MediZens

Of the many advancements in diagnostics, one which has stayed so conservative for a long time is the humble ECG. It just measures the electrical activity of the heart and scribbles it in a piece of paper. But every little detail of the scribbling is so precious, that it gives information like, heart rate, rhythm, conduction defects, enlarged chambers, ischaemia, infarct, etc aiding to arrive at a diagnosis. Another good thing about knowing how to read an ECG is that, You can show off..! Lets discuss how to enlist the findings in an ECG just by glancing at it like a pro..! Quick Basics Recap: Conduction System of Heart ECG:Waves, Segments and Intervals 1) Calibration: The first thing to do while looking at an ECG is make sure the machine is not at fault and is calibrated correctly. The machine automatically performs a calibration every time before a recording, which is usually found somewhere along the left hand side of the ECG. Check if its 2 large boxes tall and 1 large box wide like ...

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 ...

Assessing GCS of a patient within a minute is an important skill every Medizen must have. Though most Emergency Rooms have charts sticked to the walls,Its always better to imprint these in ur mind so as to not get embarassed in front of consultants or ur juniors. Lets dig into it..! Why GCS? When someone faints on the road,the first thing people check for is consciousness, i.e "the state of being aware and being responsive". But in a hospital setup just assessing for consciousness is not sufficient.We have to assess the 'level of consciousness'. For this purpose, Many scales were devised, the most widely accepted and used is the Glasgow Coma Scale devised by two renowned neurosurgeons who worked at the Glasgow University and hence the name. What is GCS? As discussed above, It is a neurological scale used to assess the level of consciousness in a case of head injury or a comatose patient in an ICU. It can be used subsequently and compared to the earlier score to unders...

    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 ...

Reading an ABG analysis report may be as cumbersome as drawing blood for ABG analysis. We ll help u diagnose the derangement in ABG in a simplistic way without having to depend on the ICU doctor or Consultant. Let's Get Started..! The diagnosis is primarily divided into 3 parts. Acidosis/Alkalosis Metabolic/Respiratory Compensatory Changes First is the pH           <7.35-Acidosis           >7.35-Alkalosis Next is CO2 and HCO3 Quick Fact: CO2 is the Respiratory Component HCO3 is the Metabolic Component PaCO2: Normal Value :35-45 mmHg/ 4.7-6kPa Remember this Golden Rule CO2 is an acidic gas. Its conc is increased in acidosis and decreased in alkalosis. If the above statement is satisfied, then it is Respiratory without any compensation. For example if pH is 7.2- acidosis, so CO2 should be raised, if it is raised, then it is Respiratory Acidosis. If pH is 7.5-alkalosis, CO2 should be low, if it is low, then it is Respiratory alkalosis...