A Small potato in "The Unit"

Hey, remember that patient you saw?

2010-10-19T02:23:00.002+08:00

It's one of the most panic-triggering phase during our day-to-day work...
Reference: http://thecentralline.org/?p=568

Rules

2010-10-10T16:46:00.000+08:00

First of all, "Anything can go wrong WILL go wrong, at the WORST POSSIBLE TIME."
Always recheck marking of ET tube for desaturating patients
Rising pCO2 in spontaneously breathing patients/pt on PSV => decrease sedation first
USG is your best friend for procedures (e.g. lines, pleural tap...)
Remember bougie for endotracheal intubations, check mouth opening and ROM of neck beforehand, position well beforehand, insert the tube deep enough, always check breath sound yourself after intubation, protect patient's teeth during DL
Stick higher for IJ lines at level of thyroid cartilages to avoid pneumothorax, manipulate to increase diameter of IJ vein (head down, limited head turning/extension, light palpation of carotid pulse)
Do not blindly correct INR, platelet. Think before given pack cell/FFP/platelet concentrate
Always check ionized Ca2+ level for post-TOTAL thyroidectomy patient
O2 flow rate of NRM should > 6L/min
No need to stop NG feeding just because of coffee ground aspirate
Always check the patient's position while reading a CXR
Offer comfort care (e.g. morphine infusion) earlier if indicated
Use sulperazone as emprical abx for nosocomial infections in "The Unit"
Know when to wait and when to start antibiotics
Bronchospasm..."treat medically"...remember "second-line agents" e.g. MgSo4, IV salbutamol, adrenaline infusion, ketamine infusion...
Remember Difficult Airway Algorithm: Awake Vs GA, Spontaneous ventilation Vs paralysis, Superglottic Vs Infraglottic. (always remember awake intubation under topical anesthesia +/- sedation for expected difficult airway)
Filp Technique of airtraq insertion (like 180-degree turn while inserting oral airway)

(To be continued...)

Topics

2010-10-10T16:30:00.002+08:00

PPH (massive transfusion)
Typhoid fever, CNS involvement
Neuroleptic malignant syndrome
Rhabdomyolysis with AKI
ARDS/ALI
Brain stem tests/Organ donor support
Management of increased ICP
ACS
Heart block/temp. pacemaker management
DKA/HONK
Thyrotoxicosis
Bronchoscopy
Adrenal insufficiency
GBS
Thrombolysis for ischemic stroke
Plasma exchange
Becker myopathy/Inherited myopathy
Pulmonary embolism
Major burns/inhalational injury
VF
Reperfusion syndrome
Contrast nephropathy
Insulin overdose
Rickettsial infection
Metformin induced lactic acidosis/other causes of lactic acidosis/metabolic acidosis
Therapeutic hypothermia
TB meningitis (with associated hydrocephalus)
Deep neck space infection and associated complications (e.g. mediastinits)
Therapeutics of anti-heart failure medications
"Severe" acute pancreatitis, including hypertriglyceridemia-induced case
Citrate toxicity during anticoagulation for CRRT
Venlafaxine toxicity
Infection of resistant bugs e.g. Acinetobacter, Stenotrophomonas, ESBL, ICBL strain, MRSA...
Severe/near-fatal asthmatic attack
Agents for bronchospasm, ventilator management for severe obstructive lung disease
Difficult-to-control seizures, second-line anticonvulsants
SLE with multi-organ involvement
Intubation/extubation strategy for tracheomalacia
Empyema thoracis
Dislodged/blocked tracheostomy drill

(To be continued...)

AIRTRAQ intructional videos

2010-10-10T16:23:00.001+08:00

AIRTRAQ instructional videos

YouTube
- airtraq1's Channel

BVM Ventilation for "tooth-less" patient

2010-10-10T16:22:00.001+08:00

BVM Ventilation of the Edentulous Patient

emupdates.com

BVM should be replaced with LMA ventilation. Aside from that, if this technique is half as effective as they suggest, we need to know about it because we bag a lot of edentulous patients.

aVR - Gets No Respect!

2010-10-10T16:20:00.000+08:00

EMRAPTV Episode 68: aVR - Gets No Respect!

emrap.tv

EMRAP - Emergency Medicine Reviews and Perspectives

Rocuronium Vs. Succinylcholine

2010-10-10T16:19:00.000+08:00

Rocuronium vs. Succinylcholine

vimeo.com

For 8 minute Pecha Kucha competition at Scott Weingart's ED Critical Care Conference, January 13 2010.

