Italian hangover

SPO2 monitoring 

I was zonked out yesterday. Watched the World Cup finals from 2 am and went to work straight away after that. I was in charge of daycare surgery thus the 8am sharp start.I was finished by noon but my pre med rounds took me hours to sort out.7 paediatrics cases man ..complicated lak tu. By the time i went home I was so stoned that i slept from about 4pm till 9pm !! haks.. gile miss sembahyang !!!

I was satisfied with the game , initially it promised goals as it was 1-1 by the 20th minute. As time progressed , you can sense that nobody will be scoring and thus the penultimate penalties. It was obvious from their body language ; whose team was more confident Besides Zidane's heroic head butt , there was nothing else exciting about the game. The italians deserved to win .. and now they are the most successful European team to win the World Cup. Forza Azzuri !!

I was quite glad this morning to find out that the surgeons cancelled 4 cases , making only 3 to do today. I was doing the CVL list ; surgeons putting on a permanent IV access on the child's major veins via surgery. This is usually common for terminally ill patients for their parenteral feeding or chemotherapy. This is also always a nightmare for us to anaesthetize ; imagine telling the parents about the risk of having their child expired after administrating anaesthesia.

Anyway , I was really sad for this 12 DAY OLD baby. She was very unfortunate to have her intestines resected on her 5th day of life ; she had duodenal atresia ; in layman's term ; her gut was not well formed therefore causing absolute obstruction. It was a very major Op then; the surgeons were hoping to save some of her gut ; but unfortunately it was really bad. Her parents did not have a clue about all of this ; their initial complaint was baby did not defecate for 4 days since birth.

SHe looked very thin ; cachexic and malnourished. Imagine , 12 days of life and she just cannot take feeds . The line inserted today was for her nourishment ; but honestly , her prognosis is very poor. There was no way she can absorb any kind of nutrition into her body and she will die slowly. The measure taken today was just palliative ; and nothing can actually be done. So sad...

I was with a final year student doing the list. She was a bit of a nightmare to start off with because we can't intubate her.. Well , we did but her tube dislodged when we repositioned her head and she desaturated to 48% with her pulse rate coming down fast. I went a bit panic because the staff nurse was extra "rajin" today by throwing away all my emergency drugs prepared especially for this baby girl ! haks.. Nasib baik my 1mg in 10ml atropine was around .. so we resuscitated her and she all right with LMA. Somehow , with the small ETT she has some obstruction.. somewhere..

The procedure was simple ; thus the short time of anaesthesia. Before sending her off to the Paeds ICU , I was a bit disturbed.. because i know her prognosis and maybe ..that'll be the last time we meet..