Iri is having fever

Ziqri @ Iri started having fever yesterday. With flu..now nasal congestion. 

Ape pun less than 2 years old cannot give antihistamines (cough mixture, chlorpheniramine, etc).
Actually, all these already written on bottles. Please check the small print, ok..

Kalau nk jgk..can go to private clinic. Most are prescribing this meds. As for us at Govt clinic..we cannot practice this..must strictly follow MOH guidelines.

But, frankly said, anak aku kalau umo 1 year 2/12 & above...developmentally normal (gross motor, fine motor, speech & hearing, and social), growth charting normal (weight & height-to-age, and also HC (head circumference)...aku bagi je...tp, mesti under close supervision tau.

What's in Dr's mind are a lot...kite dilatih peripheral thinkings. Tapi, public tak pikir camni kan. That's why aku nak SHARE with u ols. THE MORE U KNOW...THE BETTER. Ilmu yg bermanfaat walaupun sedikit mesti dikongsi (Sunnah Rasulullah).
Everythings that may looks simple to you guys may not be so simple to a responsive doctor. So, please ask NICELY when you in doubt...,coz i definitely not kind of entertaining MR / MRS ARROGANT..(harap maklum & harap keluar dari bilik aku dgn segala hormatnya..huahuahua...Inilah doktor kecik yg dh separa senior tp patient slalu kate aku muda mcm baru grad. Ade yg ckp aku mcm bdk sekolah form 3. Sob sob sob..) ->Taktau nk classify feeling sedih or happy or terharu...kui kui kui.

Lagi satu, jgn order Dr. for antibiotics if Dr. says no indication for it..
(antibiotics are not OTC drugs..that's why only doctor who are trained for at least 5 years medical training can decide whether u can have it ir not)......
Not '1 day doctor' who wiki or read on medscape. Clear?
Ermmm...lagi, kalau anak demam..jangan malas tepid sponging tau..Takottt kene Febrile Fits nanti. Nak tdo mlm sumbatlah Supp PCM (Aku sumbat Supp Voren..power sket..amek kt klinik A..tmpt aku locum 2 thn lpas)..

Ok lah..lenkali aku share lagi.
Anak aku dh start nangis balik.. Waktu tdo asik terperanjat je.
Ni aku kene lah cuti lagi...jage anak..

Till then, enjoy reading.
 

Death-in-line..DIL

Mggu ni aku oncall. Kat klinik ni..oncall office hour je. Bukan sampai malam. Ade certain KK, especially yg jauh dari hospital & penempatan staff mencukupi ada MO passive call (Yg ni dpt la elaun oncall).
Okess..rini dh pulak tepat2 kol 8am aku sampai klinik..baru tgk 3 org pt, MA dah call.
MA Nizam: Dr Shikin ade patient AEBA. ( Rase x sedap hati..baru 3/52 lepas aku hantar pt AEBA check-in ICU).
Masuk Bilik 9 a.k.a Treatment Room/Bilik Rawatan.
Allamak..
79/Malay/lady..U/LB.Asthma...gasping..
MA Nizam is giving her nebulizer.
MA Nizam: Dr nak bagi hydrocort?
Family members around - : Dr, nenek saye ni mmg asma. Tapi, dh lame x kene. Kene serangan asma ni pukul 5pagi tadi. Dr. boleh cpt2 htr die ke hospital?
Aku: Ok..bg IV Hydrocort 200mg.
(WTH skrg dh pukul 10pg baru ko nk bawak pt?) Ehh..nak cepat2 pulak.. Nape bawak pt lambat sgt. Ni dh tahap kene masuk ICU tau! (Terus senyap.. Tau pon tutup mulut. Kot ye pon tggulah aku check dulu. Die igt doktor spital tu nak terima kes sesuke hati tanpa full history & examination & management at our primary centre? U igt i nak hntr nenek u check-in hotel kerrr?)
Pt ni mmg mcm nak collapse je..tp, still alert.
BP:199/118, PR: 146, RR 42/min. Reflo 25.4 (hoh ni macam undiagnosed DM...kes tak penah check health status kt klinik ler ni..)
JVP not raised.
Lungs : generalised ronchi, reduced A/E both side.
CVS: S1 S2 No murmur. ECG - SR, no ischaemic changes.
No pedal oedema.
Aku nak admit pt dh mase tu. Tp, mcm2 dugaan terjadi...
Pt suddenly collapse..GCS3/15..kene intubate.
Aku kol Medical MO oncall HPD, MO ED HPD...dorg x dpt trime pt coz ICU full.
Then, aku kol MO Medical HTJS, MO Anaest HTJS....xde ventilator jugak. (But actually HPD kene accept case..stabilize pt...then decide further. HTJS pon same. Ade ker suruh doktor KK yg cari outsource? Kadang2 kitorang kat KK ni rase mcm kitorang pulak yg keje spital. Sampai bile pulak kite nk ambubagging pt?). At last, aku lari tgkt atas cari FMS..tak kirelah die tgh meeting ke hape. Die tgk patient..and kate mmg kene htr HPD jugak. Apalagi..aku terpaksa gune org atas..Aku kol bos besar, Specialist Medical HPD...die kate mmg HPD patut terima kes becoz we had managed pt at our best in our primary centre. Thereafter, hospital yg kene decide & find the outsource. Baik betol boss..die kate akan kol Anaest..)
Aku accompany pt ke ED HPD..MO ED tanye....dh inform DIL kat family members?
Aku : Ohh..belum. (Aku mmg dh x cukup nafas berlari ke sana/i...caling2 sume pon dok tolak case. Ape kate ko jelah inform DIL).