Advanced Airway Management for the Emergency Physician

2010-10-10T16:17:00.000+08:00

Advanced Airway Management for the Emergency Physician

vimeo.com

Audio, slides, and the Emergency Department Intubation Checklist are available at http://emupdates.com/

日夜輪班的生活睡眠作息

2010-10-10T16:16:00.000+08:00

急診夜未眠: 日夜輪班的生活睡眠作息

decode-medicine.blogspot.com

實驗發現日夜作息顛倒的動物比較短命。在日本，已經有因為值夜班造成過勞死而賠償的判決先例。實驗證實，人體內存在一個以25.1小時為週期的生理時鐘，因此一般年輕人比較傾向於晚睡。這項發現，對於日夜輪班者的生理時鐘調節亦有重要的影響。雖然很多排班輪值上班族相信，隨著時間及技能的熟練，他們將能適應這樣的輪值工作。但是證據顯示，年紀的增長使得輪值工作的適應變得更加困難。美國曾經做過調查，發現有25%的急診專科醫師(平均工作年資10.3年)需要靠藥物來幫助睡眠或保持工作清醒；相對之下，已經結束急診輪調的住院醫師，只有15%有服用藥物的習慣。睡眠時間有一大部分是由日夜週期決定，這可部分解釋為何夜班輪值工作者...

Airway World

2010-10-10T16:15:00.002+08:00

Airway World

www.airwayworld.com

Welcome to Airway World! If this is your first visit, please click on “Register.” After answering a few questions and creating a password, you are ready to enter this one-of-a-kind airway management knowledge center. ...

123sonography.com

2010-10-10T16:15:00.001+08:00

123sonography Blog

www.123sonography.com

Hi there! This is the 123sonography blog on echocardiography. We provide you with innovative teaching materials on echocardiography. We will regularly post videos on basic and advanced echo skills. The videos you will see on this site were produced by echocardiographers – for echocardiographers. ...

Presentations on intensive care by Andrew Ferguson

2010-10-10T16:12:00.000+08:00

Presentations on intensive care

Andrew Ferguson’s Presentations on SlideShare

www.slideshare.net

Videos on anatomy and physiology

2010-10-10T16:11:00.000+08:00

Videos on anatomy and physiology by a student from U of Toronto major in human physiology

YouTube - hyperhighs's Channel

www.youtube.com

Share your videos with friends, family, and the world

Bread and Butter info on physio and pharmacology

2010-10-10T16:09:00.000+08:00

Online Community Of Clinical Excellence

www.o2demand.com

"Bread and butter" info on anesthetic practice eg. videos on physiology and pharmacology

SurgicalCriticalCare.net

2010-10-10T16:08:00.000+08:00

SurgicalCriticalCare.net

www.surgicalcriticalcare.net

Surgicalcriticalcare.net is an interactive website containing evidence-based medicine guidelines, lectures, resources, and educational case presentations pertaining to the practice of Surgical Critical Care.

Thoracic USG for pneumothorax

2010-10-10T16:07:00.001+08:00

thoracic ultrasound for pneumothorax

www.youtube.com

instructional video discussing the use of thoracic ultrasound for pneumothorax

Understanding Capnography

2010-10-10T15:42:00.000+08:00

Welcome to capnography.com for understanding capnography

www.capnography.com

E-mails also suggested that the use of multimedia programs, digital images, and clip arts, and real-time animations, that convey the complex physical, physiological and clinical principles underlying capnography, had a great impact on viewers in facilitating easy understanding. ...

Cardiovascular Pharmacology

2010-10-10T15:40:00.002+08:00

CV Pharmacology: Home Page

www.cvpharmacology.com

Click here for information on Cardiovascular Physiology Concepts, a textbook published by Lippincott Williams & Wilkins (2005)

Cardiovascular Physiology

2010-10-10T15:40:00.001+08:00

CV Physiology: Home Page

www.cvphysiology.com

Click here for information on Cardiovascular Physiology Concepts, a textbook published by Lippincott Williams & Wilkins (2005)

Ultrasound Guide for Emergency Physicians

2010-10-10T15:38:00.000+08:00

Ultrasound Guide for Emergency Physicians, from American College of Emergency Physicians

Introduction

www.sonoguide.com

This online website was a creation of members of the American College of Emergency Physicians (ACEP) Section on Emergency Ultrasound under the direction of Beatrice Hoffmann, MD, PhD, RDMS and the coauthors ...

OpenAnesthesia.org

2010-10-10T15:36:00.002+08:00

Wikipedia-type anesthesia and critical care resource from "Anesthesia & Analgesia"

OpenAnesthesia.org

www.openanesthesia.org

Anaesthesiamcq.com

2010-10-10T15:36:00.001+08:00

www.anaesthesiamcq.com

Use the board for your comments or messages about any topic related to anaesthesia. (See adjacent notes about log-on requirements).

World Federation of Societies of Anaesthesiologists

2010-10-10T15:35:00.001+08:00

Home-World Federation of Societies of Anaesthesiologists

www.anaesthesiologists.org

The World Federation of Societies of Anaesthesiologists (WFSA) wasfirst formally constituted at the World Congress of Anaesthesiologistsin Scheveningen, the Netherlands in 1955. There were 28 founder membersocieties.

