PRP Week 19 - Clinical (Ward NICU)

Yuhuuuuu, my second week in clinical was still dealing with kanak-kanak. This time, involved neonates. In NICU (Neonatal Intensive Care Unit), usually the preterm babies were kept here. Also for the term babies with some illnesses. NICU hold approximately 50 babies, which is more than any other wards. 

Every morning, I will follow the ward pharmacist to do ward round with the specialist. Some common cases in NICU are neonatal jaundice, respiratory distress syndrome (RDS), presumed sepsis and retinopathy od prematurity (ROP). It's sad watching small babies having these sort of illnesses. Poor babies...

Many medications in NICU are made into floor stocks, that means the nurses don't have to go to satellite pharmacy to pick their trolley. NICU don't have the medication trolley. Some common drugs used in NICU are C-pen and Gentamicin for presumed sepsis, aminophylline or caffeine for RDS, multivitamin, folic acid, vitamin b complex and many more. Other than drugs, other important supply for the babies include EBM (expressed breast milk), preterm formula and term formula. For babies who requires oxygen supply, they will be put under CPAP (continuous positive airway pressure) or nasal prong.

For babies who requires treatment for jaundice, they will be put under phototherapy, from single to even triple phototherapy for a least when their bilirubin level has dropped down to normal range.

For NICU, I presented a case of presumed listeriosis. Quite a rare case in NICU.

Ok, that's all.. =)

Photobook #2 - Paris & Disneyland

by Photobook Malaysia

RM52 (coupon) + RM12 delivery

Around Paris city

Disneyland & Walt Disney Studios

Photobook #1 - Amsterdam, Holland

Hey guys! Good morning! Hari ni nk blog pasal photobook Amsterdam. Photobook dah berkoyan2, jadi apa salahnya nak bagi preview sikit kan. Kalau nak tengok full, kena la datang Johor Bahru. Hahaha.. Trip ke Amsterdam ini ialah pada musim bunga tahun 2012. Cuaca sedang elok gitu, tak sejuk sangat dan tak panas.

Photobook ini bersize portrait 8" x 11" dengan ketebalan 40 muka surat. Harga asal RM208 tapi beli pada RM52 sahaja daripada Ilovediscount ataupun Groupon. Syarikat pembuat ialah Photobook Malaysia. Alhamdulillah, so far semua produk yang dibuat sangat kemas dan cantik. Next time nak tunggu lagi promotion & nak beli kupon banyak2. Harga delivery ialah RM12 per book dan dihantar melalui kurier. Sangat pantas dalam seminggu dah bleh terima photobook ni. :)

Front cover

Walking to Zaanse Schans

Zaanse Schans

Iamsterdam

Clog & windmill

Keukenhof tulip garden

Keukenhof

Dam Square

Group photo!

Ok, itu je.. bye2..

PRP Week 18 - Clinical (Ward 8D)

Hurrayyyy~ Finally I entered into clinical department. The toughest and the most exhausting dept ever.

Since this week was started with CNY breaks, thus I only attached to Ward 8D for 3 days only. Ward 8D is a paediatric ward which means the patients are mostly children. However, there is a case of patient age 15 years old who was admitted here because other ward didn't want to admit him.

During my attachment to ward, there are some routines had to be done throughout the day. These are what most of the ward pharmacists will do:

1. Clerk case in the morning to see whether there are new admissions into the ward.

2. Write down all the medications for each patients and their significant lab findings to see whether there is a need to make interventions.

3. Follow specialist ward round, usually started at 8.30 am or 9 pm depending on the specialist. Most of the time, house officer (HO) and medical officer (MO) will follow the round and they will present the case to the specialist. The specialist then will do some examination on the patient such as blood pressure measurement, pulse rate, saturation and others. Usually my job is to listen to the discussion and then write down if there's any change, addition or removal of medications. Also need to write down which bed will be discharged today. Any inquiries regarding medications will usually be asked to the FRP since they have more experiences.  

4. After round, I will go to Farmasi Satelit to check the medication trolley for the ward. If there's a change, I will checked the trolley, removing or adding the respective medications. However, there's no trolley for ward 8D, so I'm kinda free after ward round.

5. Since some paeds wards do not have medication trolley, I have to write down a list of patients who have CIVAS and then I need to print the labels out. Usually, CIVAS is for antibiotics except Augmentin, ampicillin, cloxacillin and c-pen. These 4 antibiotics are not stable to make CIVAS.

6. At 12pm and 4 pm, I will call satellite to ask if the discharge medications are ready or not as I need to send those medications the the patients. 

7. Some patients need counselling on certain instruments or medications such as insulin pen (Novopen), MDI (metered dose inhalation), warfarin or others. The most common counselling in ward are insulin and MDI.

8. Clerk case is one of the requirement in clinical dept. For adult ward, 20 cases per week while for paeds 15 cases per week. For ICU, 15 cases per week. Thus I have to fill in the CP2 and CP1 form everyday to make sure I have met the requirement. I will usually stay back after work to do the clerking until 7 or 8pm.

