I was at my last day of my GP placement yesterday, and i took an observed history of a patient with atrial fibrillation.
I asked about his palpitations, he told me how he feels odd irregular beats across his chest, and with all that in mind, i then did a cardiovascular exam, and what seems logical went out of my head..
i just went with my "routine" comment, feeling for the pulse and commenting: "the pulse is of sinus rhythm, regular, HR within normal ranges, symmetrical on both arms, there is no radial-radial delay.." this was when the Dr looked very worried and stopped me...
"Tofu... are u sure?! this man has AF!"
.. this was when i snapped out of my stupid routine and realised how stupid i was! i was almost day dreaming, and just repeating a routine... so so so stupid >.<
AF - is irregularly irregular! i should have known that from the history alone!
This was embarrassingly stupid, but in a way im glad it happened in hindsight. It annoys me how silly it was, but i guess it's a good time for me to realise i need to REALLY pay attention to things... to look, listen and feel for signs.. and not just assume patients are "normal".
I will take it as a learning experience.. going to never do that again!
Okay.. it's now croissant and coffee time, then off to my ward! (with a more serious approach to clinical examinations, no more relying on my safety routine comments!!)