Practical Plastic Surgery

2010-10-10T15:33:00.000+08:00

Free handbook on plastic surgery (also covering burn care/hand surgery) written by Dr Semer, an US plastic surgeon

Practical Plastic Surgery

www.practicalplasticsurgery.org

Practical Plastic Surgery for Nonsurgeons was written to bring plastic surgical expertise to areas with little access to plastic surgeons. Please feel free to download/print as much of the book as you desire. And please, tell others about this site!

MicroTextbook of Clinical Airway Management

2010-10-10T15:31:00.000+08:00

MicroTextbook of Clinical Airway Management

airwaymicrotext.homestead.com

Difficult Airway Book

2010-10-10T15:30:00.002+08:00

www.orag.co.uk

A unique feature of this book is the inclusion of slides and video clips on the Oxford Region Airway Group (ORAG) website - www.orag.co.uk. This is intended to complement the material in the book. It is therefore important that the reader has read the chapter(s) before logging on to view the slides.

Echo in Context

2010-10-10T15:27:00.000+08:00

www.echoincontext.com

Echo in Context is the longest standing and most watched recurring telemedicine event in the world. Site supports all phases of Echo training.

Videos on airway management

2010-10-10T15:25:00.000+08:00

YouTube - AirwayCam's Channel

www.youtube.com

The videos uploaded here are a variety of educational videos obtained from our training series, cadaver lab or various patient contacts. www.airwaycam.com

Videos on emergency ultrasound and more

2010-10-10T15:22:00.001+08:00

YouTube - hqmeded's Channel

www.youtube.com

Instructional videos related to emergency medicine produced in the Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota. Associated with hqmeded.com, your source for high quality medical education media.

Change, change, change

2009-05-20T22:24:00.000+08:00

Change is coming...

"Yes I can"

Hiatus

2008-07-09T21:50:00.003+08:00

It has been a long year...

Things happened let me understand more on what I really want...

Judgement, experience

2007-11-10T00:10:00.000+08:00

"Good judgments come from experience. Experience comes from bad judgments"

Prof Frank Walter, AHLS course instructor

I have made enough bad judgments, but they not yet converted to be my experience

Life is a peculiar thing

2007-09-18T02:08:00.000+08:00

Life is full of surprise, and the circle of friends is revolving...reminded me of good time experience d around 1 year ago...

I will try my best to protect it

Betrayal of my dream?

2007-08-31T01:05:00.000+08:00

Um...Broadest spectrum of case mix Vs sickest patient in the hospital
Afterall I just want to deal with more acute medicine at work, instead of those meaningless rountines

Perhaps I need more time to work at my parent dept. to clear up my mind, as I only have 2 week time of exposure, but if I really want to make the switch, I should made the decision much earlier...

Early goodbye

2007-07-12T01:07:00.000+08:00

Practice of Emergency Medicine really different to other specialty:
- Undifferentiated patient, life-threatening conditions can present with subtle complaint at early phase
- No perfect investigations to rule-out every possible life-threatening conditions, and if "shot-gun" approach is adopted, it will hinder the patient flow and it's waste of resources

So we're bearing uncertainty and risk everyday. There are always cases that I've first seen, or I'm not totally sure whether my management is right or not...

However it's going to be the end of the stay at the emergency dept. I was summoned to rotated to general surgery then orthopedics, then back to A&E in mid Jan 2008
Down side: I hate ward rounds and oncall. For oncall, there's no overnight call for "E" call now, should be more tolerable
Up side: I may have chance to learn more procedures...bedside ultrasound is the thing I'm looking forward to experience more, also procedures like CVP insertion, suturing etc.

for Ortho, it's A&E related as I see lots of ortho case during my shift, so I've no objection to rotate to ortho

Anyway, time for a new start (again!)
--------------------------------------------------------
Updates:
Shit! I was "informed" that I have to stay at general surgery for 6 months!, no more orthopedics!
XYZ!@#$%

The last round

2007-06-24T18:52:00.000+08:00

Got 3 calls in last 7 days, this place is really...

Got a new job; Rented a new apartment; Going to live in a completely new district alone

A lot of ups and downs in these 12-month period of my life, some are so unforgettable that I could re-experience the joy / bitterness I have had at those moments

After all, I think I've gained more than what I've lost, like friendships

Well, for relationships, I know I've let my friends get hurt because I'm still naive and ignorant. And I understand that when damage is done, it's done...

anyway, I've promised myself: 新生活要好好過

Life as charted

2007-05-21T22:55:00.000+08:00

Lucky enough to break away from the call=>post-call=>precall cycle...for one week
Though the rain partially spoiled the fun...

Bought some non-medical books, met some friends, and try to think about life outside work after internship completed...

Music Chair, episode 2

2007-05-10T20:51:00.000+08:00

Had central interview at TMH yesterday...

um...settled?

To be continued...

Defeated

2007-05-08T21:37:00.000+08:00

Sick for the second time in this rotation...Last time it was GE, this time URTI

Kids' bugs are really nasty...

Will go to central interview tomorrow with runny nose and sore throat...

Stimulation

2007-04-23T23:19:00.000+08:00

Wondering why I can go to work without using my brain at all...

