Started the day with a lie in, till 0900ish when I was woken up by the cleaner coming round. Porridge and coffee, both with milk this time = much more palatable! Got my things together and was just walking out of the door when I poked my head into the kitchen where the cleaner was at work. She'd obviously done the fridge as all my food was out on the top. She then took her headphones out after seeing me and said she was glad I'd come in as all the food in the fridge was out of date, motioning at the food on the top... The food I'd just bought yesterday! I mentioned this to which she said no, we're in late September now and all of this stuff goes out in August... I then reminded her that we were actually still in August! After a bit of to and fro, she eventually relented and put it all back in the fridge rather than in the bin - lucky I'd gone in otherwise £30 worth of my food would have been chucked out!!
Walked into the hospital, arriving to a very quiet A&E department, I'd missed the first patient of the morning who'd come in at 0930, and since then no one. Occupied myself with planning walking routes using a combo of Bing maps and walkhighlands. Bing maps is amazing - free OS maps of the entire country, 1:25000 and 1:50000! Printed off a few ideas, mainly down in Harris taking in the highest hill on the island, Clisham (779m). Patient arrived, interrupting my planning session. Was a review of a wound, which was going along quite nicely so quick case where we just discharged with follow up in a week or so in GP land. After that grabbed some lunch downstairs in the canteen.
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| What is this funny money... |
Late in the afternoon the phone went off warning of a patient coming in, sounded a bit more complex than the morning's case. Patient arrived, into resus. Nurses and I hooked up all the monitoring equipment, sats/BP, then took an ECG before the ENP tried to cannulate. They missed, so I went for a wrist vein and got it in, took off a whole load of bloods, flushed. Then once we'd ascertained they were stable I took more of a comprehensive history, did a brief examination and took a collateral history off a relative who'd come in. By this time one of the medical F2s had come down from the wards to see them, so I presented my findings so far and what differentials I was thinking of. Patient went off to have a chest xray, and I grabbed a bit of dinner- lovely chili/rice/cheese from the canteen! Some of the results then came back, wasn't a clear picture so the consultant was called and I took 3 sets of blood cultures to send to the lab. The patient wasn't the easiest to bleed, and in fact for the cannula we'd used this awesome bit of kit in the department called AccuVein - a device that emits laser light and shows up veins under the skin, even if they're not visible by naked eye. It's pretty incredible, and I'd never seen one before. Also up here they've got the automated CPR machine (AutoPulse), which again I've not seen anywhere else - haven't seen it in action yet, not sure if I want to!
So although this patient was a bit of a mystery I got the chance to do some stuff and get involved in thinking of differentials, using the investigation results to whittle these down and decide on further management plans. Finished dealing with them by 2030, so went back to the flat. It had been a slow day but had the chance to brush up on some knowledge, and the second patient was really satisfying to get involved with. So after the first two days here in the A&E I've sutured, cannulated, taken bloods, done blood cultures, taken a few histories, examined cardio/lungs/abdo and knees, requested/intepreted xrays, presented to juniors etc. Successful! Hope it continues :)
It was pretty cold when I stepped out of the hospital, noticeably cooler than Fort William, properly felt like Autumn! Walked into the flat to find 3 students sat round the kitchen table, got chatting and they're dental students here for the week from Aberdeen. As it was just before sunset I mentioned that I was thinking of driving out to the coast somewhere and asked if they were keen. 5 minutes later we set off for the west coast - I was thinking might be able to catch a decent sunset but in the end we were just too late and it was a bit cloudy. Was nice to get out though, get some fresh air and did come across a historic site of a battle (see pic). Rapidly got dark so drove back for some pizza/brew in the flat. Chatted a bit more then headed in for the night, hope tomorrow is a bit busier than today!
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| Nice inland loch |
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| Historic site number one! |
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