Betul ke Sarsi boleh Legakan Batuk?
3 hours ago
I was scrolling my Quora and came across this question. It is an interesting question if we are trying to answer it from perspective of healthcare workers like me vs riders.
To be honest, I don't have motorcycle license and have no skill to ride it as well. Haha.
And after working in the hospital,
I WILL THINK TWICE BEFORE RIDING ANY MOTORCYCLES. T___T
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| https://www.quora.com/Why-do-people-not-wear-a-helmet-while-riding-a-motorcycle |
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**WARNING - THIS POST CONTAINS WOUND IMAGES**
Let me share with you a recent case I attended in the Emergency Department.
It was the morning of last day of Ramadhan, maybe around 4am. The patient was a 16-year-old boy, if I am not mistaken. He was referred from a klinik kesihatan that was 40km away, with the impression of: To Rule Out Skull Fracture.
Resources in Klinik Kesihatan can be limited, they can do chest xray, but not others. I've experienced a lot of referral to rule fractures from KK and to be honest, skills of doctors and medical assistants in KK are amazing. They are usually the primary team to stabilize patient in areas without hospital.
So, back to this case, he was brought in on a wheelchair, with lots of gauzes covering different parts of all four limbs. He could even walk from the wheelchair to the bed.
Usually, when we attend trauma cases, we use ATLS as guidance.
ATLS - advanced trauma life support.
The PDF itself is almost 500 pages! -_-'
Starting with A - airway + cervical
- Patient able to speak in full sentences, no gurgling or stridor, no foreign bodies in the mouth/ nose, not on cervical collar, range of movement of neck was full.
Proceed with B - breathing + ventilation
- Here, we usually use the acronym IPPA - which means Inspection, Percussion, Palpation, Auscultation
- I - breath spontaneous, not tachypneic, chest rise was equal bilaterally, no chest wound
- P - resonant percussion bilaterally
- P - no clavicle tenderness, no chest tenderness, chest spring negative, no subcutaneous emphysema / crepitus
- A - lung was clear, equal air entry
- Don't forget to check the oxygen saturation too (SpO2)
Then, C - circulation
- check other vital signs - blood pressure, pulse rate
- CCTVR - Color of skin, Capillary refill time (CRT), Temperature of extremities (is it warm/cold), pulse Volume, pulse Rate
- for this patient, it was all normal - pink, CRT <2s, warm peripheries, good pulse volume, pulse rate around 60-70.
- then, we checked the abdomen - soft, non tender, not distended, no abdominal wound.
After that, D - disability
- GCS was full E4 V5 M6, pupils 3mm/3mm equal reactive
Finally E - exposure / environment
- Here, we inspected the whole body from top to bottom, from front to the back.
- This boy has abrasion wound everywhere - shoulder, elbow, hand, shin, foot. But there was no swelling, no limb deformity, no limb tenderness, no limited range of joint movement (means, he can bend all joints normally) - so we don't expect any fractures here.
- There was no spinal tenderness / step deformity during log roll
- But the head was covered with bandage and we could see some blood stain. When we open the bandage, fuhhhhh there was jagged wound, quite big one! the skull was exposed. And there was no skin flap to cover back the skull.
- We gave him antibiotics and painkiller too.
- FAST scan done, no free fluid.
Something like this but smaller around 6cmx6cm size.
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| https://www.slideshare.net/vipinvenugopalnair/free-ld-flap-for-scalp-reconstruction-dr-vipin-v-nair |
Okayy, I know there are LOTS OF MEDICAL TERMS here haha. It is okayyyy, you don't have to understand everything. :D
To make it easy, generally we can say that this patient was stable clinically, vital signs was okay. Just, if there was no jagged wound on his scalp, he didn't even need to be referred to tertiary hospital.
Biasalah orang accident mesti akan calar balar sana-sini. Takde patah, kira alhamdulillah sangat dah. Tapi untuk dia ni, kulit kepala dah terbukak, tengkorak terdedah camtu. Nak jahit kulit kepala pun tak boleh.
