w.I.b:warung ikan bakar:
Harap-harap INI KALILAH !

Saturday, March 31, 2007  

Chest Pain!!!

Having graduated from the labour room, I now work in a very busy male medical ward in one of the busiest district hospitals in this country. Last friday, I nearly made a major boo-boo in my young career.

During the afternoon visitng hours, (a period in the ward which I always disliked because of uninvited attention and questions from the concerned relatives and friends of my patients) , i was suddenly 'disturbed' while writing my discharge summaries by yet another concerned grandson of a patient. "Doktor, katil 23 - sakit dada. Cepat!"

This patient, day 5 in ward for an acute coronary event (UA), was already improving, and planned for discharge the next day. He is known to have more chest pain and SOB symptoms especially when family members are around. So, I slowly walk to entertain his 'chest pain', must to the displeasure of his family.

He was not really in distress, not tachypnoiec, mildly sweating on the forehead, and his hairy chest. "Doktor, cepatlah,...bagi oksigen"

I suppressed my inner thoughts "You doktor kah saya doktor?" and asked the staff nurse to do an ECG and I gave him GTN, and gave him high flow oxygen mask. All done in an unhurried pace.

I was going to tell the relative who shouted orders with the ECG print to assure her that everything is okay and lecture her about the need for oxygen and what is real chest pain and what is not.

And then the ECG showed - ST elevation of Lead II, III, aVF.

It was a humbling experience, and a good reminder that I am far too inexperienced in the trade of a physician to jump to conclusions about my patients. I am so glad to have done an ECG anyway.

| |fooji made noise at the warung at 4:48 AM

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