BBQ at Pantai Seri Kenangan November 23, 2008

ok guys..the pics are not in coordination ..ngalih ku kan put in order so i just dump everything nie ah .... kami ada BBQ at the respective beach .....it was a lovely day... attendees were of course griller hafiz and his friend joe kah his name..shahrin and GF, jack and GF, halinah and her two kids, zalin, ida and hubby, raliza with hubby and son, sofy and shema...whos missing? hmm eddy, amal, seri and damit..(FYI damit came early she had to go for a function)....ok observe the pics...

two love birds (bet u know sapa nie dri belakang ah)

hmm..ketawa ku nie pic ah...wats wrong with this pic? anak c linah yg bini2 atu was brought along with the wave so badannya pun ikut sama...haha

delicioso...chixs bbd'ed by Hafiz....thanks for him to conquere the bbq...we just have fun n eat ...

haha...penghulu looking at the foods..mmmm kekanyangan ya nie sudah at this time..haha

pic from behind....

the same log i took with sofy....this is edited one i can feel the loneliness from this pic...just like me..

shema with her lappy...zalin busy makan non stop..kalau ku estimate i think she ate within one hour...stop and then continue...hmm so much food guysss

posing for a sausage...hmmm u think that's how sofy eats a sausage? by sucking it or....hehe

shema..earlier part checking mails from her lappy...

mmmm apa nie ah? sofy from side view....

childhood days....sofy u have long legs..impossible to slide that easily...

zalind second round....no its first round..she opened a can so its a starter of the event...

EXAM FEVER!!!!

oowhhh.... most of us experiencing adaptation of fever, nausea, headache, constipation, abdominal cramps...u name it...all presented signs and symptoms of temporary state of nervousness on the coming exam....it sucks u dry ...well its three days ahead now...read, read and read....

X rayss...

Skull #

Pelvic # (obviously u can see the detachment)

Case Scenario....

A 25 years old guy - Matt, involved in a road traffic accident at about 10 am. He was driving alone. It happened that he collided with another car, but the other guy he got into the acccident was all fine. But not for Matt... on arrival of the paramedic at 10:20 am, on assessment, he was alert, respond to verbal stimuli but complain pain on the abdomen, head, neck area and right arm. There was a big laceration on the parietal area with profuse bleeding noted.

Blood pressure 90/50. Pulse 110, Respiration is 14/min Spo2 is 89% GCS scores was 10 by 15. .......

Hard cervical collar was applied with use of hard board with body strapping as for immobilization of the body. Full blast Oxygen given via mask delivered. Thick application of bandage was applied onto Matt's head as to stop bleeding. Initial IV access was started by administering Haemacele of 1000mls. Question asked to Matt and denies any previous medical or surgical history. So, he was very fine guy before the accident.

Arrived o AED about 10:30am....wat would be the next interventions??.....ABCD people....we are now in the secondary survey!!!

REVISION WEEKSS........

hello people!!! post basic students of various specialties are now facing exam which will be held on the 20th and 22nd of this month of november 2008. there it goes.....revision, literature reviewsss...and stress all summoned up towards the end of these courses....arghhhhh stress, stress and stress. hey its non stop...however, AE students are still being posted in the AED in the respective area...so at this time of this week...either work or revision or both?! luckily...grateful to the AE staffs, hope u guys understand our situation these days....we are facing some serious matter here...its to determine whether we go through the course or the other way round...your choice people!!

just to help some of the important topic to be covered....one of our colleague found a very interesting site on the management of polytrauma here it is .....

1 . http://www.rcsed.ac.uk/eselect/cc11.htm (author Neil M. Nichol) very interesting site as to cover up the management of such case...if u guys go through "next module" u will find more managements of different cases.....so i think its very useful resources.....

2. Another web site i found pertaining to the course management..i obtained from the medical blog of RIPAS team click the (The Nightingale's Page)...they posted some links with interesting topics which might help in your revision....hey its +- 2 weeks from now..so u wont have the full time to start fresh i assumed!!!

3. Next is, as of polytrauma case hintsss........ ABCDE!!!!!

4. http://www.moh.gov.bn/satisticshealthguidelines/indicators.htm ..... or http://www.moh.gov.bn.... this link u guys to our Ministry of Health website if u need statistics of your favoured cases....the latest statistics was that of 2006. hmmm i heard there's already 2007 edition but as if you see in the website, it ended up to 2006 version only.....for this purpose..it helps u to answer some of your queries of the pertaining problem...banyak kah nda case anie di Brunei?...sumthing like that....

ok people...enjoy your revision...and discussion....