We managed to request CT brain in view of the wound was big and skull was exposed - just to rule out any skull fracture or any possible bleeding in the brain (ICB - intracranial bleeding).
Alhamdulillah, turned out CT brain was okay - no ICB, no skull fracture.
So, what we did for his jagged wound - we referred him to Surgical Team so that they can refer the patient to Plastic Team. In big hospital, you can see lots of sub-specialty for Surgery - neurosurgery, plastic surgery, ear-nose-throat, hepatobiliary team etc. But, we don't have such sub-specialties here. There nearest one for that is HRPBI - Hospital Ipoh.
If the wound was a simple laceration like the one below, usually we can suture it ourselves..
| https://www.medicalimages.com/stock-photo-image-image9257585.html |
I feel sad for his father, he looked very tired and when the surgical team informed him that the patient will be transferred to Ipoh, we could see his 'pasrah' face. I believe the importance of parenting, but kids nowadays can be beyond control.
This is one kind of accident that actually can be avoided.
Why?
The boy is underage, without licence, without helmet, went out riding motorcycle with his friends around 12am, speed at least 80km/hour and the mechanism of accident was as I expected - he said "kawan main motor himpit-himpit, saya tak boleh control motor tu yang terbabas"
Rasa sedih bila jumpa kes macam ni.
And there were countless cases like this EVERY SINGLE DAY.
So, if you guys or your family members are motorcycle riders, do remind each other kay.
Always wear helmet.
200530
SM, Perak, Malaysia
Day 10 of May Photo Challenge - Self Care
I Miss...
May 15, 2020
I miss travelling actually, walking around the airport to catch flights.
I miss sitting by the window and watch the beautiful scenery from the top.
I miss the feeling to pass the security control and to have another stamp on my passport.
:)
I was actually planning to have a trip back to Czech after completing my housemanship hehe :D. Usually, after housemanship, we are allowed to use the remaining annual leaves and take a long holiday up to 27 days (if I am not mistaken). But my husband was still working at that time, so I decided to wait for him first to go later together. I went to the office to inform that I would be starting my floating (junior medical officer) soon.
Due to Covid19 outbreak, my friends who decided to take that long holidays were called to start working and our leaves were apparently have been frozen since March.
Ouch.
And I think travelling abroad is going to be tricky after this pandemic, right?
Maybe travelers need to provide supporting documents, health reports - new norms maybe?
Day 9 of May Photo A Day - I Miss...
SM, Perak, Malaysia
200515
The Sky
May 12, 2020
Sunrise from the hospital, to be exact - the Emergency Department. :D
I think this one was taken on my post-night shift around 7am plus.
Sunrise.
Means it is another day.
Another opportunity. Another chance.
For?
Being a better person.
I always wonder, how did I survived housemanship the past 2 years. To be honest, I believe most housemen will have the thought of quitting, but due to every own reasons, most of them survived and still surviving. It was a tough journey. Hanis Amanina who you are seeing now is a lot different than who she was in Czech or before that. Hehe :D
Go with the flow.
Sometimes, I cannot deny that the HOship hurt my heart and feeling a lot. I believe it affects my personality, my attitude and my knowledge. Learning as a medical student is not the same as being a doctor itself. The responsibilities I need to carry every time I do something to the patients, always overwhelm me. Still.
But at the same time, honestly it gave me happiness as well - able to manage patients correctly, able to see patients getting healthy, surrounded with good and helpful colleagues, have the opportunity to say the first Assalamualaikum to newborns. MashaAllah, the feeling was AMAZINGGGG and I will never forget that! :)
I believe the key is not to give up.
Recently I read the The Art of Letting God, at the very first chapter, it shared about the greatest temptation. I agree that the greatest temptation to deal with is the temptation to give up.
"Are these goals truly achievable? Am I being realistic? Am I good enough? Am I worthy of such achievements? Or is it simple better for me to just give up?"
In the book, it mentioned about dealing with it is by asking help from Allah. When we looked back the story of Prophet Moses (peace be upon him), despite only asking for ease, he also asked for strength, wisdom, patience, ability and support.
