I'm really suffering from a bad cough at the moment. I've recovered from my URTI , no more fever but my non productive cough is persistently making me uncomfortable.
I was on call yesterday , and the cough was obvious with my colleagues and nurses voicing their concerns. It was Ok in the morning , but with the cold air conditioned OT environment it made my cough worse especially last night. I was coughing non stop late last night doing my last case. I have never thought myself to have asthma but a colleague suggested that maybe my irritation is caused by some hyperreactive airway activities ; aka bronchospasm. I auscultated myself and yes.. there were ronchi !! damn..
So last night.. was MY FIRST EVER NEBULIZER episode !! hahaha.. I looked really funny with the nebulizer mask on , sitting by the corner in PASCA.( a small corner in the OT where we put our complicated post operative patients ) The nurses were actually laughing at me as i admitted myself to the unit.
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THe call was allright ; as i managed to do quite a number of new things with my Senior MO in charge. He's a kewl Jo and taught me certain interesting tricks in anaesthesia. Usually we are taught in theory to use certain drugs but rarely do it. LAst night , we made it into practical and yup.. it was useful !! Good old KETAMINE.. hehehehehe..
One thing unique about UM is that we practice regional blocks extensively. All my orthopaedics Op patients yesterday were on this purely local technique and alhamdulillah most of my blocks worked. There was this 25 year old malay boy , who was assaulted when he was drunk and being young and thin , he was the perfect candidate for us. His right hand needed reconstruction and we managed to make him agree for a regional brachial plexus block. He was apprehensive in the beginning having the thought of not being put into sleep during the procedure. I reassured him and we did the supraclavicular block easily.
Of course during the procedure we gave other drugs to sedate and make him sleep but it is not General anaesthesia.GA has its complications and in a way , if we can avoid it , we should. Midazolam is a very good drug and the other benefit was we were able to extract extra information from him willingly. He takes all kinds of drugs under the sun !! damn it, and to think that he is a final year undergraduate student in one of our universities in Malaysia !! .. He was satisfied having the whole of right upper limb numb and heavy ; not being able to feel anything at all during the procedure.
Will i become a regional anaesthesia blocker ? I'm forming a club here...
1 comment:
didnt know u a fan or, 2-(2-cholorophenyl)-2-9methylamino)-9cyclodexanao, otherwise call kat or Vit K.
try using it orally, take 1mg per poung or a quater of that nasally..
Vit k doesnt always do justice for music but it really improves your sensation and perception.
You need several doses before you get a good line dose, the dose that will send you into orbit without burning you down and crashing
Before reaching the first line, fragmentation will occur- the world will begin to spin, but it won't be dizzying. Music will become fragmented. Chaos will ensue. At some point, you will find yourself complete removed from your surroundings and your body. Descriptions of the post-line experience vary substantially, but most include talk of alternate planes of existence, oneness, past and future revelations, and strange fabrics of all sorts. It will be very difficult to communicate at this point, and you probably will not be able to see or hear others in the room. Some revelations will be extremely heavy and some scary, but that fear does not seem to come back with you and is therefore difficult to describe as scary. You will probably find yourself coming back across the line again visibly, attempting to put an object in focus or define it.
carefull though, you can get quite nauseated........
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