Drip setting/blood taking/printing labels...

My medical rotation is the most "stimulating" among rest of the rotations, on the other hand, now I strongly feel these 3 month would be the time that my brain will be under-utilized

But I need my brain back after these 3 months

Lack of stimulation leads to hollowness of mind...never thought it will be that bad

Music Chair

2007-04-14T21:11:00.000+08:00

Finally got a seat in this "Music Chair" game...

To be continued...

The Serenity Prayer

2007-04-07T19:03:00.000+08:00

God,

Grant me the SERENITY to
accept the things I cannot change;
COURAGE to change the things I can;
and WISDOM to know the difference.

Living one day at a time;
enjoying one moment at a time;
accepting hardships as the pathway to peace;

taking, as He did, this sinful world
as it is, not as I would have it:

Trusting that He will make all things right if I surrender to His Will;
that I may be reasonably happy in this life
and supremely happy with Him forever in the next.

Amen

mini-sized world

2007-04-03T01:02:00.000+08:00

On call at UCH pedi tonight

Working at NICU/PICU today, every babies seem so small and fragile to me

Know nothing about pediatrics, really handicapped

Still no interviews...need to do something to change the situation...

Regrets

2007-04-01T18:22:00.000+08:00

懷着一絲遺憾離開東區醫院

Maybe I'm better off to be alone

Zero progress in job-seeking...perhaps I won't be an Emergency Physician at the end

雙重打擊

最後的歌

2007-03-29T18:41:00.000+08:00

看那麼多嘴角在微笑是為何
有那麼多聲線在合唱愉快的歌
誰都比我爛漫笑聲若然沒結果
這天這些開心的人怎麼過

我我記得跟你在何處唱遊
聽每首歌終結便輪到下一首
時光總會落後美好事情沒永久
只好怪貪心人無論滿足多麼久也未夠

假使這歌到明年還在播假若世界永遠都快樂
假使可跟你重頭開始過何須將這鋼琴都敲破
最後一刻仍然還屬於我
最後的歌還想聽到甚麼
最後想聽聽你說願我未來如何語調熟練仍然像最初
最後一刻提琴還剩一個
最後的歌還可珍惜甚麼
最後想講毋忘我

可惜我我懂得當那鋼琴要靜下時
你會記得給我動搖過便要休止
旋律比我幸運我的下場沒法知
比不起最後的歌可以給我翻唱千次
縱使只得一次稱心滿意至少半次

Music And Lyrics

2007-03-11T16:23:00.000+08:00

Had watch this movie last week. It's really a good one
The theme song has been hanging in my mind these days

"Way Back Into Love", Haley Bennett and Hugh Grant

I've been living with a shadow overhead
I've been sleeping with a cloud above my bed
I've been lonely for so long
Trapped in the past, I just can't seem to move on

I've been hiding all my hopes and dreams away
Just in case I ever need `em again someday
I've been setting aside time
To clear a little space in the corners of my mind

All I wanna do is find a way back into love
I can't make it through without a way back into love
Ohhhhh

I've been watching but the stars refuse to shine
I've been searching but I just don't see the signs
I know that it's out there
There's got to be something for my soul somewhere

I've been looking for someone to shed some light
Not somebody just to get me through the night

I could use some direction
And I'm open to your suggestions

All I wanna do is find a way back into love
I can't make it through without a way back into love
And if I open my heart again
I guess I'm hoping you'll be there for me in the end
oh, oh, oh, oh, oh

There are moments when I don't know if it's real
Or if anybody feels the way I feel
I need inspiration
Not just another negotiation

All I wanna do is find a way back into love
I can't make it through without a way back into love
And if I open my heart to you
I'm hoping you'll show me what to do
And if you help me to start again
You know that I'll be there for you in the end

Most Wanted

2007-03-04T20:41:00.000+08:00

http://www.ha.org.hk/ho/resident.htm

There is rumor that HA will publish the number of openings for each specialties in coming weeks...

Let's hope we can get what we want in the demand-and-supply game

Stupidity

2007-02-21T00:26:00.000+08:00

25/M
drank a cup on long island iced tea at a pub at TST
sudden LOC at toilet on micturation for unknown duration
found himself lying on floor while regain consciousness
c/o dizziness and sweating since then
vomitted undigested food x1 an hour after back to dorm

note: This poor guy needed to oncall on the following day...

This guy learned not to drink on post-call day

The wall

2007-02-10T17:21:00.000+08:00

I'm determined, my mind is clear, yet I'm not sure how to get the message across
How to make the particular one be convinced?

Sorry, I'm "late". Will you forgive me?

Seem time is the solution

enough procrastination...

2007-02-04T18:04:00.000+08:00

Was procrastinating about job application in recent weeks...today I finally pulled myself to together to print all the related stuff and mailed the application letters today...

Birthday is near,

生日......快樂?

What am I?

