Check Me for Venom

One fine night at around 11.30PM, When I jus entered Stage 3 NREM sleep,My calling bell went off. With palpitations resulting from sudden arousal from my deep sleep, I went to attend the door, scratching my head, mumbling to myself 'Who wants what now?'

As I opened the door,I found a 50 year old man grinning at me with bright eyes..! It was my neighbourhood shopkeeper whom I met the previous day, and he came to know that I am a doctor.

"Hello..How are you?What happened?"

'Greetings Sir..I was walking on my way home,and I accidentally stepped on a snake'

"OMG..What happened?Did it bite you?"

'No Sir..I only stepped on it..It ran away'

"Let me see ur legs"

I checked for bite marks but cud'nt find any. I reassured him, and told him to go to the hospital immediately if he has any symptoms like difficulty in breathing,double vision etc

He nodded patieny and stretched his hand towards me.

I thought, May be he is offering me doctor fee and said

"No no..its ok..No problem"

But he insisted,and its not the fee

'Please check if the poison has gone inside me'

What the Heckk..Face palm

"How wud I do that in my home!"

I explained him if he is in doubt he should go to the hospital and do some blood works.I also lectured him about various types of snakes,neurotoxin,hemotoxin,how we test for it blah blah blah.He listened patiently and asked

'But can you not check my pulse and tell if I am poisoned?The healer in our village finds out poison by this method only and he breaks the poison too'

Second facepalm,break the poison..ahem ahem

checked his pulse rate,

"82..Nothing to worry,60-100 is normal,Go Home"

'So No poison na sir..I know how will I be poisoned if the snake did not even bite me'

It should have,I thought to myself,"Go home" I repeated.

And he went happily with the satisfaction of ruining my sleep.And I could not sleep for an hour contemplating between,'Should I have send him to hospital and get atleast his clotting time done'and 'Anyway he was not even bitten.'

But What I never expected happened the next day.On my way to work, I saw a group of 10-15 ppl on the roadside gathered (my heart started racing)around a lifeless body.And my heart skipped a beat..To my utter horror It was none other than the snake!!And the shopkeeper was standing there grinning at me,

'Our snake only..Dead...Dead (Grin)'

Dr.Praful JK, MBBS

Comments

ECG Made Easy(Part-2)

P wave: P wave denotes atrial contraction. Look for P wave in lead II. Normal P wave measures 2.5mm tall and 3mm wide. Absent P wave with an irregularly irregular rhythm may indicate Atrial Fibrillation. Tall peaked P wave is called P pulmonale and indicates Right Atrial Enlargement. Broad Biflid P wave is called P mitrale and indicates Left Atrial enlargement. Inverted P wave indicates Atrial ectopic If PR interval is less than 3 small boxes, the origin of ectopic is AV node If PR interval is more than 3 small boxes,the origin is elsewhere from the atrium. PR Interval: It is measured between beginning of P wave to beginning of QRS complex. It represents spread of impulse from SA node to the ventricular tissues. It measures about 3-5 small boxes. The significance of PR interval is diagnosis of heart blocks. Heart Blocks: 1st Degree Heart block: Prolonged PR interval more than 5 small boxes indicate 1st degree Heart block. 2nd Degree Heart block:(Mobitz Type 1): This is characteris...

Identifying Arrhythmias (Part-2)

Tachyarrhythmia: Broadly Tachyarrhythmias are classified based on their origin into two main types. SUPRA VENTRICULAR VENTRICULAR Supraventricular Tachyarrhythmia: As the name implies, the impulse originates above the level of AV node. Sinus Tachycardia: HR more than 100 with upright P wave followed by QRS complex is termed as Sinus Tachycardia. It has a variety of causes and the most probable cause of each case should be identified. Atrial Fibrillation: Absent P wave with an irregularly irregular rhythm may indicate Atrial fibrillation. The more specific term is Atrial fibrillation with rapid ventricular response when the HR is more than 100. When the patient is connected to an ECG monitor, You will find the heart rate fluctuating to a wide range from 100-160. Atrial Flutter: Atrial flutter can be easily identified on an ECG from the presence of Flutter waves which gives a saw tooth appearance. The baseline could not be identified. PSVT: When the term Paroxysmal Supraventricular ...

My First Intubation

Though I've intubated a few times during my residency it really doesn't count because, I was never alone. My backup with loads of experience was standing right next to me. We also had a videolaryngoscope and a fibreoptic bronchoscope just in case. But once I was out of Medschool, I was all alone, on my own. I got into my job right the next day of getting registered to the Medical Council (just bragging). My designation was "Emergency Care Physician" in an Emergency Care and Stabilization Centre in Chennai.Chennai as you may know is a large city with a huge population and hence a huge TRAFFIC. In case of any emergency, shifting the patient from the scene to a tertiary care centre costed the valuable 'golden hours' and mortality was pretty high. To overcome this, Govt came up with the idea of Emergency Care Centres scattered within the city,which would serve as stabilization centres and I started my career in one such centre. It was my second week of joining ...

MediZens

Search This Blog