A teacher taught

I think YANG ESA had given me the SIGN to buck up my knowledge and skill in anaesthesia.I have not been reading nor revising in late . I don't need to really but i suppose it is my responsibility to renew and enrich my knowledge. haks.. I'm just lazy because i know i will have to work extra hard when i enter UM this June.

I had 2 difficult intubation cases in the last 2 days. The first one was expected , considering the magnitude of his submandibular( jaw ) abscess. The swelling was around his neck and he himself was a bit obese. I had my specialist in to do this one ; and i could not visualize the vocal cords. Obviously , it was easy for boss to insert the tube.. although we were a bit worried too as we could not ventilate him well.

Yesterday;s case was a bummer. I had a tagger with me. She is fresh from her housemanship posting and decided to join anaesthesia. Me , being myself. kononnya jadik cikgu la dok mengajar.. heks.. And this fella , a 50 year old chinese man , whose Airway looked normal , thin..and should be a piece of cake. I gave my "padwan" to intubate. There was no problem in ventilating the patient. She said she could not see the epiglottis. i said..ok.. let me show you.

" Ok.. just observe me closely. You gently lift up.. haa.. you can see the epiglottis right.. then you just lift.. eih... alamak.. "

I found the epiglottis but unfortunately i was not able to lift up to see the cords.Shit ! Malampati III , I nearly panicked. then we bagged him , it was alright. his saturation never decreased. I tried again with a longer blade.. but still , I just could not locate the bloody larynx. Told the nurse to call my specialist. She came eventually , and we managed to intubate him via the bougie ( a special apparatus ). haks !! Tula.. kononnya nak mengajar.. tak dapat pulak tetiba !! haks..

I'll be going for MSA's airway workshop in Melaka next week. I one day course in enriching us with airway knowledge especially handling the un "handlable". heks.. It should be fun as Shakti will be there too..