I have shared a post about DOA PENERANG HATI when I was still a medical student. At that time, I was having difficulties adapting with Czech's exam system where almost all exams were done orally. T_T It was a struggle to speak medical stuffs or answer medical questions confidently in the exam because once you said something wrong, the examiner will directly know you are lacking something there and suddenly he will go deeper on something that you are not confident with.
But Alhamdulillah, that phase has passed. :)
Housemanship tooooo :)
Alhamdulillah alhamdulillah.
Anyway, still remember my collections of sky over 2014? Can't believe 6 years have passed. WOWWW. MashAllah :)
Day 8 of May Photo A Day - The Sky
SM, Perak, Malaysia
200512
I am not sure if you can find people talking about this movie on your Facebook
timeline, but it happened to mine. I was a bit hesitated to watch at first but
subhanAllah it was definitely a great movie to be appreciated! :)
It is actually a Turkish movie and I have no experience watching any before.
Synopsis:
The story played around the Korean War eras which was between 1950-1953,
where United Nations came to help South Korea from being attacked by North
Korea. One of the countries that send a lot of soldiers was Turkey. A
Turkish brigade was sent there, one of the soldiers was Sergeant Süleyman.
While Ayla was a 5 year old Korean girl, lost her parents when their village
was bombed. The name Ayla was given after she was saved by Süleyman from a
frozen night in the moonlight. Two of them developed deep connection as
father-daughter, where Ayla could be seen around Süleyman almost every time
and everywhere. They were together for almost 1.5 years.
Upon completing his task in South Korea, finally it was time for Süleyman to
return to Turkey and he found it difficult to leave Ayla. They were attached
to each other. Süleyman tried to leave Ayla at Ankara School but ended up
trying to bring Ayla back to Turkey in his suitcase - his mission failed.
Süleyman had to leave Ayla alone. Upon arrival to Turkey, he tried his best
to get in touch with the school but the communication was disaster because
of the war. Both of them reunited after almost 60 years. T__T
This is a real-life story where we can watch the documentary Kore Ayla on
MBC in 2010.
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| Sweet! |
2. War Ethics
Ayla was found in the sea of dead bodies.
"Cowards! They slaughtered everyone, even the children."
Somehow, I suddenly recalled the war ethics of Rasulullah - one of them is
don't kill a woman / a child. Ayla witnessed her parents died and refused to
talk, maybe she was traumatized. Süleyman didn't want to leave her anywhere,
he ended up taking her to the base.
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| The very first time Ayla met Süleyman |
After failed his attempt to bring Ayla onto the ship back to
Turkey, Suleyman accepted the fact that he need to return alone. He promised
himself and Ayla that he will return to meet her.
The scene was heart breaking T_T
Can you imagine a small kid who had lost both parents in front of her eyes,
now need to be apart with the one she loved as a father? T_T
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The ending T___T |
I know that we are now in PKPB where almost all local roadblocks have been
lifted. I think there are some at the districts' borders, no idea actually as I
haven't try crossing the district yet.
Lots of time, the scenario was like this:
During the PKPD, I need to pass through 2 roadblocks between my house and the
hospital. It was supposed to be 8 minutes journey, but with roadblocks, I need
to leave the house at least 15 minutes earlier. Less cars actually at the
beginning and the middle of PKPD, but fuhhh the traffic was torturing towards
the end of it, especially when we were entering the PKPB.
|
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Kad Petugas Kesihatan |
Similar to other health care workers, I received my own card too. Just
sharing this here so that I can read this later. Still not fancy much to
share life journey on Facebook. And I still prefer the blog to elaborate my
stories and experiences than on Instagram.
Police / army: Assalamualaikum Cik/Puan. Nak pergi mana ni?Me: Nak pergi kerja encik.Police / army: Oh, kerja mana?Me: Kat hospital.Me: *I can see they suddenly took a glimpse on the front screen*Police / army: Ohhh, maaf Cik/Puan, tak perasan kad ni. Okay, boleh jalan, lambat pulak sampai nanti.Me: No problem. Terima kasih Encik.
