Thursday, January 8, 2015

Friday January 2, 2015

Friday was next 24 hour call shift (now q6 since one of the other doctors returned from off-island).  There were 2-3 c-sections and two admissions (plus multiple phone calls and consults).

The most interesting patient I had admitted was a 13 year old girl coming in with DKA.  I had managed DKA in adults several times on our inpatient service, but this was the first time managing a child. It was also interesting because I needed to physically write out all the protocols (insulin drips, hypoglycemia, etc) by hand - I had gotten so used to simply opening the DKA orderset in EPIC back home and click-click-click... move on.  Looking back, I think having to write out the orders really tests your knowledge of the etiology and management of the disease.  There are also limited computers and no wifi, so you have to rely on *books* and other sources to look up information.  I actually felt like I was doing real medicine.

Another strong learning point was in the interpretation of Xrays.  There is no on-call radiologist to read your films - you are it.  The films are read several days later, but by that time you hopefully have treated whatever the patient had.

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