Rainy Monday, November 3rd 2008

rain started since midday about 12 noon...quite heavily and stops awhile around 1:40 pm....it continues again sometime about 6pm...off and on...till around 9:30pm. AED in RIPAS was also busy in the afternoon..well..it's been busy all the time anyway.

encountered patients in resus area....cases such as Intra Cranial Haemorrhage (ICH) and Epilepsy...later i talk about these patients.... and even in medical wards both female and male alike were full out of empty beds to occupy the in coming patients....arghhh where else to put them?! up to the medical to decide....stress continues as these awaiting pts to be transferred to the respective wards...and thank God! paeds wards at least not a real much concern regarding admission.

back to the resus area...yess both patients (ICH and epilepsy) developed stages of fits somehow for either a minute or few minutes...cant really tell u guys how long exactly the episodes last...the ICH patient was confirmed through CT scan done and it was very obvious that u can see the depressed of certain part of the brain....hmmm i forgot which part sorry for that...given IV Diazepam 10 mg to settle his state of epilepsy....hmmmm..at this stage not sure if he is supposed to be put on IV steroids as to relieve or reduce ICPressure (ICP)...it is known steroid does this job....anyhow...maintaining O2 sat with delivery of O2 via mask has been continued till his admission around 4 pm plus.....(he came before 1:30pm)...due to unavailability of bed in the medical ward...

next epilepsy patient from some are (can't tell u where he's from exactly!) while in the AED, had developed several episodes of fits which lasted <1 minute...took sometime till seen by medical on-call to order IV diazepam 5mg....while CT scan, no meds given ..hmm am afraid somthing terrible will happen...fits patient with no meds send for CT scan? think about it..it will harm u and ur career as a nurse....this is where nurses role came to us....assure is it ok pt send for Ct scan without any meds prior to the procedure??? ....it was a tough decision coz if anything happen..the blame is on u(nurses), not others.... where is assurance, where is safety for us and for patient??

it seems that AED on Monday was actually like any other day busy as usual....per se, 'datanglah beramai-ramai bagi memeriahkan suasana di AED'. i know its not funny but it depends on u people to decide....AED nurses are used to endless work and duty in this dept.

interesting case also, one child came in with # radius (i think) it was a green stick #(?le or re?) ...MUA was done in the dept with assistance of another medical officer..well done guys...the infamous Ketamine came up as a sedative for this pt...Ketamine is well known drug as for children as a sedative....the MUA was done as soon as the child has 'fall asleep'...or not actually asleep...but mcm 'heng' sekajap....i wonder what actually this child experience?? is it pain but no voice or really 'heng' abis!? i look up in his eyes give him a smile..just to say hello to him and how he's worked out after admission of ketamine....yes he was totally unresponsive....i like to say goodbye sometime for pt under sedative...as for me is to make them comfort...banar kah tu?

anyhow..he got through an another x-ray was done to confirm the MUA was a success.... only three cases shown ....in fact there's more but i cant tell everything in detail....am not a camera surveillance btw...

the time is 10:45 pm and is still raining......wat a wonderful life..u think so?

Outing at Cikgu Zaleha's Saturday 1st November 2008

saturday....2nd house of cikgu zaleha...another function...ermm this commemorate late raya celebration....however....i failed to produce group pic with cikgu zaleha..sorrrrryyy for that again..i think i was too busy with karaoke..hehe.. ermm....gengzzz yg lain mana??? eh nanti u all kalau ada function lagi mesti kamu attend ahhh....esp. function that involves our AE group 2008......so next one will be compulsory for all AE PBS.........

cikgu zaleha, with zalin and fatimah.... at the back was cikgu punya'anak buah'. sorry no name..

sofy and shema..busy playing games with zaleha's daughter and son...

sofy and shema...


cutey ...ida's son...eeee gigitan meliat!!

ermmm for me ..i interpret this pic mcm org be kelaie..nda betagur(kidding!!)..haha..ok..on ur left Dr. eddy and right Dr. Da

for this issue...not much pics were taken ...sorry again...so actually amongst those attendees not included here were..cikgu mai, cikgu jainah, cikgu sendi, matron hj julaini, cikgu rahim...sorry guys..we were too busy with singing and stuffs...nda lagi te ambil gambar...plus amoy, timah, raffee, hj salleh(AE tutong), iskandar and hj helmi (AE temburong)..also attended at zaleha's house......from AE post basic 2008...thanks alot for the treat...we appreciate it!!....

Eating Out at Cikgu Salmah's on Friday 31st October 2008

hi guyss...this week was busy with invitations...so friday at salmah's house as to celebrate her daughter graduation plus raya celebration...btw...congrates for her daughter on her achievement. here were some of what we upto while at her place.... (sorry for cgu salmah, her pics turn out blur so i dont want to post the pic....)

wats so funny about this pic? hehe see how sofy reacts!! haha

me (posing for nothing)

group pics ..these guys are the only one who attended as for representing the AE group

some menu available..

sofy and seri...

haha..look how sofy and seri behaves...

hjh zalin and me(nizam)...

hahaha..love this pic..sofy looks so full..people! dont judge from outside of her slim figure!!

seri and her hubby....