the procedure
Started my ICU posting in Selayang today. I was preparing myself for a busy month as ICU posting was the most demanding area of anaesthesia during my HKL days. Post call , I'm usually knackered and my off day will be spent on bed. Selayang has less ICU bed but we are practising the "open" system where the primary team will have the say in the management of the patient.So maybe not as busy as HKL lor..
My first day in Selayang ICU was very mild. There was nothing much to manage as yet.. being a new day with mostly having old patientsaround. After rounds , Dr Suresh ( our cool Intensivist ) offered us to do tracheostomy on a particular patient. As i've never done it before , i volunteered myself .In HKL , it was only the consultants and specialists doing it. So why not ?
It was quite scary really. Imagine , poking somebody's throat and inserting a device for the patient to breathe.This 28 year old man , who developed really bad bleedingintracranial haemorrhage ; and the neurosurgeons had opted to treat him conservatively. He did not recover neurologically ; which means that he remained stone with the ET tube in him.Sort of vegetated . We don't think he will progress from what his current condition is. Therefore , the indication for tracheostomy.
Dr Suresh guided me well and i managed to do it without totally traumatising the patient !! Of course , we had to make the patient relaxed and paralyzed first before doing all this .After dissecting the area i poked my patient with a needle to get a free flow air gushing out from my syringe. Dr Suresh viewed through the fibreoptic scope from inside to ensure that i don't poke through to the oesophagus !! Then, I had to use brute force to insert my "rhino" ; a dilator before inserting my trachy. haks.. Nasib baik tak pecah tekak noo.. heks..
Not bad for my first day in ICU. Looking forward in doing more procedures !! haks..
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