Thanks Mr EJ!
I am thankful to this patient of mine, Mr EJ, for giving me the opportunity to have my first go at drawing out fluid from his lungs. I am feeling grateful because he knew that I have never been trained or taught how to do this, and it is not the nicest thing to do on someone either. Imagine having a needle pricked into your lungs....doesn't sound fun right?
I was excited, yet a little worried because it's my first time, and because it's going right into the lungs, I was worried that I will cause a disaster to befall him. I will start blaming myself horribly if that happened.
It was a sterile technique, so my seniors were only able to guide me by talking. They were not allowed to touch anything of my equipment too.
I had to percuss the chest to find the area of dullness, which will indicate the position of the fluid. It was then essential to find the rib near to it, and the needle has to go above the rib because if I were to go under the rib margin, I will hurt a nerve and a vessel that runs beneath it. I drew up some anaesthetic and straight into the spot I decided upon, after cleaning the area with antiseptic solution. Injected anaesthetic into the area after drawing back the syringe to make sure my needle isn't aimed into a blood vessel (u don't wanna end up numbing the entire body). I was amazed to know that even injecting anaesthetic required skill. You don't just put in the needle and inject everything in. The needle has to go into the surface, inject, wait a few seconds, then deeper in and inject again. This goes on until u have finished injecting all the anaesthetic you've drawn up. Then wait for the anaesthetic to work.
Meanwhile, my senior talked me through the 3 way tap so that when I perform the procedure, I will not fumble. When I was confident and ready to do it, I checked if the anaesthetic has worked by pricking the spot to see if he felt it. And when he was all ready, in went a new needle attached to the 3 way tap and syringe. I had to manouevre the needle within the lung to find the spot of the fluid (I actually could feel the needle touching the rib at times), and after a few moments, I found it! Out came straw coloured fluid. It was absolutely amazing!!!
And it was a chore getting the fluid out, because I actually drew out more than 600ml from a 20ml syringe. That's not the worst case...some patients have litres in them. Had to turn on and off the 3 way tap each time I insert and remove the syringe respectively because I didn't want the fluid to flow back. Had to immediate cover the wound with a gauze as I remove the needle too to prevent air from getting in and causing a pneumothorax (that will end up causing another needle to go into the lungs to release air).
Sent off some samples for lab testing, and I was proud and happy with myself for getting through it. An unforgettable experience indeed.
The fluid out of his chest will make him feel better, and that is the most important thing which is making me happy. It feels great making a difference to someone using my pair of hands.
Will check to see how he is tomorrow. Hopefully he is feeling better and hasn't deteriorated in the night. And not suffering greatly from any complications of having the procedure done, of course.
I think my fatigue is taking its toll on me. Working for 39 hours in 3 days is no joke. I was feeling extremely cold and shivering in my room after I came home today after work, and I did feel quite unwell. I guess perhaps I was having a fever, but didn't realise it. Was on the phone with Dearie when that happened, and because I felt so unwell, I cried. I miss him quite badly these days, and maybe I wasn't feeling well, so I felt worse. Wished he was here to give me some comfort and let me sleep on his shoulder/lap.
I'm still missing him a lot now. I can't help but keep asking him "When r u coming back? Can u be back earlier?" each time we chat. We haven't talked much these few days because of my on calls, and ffff..I'm on call again tmr!!!!! ARGH! Can't talk to him again. But anyway, I'm consoled by the fact that he made the effort to wait for me to finish work today to talk to him. It was a late night for him again because of my insane working hours. Sigh...
Looking forward to end of my on calls for the time being tmr...
I was excited, yet a little worried because it's my first time, and because it's going right into the lungs, I was worried that I will cause a disaster to befall him. I will start blaming myself horribly if that happened.
It was a sterile technique, so my seniors were only able to guide me by talking. They were not allowed to touch anything of my equipment too.
I had to percuss the chest to find the area of dullness, which will indicate the position of the fluid. It was then essential to find the rib near to it, and the needle has to go above the rib because if I were to go under the rib margin, I will hurt a nerve and a vessel that runs beneath it. I drew up some anaesthetic and straight into the spot I decided upon, after cleaning the area with antiseptic solution. Injected anaesthetic into the area after drawing back the syringe to make sure my needle isn't aimed into a blood vessel (u don't wanna end up numbing the entire body). I was amazed to know that even injecting anaesthetic required skill. You don't just put in the needle and inject everything in. The needle has to go into the surface, inject, wait a few seconds, then deeper in and inject again. This goes on until u have finished injecting all the anaesthetic you've drawn up. Then wait for the anaesthetic to work.
Meanwhile, my senior talked me through the 3 way tap so that when I perform the procedure, I will not fumble. When I was confident and ready to do it, I checked if the anaesthetic has worked by pricking the spot to see if he felt it. And when he was all ready, in went a new needle attached to the 3 way tap and syringe. I had to manouevre the needle within the lung to find the spot of the fluid (I actually could feel the needle touching the rib at times), and after a few moments, I found it! Out came straw coloured fluid. It was absolutely amazing!!!
And it was a chore getting the fluid out, because I actually drew out more than 600ml from a 20ml syringe. That's not the worst case...some patients have litres in them. Had to turn on and off the 3 way tap each time I insert and remove the syringe respectively because I didn't want the fluid to flow back. Had to immediate cover the wound with a gauze as I remove the needle too to prevent air from getting in and causing a pneumothorax (that will end up causing another needle to go into the lungs to release air).
Sent off some samples for lab testing, and I was proud and happy with myself for getting through it. An unforgettable experience indeed.
The fluid out of his chest will make him feel better, and that is the most important thing which is making me happy. It feels great making a difference to someone using my pair of hands.
Will check to see how he is tomorrow. Hopefully he is feeling better and hasn't deteriorated in the night. And not suffering greatly from any complications of having the procedure done, of course.
I think my fatigue is taking its toll on me. Working for 39 hours in 3 days is no joke. I was feeling extremely cold and shivering in my room after I came home today after work, and I did feel quite unwell. I guess perhaps I was having a fever, but didn't realise it. Was on the phone with Dearie when that happened, and because I felt so unwell, I cried. I miss him quite badly these days, and maybe I wasn't feeling well, so I felt worse. Wished he was here to give me some comfort and let me sleep on his shoulder/lap.
I'm still missing him a lot now. I can't help but keep asking him "When r u coming back? Can u be back earlier?" each time we chat. We haven't talked much these few days because of my on calls, and ffff..I'm on call again tmr!!!!! ARGH! Can't talk to him again. But anyway, I'm consoled by the fact that he made the effort to wait for me to finish work today to talk to him. It was a late night for him again because of my insane working hours. Sigh...
Looking forward to end of my on calls for the time being tmr...
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