2007-01-23T00:51:00.000+08:00

It's the season for job seeking. I should be working hard for the cover letter, but how come I don't much motivation to work on it?

Time for self-reflection...

I used to spot my weakness and blind to my strength. Honestly, I don't think I'm gifted in any aspect.
What will other thinks after meeting such guy with low self-esteem like me?

It's time for the problem to surface...

Another corner of the island

2007-01-15T22:53:00.000+08:00

The 3rd week at PYNEH...

Had to stay at dorm most of the time because is too far away from my home, and not much place for entertainment (not like in MK), luckily got some familiar faces at dorm...feeling good

Talking about work...MO are nice...the pace is not "hustle around" like in medicine and surgery (I'm grad that I've finished my medical internship before the winter surge comes), still, occasionally late for lunch and leave from work late

And the journey goes on...

Time for job seeking

Gone again

2006-12-31T20:55:00.000+08:00

Leaving KWH today, the place I worked for half an year, but forgotten to return the key...making me to return there again tonight

Moved in to dorm at PYNEH already...the view outside windows is not bad...but facilities are so-so...and still haven't got the room key yet...

And I'm anxious about the call tomorrow...really forgot all orthopedics stuff...and need to adapt for new place...

Hope more people move in and the floor will be more lively

Re-unions

2006-12-18T22:23:00.000+08:00

Meet many familar faces during activites in this few weeks, like congregation day, gathering with my ex-colleagues, job-hunting workshops...

I'm think I'm getting more nostalgic now...

I saw her again...but this time we pretended we didn't see each other, so we didn't talk

I don't know if we will meet again in future. Moreover, I don't know what to talk about if there is really such chance

Still haven't get over it, I know

You're beautiful - James Blunt

2006-12-11T23:30:00.000+08:00

My life is brilliant.

My life is brilliant.
My love is pure.
I saw an angel.
Of that I'm sure.
She smiled at me on the subway.
She was with another man.
But I won't lose no sleep on that,
'Cause I've got a plan.

You're beautiful. You're beautiful.
You're beautiful, it's true.
I saw your face in a crowded place,
And I don't know what to do,
'Cause I'll never be with you.

Yeah, she caught my eye,
As we walked on by.
She could see from my face that I was fucking high,
And I don't think that I'll see her again,
But we shared a moment that will last till the end.

You're beautiful. You're beautiful.
You're beautiful, it's true.
I saw your face in a crowded place,
And I don't know what to do,
'Cause I'll never be with you.

You're beautiful. You're beautiful.
You're beautiful, it's true.
There must be an angel with a smile on her face,
When she thought up that I should be with you.
But it's time to face the truth,
I will never be with you.

Affirmative

2006-12-11T23:12:00.000+08:00

Got the mail from the HK College of Emergency Medicine today

Get a pass in an exam that I've spend the least time for revision on any exam in my lifetime...what can I ask more?

A little step closer...

expectations

2006-12-10T22:12:00.000+08:00

finished PEEM exam on friday...it's damn difficult...anyway

Had congregation ceremony on thursday. Actually is quite boring, but it's good chance to meet my friends

Feeling excited yet a bit anxious for working at a new place after 31 Dec,

New place, familiar faces

Series of two

2006-12-06T20:29:00.000+08:00

Only 2 housemen working since yesterday pm (the rest went to the HKU congregation)

2 resuscitations (failed to revive both 2 patients)

2 IVDA patients admitted at the middle of the night

2 day before the PEEM exam ( and I still haven't really studied enough for that...)

Fall

2006-11-26T12:03:00.000+08:00

Autumn has come...um...become more moody because of the weather

Met my ex-colleagues on Wed, supposed to be a good thing, but got a phone call during my last call on Friday...

I think the situation goes into the way of no return now, maybe It's a blessing in retrospect...

And seems everyone know what happen on me...even know more than myself

Got some positive feedback on Mock interview yesterday, should be the few good news in this week

Wandering

2006-11-12T18:49:00.000+08:00

A friend asked me if I'll join MSF after passing membership exam 3 years later...
Sounds like a good idea...I don't think I've too much burden hindering me (Still got my family to support though)

Talking about goals in life...
For career, I know what specialties to pursuit for...
But what kind of life I'll have 3-5 years later? completely blank
Personal development? Do I have other interest?

And even worse for my personal life...
used be to be alone but my friend asked me to change...how to change?
Even I'm not sure if I really want to change

ins and outs

2006-11-12T18:08:00.000+08:00

had vocational leave this week...
the main theme is meeting up with people

Met up Lawrence at Temple Street on Monday for dinner...Sunny joined later and have drinks at Langham Place

Visited Ngong Ping and Tai O on Tuesday, had a ride on the cable car and enjoyed the breeze at Tai O during sunset time

Sing K overnight with bondchu and his friends on Wed, know some new friends, um...

Met Clara at Shatin for lunch on Thursday...

