Holiday Season June 16th till July 14th 2008....

one month holiday!!!!!yeayyyy hope u guys enjoy ur holiday and yes i am ..... first week of holiday stuck in the college as...'membayar hari bekaraja' ....oklah i dont mind pulang.... but at least we finish most of our log book right? and in addition me (nizam), will present 2 additional discussions as of for my very safe site in regards with the clinical competencies....i mean saja kan menambah so masa abis cuti krg nda payah ku ingau kan log book lagi....ok guysss sana saja ....more newsss to cummm ok....

CONGRATULATIONSSSSS ON ACLS GUYS!!!

hi ...just to congratulate all post basic ae students 2008....damn that MCQS' sure not very easy...nizam here...arghhhhhhhhhhhhhh shit i had to take the third attemptbut eventually i still get thru........thank God for all His trials and i am glad though deep inside me ..i dont feel satisfied but anyway i still get thru though.......ok enjoy guysss... wish on everythinggg...got something lagi nie....hmmm thinking for singapore again....hehe

ABC of Sinus Arrhythmias....bla bla bla

Ok here is about .... normal looking QRS... QRS dulu baru P

NO? maybe VF, VT, Torsades de Pointes, Asystole, Idioventricular????

Yes? are QRS nya atu sebaya? (morphology?)


Then tani liat rah P wave.........normal kah nda?

NO? AF, Atrial Flutter, Junctional Rhythm or SVT

YES? P ada relation kah dengan QRS? start to think for heart blocks

ACLS REVISION ..... HEART BLOCK?

whats the difference BETWEEN THOSE? there are first degree, 2nd degree type 1(wenckebach) and type 2 (mobitz2) and 3rd degree heart block...RX LASTLY IS BY TRANSCUTANEOUS PACING (antar Gleaneagles ja!!!)

First Degree - stated that PR interval is more than 5 mm (meaning more than 1 big box).

Second Degree; Type 1 - Known as Wenckebach. it is when PR interval has been prolonged till at one time P wave is all by itself.

Type 2 - known as Mobitz 2. PR interval is constant and normal but then some P wave does not followed by QRS. ( OH YEAH I GOT IT NOW!!!!)

Third Degree - P wave has no relation with QRS complexes ( ani sanang ).

N.B all abnormal wave forms should be at least identified 3 or more !!

Advance Cardiac Life Support (ACLS) ON 2ND JUNE TILL 5TH JUNE 2008. VENUE COLLEGE OF NURSING

hi guyssss enjoying three days break? i did!!! ok now back to reality ACLS is coming and pooooffff!!! if we get thru this we will be considered all through as we are taking AE course (obviously) arghhhhhhhh i just wana cry nowwwww.... remember what will u do in emergency cardiac patientssss...... ok follow me... food for thoughtssss!!!

Shockable waves are ----- PULSELESS VENTRICULAR TACHYCARDIA & VENTRICULAR FIBRILLATION.

in any emergency situation never forget DRABC!!! Danger, Respond, Airway, Breathing, Circulation.... whatever the situation might....

ok so u call for help if no respond from the patient...call 991 or alert medical team on call on that day since ur in hospital....

again what do u mean by NAVVEL? INGAT SAJA PUSAT..HEHE ok if IV access cannot be establish.... 6 medications can get through via ETT tube...Naloxone, Atropine, Ventolin, Verampamil, Epinephrine(adrenaline) and Lignocaine.

so after u call for help....do 30 chest compressions with 2 rescue breathes via ambu bag dont forget airway or if u can do insert ETT tube...which u have to master in ACLS....attempt AED of 360 J(mono) or 150-200 J(bi)...

masih lagi VF or pulseless VT?? start 30 chest compressions and 2 breathes....give IV adrenaline 1mg 1: 10 000 dilution of 9 mls saline and 1 mls adrenaline then after 1-2 mins compressions...do another shock of 360 J... meaning finish 5 chest compressions tu baru bagi shock...

then on and on .....till bila? sampai dapat almost near normal wave or the doctor call it off!!!

Therefore; i can get through this ....we all can!!! May Allah bless post basic AE students 2008!!!