A&E so far...

I'm 3 days into my new job in A&E. Spent most of the first 2 days at "induction", where they run you through presentation after presentation of "what you should know", "red flags", "what to do with a sick child" etc.

Honestly, it the presentations really don't help with my confidence levels. Before I go to work each day, I'm filled with anticipation, dread, excitement... which just means that my stomach churns and my adrenaline levels escalate. We all have comfort zones. So I'm pretty comfortable seeing patients with a medical problem, ie., chest pains, COPD, pneumonia, haematemesis etc... yup, even the classic presentation of 82-year-old Mrs Bloggs who's simply "off her legs" brings me comfort. What I haven't a clue about... is everything else, especially orthopaedics (so the thought of broken bones, torn ligaments etc all freak me out), O&G (if you're preganant, I won't dare give you anything apart from paracetamol and intravenous fluids) and paeds. Paeds is the ultimate challenge. I mean, their whole anatomy and physiology is totally different. In the words of the registrar who gave us the paeds lecture, "Never treat a child like a little adult. They're different antomically and physiologically." So there goes... that's if I can get past the whole history and examination bit in the first place. How can I examine a kid without making him wail? Ok, some kids won't wail even if you stabbed them with a needle to get bloods of them, but that totally spells danger... when a kid is too sick to wail, they're very very very sick...

Ok... I do realise that this blog entry makes a really boring read. Please forgive my need to rant on... It keeps me sane.

Oh yah, here's what I saw this evening:
- lady coughing up copious amounts of blood
- guy with blood in his vomit and stool
- driving instructor with paronychia (swollen, tender pus-filled finger/nail bed)
( if you bite your nails, this is what you get)
I incised and drained the paronychia... not without problems though...
- preganant woman with abdominal pain
And my last patient of the evening was a classic. swollen, red and very tender left testicle.
Needless to say, he went to the surgeons.

Think I'll have to stop here and go do some of this reading... then get some sleep...