412# Paediatrics: Start(ed)

Final posting for semester 7 has begun.

I now got posted to Port Dickson hospital for 7 days, after that I'll continue my posting back to my hospital. Spending 30 minutes of driving to the hospital isn't really fun.

But one good thing is that the atmosphere there is more relaxed, since it's a district hospital, instead of a general hospital.

Right there, we see different cases, cases that we might not see in the general hospital. According to the statistics showed by the hospital, the top 5 cause of admission to the hospital are;

Neonatal jaundice, acute gastroenteritis, febrile fits, pneumonia and asthma.

To my colleagues who will get posted to this hospital later on, it's recommended to read and understand these cases.

Now we don't take history from the patient. History is to be taken from the patient's parents or guardian. We can still take history form the patient if the patient is old enough and able to communicate

I like the examination part. Those babies hands are so... small. The skin is so silky soft and looked so delicate. I really afraid that I might hurt them.

Auscultating the heart isn't easy. Physiological splitting of second heart sound is best heard in young children. But the heart beats are so fast and it sounds like a fixed splitting to me instead of respiratory depended splitting.

Picture source

Building rapport with the patient is a must during clerking. For adult patient we build rapport by talking, for paediatrics, rapport needs to be build by... erm, playing?

Playing with the patient is part of our clerking I'd say. It's good when you have the mood to play with them. But it's real bad if you don't have the mood, and yet you still need to be happy and play around with them so that you can complete your clerking.

Unlike the others, I don't have any soft toys to bride or to distract the children. Those things that I have, which you may consider as toys, looked like this;

How can I possibly give this kinda "toy" to a 15 months old child to play?

Anyone has a Winnie the Pooh soft toy to lend? I'll buy you a real Winnie the Pooh from the zoo.

Paediatrics, not too bad after all. I like internal medicine and paediatrics is just the under 18 version of medicine. Will try my best to finish the posting. And finals is next.


StarGhazzer:太空人 said...

LOL... give those "toys" to the child and you'll cry inconsolably when they break it :P

Paeds is fun in a way, but developmental assessment isn't exactly the best job in the world. Interesting yes, tedious and ambiguous VERY. Examination of babies are ok, but try doing it to a wailing toddler and you'll wish you could just give them some "special K" to shut them up.

I reckon 70% of your patients, particularly those who come into A&E would be asthma or gastro, with the remaining 30% trauma/fractures/minor injuries...

One thing good about paeds is that hey, they don't have 10 pages of past medical history... or drug lists that fill up an entire notebook :D

Enjoy your paeds, it's one of the more enjoyable rotations around, especially compared to the crazy O&G (although O&G is more technical and has some really crazy shit).

Mike said...

i have done obstetrics earlier in this semester. was hectic, but ward covering was optional for me, and i did it for the first 2 weeks.

paeds is quite ok so far. oh yes, the past medical history is short indeed. what bothers me is that i'm not sure whether birth history is necessary or not in some situations. eg, acute gastroenteritis, pneumonia, asthma... do we really need to assess the birth history? zzz.

don't know much bout developmental assessment yet, will have the class in this week.

speaking of breaking my models, the Revoltech Eva01 just broke. It fell out from my hands and hit the floor. The little pole which connects the shouder blade to its body is broken. As well as my heart. I only displayed it for 24 hours and now certified dead. Bye bye RM95.

StarGhazzer:太空人 said...

You could try to repair it... I'm not entirely sure about Revoltechs, but my Astray's arm joint broke before... Costed me RM10 just to replace the peg. But at least the shop owner was happy enough to help me repair it.

Mike said...

my 1/100 astray red frame's deltoid to bi/tricep peg broken. 1/100 astray blue frame has ehlers danlos syndrome, whole body loose already. my earlier gunplas, moved it too much already.

now i learnt not to move it around to avoid all these problems. but who knows malang tidak berbau. for this revoltech, i can try to glue the broken peg with cement. but afraid that once i connect back the shoulder blade, a minor movement might break the glued peg again.

now all 3 of my new revoltechs are back to their respective boxes, after breathing the air for 24 hours.

YY Ong LTR! said...

hello, just passed by decarboxylation.

Enjoy paeds! and be careful not to let ur toys coated with too much saliva and learn how to take back your toys . haha.


StarGhazzer:太空人 said...

Looks like the Astray's deltoid-biceps joint is truly fragile after all. Mine broke at the exact same location. And yes, the Blue Frame does suffer from ehlers danlos lol... I gave up on the huge backpack as it will never stand with it. Now my blue frame is using the normal astray shoulder armours and carrying destiny's rifle instead. Actually it's packed up in a box back at home lol...

Mike said...

Ong: Enjoying paeds now. Just that the ward is too crowded!

starghazzer: now both of my red and blue astrays are in their respective boxes. think of buying PG astray red after my EOS, as a reward for my EOS and bday... anyway it's just an excuse la. really drooling for that PG. Sem8 got time to fix, lol.


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