Visit HK Museum of Arts on Friday...ran into some HO colleagues and classmates at restaurant

Sing K with Esther and her friends, met up with Lawrence, Sunny, Jar and his GF for dinner...I became the subject of discussion again. Go to have some drinks with Lawrence and Sunny again

In summary, In this week I've spend more compared with past 3 months, and probably drank more alcohol compared with the total amount in past 3 mths

ai ya

2006-11-04T10:19:00.000+08:00

Missed the chance to apply for attachment at QEH AED in the coming vocational leave...my fault

To play or to rest for the whole week???

um...lost soul

2006-10-28T01:32:00.000+08:00

Finding friends to eat outside every night...or go back to home instead...
u see how boring I'm at dorm...

Made some stupid mistakes recently, both at work and during my personal life
Feel frustrated about myself...

Am I a loser or not?

Perhaps I thought too much
or indeed, I cared too much

I thought I could really live my life alone...but indeed loniness is difficult to bear at the end
Bound to take risks to make changes on my current life
I thought I've given up on taking risks already, but the same story repeats again and again

滄海遺珠 - 劉浩龍／謝安琪

2006-10-11T00:31:00.000+08:00


作曲：謝國維 | 填詞：黃偉文 | 編曲：謝國維 | 監製：伍樂城

劉：大眾也喜歡珠光寶氣
　　沒有空完全明白你的美
謝：只得我　望見你　關起了心扉
　　猶如合上　貝殼的傳奇
　　若世間疏忽　從未細味

劉：讓那些蠢人　庸人嫌棄你
合：切莫讓人　影響了你　信仰你的真理

＊謝：如滄海深處　埋藏著遺珠（劉：埋藏著遺珠）
　　　其實你好處　個個也不知
　劉：唯獨我先可以　明白上帝構思
　合：於沙礫裡　找到　璀璨珍珠

　劉：人家冤枉你　平凡悶孩子（謝：如像孩子）
　　　但是你心事　我不信　
　合：無聊沒意思
　謝：沒有人識得欣賞　
　合：但天知　誰可以＊

　劉：大概這種　非一般的美
　謝：慧眼太少　旁人未賞識你
　劉：因此你　極客氣　差點算謙卑
　謝：從來沒對　愛　有所預期

　謝：若世界疏忽　從未細味
　劉：讓那些蠢人　庸人忘記你
　合：要是別人　都不愛你　有我這邊等你

REPEAT＊

　謝：你是誰你是誰　
　劉：可有地方發亮
　合：旁人忙著誇獎色相
　劉：沒有空管你的修養　
　合：唯獨我　留下拍掌

　劉：如滄海深處　埋藏著遺珠
　謝：其實你好處　個個也不知
　　　唯獨我先可以　明白上帝構思
　劉：於沙礫裡　　　合：找到　璀璨珍珠

　劉：人家冤枉你　平凡悶孩子
　　　但是你心事　我不信　
　合：無聊沒意思
　劉：就算誰都不欣賞　
　謝：但偏偏　　合：我可以

1.5/52

2006-10-11T00:18:00.000+08:00

10 days in KWH medical...

Life in easier for non-call days: I can really just work from 9 to 5, which is quite impossible for my previous rotation.

And MO will write lab form, obtain consent for CT/OGD, type discharge summary/discharge medication...which makes the daily duty of HOs more easier

Still, medical case is more complex than surgical cases and I found myself extremely slow for admitting a medical case compared with MO

Meeting with Mandy and Elaine on Monday, listening on how they complaining on there current rotation...actually my previous rotation is not that bad. However, we can't help comparing different rotation, and once there is comparision, there must be some point that we think our working environment is inferior to others places.

And after you guys had gone, there's something missing...life is easier, but more empty...
But still we have to move on, and we shall meet again

Go, Went, Gone

2006-10-02T19:17:00.000+08:00

Finally leave KWH surgical ward at around 1am, 1st Oct...

This rotation is more than a start of my medical career...

3 mth of hardship
3mth of funs (still remember our vetilation meetings during meal time, the chat and laughter at vascular lab on Wed...)
The 1st and the last time to assist an operation (well, too slacked on this aspect for a surgical HO)

Though hours are long and tiring...I think I can't ask for more

Just the busy work during oncall on the last day blunt my feeling on how I missed the time and people there, just want to leave ward ASAP after I've cleared up "homework" and get on the night bus to back home...

Next stop: KWH medical
How will my colleagues and MOs be?

Keep going

2006-09-23T01:26:00.000+08:00

Some Up's and Down's for the last few weeks working in this unit:

Ups: the relationship problem...seem to be resolved
Get to meet junior MOs outside workplace, eg. for meal...actually they're very playful and easy to go along (though quite mo liu at times)

Downs: had 2 crash calls in this month. I'm partially resposible for the death of a patient as I failed to catch the moment the patient was deteriorating. Definitely not a good thing...
and I learned that some MOs and nurses don't like me because I'm inefficient...I don't know how to response to that...feeling depressed yet angry at the same time...

Though I sweared I will never back there to work in future, this 3 months is definitely an unforgettable experience.