I am not sure if the card is small to be seen, or maybe I put too deep between
the dashboard and the screen so it could be hard to be seen. Haha
But, never mind as the questioning did not take too much time every time I
mentioned about the hospital.
To make it even easier was by hanging my stethoscope around the rear-view
mirror.
Honestly, I think they have a challenging task to check every cars. I felt so
bad seeing them standing in the middle of the road under hot sun, even on
rainy days too. T_T
Police / army: Ohh doktor kee? Boleh check kami tak? *sambil gelak-gelak*
Haha, here I knew they were already tired. You know, sometimes, you can see a
tired face trying to say something funny to cheer themselves. :)
Me: Bolehhhh, nanti saya inject sekali. Nak saya cucuk kat mana?Police / army: *sambung gelak*
Thank you to all frontliners.
Now, everyone need to take care of our own.
- Always think twice before leaving the house especially if we don't have solid reasons.
- Always wear face masks outside especially if we are dealing with people
- Always wash our hands / use sanitizers
- Keep 1 meter distance with each other - social distancing.
- Avoid 3C - closed conversation, confined space, crowded place.
Day 7 of May Photo A Day - A Throwback
SM, Perak, Malaysia
200511
I Made This PPE :)
May 10, 2020
On last Wesak day, I had this opportunity to learn and watch the staff nurses making our own Personal Protective Equipment (PPE) in our observation ward, this ward was closed due to rearrangement of our Emergency Department into Respiratory area & Non-Respiratory area and has become our 'store' and staff area.
- Respiratory area - attending patients with any complaints of SARI (severe acute respiratory infection) symptoms like fever / shortness of breath / cough / runny nose / sore throat / any history of Covid contact. Sometimes, the patients may come with other main complaints like infected wound over foot but just because he/she have any of these SARI symptoms, the patient will be attended in Respiratory area.
- Non-Respiratory area - attending patient with any complaints without SARI symptoms
Me: kak, nak try buat satu bolehh?
SN: haa, nah try jahit bahagian lengan ni dulu.
At first I just need to sew the stretchy area over the end of the sleeves. Then, slowly and patiently, Kak Daini & Kak Atun taught me how to sew the whole PPE. Since I have no skills of using the sewing machine, my product was not that neat. Terlebih sana, terkurang ni. Hahaha. Nasib baik laa PPE ni pakai buang. If you compared to their products, fuhh, dah macam baju raya, kemas sangat!
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| My first PPE everrrr. |
Honestly I only have the most basic skill for sewing, which means, I can only do hand sew like picture attached below.
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| Source - https://www.apartmenttherapy.com/how-to-sew-basic-stitches-221433 |
Though my mum is literally good in this, I guess I don't inherited the skill haha. For every Eid celebration, my mum will usually send some plain cloth to her favourite tailor and then she will make her own decoration on the dress with all those beads, labuci etc. For mine, my mum will 'encourage+force' me to the same so that I can survive with hand sew haha.
But, my skills of using the sewing machine - NIL
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After completed one and a half of PPE suit, we heard the bell informing there were new cases in the respiratory area. So, that marks the end of my PPE sewing journey. Lol, when I returned to the sewing area later, seems like they already finished sewing. :D
It was honestly a nice experience.
Thank you akak-akak sabar mengajar!
p/s - my mother-in-law has awesome sewing skill too! :D
Day 6 of May Photo A Day - I Made This
SM, Perak, Malaysia
200510
My Fave Room
May 9, 2020
If you have read my blog since I was still a student in Czechia, you must have seen this view somewhere. :) Hehe
Though it looks quite messy (read: too many colours), at that time, I was satisfied with the wall. There were lots of memories that I can see almost every second being in the room.
