GEneral paediatrics

October 2008

Sometimes our aspirations do not come out as what we had planned it to be. While I was in NICU, I had longed to be out of the ward and be posted to the general paediatrics. Probably it was because of the specialist that had frighten me out of my wits.

Now, when I’ve arrived to the general ward, suffice to say that it is not as merry as it had been painted. It starts all over again, that is to become blank as a board as I had been 2 months ago. The first two weeks were a bit harrowing, to say the least. On my 2^nd day of work, I had to whisk of my patient to Sg Buloh Hospital. Without any preparation, I had to take this congenital heart disease patient and monitor her condition lest anything should happen. She was due for her neurological checkup at the neuro clinic. My hospital doesn’t have any neurosurgical unit for paediatrics. (that is what I understood, or else they would have simply refer to the department)

I was chosen to accompany this patient because I was already trained in regards of neonatal resuscitation. She has history of fitting, and this demands for a person who has been trained in resuscitation in case that she should fit during the trip.

Now, being trained and actually have done in the aspect of intubation is two totally different aspect. I myself have never intubated a baby before during my days in NICU, it has always been the job of the MO. All this while, alhamdulillah, those babies that were born flat initially recovered well after positive pressure ventilation have been given. And everytime a baby was delivered flat, I would urgently call my MO for help. I would definitely not allow myself to handle to situation myself. Babies are very fragile and unstable, to say the least. One minute, they can look normal, not in respiratory distress and suddenly develop grunting, with tachypnea and recession. Oxygen saturation would hover around less than 90% and definitely we would panic. To date, I think I have admitted about 4 babies to NICU because their oxygen saturation was less than 90%. Even though, sometimes they look comfortable and no signs of respiratory distress were present.

Even more frightening, was a case discharged by my friend during neonatal screening but after 20 minutes of arrival at home, the baby had died. I did not further investigate regarding the case, so I cannot comment further. It was said that the baby had undiagnosed congenital heart condition. I cannot blame my friend, because after having done screening many times, I feel that sometimes it was not that clear cut in regards of picking up the murmurs, especially if it the heart defect was small.

“Kepada Allahlah kembalimu, dan Dia Maha Kuasa atas segala sesuatu” (Huud :4)

“Sesungguhnya Tuhan kamu ialah Allah Yang menciptakan langit dan bumi dalam enam hari, kemudian Dia bersemayam di atas ‘Arasy untuk mengatur segala urusan. Tiada seorangpun yang akan memberi syafa’at kecuali sesudah ada keizinanNya. (Dzat) yang demikian itulah Allah, Tuhan kamu, maka sembahlah Dia. Maka apakah kamu tidak mengambil pelajaran?” ( Yunus:3)

Doa to Allah is the single most important tool that all of us need, for we are never in control of our destiny. We can definitely try our best to and it is what Allah intends us to do, but in the end, the ultimate power that determines the outcome is Allah.

Terms:

NICU – neonatal intensive care unit

Wad instensif untuk bayi2 yang berumur kurang dari sebulan

MO – medical officer

Pegawai perubatan yang dah habiskan houseman training dan di register bawah MMC. (fully registered as doctors)

Fit – sawan

Intubate – memasukkan tiub kedalam rongga pernafasan utk disambungkan pada oxygen untuk membantu proses pernafasan

Reference ayat2 al-Quran:

Al-Quran dan terjemahnya , Rasm Uthmani