Send forth thy light and thy truth: they have conducted me, and brought me unto thy holy hill, and into thy tabernacles. And I will go in to the altar of God: to God who giveth joy to my youth. To thee, O God my God, I will give praise upon the harp: why art thou sad, O my soul? and why dost thou disquiet me? Hope in God, for I will still give praise to him: the salvation of my countenance, and my God.
ATEC Stage 1 was a success! The ATEC MO thought I did very well for the resus procedures. Well, I don’t know. I did make a few mistakes here and there but then I tried to be as thorough as possible. I was happy as I thought I could relax after ATEC.
Wrong!
This week was madness! All the specs were gone from the medical centre, leaving only me to keep things up. Monday was not a good day. Most of the MOs were quite edgy, even the usually jovial ones. I also had a hell of a time trying to manage the medical covers for the week, most of which were unfinished business left by my fellow specialists. I hate dealing with this kind of crap. I didn’t even know what was going on, and yet I had people calling me all week to ask me. It was also annoying, having to deal with people requesting for things last minute. Tomorrow, that will repeat.
On Wednesday night I had to go to the SAF Ward at Alexandra Hospital. I had to take the duty for my upperstudy because he was seconded elsewhere. It was a mad rush trying to finish all the tasks for the day before going down to the hospital. The SAF Ward is where they keep mild psychiatric patients for observation. That night we were supposed to have one patient only, but then some guy was admitted at four in the morning.
The next morning I didn’t return to camp. Instead, I went home to rest. In the afternoon there was our Company HQ/S4 chalet at Changi. The chalet bungalow was quite big. But there were a lot of mosquitoes. It was worse than outfield. The bungalow looked like a guardhouse too.
I had a lot to eat and drink. I managed to get to know a few people here and there, but most of them were stuck in their own individual departments. Clerks stuck with clerks, storemen with storemen, and my medics by themselves. The RPs are a jolly bunch. OC-Sir himself egged us on with a few drinks. CSM was a teetotaler. The RPs couldn’t get him to have any.
Well I learnt a few things this week.
1) It is always good to know your stuff, very very well.
So far the rehearsals have gone well. We managed to deploy our Battalion Casualty Station in twenty minutes. Still, I think we can do better than that.
Setting up is one thing. The next examinable portion is the resuscitation procedures. Basically when severely wounded casualties come in, some life-saving procedures have to be carried out stat. We are like the A&E of the battlefield. In fact, many of these procedures are indeed used in an ordinary A&E department. For example, Endotracheal Intubation (ETT) is used to ensure that a patient can breathe even though his neck muscles have failed. For next week’s exercise I will be one of the medics assisting at the resus tables, and being examined as well!
This week we have been practicing the resuscitation procedures. So far it is moving along well. I just hope I don’t make any silly mistakes.
Yesterday we had some helicopter drills. It was really cool. In the morning we went to Sembawang Airbase to familiarize ourselves with the Super Puma helicopter. There are protocols to be followed when mounting a helicopter that is still running. For example, one avoids running near the tail of the helicopter. This is to avoid being chopped up by the tail rotor. Much of the drills involved running towards the helicopter with a stretcher and improvised casualties. It was quite tiring.
In the afternoon, we went down to Pasir Laba to execute an actual casevac drill. It was quite exciting. The feeling of sitting in the helicopter is something one has to get used to. Fortunately I felt all right.
All right, when’s the next round?
My sources tell me that we might have to do this again in September as part of a graded exercise. Yes, the dreaded ATEC (Army Training Evaluation Centre) assessment. We are having the first stage in two weeks time. Damn. We’ve been practicing the setup of the casualty station in the quickest time possible for the past week. I hope we can meet the target. And earn some off days in turn.
Although I am a specialist with the Brigade, I have to take part in this assessment of one of our battalions. These guys.. are not a bad bunch. Though they have some motivation issues, I think we can sort that out.
Last week I spent two days revising some basic first aid with the battalion’s troopers. Really, it takes a lot of effort to even gain their attention and respect, especially with the monointake guys. I take my hats off to their sergeants who can handle them. That’s another issue I have to take note of. I cannot afford to lose the respect of the people here. It will only make my job more difficult.
I was never good at practicals. Asking me to teach Continual Medical Education is the same as asking me to eat humble pie. Here, I feel like I’m over consuming it. Like today for instance, I absolutely murdered the correct ways of bandaging, causing everybody to snigger.
I hope the rehearsal goes well tomorrow. No more time for anymore screw ups.
On Monday I went back to SMTI to collect my posting order. Based on rumours in the previous few weeks, I was apparently supposed to become an instructor in SMTI. It was not to be. I was posted to HQ 4 SAB at Kranji Camp 2. On hearing the news, I was quite shocked with being sent to Armour. I didn’t even know where this camp was. Best of all there was no transport, and I had to take a cab there myself.