I do miss some people, like my HO colleagues, junior MO in my team...
If that incident didn't happen...we could be closer....

Bubbles

2006-09-13T01:54:00.000+08:00

Something happened in this few weeks, and it's not a good thing at all

The thing I'm proud of for working here has been kind of destroyed

If there is no good bonding between all of us, 沒有其他事可以令我留戀了

And about myself...more expectation, more disappointment

或者我真的想得太多了

Counting down the time till I leave KWH surgery...should a positive thing

Late entry

2006-08-26T22:38:00.000+08:00

Week 2 of August (7-13):
Vocational leave, back to UCH AED for attachement...this time I encounter more critical cases compared with the time back in Med4 summer. Susprised that some MOs do recognize me...

Back to ocamp need the end of the week, spend time overnight there. In fact I chatted with those med 3s more than those med2s and freshmen...also went "yum cha" with the med3s

Week 3 of August(14-30):
Just ordinary week...well, hard to recall anything spectacular...

Week 4 of August(21-27):
A week without phlebotomist...everything goes crazy...feeling tense about the "short-call" on Sunday
One thing worth to note...I successfully set an IV drip on a 7 yr-old kid this week...after 3 attempts though...

Um...finally, the last 4 wk of 1st rotation...everything could happen within this coming 4 weeks, but I can see the light at the end of tunnel now

Missing

2006-08-06T14:53:00.000+08:00

Being a HO for a few week already, so far frustration >>> satisfaction, don't think what I did does any impact on patient care...

Well, I work hard only because I don't want to leave any task behind for my fellow HOs...also work fast just to escape from ward ASAP everyday...

Where has my passion gone?

Maybe the ideal practice only exists in books

Rest

2006-07-30T12:29:00.000+08:00

It is the 1st time I don't need to oncall during weekends in this July. Crazy...but it's the last weekend in July!!!

Feel depressed to work at female ward alone in coming week, to relieve my colleague who is going to have her vocational leave...dreaded of drawing blood and setting drip on women...and my super low work efficiency

Tired body, idled mind

2006-07-17T22:06:00.000+08:00

The 17th day of internship...

I regretted to place KWH surgery in such a high priority, too busy, and nurses are not professional at all...
Did I learn anything? ummm
I would place QEH or even PWH surgery higher if I had a second chance

But I'm delighted to have such group of nice people to be my colleagues. We will help each other to clear up "homeworks" so that we can go to have meals together earlier. And meal time is the most joyful moment everyday as can chat together and "ventilate". And they are a group of funny gals...

Internet is important for me...but I still haven't go online in my dorm room...just can access intranet only...

By the way, I'll have my vocational leave on the week of 7 Aug...welcome to find me during that week

Placement

2006-06-29T00:35:00.000+08:00

Got the Ward and team list today...I will be at Ward S6 and Team 1 for 3 months, team up with ppl I know but not very very close with...well for this 3 mths, hope we can develop some rapport...and make some new friends

Happy working!

我不是好人

2006-06-27T22:59:00.000+08:00

Sometimes I feel uncomfortable as I think too much on how others think about myself

But being a "Good Guy" is important...I always worry about pissing others off because I did something or said something wrong...

This worry is not quite healthy...um yes I know...

Old memories, new routines

2006-06-26T20:55:00.000+08:00

1st day for following HOs at work, try to learn to take the role on the 1st day of July

Memories from the period I was as an Assistant Intern pop up in my mind when I was leaving hospital today, but "everything old is new again"...

At least I'm no longer an observer anymore...

Clinical Trial Coming to My Home

2006-06-25T22:08:00.000+08:00

Saw this poster at the notice board at G/F lobby today...

Day Zero

2006-06-24T16:15:00.000+08:00

Back to KWH for the 1st day...
1) Boring talk about KWH's background info, Admin structure
2) Get to meet all fellow HO for this rotation
3) Suprised to know I'm the only male there
4) Sociable colleagues
5) Funny tour around KWH
6) Many unknowns, including team and ward I will be in

Right...Let's hope for a good 3-mth period

Decoding the Code

2006-06-21T00:35:00.000+08:00

Attending the ACLS course for these 2 days (Pre-course prep talk on Sunday)
It's tiring but I do feel learn a lot from the course

I might need to take the leader's role while attending very sick patient...It's always difficult for me to be the leader...

P.S. Code: Cardiac arrest, for example, "run the code" means resuscitating a arrested patient

The Road Ahead

2006-06-12T21:14:00.000+08:00

The route of the 1-year journey...

1st rotation: KWH surgery
2nd rotation: KWH medical
3rd rotation: PYNEH ortho
4th rotation: UCH ped

Kay Tse - 謝安琪

2006-06-08T23:29:00.000+08:00

Bought her new CD album 2 days ago. Highly recommend!!!
She's a rarity among HK singers, a true gem in a haystick

Taiwan - Day 5

2006-06-08T23:16:00.000+08:00

For the whole album, visit here: Link

Taiwan - Day 4

2006-06-07T21:56:00.000+08:00

Taiwan - Day 3

2006-06-07T16:51:00.000+08:00

Taiwan - Day 2

2006-06-07T01:27:00.000+08:00

Taiwan - Day 1

2006-06-07T01:03:00.000+08:00

Moving out

2006-05-21T11:23:00.000+08:00

Archiving the old entries...

