Friday, January 9, 2009


The guy with the AAA didn't make it. He died last night after his heart went into abnormal rhythm called ventricular fibrillation.

However this afternoon we got a new case, a 28 year old lady with a type I diabetes mellitus since 9 years old which resulted in diabetic nephropathy now causing nephrotic syndrome.

Her immediate problem now however was having recurrent hypoglycaemic attack apparently from her long acting insulin called glargine. The effect is catastrophic since she's not eating well recently due to her infected diabetic foot ulcer.

Nephrotic syndrome made her body and limbs swollen up and filled with fluid which make it almost impossible to establish an intravenous access.

I was happen to be in the neighbourhood when Husin and Hasan, the ever hardworking orthopods MO were struggling in setting up IV line on her. Multiple jabs and pokes had left her body all bruised up.

With her glucose level of 1.9 we know she wouldn't last long. Without sugar the brain would get screwed and she could risk slipping into coma and irreversible brain damage. So we need to find a way to give her sugar quickly, and she's too drowsy to take anything orally.

3o minutes had passed and we were losing time, so I decided to do a femoral line by inserting a triple lumen into her right groin.

A gush of dark red blood filled in the syringe as the 16 gauge needle pierced her femoral vein...

Soon after a 50CC of Dextrose 50% went into her, she woke up and asked us "Huh! Who the heck are you.. where am i?'

Me and the orthopod boyz look at each other and laughed our ass off.


sina said...

Saint Aspirin? I shall worship you then - I take aspirin to relieve all kinds of ailments. Heh.

doc said...

i thought she'd say : what is that thing sticking into my groin??


1. Sina, i shall smuggle some for you at 27.4% discount. Haiya kasi cincai2.. kowtim sama gua.

2. Very funny doc, sticking into groin can be tricky. Location is extremely important here i tell you.