On arrival at the Medical Centre, I was greeted with by the medics with, ‘You have arrived at the wrong time! Good luck!’ My upper study was more than happy to see his replacement arrive. This week was spent get oriented to the camp and the various important personnel I will be working with.
My job involves taking orders from the MO and Senior Medics. I also supposed to maintain the medical centre’s infrastructure. Office supplies, air conditioning, even pest control. Then I have to take charge of the medics here. It will take some time to know the people here. My upper study tells me PR is very important for this job.
There are lots of events coming up soon. I hope I will react to them well. I cannot afford to mess things up. My life is really on the line now.
I don’t know, maybe I’m being stressed for nothing. One of the old birds told me, ‘Eh Sergeant you look very stressed! Relax man!’ How to relax? Got so many directives to study. I haven’t even finished revising my resuscitation procedures yet. Really, life at SMTI was too slack. I feel very unready for this job. Yet I have to project the image that I am always ready.
I’m bunking in with my upperstudy, his combat medic and a newly arrived service medic. The bunk was really filthy. I had to make do with the broom, dustpan, and lots of toilet paper to clean up the dust. Absolutely unbelievable. I could only use the magiclean magic wiper after retrieving my other stores on Thursday’s night’s out. This unit has night’s out on Tuesday and Thursday. I will be sure to make use of it liberally.
Oh yes, I’m typing this from camp computers. I’m confined here till next week. Unit directives say that all newbies are to be confined. Dumb! Well, see you next weekend. It’s time for me and my service medic to go to the cookhouse to consume the swill that has been prepared for us.
The hospital attachment was quite boring. I elected to stay in the treatment room administering ECG (or watching the nurses do ECG), cleaning and dressing wounds. I even had the opportunity to administer the nebulizer to one asthmatic patient. Nonetheless, it was very eye opening. It has proved one thing: that everything that SAF teaches is a farce. The things are taught inside do not correspond with what I see in a public hospital. To a certain degree, at least.
Ah, the only good thing about the hospital is the girls.
I spent only one day out of three in the hospital, because I took MC for the other two days. My staff sergeant was suspicious about my MC. He thought I was just bored. In any case, I was on attend B for the whole of last week. I was afflicted with fever, headache, bodyache, sore throat, cough, green sputum and breathlessness. I must have caught something bad at the hospital. Medication didn’t seem to help much. The antibiotics were completely ineffective.
I went to see a neighbourhood GP on Saturday. Then I actually saw the MO in-camp twice, after that. On the second time he finally gave me some pills, but then he remarked that they weren’t of much use.
MO: Ok, these are lozenges for you to suck on. But since they are from SAF, they won’t really help.
Me: Err, Yes Sir.
I was struggling to breathe for most of the week. Fortunately I didn’t take part in the PT. No route march either, because it was cancelled!
On Saturday I went to see Speed Racer with Kirk and Yeo Kent Lee. What a great show! We had kopi at Joo Seng after that. I came home quite late this morning.
A blessed Pentecost to all. I found this good video with two traditional hymns sung in honour of the Holy Ghost, namely Veni Creator Spirtus (Come Creator Ghost), Veni Sancte Spiritus and Come Holy Ghost. I’m sure we know the third hymn very well, since we hear it at the Saturday Novena quite often. Still, I’d like to share with everyone the original Latin chants.
Hostem repellas longius,
pacemque dones protinus:
ductore sic te praevio
vitemus omne noxium.
Per te sciamus da Patrem,
noscamus atque Filium;
Teque utriusque Spiritum
credamus omni tempore.
Deo Patri sit gloria,
et Filio, qui a mortuis
surrexit, ac Paraclito,
in saeculorum saecula.
Amen.
COME, Holy Ghost, Creator blest,
and in our souls take up Thy rest;
come with Thy grace and heavenly aid
to fill the hearts which Thou hast made.
O comforter, to Thee we cry,
O heavenly gift of God Most High,
O fount of life and fire of love,
and sweet anointing from above.
Thou in Thy sevenfold gifts are known;
Thou, finger of God’s hand we own;
Thou, promise of the Father, Thou
Who dost the tongue with power imbue.
Kindle our sense from above,
and make our hearts o’erflow with love;
with patience firm and virtue high
the weakness of our flesh supply.
Far from us drive the foe we dread,
and grant us Thy peace instead;
so shall we not, with Thee for guide,
turn from the path of life aside.
Oh, may Thy grace on us bestow
the Father and the Son to know;
and Thee, through endless times confessed,
of both the eternal Spirit blest.
Now to the Father and the Son,
Who rose from death, be glory given,
with Thou, O Holy Comforter,
henceforth by all in earth and heaven.
