Tuesday, 10 December 2013

S;U;R;G;I;C;A;L

Cirugía ~ Bedah ~ Chirurgie 
All Kind of Surgery Under One Roof











Surgical, the name itself says it all, obviously is NOT a medical-based department
In other words, besides the usual ward work, you have to go inside and help your superior in the operating theater as well, in case if you cant notice the difference!

Some people may have prefer OT (operating theater) but as for me, i find myself hating OT, because of ONE reasons :-

 Its damn cold in there!
- this is my main reason, if only OT is not too cold, I may have end up becoming a surgeon. Can you guys believe it, the damn nonadjustable-centralized-aircond is responsible for my future !! I believe all hospitals are the same, but i have no evidence to support that.
I don't care anymore, its all in the past. How about you? xD



" I am too HOT for this cold environment "
      - ancient Zimbabwe Proverb :p





There are several sub-division (if i can say) in Surgical Department,
but depending on which hospital you're at..
Example, HKL has neurosurgical department but Hospital Kuala Pilah do not.
What does this information has to do with houseman?
Say you're in a hospital where theres no neurosurgical, if a patient brought to ED (emergency department) with severe head injury that requires operation, the patient will be straight away sent to a hospital where there are neurosurgeon, less admission to your ward, right?
Less job for houseman !!

There are :-
1) General surgery : Appendicectomy, colostomy, laparatomy, hernia repair, Mastectomy ect..
2) Hepatobiliary : Cholecystectomy, Biliary Reconstruction, Whipple, ERCP, ect..
3) Urology : Cystoscopy, TURBT, TURP, ect..
4) Neurology : Craniotomy, Evacuation of Clot, ect..
5) Paeds : Appendicectomy, Hypospadia repair, Anoplasty, infected circumcision, ect..
6) Plastic : Skin graft, facial reconstruction, burn injury, ect..
7) Cardiothoracic : Heart problem, lungs problem, ect..
** not all hospitals have all sub-division
** not all sub-division are compulsory to housemanship

If you love surgical based, then more is better...

If you don't, less work = less stress...

I don't have detail info on every hospital in Malaysia, ask Mr Google yeah!



Surgical Houseman Preparation ^_^
Most common cases you'll find in surgical are :- (read & learn how to manage them)
- Acute appendicitis
- Urolithiasis
- Breast cancer
- Colon cancer
- UGIB / LGIB = upper/lower GastroIntestinal Bleed
- Intracranial Bleed or Cerebral Concussion
- Rib fracture





" Inspiration is like bathing. It does not last, that is why we recommend it DAILY "

# watch this movie for inspirational purposes only,
NO, the actor is not my father, nor does I am representing Johnson & Johnson in any way !!!
- this is a good movie for doctor, i personally recommend it








** Tips #1 : To be a successful houseman, the 1st thing you need to think of, when there is a new patient admitted to the ward (no MO around), is whether this is EMERGENCY case or NOT. You are expected to handle cases based on PRIORITY !! Always think and work smart. So go learn what are the cases considered as emergency in surgical.

** Tips #2 : To be a successful houseman, the next thing you need to consider is, to anticipate whether the new case is going for emergency operation / procedure or not. If you think your Specialist / MO will decide for operation, then you should PREPARE the patient for operation. Such as, keep nil by mouth (puasa) + set IV line + give IV drip + take all the necessary bloods + consider ECG / Chest xray for older patient (normally age > 40 or younger if with underlying illness such as Diabetes, Hypertension, asthma)

** Tips #3 : Always ask your MO FIRST if you're not sure, don't simply give your plan if you're in doubt. Give your superior a phone call, it is much better to get scolded via phone, than in front of everybody for doing the wrong thing. Senior houseman can be a good reference to you, but there is still risk as they are still HO anyway. MO is your best shot.


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