night 5, not a bad shift actually.

came on tonight to find only two new electives from todays list, which i thought was pretty impressive.

got called early to the cardiothoracic ward to consult on some young ivdu* guy with staphylococcal endocarditis on the posterior leaflet of his mitral valve, type 1 respiratory failure from a right basal pneumonia/effusion (probably the source) and subsequently acute renal failure (creatinine peaked at 500 yesterday) and diffuse abdominal pain. sounds like he has fired off septic emboli everywhere, including to his gut (mesenteric ischaemia) and his kidneys (acute glomerulonephritis). in fact, abdominal ct scan showed a splenic infarct too. intense gentamicin therapy could have also contributed to his renal failure. now on quadruple antibiotic therapy with flucloxacillin, ampicillin, metronidazole and gentamicin. i declared that he didnt need to come to the unit tonight, his multiple organ failure currently being mild and treatable on the ward. not a turf (cuz the patient wasnt mine to start with), but what a deflection! am i good or what?! =D

didnt really have to do much after that, just babysat for the rest of the night. all is well. =)

pretty lame world news tonight. nothing worthy of note. back home however, britains most notorious murderer and former gp harold shipman was found hanging in his cell in hmp wakefield yesterday morning. so whats the big deal? why the hell is this getting blanket coverage?

food of the night:

sliced pork and broccoli on rice

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* ivdu = intravenous drug user

posted by Chas at 07:46
go ahead, roll the donut!