The patient who could see the dead
Oh, i also teach how to calculate drug dosages
Why did I choose to start this newsletter?
I could be cheesy and say why not, but I will actually try and explain.
For the last 2 years, I have been living with the philosophy that if there ever is anything I really want to try or that I am interested in, I will just go for it and not worry about what people have to say.
What will people say?
This is a mentality that most people are raised with, and I think it’s more prevalent in the Black and Asian communities.
I try my best to get out of that mentality by starting my youtube channel, getting a tattoo etc, you get the gist.. so in short, I started this newsletter because it is something that intrigued me and I do NOT want to be 70 one day and ask myself "
Why didn’t I start the newsletter?
As our friendly neighbourhood spiderman would say:
💀 The patient who could see the dead
Obviously, all patient information has been changed to maintain confidentiality*
This week in the ward I followed the resident who took me into a room with a patient in her early teens. I was told that she had episodes of syncope (basically fainting) every time she argued with her partner.
The resident then informed me to carry out a cranial nerve examination on her and that she will be right back.
A little side note: The last time I did the cranial nerve exam was probably 2019 and I could barely remember anything, I probably did 6 out of the 12 nerves - but oh well, you live and learn.
After I was done, the resident came back and mentioned to me that the patient kept telling her that she can see a dead relative of her’s sitting right next to her on the patient bed…
Me internally at that moment:
I genuinely felt bad. These types of cases were only in TV shows, movies and textbooks for me up until this point. Reality then quickly hit me because I now need to realise that I am going be seeing a lot of these cases when I do my psychiatric rotation in around a month. Pray for me.
💊 Drug dosage calculation tip
If you need to calculate drug dosages for a patient, i learnt it in 2 very easy steps.
Find out what the patient needs
Calculate how much to give from the bottle
An example:
4-year old who needs paracetamol. He weighs 24kg.
The BNF mentions that the dose for his age is 20mg/kg every 6 hours.
The bottle you have available to you in the ward is a 300ml bottle of paracetamol 120mg/5ml.
You are asked to calculate how many mls should be given to the boy every 6 hours.. how do you do it?
Let’s follow what I learnt:
What does he need?
He weighs 24 kg so 24 x 20 because it’s 20mg/kg
Therefore, every 6 hours he needs = 480 mg
How much to give him?
This is where the trick comes in. ALL you need to do is take the TOP number from the 120mg/5ml and use it to divide the dose the child needs and then multiply THAT number by the bottom number.
So basically, 480 mg / 120 mg = 4
4 x 5 = 20 ml
Every 6 hours, the boy needs to be given 20 ml of that drug.
Simple right? Just remember this is for simple calculations and you need to consider max dosages per drug and specific doses for each person.
ALWAYS REFER TO THE BNF WHEN YOU ARE NOT SURE
💔 Treating a pericardial effusion
Colchicine - Yes, that drug you learnt about in gout.
NSAIDs - Ibuprofen etc - AKA the drugs that can kill me (I’m allergic to them, did I mention that?)
Steroids
Aspirin
Apparently, you don’t have to prescribe all of these, it sounded like the steroids and aspirin are given on a case to case basis
🍿 TV Shows / Movies to watch/avoid:
WATCH - Peaky blinders - AMAZING SHOW. Solid 8.5/10
🎧 Song of the week AKA the song I had on repeat:
I hope you guys enjoyed your first IV dose!
Take care,
Habib