To those who have just being a reader to my blog, welcome :)
This is actually from my room back in Czechia, it was a rooftop (4th floor) flat, 2 bedrooms + 1 bathroom with toilet + a kitchen. When I tried to recall memories staying in the flat, alhamdulillah, I must say I should be grateful to be able to rent it due to many reasons
1. Nice landlord.
- though there was a huge language barrier (even with our agent), we managed to confirm our rental with agreed amount of monthly rent. The landlord was initially an uncle with his wife. After he passed away, his daughter took over (she even decided to return to Czechia to take care of her mother although she already settled down somewhere in African continents).
- I was beyond happy when they agreed after we requested to reduce our rental a bit (due to final year, I planned to do my attachment in Malaysia). And it was fated to be, I went home 4x that year (summer break - my brother passed away - medical attachment - back for good).
2. Strategic location
- it was located very close to the main train station, so it was such a relieve if my friends and I return late at night from Prague. At that time, we usually take a day trip to Prague to buy those varieties of halal meat or for usrah, so the final train was around 10pm (arrived at Hradec Kralove around 12am)
- Tesco was just within walking distance. I found to be awesome as I can go to Tesco any time I want haha.
- most official offices are around as well - Vodafone (internet plan), main post office, 2 shopping malls, library.
- peaceful neighborhood (despite being in the city center). The main road in front of the flat was only for residents and public transport, so there was no traffic at all!
3. Fully furnished.
- I am still searching photos of the flat (they are somewhere in the gallery), but the price is totally worth the flat - in view of most basic furniture and electrical appliances were included - fridge, washing machine, dishwasher, oven, microwave, 2 sets of bedroom furniture, full set of kitchen table. If I am not mistaken, it was CZK 12000 approximately RM2000/flat/month.
Alhamdulillah, this time around, I managed to get good landlord in Manjung too :)
Anyway, I miss Hradec Kralove, I miss Czech! Hehe.
Okay, off to night shift, pray for a smooth one kay :)
Day 5 of May Photo A Day - A Fave Room
SM, Perak, Malaysia
200509
Neighbourhood
May 6, 2020
This was taken on the first day of PKPB. :)
The view look much fresher than before, I can say.
Day 4 of May Photo A Day - Neighbourhood
SM, Perak, Malaysia
200506
I am Dreaming of...
May 5, 2020
... this pandemic to be over.
I am sure everyone hope for the same too.
It was a hard year, I can say. Beginning from end of January, when the team was given a briefing about the potential spread of Covid19 in Malaysia, then we were taught on how to properly don and doff our PPE. At that time, the cases were still low, there was no social distancing even in the hospital. When the cases increased in number, almost all seminars / teaching sessions / CME have been cancelled. In the middle of March, healthcare workers' leaves were freeze and most of us need to work and go to the health care center as usual.
It is already 2 months since I last met my parents too. I miss hugging them.
I miss the beach, so close yet so far.
I miss travelling.
I miss freedom of playing badminton at the courts with friends.
I miss going to body massage (which my body need it right now).
I miss eating out.
But, I believe everything surely happens for reasons.
I hope by the time this pandemic is over, we already learnt how to appreciate the health more. Always continue all the proper hygiene we have learnt through out the MCO. We will appreciate the moments we can spend with the families too. InsyAllah :)
Day 3 of May Photo A Day - Dreaming of...
SM, Perak, Malaysia
200505
Dalgona Coffee's Impact
May 2, 2020
I was working morning shift that day when my colleague passed over a pending night case. I That was my earliest day of returning to work after 2 weeks of quarantine as I became close contact to 2 positive Covid19 colleagues. Alhamdulillah my swabs turned out to be negative and I need to be non-symptomatic and complete 2 weeks of quarantine.
So, this young lady (Miss A) was in her 20s, with no underlying diseases, presented to us with palpitation and no other symptoms. Basically palpitation is an uncomfortable feeling that the heart is racing or the heart beats too fast. Same feeling when you are about to receive your exam results, or maybe when you see your crush walking around. :)
This same feeling is normal to me ever since I started working too. Haha. Nak masuk kerja selalu nervous sebab tak boleh nak expect much apa akan jadi sepanjang shift. So, I will always expect the worst situation so that I can get more prepared.
Okay, back to the patient.