Amen.
The lyrics were taken from a site called Thesaurus Precum Latinarum. It is a most excellent site, with many Latin prayers and hymns. It is an excellent resource for those interested in the venerable Tradition of Mother Church. Even if Latin is not your cup of tea, it’s always good to appreciate the meaning behind these songs.
Oh, reciting this hymn on New Year’s Day or Pentecost grants a plenary indulgence. Under the usual conditions of course.
In labore requies,
in aestu temperies
in fletu solatium.
O lux beatissima,
reple cordis intima
tuorum fidelium.
Sine tuo numine,
nihil est in homine,
nihil est innoxium.
Lava quod est sordidum,
riga quod est aridum,
sana quod est saucium.
Flecte quod est rigidum,
fove quod est frigidum,
rege quod est devium.
Da tuis fidelibus,
in te confidentibus,
sacrum septenarium.
Da virtutis meritum,
da salutis exitum,
da perenne gaudium,
Amen, Alleluia.
Come, Holy Ghost,
send down those beams,
which sweetly flow in silent streams
from Thy bright throne above.
O come, Thou Father of the poor;
O come, Thou source of all our store,
come, fill our hearts with love.
O Thou, of comforters the best,
O Thou, the soul’s delightful guest,
the pilgrim’s sweet relief.
Rest art Thou in our toil, most sweet
refreshment in the noonday heat;
and solace in our grief.
O blessed Light of life Thou art;
fill with Thy light the inmost heart
of those who hope in Thee.
Without Thy Godhead nothing can,
have any price or worth in man,
nothing can harmless be.
Lord, wash our sinful stains away,
refresh from heaven our barren clay,
our wounds and bruises heal.
To Thy sweet yoke our stiff necks bow,
warm with Thy fire our hearts of snow,
our wandering feet recall.
Grant to Thy faithful, dearest Lord,
whose only hope is Thy sure word,
the sevenfold gifts of grace.
Grant us in life Thy grace that we,
in peace may die and ever be,
in joy before Thy face.
Amen. Alleluia.
This hymn is sung as a Sequence before the Alleluia during the Mass in the day for Pentecost. These days we merely recite these beautiful sequences. Why not sing them, and pray twice while at it?
I was attached to Sengkang Fire Station for an ambulance attachment for Tuesday and Wednesday. Fortunately we get to stay out.
There wasn’t much of a briefing or welcome when I arrived at the station. The moment they changed shifts I jumped into the action. Monday, 0800h, was my first call. It was a case of chest pain. Relatively uncomplicated. Then more and more cases started to flow in as the day passed. On Monday I had two cases of chest pain, one case of routine transport from the old folks’ home, one case of fall from height, and one road traffic accident. The accident case was the closest I have ever seen. Plenty of broken glass and metal everywhere. Apparently this car full of polytechnic kids hit a tree and flipped over a few times. Amazingly the driver and two backseat passengers only had light injuries. The front passenger however had lots of bleeding.
The night shift one was quite exciting. I had two unconscious cases, one case of fractures, one case of chest pain, and last one: one case of 6-months pregnant lady with multiple seizures. My God! We really had difficulty with this case. Luckily I didn’t get kicked in the face! But there was one cock-up for that case: I left the jumpkit at the patient’s house. Oh crap! But never mind, we went back to get it after the case.
The paramedic’s life is tough. Your meals come at odd hours. And the bloody hospital food is so expensive. I didn’t really do much during these two days (or sleep much), but I did see a lot of cases. Some of my friends complained of not having any cases. This experience was really eye-opening. I even managed to put some of my skills into use. But as forewarned, they were quite unorthodox in their methods. I hope I don’t apply any bad habits for next week’s test.
Tomorrow we go to Changi General Hospital’s Accident and Emergency Department. I hope it will turn out okay.
Tomorrow will be the first time I step into a SCDF ambulance. This week we are posted out to various fire stations and hospital Accident and Emergency departments. On Tuesday and Wednesday I will be at Sengkang Fire Station. Thursday will be my off day. I will report to Changi General Hospital on Friday to Sunday.
I’m really not sure of what to expect. There is this feeling of excitement, yet a certain dread. Today our course commander remarked, ‘Gentlemen, in this line, we always say “No business is good business.” I somewhat think he is right. But I’m sure it will be an eye-opening experience.
Damn, I hope that my skills don’t fail me when the time comes.
I’ve had Saturday duty for the past two weeks. It is very draining. I spent most of Sunday asleep at home. On 26 April I attended Solemn Vespers and Benediction at SJI International’s chapel. It is a very nice place. Modern in design, yet faithful to rubric. Vespers was according to the extraordinary rite. The priests presiding were Fr Anthony Ho and Fr Augustine Tay. Wonderful, we should have this more often! Unfortunately, there are many people who rather see all this done away.
