Wednesday, 6 June 2012

CCS week 2 + MET3a ICA

I struck a deal with D, if he allows me to insert a nasogastric tube into him, i would let him do the same after. We shook on it. 

So under the supervision of the teaching staff, i had a quick practice on the dummy with the self/water- lubricating NG tube, and as expected with a plastic dummy, it went straight in without any resistance whatsoever (Hoping for the same luck, if this comes up as an OSCE station!). 

However, i'm pretty sure both D and I knew it wasn't going to be quite the same when it came to our nostrils being penetrated. 

So firstly, i had to drape the tube from his nose to his ear, and then down to his xiphisternum, okay, so approximately 55cm; that's how far the tube has to travel in. I gave him a glass of water to hold, dipped the end of the NG tube with ky jelly for lubrication, and asked him which nostril he preferred, and off we went! I probably got around 5cm in before i hit my first bit of resistance, i was instructed to turn the tube 180 degrees and keep pushing... it was just stuck, and i started to feel bad as D's eyes started to well up (it's pretty normal, around the room i don't think i saw a single student with a NG tube in, without tears rolling down the same side of the face!.. but still.. i felt bad!!). It sort of eventually gave way, and i asked D to keep sipping water, and once it got past the second bit of resistance, it was just like the dummy, slipping straight down until i hit the 55cm mark. Yep, almost there. 

Last bit, was just to take the syringe and aspirate some stomach contents and test the pH on a bit of litmus paper just to make sure it was in the stomach and not the lungs. 

Now my turn. Okay, so it was pretty much the same thing, just i was a little more self concious as i just had a tuna salad for lunch, and was a bit worried he'd syringe out a bit of that onto the tray (!!) It really wasn't too bad, definitely not pleasant though as it stings a LOT when it goes through the nasal cavity, (and the tears... you really have no control over it!!) but once it's into the back of the throat, it no longer stings, perhaps a little more uncomfortable than anything. 

.... and no tuna salad was aspirated. 

So that was probably the highlight of CCS week 2, and at the end of which i had a weekend of cramming, followed by Met3a ICA on monday!

So now having sat all 3 ICAs of the year, personally i think i would rank it as: 
CR --> Met3a --> Met3b in order of difficulty. Not...that is matters, as I still have to revise all 3 for finals >.<

Now onto my Vascular surgical firm, revision for finals, and looking forward to my summer vacation!


Grumpy Biomed said...

Oooh, when are your finals? Good luck! And erm, well done on not bringing up your lunch :P

Tofu said...

They're really soon.. too soon!

ilovehotchocolate said...

Oooo, brave. We did NG tubes that day too and although one of my class mates offered, there was no way I was letting anyone go anywhere near my nose with that thing. Good luck with the exams :)

Tofu said...

ILHC: haha, you should have offered up your nostril ;) it wasn't really too bad once it went past the nasal cavity. Thanks for the good luck ^^!