Cito! Quick Thinking in Emergency Department at Hospital Canselor Tuanku Muhriz (HCTM) Universiti Kebangsaan MalaysiaCito! Quick Thinking in Emergency Department at Hospital Canselor Tuanku Muhriz (HCTM) Universiti Kebangsaan Malaysia
In the rapidly evolving field of medicine, I find it necessary to enhance my knowledge and skills to compete and strive to become “five-stars doctor.” One of the initiatives taken by the Faculty of Medicine Universitas Airlangga is the elective blocks, where students are given the freedom to choose programs of interest, not only clinical but also non-clinical. This time, I will show you the elective program organized by the Faculty of Medicine at Universiti Kebangsaan Malaysia. This program came up with a selection of six departments (emergency medicine, anaesthesiology, pediatrics, family medicine, orthopedics, and ophtalmoloogy). Each student can choose a maximum of two departments, with each program lasting for two weeks. However, I opted for just one department, which I underwent for a full month, Emergency Medicine Department.
Located at Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, emergency medicine department offers prompt and accurate initial patient care. There are several differences between the emergency systems in Malaysia and Indonesia, one of which is the presence of emergency consultant. In Malaysia, they have the emergency consultant who specialize in handling emergency patients. I learned a lot about emergency medicine, not only classes but also through the patient. We learned how to manage patients from the moment they enter the emergency room, stabilize them, and eventually refer them to the relevant departments.
When a patient arrives, the doctor must quickly perform a primary triage and manage vital signs. If the patient is yellow/ red code, they will enter the “Red Box,” where a secondary triage will determine whether the patient is placed in the yellow/ red zone. Additionally, we observed how emergency doctors, working as a team, manage patients. In cases of emergency patients (trauma, intoxication, and cardiac arrest), they promptly form a team as if they already understand their roles. Some handle airway stabilization, breathing, blood draw, medication administration, runner, and more.
Every morning, we join the rounds with residents and consultant to follow up on the condition and progress of each patient. In this regard, we are taught how to diagnose patients using various assessment criteria such as NIHSS for stroke and Burch-Wartofsky score for thyroid storm, the necessary examinations, and initial management. We are also provided with knowledge regarding prehospital care and various types of ambulances owned by the hospital.
Then, am I merely an observer there? Certainly not. I was given the opportunity to conduct patient anamnesis and physical examinations, draw blood (both arterial and venous) and interprete them, perform ECG, suture wound, log roll for patients and estimate their GCS, bagging the patient’s BVM (Bag Valve Mask), and was even given the chance to perform CPR six times. It was an extraordinary experience to witness a patient achieve Return of Spontaneous Circulation (ROSC) after a few minutes of our CPR efforts.
Not only that, but we also attended several classes and simulations organized by the emergency department. Regular classes conducted by housemen on topics such as thyroid storm, pain management, trauma, and intoxication. Joined classes with medical students on the topic of stroke. Radioconferences about interpretation of the imaging (Xray, CT, MRI). A guest lecture from Tohoku University, Japan, regarding Analytical Toxicology. Simulations related to echocardiography, and even simulations of Advanced Cardiovascular Life Support (ACLS) and Advanced Trauma Life Support (ATLS) in the American Heart Association (AHA) training room. After we finish the program, each of us was asked to choose an interesting case and present it in front of the supervisor, so that we can discuss and gain a deeper understanding of each case chosen.
This opportunity is undoubtedly valuable to me as it allows direct exposure to the clinical world even if only for a month. The chance for hands-on experience with patients can make us realize the importance of becoming a “five-stars doctor.” There is a need for effective communication, teamwork, and critical decision-making skill that can be achieved through joining this kind of program.
By : Fawwaz Rahman Hakim