Moving on

2006-05-20T16:39:00.000+08:00

Fat Hing the medical student was a history now...I'm going to be Fat Hing the houseman in 2 month's time

Some good memory at the end of this 5-year period...thanks for everyone who share the same life together

A long journary is ahead...my friends, hope we can keep in touch

Waiting...

2006-05-20T10:26:00.000+08:00

Susposed the final MB result will be released after noon today

Heard many bad news in these few days...I'm more anxious now than when I'm taking exams...

I wish the mist will go away...and no more myth about exam result

The bigger challenge is ahead

Ambivalence

2006-05-16T16:03:00.000+08:00

Will my "3rd heart sound" + displaced apex = "confabulation"???

Pressure

2006-05-15T23:32:00.000+08:00

Exam in less than 8 hour's time...may the force be with me

Adjustment of mind...

Preliminary report

2006-05-10T21:45:00.000+08:00

Surgical Long Q: why it's exactly the same paper from last yr????

Medical MCQ: Infectious diseases, rheumatology, toxicology????

Nothing I can say...

Field Report

2006-05-08T23:44:00.000+08:00

Medinice long Q paper: ...I don't know what to say

Surgery MCQ paper: Longest MCQ exam I've ever taken...difficult questions with some physiology, anatomy, pharmacology, statistics...few "easy" questions

Conclusion: difficult to say

But I'll keep moving on for tomorrow

數字人生

2006-05-05T00:03:00.000+08:00

These days I was studying on dosage of various drug used in common medical conditions. It's really over-whelming. Memorizing numbers is really my "Achille's tendon", so it's quite easy to cheat me out of a few dollars...really admire people who got sense on numbers.

Studying really makes people more stupid

Golden Week

2006-05-02T17:48:00.000+08:00

Labor Day marked the start of the "Golden Week"...This week is golden as it's the last week before the start of Final MB exams...
--------------------------------
Task for this week:
1)Photo taking for Smart ID
2)Enter my internship choice on web

I shall behave like a soldier:Execute the plan first, question it later

戰至最後一兵一卒 !!!

Teacher or Researcher?

2006-04-05T22:18:00.000+08:00

Attended Prof. KL Chan's inaug. lecture

It was as good as his bedside teaching

But how many teaching staff do really teach, instead of just concentrating on publishing journal article to extend their contract?
(Prof KL is an exception though)

I would like to be like Dr. GC instead of Prof KL...doing research is good, but I think transfer of skills and knowledge are more important.
By the way, doing clinical research is difficult, but innovation is another level, which is much harder, and fewer people can do it.

Ending? Beginning?

2006-03-26T14:10:00.000+08:00

"Now, this is not the end. It is not even the beginning of the end...

but, it is, perhaps, the end of beginning."
Winston Churchill

曹操 -- 林俊傑

2006-03-25T19:07:00.000+08:00

作詞：林秋離　作曲：林俊傑

＊不是英雄　不讀三國
若是英雄怎麼能　不懂寂寞

＃獨自走下長?坡　月光太溫柔
　曹操不囉唆　一心要拿荊州
　用陰謀　陽謀　明說　暗奪的摸
　東漢末年分三國　烽火連天不休
　兒女情長被亂世左右　誰來煮酒
　爾虞我詐是三國　說不清對與錯
　紛紛擾擾千百年以後　一切又從頭

repeat ＊,＃　＃

Fw: 恐怖份子和女人有咩唔同

2006-03-19T14:52:00.000+08:00

1. 一個可以談條件、一個不可以。

2. 恐怖份子明確地告訴你他們要什麼，女人總是要你猜她們要什麼。

3. 恐怖份子?|跟你談判，而你不能跟女人談判。

4. 恐怖份子?|殺害人質，但是女人不?|這樣做，她們只?|綁架人質一輩子。

5. 遇到恐怖份子，你只有死路一條。遇到女人，你?|活在十八層地獄。

6. 恐怖份子用別人來談條件，女人用自己來談條件。

7. 跟恐怖份子談判，贖金可能越談越少。跟女人談判，要花的錢可能越談越多。

8. 談判中你可能可以找一堆人和警察來抓恐怖份子，可是通常女人?|找一堆人和警察來找你麻煩。

9. 女人把褲襪戴在腳上，恐怖份子把褲襪套在頭上。

10. 恐怖份子不一定是女人，但女人一定是恐怖份子。

The one and only...

2006-03-10T01:31:00.000+08:00

Shaw grad photo taking day today...天時,地利,人和
萬事俱備,只欠東風

Dilbert comics on Palm

2006-02-21T11:33:00.000+08:00