Emergency Rotation Day 1

It’s time to say byebye to Ob/Gyn and hello to Emergency!

Here is an account of what happened today.

I roughly woke up around 5 am because of a strange dream that I can’t really remember but I’m pretty sure it involved medicine…maybe I should consider it a nightmare? I don’t know but that’s beside the point.  I laid down in bed until 6.30 am when it was time to get ready and have breakfast.

We had a small intro/orientation which lasted less than two hours and we were then sent to our wards.

First note to self: Do not wear skirts or dresses. It’s way too cold inside and knowing how cold intolerant I am, wearing dresses would be like committing suicide. Do not wear high heels too (doesn't really apply to me since I hardly ever wear them). 

I must say that the staff is quite nice and it’s actually hard to know who are the specialists or the medical officers. They all wear that black jacket with their name stitched on it. I guess after a week, I will be familiar with the staff.

Anyway so moving to the interesting part of what actually happens in the ED. Well it is basically divided into three zones: red, yellow and green where patients are sent according to their medical emergency. Red means very serious patient!

So one of the first patients I saw came in with sepsis secondary to necrotizing fasciitis. The house officer asked me to put on my gloves and feel the crepitus over the skin lesion. I was so ‘excited’ that I was having trouble putting on my gloves and when she hurried me, well I ended up putting my gloves the wrong way! I hope no one noticed… well I was also asked to describe the smell of the lesion. The smell must have been pretty strong because even with a blocked nose, I was able to smell it just by standing next to the patient. The patient was then transferred to the wards for further management.

The next patient was a young lady who came in with a chief complaint of heavy per vaginal bleeding. Her hematocrit was low and she was tachycardic. An abdominal ultrasound was done with showed some kind of cyst but no definite diagnosis could be made.

In the meanwhile, another elderly lady came in complaining of shortness of breath and chest pain. It was quite hard to get a history from her. She mainly replied ‘don’t know’ to everything. An ECG was done for her, which showed some kind of heart block (I think). This brings me to the second note to self: revise ECG! I was unable to make a diagnosis based on the ECG, which is quite embarrassing, considering I’m now in final year.

I have no idea what happened to the last two patients because the specialists wanted to meet all of the students and gave a small presentation. And he stressssssed on being professional and wearing a proper attire.

And that is the end of my first day in the emergency department. I hope that it’ll be as good as the other rotations and I’m pretty sure it will give me an opportunity to refine my procedural skills!