headache

It feels like the temple of my head is squeezing everybit into my mind.

It is aching pain.. 

Results from getting all tensed up for the ACLS I"m taking on Monday. 

Well, why tense up..? cause it's the second time I'm taking and I don't want to fail it again. 

I think I give lots of 'what if' situations when I'm studying the algorithm, and ends up with ' what if she (examiner) came up this... oh no.. what should I do?' questions. 

I know where I screwed up in last exam. When my friends were taking the exam, I can answer the questions that the lecturer asked them in my heart. I know where I should be going. but when it reaches me... 

I panicked, kept my mind focused on the second part of 'getting the bp set, oxygen mask, iv lines' cause I scared that I might forget. THAT leads me to forget the straight away thing after checking responsiveness and call for help is check pulse.. 

A total wrong right from the start and I lose all the confidence.  

she says no pulse. 

start cpr immediately.
get defib, give oxygen bag mask, set up iv lines, and cardiac monitoring. This is where it should come.
the cardiac monitor shows this:

the second part I get wrong, is I didn't figure out it's a PEA activity. 

the screen shows sinus tachycardia. 

the examiner looked at me saying "are you sure?" when I said 'shock' patient.. then I took a lot at the screen again.. I know I'm not wrong. It shows "sinus tachy." THEN after like 5 seconds of looking, the chart pop into my mind. only VT and VF is shockable. I was like.. 'OH HELL!!' and it's a 'pulseless' and so it's a PEA. should not shock the patient! this is non-shockable rhtyhm. 

continue cpr for 5 cycles and then add in atropine 1mg iv every 3-5 min. 

check rhtyme and pulse.

then she continued saying no use. no use for two times and I repeated my answer with atropine two times.. 

so what should I do? 

yes, investigate the causes..

I listed out the 5T and 6Hs. but took some time again listing cause I was panicking already.. 

I was all 'crap crap' 

then she asked me what's the most possible cause in this patient. 

pt is young asthmatic. 

I said "hypoxia"

what else? 

eh... 

what others in young asthmatic? 

so. then after I paused for awhile i decided to give it a shot since it's the only answer in my mind, so I said "tension pneumothorax"

correct..

so what should I do? 

needle decompression. 

landmarks?

second intercostal space, midclavicular line. 

and you'll hear a hiss sound after poking

then what do you do?

check rhtyhm and assess vital signs. 

take x ray

patient returned normal

pulse present.

yay.. then..? 

what did you do just now?

I think think back.. needle decompression... 

insert chest tube! 

take x ray. 

asssess vital signs. 

patient returned normal

monitor. 

post resuscitation care.


so the most important thing for me is not to panic..  and have confidence. oh well.. I got the most difficult twisted case.

I studied hard for this time.
I must pass this time.
I can be a leader when I want.

best wishes for me. 

Windows break down

Technically, infected by malware. Something called windows vista antivirus 2011. DO NOT TRUST THIS PROGRAMME.

Few days ago, I noticed my computer started lagging behind but I blamed it on my memory ram. Then, later, there was something popped up from the windows when I was surfing the net, claiming that there are 25 infections on my computer and I need to buy the programme i.e., Antivirus Window Vista 2011, to clean it. I was scared because it sounds so true, so real, and some more it's from window itself, but my nod321 did not scan out any viruses from my computer. Then, it blocked me from going online.

How frustrating I was, then, I get myself spyware doctor, and went through the steps taught in the website. It works for a day, then, my computer started going crazy. The next day I started up, I couldnt' find my nod321, I lost chrome, mozilla, msn, skype, pps, microsoft, and even the control panel was not within my control. I have no choice but to reformat everything.

And now, I'm updating, and reinstalling everything, as I could. And my new version of computer desktop.... *rolls drum* TADA!

Dun feel like going back to vista as well after this, it's like a PTSD. :D windows 7 should be better. I hope.

Medic, I can't hold on?

Once one get into medical field, you'd surely be asked, 'how's medicine? Is it hard?"
Some people might nod, some people might say 'it's okay'.
I used both responses.
To different people.
At different time.

I used to say to people.
"No, I don't regret studying this." with a joking "not yet." added to the end of that sentence to make people think that I'm not egoism.
But now...

I have different thoughts.

Recently, this year,
I'm thinking more and more to myself, asking myself, do I regret this?

The answer, out of 99% is 'yes'.
Most of the time, I have this thought of 'giving up'.
But all the time, I rejected the 'pulling myself out' from this mess idea, because I still wished to think that I can do this.
I still wished to prove to myself that my future life is not as bad as what I thought...

Sometimes, I wished I had chosen a different thing.
I wished I had been more firm and more AWARE of what is happening around me.

But I was not.

And I doubted if I am out of it now.

Spice of life

Looking back at my time, suddenly realized that the last 22 years in my life was blank as paper. Nearly.
They said that if someone knew that one's life is near death, he/she will have a list of to-do list, wanting to finish them all off before life's over.
You wouldn't know when your time will be over.
Every day, you set a target for yourself to achieve.
Life's short if you think about it.
Before you knew it, ten years passed.
How many more ten years do you still have?
You wouldn't know.

We're young for a reason.
To live it.
Enjoy it.
Savor it.
To the fullest.