The latest news on the block is that ALL local RIPAS doctors (medical officers only) will be ordered to go to Temburong hospital and take turns to work there for a week. A schedule beginning march 1st has been distributed and every department are suppose to take turns and nominate their MOs who will be sent to Temburong that week.
The objective of this 'exercise' is to allow local Junior doctors to be exposed to working in a hospital environment apart from RIPAS, and allow oppurtunity for the junior doctors to be interacting with patients from other districts closer. It is hoped that after this exposure, some doctors would be more attracted to work at other districts hospital apart from RIPAS.
Since it's announcement on the 19th February, the move has not been met very favourably amongst many of the junior doctors. Though the objective of this mission is understandbly noble and necessary, as it is quite apparent the lack of local doctors working not just in Temburong, but also in Tutong and KB.
However some of the doctors believe that the decision to send the doctors away for a week is a little bit on the hasty side, and some even voiced concerns about doctors looking after other specialties at which they are not trained for and there are no specialists mentor at the hospital site (Temburong), to guide them.
Others mention concerns about doctors who have been trained in their specialty field for so long and not seen an ischaemic ECG for many years to correctly diagnose one, or doctors who will be asked to examine patients of a different age group than the one that they are routinely used to.
All these are valid concerns, but nevertheless the objective of the 'exercise' is also equally important. Further discussions between the doctors and the administrators are to be planned this week. What is your say?
Sunday, February 24, 2008
Wednesday, February 13, 2008
Well Done Docs!
It was only moments before the friday prayers sermon, a 72 year old male collapsed following a cardiac arrest at the Serusop Mosque in Berakas.
Thanks to the quick response from 3 good samaritans, prompt resuscitation was delivered which saved the man's life. We would like to acknowledge these 3 fantastic young local doctors for their heroic effort, and convey huge gratitude from the patient and his family.
Well done Dr Nirwan (Navy), Dr Fakhruddin (RIPAS A&E) & Dr Ahmad Fakhri (Public Health)!
Dr Fakhruddin
Dr Ahmad Fakhri
The story unfolds...
Mr I was a 72 year old male with a history of Hypertension and Hypercholesterolaemia. As usual he was about to perform his friday prayers at his local mosque when suddenly he felt unwell and collapse. He was brought aside and help was called upon. Dr Nirwan, who was about to join the prayers was first to arrive at the scene and assessed the situation, quickly followed by Dr Fakhruddin. After confirming it was a cardiac arrest, CPR was initiated immediately. Dr Fakhri arrived at the scene moments later to lend assistance and the paramedics arrived bringing with them the defibrillator, soon proven to be another life saver.
As soon as the leads were connected, Ventricular Fibrillation (VF) arrest was diagnosed and shock was delivered immediately. Normal Sinus Rhythm was regained but Mr I was still apnoeic. Manual ventilatory assistant was continued as Mr I was transferred to RIPAS Hospital by the paramedic team.
Upon arrival, Mr I was intubated and admitted to Intensive Care Unit where again he had another VF arrest which reverted back to Sinus rhythm after receiving another shock.
Grave prognosis was feared for Mr I, as the survival rate for out of hospital cardiac arrest is low. It is estimated that less than 60% of cardiac arrest will survive hospital admission and only about 12% will regain full neurological recovery, if resuscitated on the scene.
Alhamdulillah, praise to god almighty, within a week Mr I was extubated and 2 weeks after his admission, Mr I was discharge from RIPAS with full Neurological Recovery.
In the most recent literature, it is estimated that the survival rate of Out of Hospital Cardiac arrest event which did not received CPR on site was 7%. This is improved to 9% with good CPR.
However the rate is significantly increased up to 30%, if the patient received a shock with an Automated External Defibrillator (AED), (Hallstrom AP et al. N Engl J Med. 2004;351:637-646).
Having AED and equiping the public about using the machine and performing CPR do save lives as demonstrated in this particular event.
We support the idea of having AED machine in public areas such as the mosque, shopping malls, stadiums and recreational park. This paired with increase awareness and knowledge of the public on how to perform CPR may help save another life in the future.
Finally well done to the paramedics, Accident & Emergency staff, the Intensive Care Unit and the 3 doctors on site, Dr Nirwan, Dr Fakhruddin & Dr Ahmad Fakhri, for their outstanding work.
Thanks to the quick response from 3 good samaritans, prompt resuscitation was delivered which saved the man's life. We would like to acknowledge these 3 fantastic young local doctors for their heroic effort, and convey huge gratitude from the patient and his family.
Well done Dr Nirwan (Navy), Dr Fakhruddin (RIPAS A&E) & Dr Ahmad Fakhri (Public Health)!
Dr Fakhruddin
Dr Ahmad FakhriThe story unfolds...
Mr I was a 72 year old male with a history of Hypertension and Hypercholesterolaemia. As usual he was about to perform his friday prayers at his local mosque when suddenly he felt unwell and collapse. He was brought aside and help was called upon. Dr Nirwan, who was about to join the prayers was first to arrive at the scene and assessed the situation, quickly followed by Dr Fakhruddin. After confirming it was a cardiac arrest, CPR was initiated immediately. Dr Fakhri arrived at the scene moments later to lend assistance and the paramedics arrived bringing with them the defibrillator, soon proven to be another life saver.
As soon as the leads were connected, Ventricular Fibrillation (VF) arrest was diagnosed and shock was delivered immediately. Normal Sinus Rhythm was regained but Mr I was still apnoeic. Manual ventilatory assistant was continued as Mr I was transferred to RIPAS Hospital by the paramedic team.
Upon arrival, Mr I was intubated and admitted to Intensive Care Unit where again he had another VF arrest which reverted back to Sinus rhythm after receiving another shock.
Grave prognosis was feared for Mr I, as the survival rate for out of hospital cardiac arrest is low. It is estimated that less than 60% of cardiac arrest will survive hospital admission and only about 12% will regain full neurological recovery, if resuscitated on the scene.
Alhamdulillah, praise to god almighty, within a week Mr I was extubated and 2 weeks after his admission, Mr I was discharge from RIPAS with full Neurological Recovery.
In the most recent literature, it is estimated that the survival rate of Out of Hospital Cardiac arrest event which did not received CPR on site was 7%. This is improved to 9% with good CPR.
However the rate is significantly increased up to 30%, if the patient received a shock with an Automated External Defibrillator (AED), (Hallstrom AP et al. N Engl J Med. 2004;351:637-646).
Having AED and equiping the public about using the machine and performing CPR do save lives as demonstrated in this particular event.
We support the idea of having AED machine in public areas such as the mosque, shopping malls, stadiums and recreational park. This paired with increase awareness and knowledge of the public on how to perform CPR may help save another life in the future.
Finally well done to the paramedics, Accident & Emergency staff, the Intensive Care Unit and the 3 doctors on site, Dr Nirwan, Dr Fakhruddin & Dr Ahmad Fakhri, for their outstanding work.
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