THANMAI DASAROJU from 2017 batch posted in General medicine department from 12 th October to 11th December 2022
for the first 8 days i have been posted in
NEPHROLOGY
During this time i have assisted in central line insertion under the guidance of
Dr. Bharath sir
Dr. Raveen sir
Dr. vamshi sir
Have learnt the proceedure for the central line placement
Have witnessed few complications that may arise during the procedure and learnt from them.
i have learnt CPR on a patient who went into cardiac arrest. Unfortunately we couldn't revive the patient . Got shattered as it was my first patient but eventually learned to detach from humanly emotions and to do my duty. learnt how to convey bad news to Patient's attenders.
I have also learnt how a simple misunderstanding could kill a patient, as i was confused with NTG and Lasix vials.
would have lost my patient if i hadn't been vigilant.
Thanks to the Sister working at dialysis for pointing out my Mistake.
Seen CRF, AKI cases and learnt their management .
For Next 7 days i have DONE ICU duties
most of the time my work was just monitoring.
but yet i tried to learn whenever i got time.
i learnt how to take ABG samples with the help of Dr.Pavan sir and Dr. Shashikala ma'am
i have also done RYLES tube insertion under Dr.shashikala ma'am guidance
i have done FOLEYS catheterization under Dr.shashikala ma'am guidance.
Assisted in ET intubation under the guidance of Dr.Charan sir
During rounds I have actively involved in ICU and AMC patient's case discussion .
one case in particular gave us a tough challenge, we couldn't control the Patient's fever spikes, we tried in all possible ways to diagnose him but couldn't. , Later after numerous tests He was referred to higher center, i have followed the case and got to know that the patient have SLE.
All the symptoms patient had was really atypical.
that made me realise that the books we read and the real life cases are quite different and unique and we learn alot from real life cases.
NEXT 15 days i have been posted in PSYCHIATRY
during this time i have seen PANNIC ATTACK, SCHIZOPHRENIA , GENERALSED ANXIETY DISORDER, ALCOHOL DEPENDENCE, BIPOLAR cases.
learnt how to deal with the different types of patients.
was really proud of our college psychiatry faculty as they made great efforts to reduce the stigma around psychiatry illnesses.
Was able to help PANNIC ATTACK patient by diverting and helping the patient to learn few diversion techniques.
Now this 30 days from 12/11/2022 to 11/12/2022
i have been posted for Unit duties.
1.During the first week we had one admission in ICU
DIAGNOSIS: COPD WITH RIGHT HEART FAILURE
with k/c/o DM ,HTN
? AKI on CKD
2decho video link.
LEARNING POINTS:
saw raised jvp in this patient
jvp video link.
Typical barrel shaped chest was seen in this COPD patient.(PICS IN BLOG LINK)
2.During 2nd week 2nd patient in ICU
my co INTERNEE has done this blog and i have continued it from 26/11/2022
This is a case OF ARTERIAL FIBRILLATION with HEART FAILURE WITH COPD WITH ANEMIA WITH BICYTOPENIA.
LEARNING POINTS:
• suspecting her very low hemoglobin levels i,e 5 gm/dl could be the cause for her right heart failure.
Anemia could be the result of poor diet
• Role of anticoagulation therapy in patients with Atrial fibrillation.
• Learnt about CHA2DS2-VASC score
• Role of Diltiazem in rate controlling, as this patient was having heart rate around 110- 130 bpm(irregular) , after treating her with this drug it came to around 80- 90bpm.
3. Blog link
New admission
28/11/2022
C/O
A 15 YEAR OLD MALE STUDENT WAS BROUGHT TO CASUALTY WITH C/O FEVER SINCE 15 DAYS
(EVENING RISE IN TEMPERATURE)
ASSOCIATED WITH CHILLS & RIGORS
C/O BLOOD IN URINE SINCE 3 DAYS
C/O 1 EPISODE OF BLACK COLORED STOOLS 3 DAYS BACK
CONSTIPATION SINCE 4 DAYS
Learning points:
• Learnt how to manage Dengue
29/11/2022
During rounds today one patient from ward was brought to icu,
He had seizures and went into cardiac arrest.
• Intubated this patient under the guidance of Dr.Raveen sir
• Done CPR .
unfortunately He couldn't be revived.
Learnt Intubation steps. And CPR protocol and procedure.
on 1 /12/2022
we had admission to icu.
This is a case if 17 year old female came to casualty with c/o
INVOLUNTARY MOVEMENTS of B/L
UL & LL - 1 EPISODE 30 MINS AGO.(NO TONGUE BITE,FROTHING, INVOLUNTARY MICTURITION. POST ICTAL CONFUSION PRESENT) .
•you can find the Detailed case here -->
LEARNING POINTS:
•I have inserted a RYLES tube & a FOLEYS Catheter to this patient.
• wittnessed a very peculiar type of tonic seizures,which lasted for about 30 seconds with a 60 seconds gap for 15 to 20 Minutes without regaining of Consciousness. the video is attached in the below link.
•we have conservatively managed this patient.
we did EEG while she is having seizures. you can watch the video here -->
• i have learnt how to manage and stabilize a seizures case.
8/12/2022
collecting venous samples
INSERTING IV CANNULA
Case:
this is a CASE OF 55 YR OLD MALE WITH C/C
PAIN ABDOMEN SINCE 1 DAY
WITH VOMITINGS (5 EPISODES)
Diagnosis: Acute on chronic pancreatitis
Learning points:
Learnt management of acute pancreatitis.
inserted NG TUBE in this patient