That's all for the first week of my clinical attachment.

Takde gambar, sorrehhhh.. XD

Liku-liku Melancong

Assalamualaikum wbt dan salam ceria semua..

Hari ni nak cerita pasal pengalaman pahit getir ketika melancong di luar negara. Maklumlah, walaupun tempat pelancongan tu maybe zero-percent crime rate, tapi kita tidak boleh pandang remeh tentang keselamatan ketika berjalan-jalan ye. Walau ke mana pun kita melancong, kena sentiasa berhati-hati dengan keadaan semasa serta dengan orang sekeliling. Kadang-kadang orang yang tak suspicious tu la yang akan merobek kocek anda.  

1. Rome, Italy

Italy memang terkenal dengan kadar penyeluk saku yang tinggi ye. Kena sentiasa berwaspada pada setiap masa. Ada beberapa kes, kawan-kawan kena seluk tanpa disedari. Walaupun beg sentiasa berzip, kadang tangan pencuri ni pantas. Zap zap zap terus hilang dompet dan segala. Peristiwa ini juga berlaku kat ayah aku semasa menaiki Metro (subway) di Rome. Tetiba dihimpit orang dan lepas tu terus sedar wallet dalam kocek sudah pun lesap. Maka habislah wang Euro & Pound Sterling, kad pengenalan, kad kredit dan sebagaikan. Memang terus gelabah, lepas tu semua orang takde mood nak jalan2 dah. I won't come here again. Menyampah... Habis sumber kewanganku tau, kena berjimat cermat je lepas tu.

2. Venice, Italy.

Wahhh, Italy lagi. Kau memang bad luck ke apa? Selain kejadian curi-mencuri, negara Europe juga terkenal dengan mogok aka strike. Peristiwa yang mungkin terjadi adalah seperti mogok kenderaan awam mahupun mogok lapangan terbang. Kalau ini terjadi, sistem kenderaan akan lumpuh sebahagian besarnya. Semasa di Venice, during our last day of trip in Italy, perkerja2 Batobas (bot) bercadang untuk mogok selama satu hari. Maka kami terpaksa berjalan kaki dari hotel ke stesen kereta api yang jaraknya mungkin 3 km dengan mengusung beg, jalan celah2 bangunan dan juga turun naik tangga. Oh, I hate it.. Sampai kat stesen je terus beli air..

3. Brussels, Belgium

Ini pun berkaitan dengan mogok kenderaan awam. Metro memang lumpuh sepenuhnya manakala bas sedikit sahaja yang beroperasi. Maka berjalan la 2km dengan beg ke hotel dari stesen bas utama. 40 minit jugak la. Tak ke membazir masa tu? Lepas tu nak pergi city balik kena la jalan 2 km lagi. Ahhhh, benci.. Pembaziran di situ.

4. Paris, France

Ok, ini bukan la liku-liku sangat. Tapi nak cerita jugak. Ni pun berkaitan dengan kenderaan awam iaitu bot tambang. Ni memang salah sendiri, di mana kau kehilangan one-day tiket. Ish3, dalam 9 Euro camtu la tiketnya. Masa tu tengah busy dok shopping souvenir, mungkin tiket tu terkeluar dari wallet. Natijahnya, aku sorang naik metro ke Louvre manakala kawan aku lagi 3 orang pergi naik bot tu, juga untuk ke Louvre. The bright side is, aku sampai lagi awal daripada diorang. So, aku sempat jalan2 kat garden depan Louvre tu. Maunye 1 jam aku tunggu kot diorg tak sampai. Time aku tengah lepak2 makan roti, tetiba banyak burung merpati datang nak mintak roti. Kacau betul la.. =.=

5. Nevis Range, Scotland

Ski trip tak menjadi. Dah semangat tau pergi ke Fort William sebab nak main ski kat Nevis Range. Masa naik bas 4 jam dari Glasgow ke Fort William tu pun dah cukup mencabar. Met Office dah keluarkan warning angin kencang ribut taufan. Ok, itu terlebih sudah. Takde taufan pun, cuma angin yang sangat kuat. Banyak kali juga la dengar dentam dentum bas tu kena pukul angin. Memang sangat kuat. Alhamdulillah sampai juga ke destinasi. Dekat atas gunung tu pulak, kitorang plan nak main sledge dulu lepas tu baru ski. Masa tengah sledge tu memang ribut dan melibas2 muka aku. Dengan hujan batunya lagi, pedih gila muka. Maka rehat la kejap kat kafe dia sambil bantai hot chocolate. Lepas tu konon nak sewa peralatan ski kat bawah. Pastu orang tu cakap tak boleh sebab tempat ni dah nak tutup due to bad weather. Cis cis cis...

Ok, itu sahaja yang teringat buat masa ni. Kalau ada tambahan nanti, aku update la yeee... 

:)