AMEE 2014 in Milano

The annual conference of AMEE for this year is going to be in Milano, and today is the last final day to submit an abstract for presentation at the meeting. Our team has sent two abstracts in undergraduate anaesthesia education, one is about the happiness of the medical students during their time with us, we analysed at the mid term that the overall time for happiness is approximately 60+ per cent of their time, and the whole year data is sent for considered at the conference.

The other abstract we sent was about the response from 5th year medical students in their decision making process in crisis management, the problems we found are two things, one is the students did not ask for help, they should learn the team working process, they are not alone, there are help available all around them, but they do have to ask for, and the latter problem is re-evaluation of the interventions given whether or not they are working well in the patients.

Will update this again in April when the results are due to release.

Cardiac Centre

Working in the cardiac centre is like working outside the normal operating room routine, however, it depends on the conditions and what procedures are scheduled to perform there. Some trainees are frightened when they are assigned to work there, because it is the place and environment that is not familiar to them.

Today we had two ageing men requiring interventions to control their cardiac rhythm, one had ventricular tachycardia while the other one had 2:1 AV block, not counting an early morning patient with an AICD implant. The former had cardiac resynchronisation therapy, while the latter had a dual chamber pacemaker implanted.

In the paediatric room, we had two cardiac catheterisation in two cyanotic congenital heart disease patients, and the last patient also the youngest of the day had her central venous catheter placed.

That was a normal busy day in the cardiac centre, too tired to have exercise, better go to bed instead.

You must be time conscious, Dear

It is unacceptable for the professional who cannot keep the time, if you have an appointment with somebody, it is your responsibility or your commitment to be there before the very last minute. It can be applied to every single student to be right at the examination place before the time the teacher lets them in, in the last academic year the department got approximately half of the final examination dates which there were somebody entered the room late that their peers.

It is totally stupid to be that, you do not have to let your friends take any advantages over you, you have take enough time to finish the paper, but you should take the start point together with your friends.

The committee for the examinations had made their minds to give the students, who report themselves later the time limit which they know well before, a failed examination result.

Time conscious is so important for professional, isn't it?

Anaesthesia for the ageing patients

Time is flying and never stops, therefore we are now facing the bigger patient group, the ageing population. The better healthcare technology together with better care management make our people live longer, and they are presenting themselves to us later in their lives. The anaesthetics for this group of patient requires some concerns such as:

1. Underlying diseases: the aged are more likely to have more problems than the younger counterparts, it is the thing that cannot be avoidable since the organ functions are declining since the age is more than 30. We should evaluate every organ system, so that we can make a further plan what we should proceed later. The more problems they have, the more prescriptions for them are increasing, and increase the risk of drug interactions.

2. Declining organ function : the metabolism and excretion of the drug given are more likely to have more effects, since the GFR is lower when the age is going up and up. Postoperative cognitive dysfunction should be evaluated in the perioperative period.

3. The skin is more likely to lose its temperature control, the longer operative time means that they would have a lower core temperature, therefore, temperature monitoring and interventions needed to control the worse outcome should be implemented.

It seems that we are doing the same things to the ageing patients like what we would do to the neonates and paediatric patients.