An Intaan’s guide to surviving ARV posting’s!

ALL ABOUT ARV POSTINGS!

Hello, My dear GMCites,
Here, We shall be updating you about our JJH ARV postings.

Reporting time:- 9 am
OPD timings :- 9-1pm


All about Rabies
Categories

Rabies

Cat 1 – Wound wash
Cat 2 – Only Rabies vaccine- Indirab
Cat 3 – Vaccine + IG – Indirab + Equirab

How to prepare vaccines!?

Indirab:
-Mix diluent and indirab
-take 8 marks of the mixture in insulin syringe
-give 4 parts on each arm ID

Equirab test dose:
-Take 2 parts equirab in insulin syringe
– fill the same syringe with NS upto 20 mark
– give the test dose on the right forearm ID
– circle the site and write T followed by the time of test dose

Equirab loading dose:
-fill a normal syringe with equirab according to the dose calculated

Imagine you are the Casualty Medical Officer, How to calculate the Equirab dose?

Equirab dose (ml)=40x Weight of patient in kg/300 IU

From where did this formula come?

Equirab (IU)= Weight of patient (kg) x 40

Now we have to convert IU into ml.

1 vial of Equirab is of 5ml containing 1500IU. So, 1ml of Equirab contains 300IU

So divide it by 300!

Rx Inj.Indirab 0.1 ml OED OED- On Each Deltoid

Rx Inj. Equirab 40 IU/Kg Eg. For a 53 kg individual, 2120IU= 7.07 ml

Here’s the readymade easy table to calculate dose!
Check this out if you suspect Anaphylactic reactions.


Adult immunization


PCV
<15 or > 65 yrs le lo

Hep booster
Titre check Karo


ARV

Influenza

HPV
Cervarix
Gardasil
Buy from outside.


Pointers to remember!

We don’t give two live vaccines together.
Ideally:- Gap of 4 weeks

Eg. OPV, Yellow

Googly scenarios

What If your patient has been already Immunised in the past 5 years?

Schedule:- 0,3 Dose:- Only on one Deltoid

As an intern posted here which all vaccines are recommended for you?

1. ARV=Pre-Exposure Prophylaxis 2. Influenza 3.HPV

HMIS ID
ID:- ms68069
PWD:- a

Dear GMCite, got anything more to add?
Please, do let us know!


Stay tuned.
Jeeyo Dil se:).

Must read stuff!

Disclaimer:
This article is for general information purposes only.
It is not meant to hurt any person, institution or entity.
Any information may change without prior notice.
Please visit the hospital or contact the office for further details.
This article is meant just to help people out.

Home Sickness Sleeping Syndrome


After sleeping straight for 14.5 hrs., on the pretext of being tired, I (literally) woke up to the realization that I was missing home. And sleeping was just an escape.


I come hostel around 6.30 pm yesterday, after slogging my ass at the Surgery ward 18, since 9 am, gave my best today since it was the last day of my rotation and I will be joining Orthopedics from the day after.
It was a splendid day, did Blood collections, wrote some discharges and Revived a (suspected Cardiac arrest ? )gasping patient.
Since it was the final day here, I conversed for a long time with my patients (I pray that Krishna* cracks UPSC! He’s suffered a lot already), my nurses and my residents.

When you stay in a hostel you devise up tonnes of the reason for sleeping long, lying like a log of driftwood on the Arabian sea. Mine was, well, ‘I wasn’t feeling like getting up.’

slept at around 7.3opm, friends came bashing at the door stating for a dinner out, bleh, I declined, and went back to my heavenly abode, 10 pm Appa rings and checks whether I am alive or not, at 6.33 am I check whether I am alive or not, then at 9.3o finally, I am done, I am done with sleeping or the excuse of avoiding life altogether.



It hit me hard, all the while, I was feeling sad.
I was feeling empty and touchy, was hugging my bear the whole night, without even realizing that.
I was feeling as if a child has been locked at home, waiting for her parents return.
I was missing home.

It was the feeling of homesick that made me sick with sleep all night.


If you ask hostel people what are their dreams, what they want to do after graduation, contrary to what localite say, that being, Becoming the best Surgeon, Opening up an interior design company, starting up at startup, most humble hostelites, reply, they want a
good, happy, home.

When I used to be a localite I used to not give a second glance to it, but now, when I have become a full time hostelite, I realize the deep emotions, feelings, and hope attached to the latter responses and the word – Home.



“Only hate the road when you’re missing home”- Passenger


Like the way the English band Passenger has beautifully described in their song, “Let her go”, how, the absence of something makes you value the presence of it, only a hostelite knows the true value of the home.
Well, we, most of the localite, just take it for granted.

When you realise your home, is 1,655.7 km far, near the Cape Comorin, aka Kanyakumari, you literally start making plans to do when you get back home, you seek every opportunity to escape, you sketch how you want to get ‘settled’.

Nothing beats a good home when are done with your tough workday eh, maybe that’s why they taught us when
we were kids, ‘Home Sweet Home.

So for all of you out there, who are at the home, express and shower your love when you are still around.

And for all of us, who aren’t, fear not,
Apna time ayega.



[Also do let me know the crazy planning’s you have done to get at home in the comment section below.]
* – Names changed. Or are they?

Till next time,
Pyar Karo dil se, Jeeyo dil se.

Yours only,
Dinesh Raja.
A lover of life.
20th October 2021.

What should I do? My patient just died in my hands.

I am here sitting alone.

7 pm

The eerie silence in the side room makes your body cold but your heart alert.

There’s sounds everywhere. Here, there’s constant ventilator’s beeping of alive patient divided by intermittent alarms of dying ones.Here being sonorous means you are alive.

Welcome to CCU. Where the only thing you dread is loud, red sound.

710pm

As I am sitting here in the side room, I am feeling cold.

I am feeling teary.

I am feeling sad.

I am feeling numb.

My patient just died in my hands. Both metaphorically and medically.

And I can’t walk.

I can’t speak.

All I am feeling is this vast ocean of tortuous silence.

As I write this down, there’s another flood rushing from my eyes.

I am feeling lightheaded, as if just a small prick, and a like a balloon it will fly high away anywhere.

Why did he have to die? I don’t have the answer.

3 of us gave CPR the best we can. And yet we failed. This failure is much deeper than it looks.

As I look down on my palms, I feel there’s blood on it. His blood.

In this moment, I wish to be wrapped around in a warm blanket and be kept in my Amma’s womb. Again.

Take me home Amma. It’s too cold here. It’s too silent here. It’s to heavy here.

It is too heavy to be a healer.

It is too difficult to be a doctor.

It is too emotional to be a medico.

In this moment, I am just feeling my heart beating, mingled with buzzing of bellavista ventilators.

It is beating slowly. It’s afraid if it’s too fast it will make some noise. It just wants to fade away. Fade away into this syrup smelling air of CCU.

My soul wants to escape. Escape from this prison of a body and hug some warm soul tightly. So much tightly that an eternity passes away.

As I look around, my seniors, my super exhausted, super hardworking anesthesia residents are toiling in and out. Not wasting a second. They shed some tears. And move on.

May God bless them. Infinitely.

Move on to othe patients who can be saved. Who can be salvaged.

Salvage, it’s a pretty funny thing no?

One imperfect human determining whether another damaged imperfect can survive or not.

Can live or not.

As I peep out of the side room, my mind wants to hide inside itself. Doesn’t want to face the world. Doesn’t wish to see the cold body of his. Again.

What should I do now? My patient just died in my hands.

As tears flow and drench my white N95 mask, my heart wonders,

What should I do?

Yours Only,

Dinesh Raja.