C.B.I.

17th January (Saturday) - Today isn't so busy, but there's a little procedure that I'm in charge of. CBI. Ah, now that's a procedure I haven't done in a while. Continuous Bladder Irrigation. :D But I haven't done this in a long while and I'm out of practice.Um, um, okay, whatever goes in must come out. Every time you put one in, the moment the jar is nearly full, you clamp the bag and measure the out. Ah, okay. Simple enough.
Ahm, I forgotten how heavy the 3000ml irrigation was. It's like carrying a bowling ball. A very lumpy bowling ball although I actually enjoy playing with it. Great fun for poking besides the autolagus bag. And did I mention that I was struggling with the seal as well. Once I realized you need to break it, not twist it, I managed to snap it open. Then comes the most embarrassing part of all, poking it through. I knew it was tough, but I didn't expect it to be that hard to poke the needle I know it's all about twist and twist and push and it should go in smoothly, but the needle just won't go through. Ohhhh, the patient felt so sorry for me that he helped me hold the bag while I managed to poke the first one through. Okay, that acts as a back up irrigation while one is running. That way all you have to do is open the next clamp. Simple enough right? Back in the students day, we used alternate bags by marking each bag with a number. Then we start off with 1,3,5,7,9. Thank goodness it's not too complicated here.
The lady whose admission I did on the previous day, she's really...particular. I like her family, they are all nice and understanding people, although they tend to compare hospitals. Well, as I often said, if you compare Hospital A whose price is super beautiful, of course the room and service are beautiful, whereas we over here, with a small fraction of the price can only get you basic, although we try to give good nursing service to the best we can. Back to the point, the lady called me because there were a few bubbles in her tube. It's not air bubbles, but her antibiotic.The solution is so thick to the point that there are some bubbles in it. But the lady made me sit in her room and flick the tubing until the bubbles are all gone. Ohhhh, how can she expect me to sit there and hit all the bubbles until they are gone? It was near her branulla some more, and she refused to let me open and flush it. No, she asked me to flick it. When flicking doesn't work, do you know what she wants me to do? She wants me to do what we usually do. Open the tubing and let everything out. NOOOOOOOOOO. Absolutely out of the question. For Normal Saline and D/Saline, Dextrose 5%, all those normal drips, we can do it, but NEVER, ABSOLUTELY NEVER, antibiotics. To flush the antibiotic out means wasting the medicine itself. And those antibiotics can't be replaced once wasted. To give too little antibiotic means under dose, and then she will never be okay. But she doesn't understand, even when I explained to her. I had to tell her family who backed me up. Thank God.
Few moments later, she called again, this time regarding about her oxygen saturation. She told me she was having difficulty in breathing and demanded me to check her saturation, of course I did. Her fingers weren't too good, they looked a little blue at the nails. 88 - 90%. It cannot be. I wasn't too happy about it even after I waited for so long. Then I went to her feet to check. 94 - 96%. Much better. She then demanded, yes demanded for a face mask. Urgh, her saturation is okay. It's only because her fingers were a little blue, but it wasn't cold. Even so, she made a big fuss til I grabbed a face mask and brought it to her, telling her that she can use it if her saturation is very low, but for now, it is okay. Her relative helped me out by explaining to her too much oxygen is also dangerous due to too much oxygenation, and she got it.
Back to uncle once more, I had to back up his drip once again, ohhh, not again. This time uncle pushed the needle in together with me cause he can't bear to see me struggle. Sigh, embarrassment, hence why I dislike bowling.
I went to check up on the little boy. He's looking much better now, walking about. Bit why is still on that temporary sling? I caught sight of a cute Angry Birds arm sling and I asked the mother whether it's his, and she said, yes, that was the arm sling that the father brought. I asked the mother why she didn't bother to change the temporary arm sling and she said cause he didn't want to. But the Angry Birds one is so much cuter. Oh well... Tomorrow tons of patients are discharging. I better get enough sleep otherwise I won't have the energy to handle the discharge rush.