than being intubated. There was also a young guy on there who had had some sort of brain bleed. He has really interesting eye signs and so we did a brief cranial nerve exam on him to see where the deficits were. We then sat and discussed his case after which actually made for some interesting learning. We then went to a case presentation on bacterial endocarditis which was interesting and informative but once again highlighted serious gaps in the knowledge of the residents as we seemed to know answers to lots of things they couldn’t answer.
After that we headed home for lunch and a nap as we planned to come back in later to do an emergency room shift. Slept for about 2 1/2 hours and felt much better for it, think I was still trying to recover from the weekend!
Spent a bit of time after that getting a bit stressed out as I was trying to plan the weekends trip away for 12 people and it was quite difficult to come to a consensus on what we wanted to do. Eventually got it sorted and everyone seemed happy enough.
Me and Emma then got a jeepney back into hospital for our evening shift at about 7pm. We headed to the emergency room which was noticeably busier than in the day time. There were patients everywhere including in chairs and on the floor and all of them had a bantay (relative/carer) with them so it was hectic. We approached the internal medicine desk but they weren’t particularly forthcoming or talkative (no surprise there). Quite soon after we arrived, we noticed a few of them rush to a patient to do CPR. We were really shocked at how poor their CPR was! We definitely would have done a better job ourselves. They then decided the patient was breathing on their own (although already intubated) and so stopped. We thought that it was probably an inappropriate attempt at CPR rather than a successful revival. We also got to watch an NG tube insertion and talk to a patients relative about their condition. After this not much was happening so we headed home around 9.30pm and went to bed.Read more