Palpitation is normal is you feel it after a sprint or physical activities
It is also normal if you are stressed or anxious about anything.
Not to forget, if you drink alcohol or caffeine.
Why? your heart is pumping blood more frequently to the rest of the body to support it. :)
However, if you came to the hospital because of this, the health care staff will definitely need to rule out the emergency causes especially the heart problem. Along with palpitation, you definitely need to visit your doctor if you ALSO feel difficulty to breath / dizziness / collapse / fainting.
For this patient, some blood investigations will be taken - usually:
- full blood count (FBC) - we can see if there is any low hemoglobin, so it can be a sign that your body does not receive enough oygen.
- renal profile (RP) - to check your baseline for kidney function
- cardiac marker (in my hospital setting, we will take troponin I) - here, it can show if there is any problem with your cardiac (heart) muscles, maybe the muscles also do not receive enough oxygen and start to break down.
- electrocardiogram (ECG) is a must - this can show the rhythm of your heart, is the conduction of impulse okay or not
For Miss A, the blood results turned out to be normal and serial ECG was normal (improving sinus tachycardia, without ischemic changes going on)
Back to the history that we already taken at the beginning, she admitted that she drank lots of coffee during this Movement Control Order (MCO). She claimed that prior to this, she drink a cup of coffee as usual and she denied having this symptom.
To my surprise, during MCO, her caffeine intake was 4 TIMES DALGONA COFFEE A DAY!
If I use the viral Dalgona Coffee's recipe, it mentioned to use 2 sachet of Nescafe for one drink. So can you imagine how much sachets she drank a day? T_T
Diagnosis: Palpitation secondary to Caffeine
We re-accessed her after a while and decided to discharge her after she claimed her symptom is much improving and she looked very comfortable. We as well advised her to reduce caffeine intake and to come to ED urgently if she developed any other symptoms (especially chest pain / shortness of breath etc)
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I know that we are encouraged to give all out in everything we do, but please do not jeopardize our health. Okay?
SM, Perak, Malaysia
200502
View From A Window
May 1, 2020
Since the MCO took place, my life rotated between the apartment and the hospital. I rarely go to the supermarkets as my husband will do most of the groceries shopping (usually after his post-night shift). Our schedule are shift based as people know. Most of times, the moment we leave the hospital is when the supermarket close.
Still, we have food to cook and eat, alhamdulillah. And surprisingly, from the 1st day of Ramadhan till now, we managed to cook ourselves (our aim is not to order outside food hehe)
I miss the beach a lot too.
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| The view from our room :) pretty! |
I am currently reading The Art of Letting God by Mizi Wahid. The book is not that thick, but I honestly took longer time to read. Not because the book is boring or what, but the contents are beautiful enough for me to take my own sweet time to enjoy.
There is a part of the book sharing about "You Have What You Need"
Human is a creation that usually gets disappointed when we don't get what we want. Our aim is that the moment we ask for something, that something should be given. In this book, you can enjoy the idea that actually Allah has already given the 'ingredients' to get that something.
For example, we want to excel in our studies. Of course we need some efforts to reach the destination. We are blessed with knowledge shared by older researchers or teachers that are contained in the books. That can be the ingredient for success. Books = knowledge. Others can be experiences, some skills that need to be polished from time to time. To be an adult as we are today, we need to grow as a baby to a kid, then to a teenager. We don't simple born and suddenly became an adult, right?
Life is a process.
Prayer is a process too.
Even if we failed, we surely will learn something if we have tried our best. I love the lists in the book about what we should look forward to despite failure:
- A greater aptitude for patience
- A richer experience of life
- Personal growth
- A deeper sense of gratitude and satisfaction
- Strength to overcome future challenges
- Grit to get through the dry seasons
- Resilience during tough times
Keep on living and learning :)
Always see things from the good windows (read as perspectives), yea?
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| I am planning to join this photo challenge :) Wish me determination hehe |
Happy Labour Day!
Byeeee.
Assalamualaikum.
Seri Manjung, Perak, Malaysia
200501
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