I have been missing Legion meetings for a long time, due to circumstances beyond my control. One week I was ill; another I had to attend a wedding; and for two weeks I have weekend duty. I will miss this week’s one because of the attachment. I feel bad for letting Joycelyn do all the work. Hang in there, girl!
I hate how these little things add to my confusion over my future plans. And how do we plan for tomorrow if we are not sure what comes? This is one thing that has always vexed me: uncertainty. It’s all very easy to say, ‘Let us have faith.’, but it’s harder than one can think. I have been vexed over many things in the past weeks. For instance, recently I’ve had friends in distress, yet my consoling and advice didn’t seem to help much. The only thing I could do is pray. I was also frustrated with my attachment to certain ideas, which I am trying to get rid off. Then my old habits all come into play as well. I am increasingly afraid that my aspiration is nothing but fantasy. Maybe I’m thinking too much. I don’t know. I often drift from a state of not thinking to thinking too much.
The Salmonella genus of bacteria is a common cause of food poisoning. The genus also includes Salmonella typhi, which causes Typhoid Fever. It commonly occurs in places with poor sanitation and water supply. In this incident, the culprit was Salmonella enteritidis. It is commonly found in undercooked poultry and unpasteurized milk, undercooked eggs and by contact with rodents and reptiles.
The disease in this case is most probably Salmonellosis. Symptoms include diarrhea, cramps, vomiting and fever. All the victims affected suffered diarrhea and vomiting. Salmonella works by invading the small intestines. The inflammation resulting from the damaged intestinal cells causes water and electrolytes to be lost from the gut, thus causing diarrhea.
Normally this illness is not lethal, if medical attention is sought quickly. The cause of death in the teenager was blood poisoning from Salmonella enteritidis. How did this happen? As mentioned, this is an invasive pathogen. It has the capability to spread to other parts of the body via the bloodstream. Salmonellae, like other gram negative organisms, have a Lipopolysaccharide (LPS) moiety on the cell membrane. This LPS is called an endotoxin, because it is built into the structure of the bacteria and only released when the membrane is disrupted or lysed. Thus when the body’s immune reaction destroys these pathogens, endotoxins are released. They can cause fever, inflammation and shock, and the poor boy’s death as a consequence.
The treatment for this, and most diarrheal illnesses in general, is to rehydrate. Drink lots of water, because you need to replenish the loss of fluids. There is also a need to replenish loss of salts. Drinking the rice water from porridge is a good agent for this. You can take sports drinks, but don’t give them to young kids because the glucose to sodium ratio is not ideal. Get plenty of rest as possible. Other than that, there is little you can do other that to go to the toilet more often than usual.
If you have prolonged diarrhea, it is never a good idea to delay treatment. Go see a doctor! You don’t want to wait till you end up on a gurney in the A&E department, where you will stuck with needles to replenish your lost fluids. IV, is not very pleasant.
We are quite fortunate to have pasteurized milk in Singapore, so my guess is that the poultry was not well cooked or the eggs were contaminated. Prevention is very simple.
1) Make sure the eggs you buy are not cracked.
2) It is always a good idea to clean the exterior of the eggs.
3) Cook the eggs well.
4) If you have to use raw eggs, make sure they are pasteurized. Or use liquid eggs as a substitute.
5) Cook the meat well. Use a meat thermometer if you have to.
6) Keep your kitchen and equipment clean and sanitized.
7) Handwashing. Enough said.
Eat and drink, for tomorrow we die. But please, not from Salmonella!
There have been several reports in the local newspapers in the past week, documenting several deaths. One was the death of a 23 year old young man who had cardio-respiratory failure. There was another report of a Malaysian woman choking to death on a biscuit. And who can forget the horrific accident that wiped out four members of a Catholic family, leaving only their 2 month old daughter?
There could have been more ways to help the casualties. For example, if CPR was administered to the young man before the ambulance crew arrived, he might have survived. In the case of the lady, they managed to fish out the debris from the mouth, but the article did not mention if the airway was totally cleared or if artificial ventilation was provided.
Unfortunately, accidents and emergencies occur everyday. What is our response to these? Let’s say one day you are walking along the street, when a man collapses in front of you? What will you do? Some will help, some will not. Some want to help, but are incapable. Some are able to, but do not want to. For most of us it’s not our problem, until one day it hits home. By then it will be too late to regret the loss of our loved ones.
I read another article which is quite heartening (pun intended), there is a First Aid Corps being set up in Marine Parade GRC. The three volunteers are trained in the use of the Automatic External Defibrillator. Some Community Development Councils also conduct CPR courses for residents. I think Mum went for one of those a few months back. I think these are good steps for making people more prepared for emergencies. We should all take some time off to learn some simple first aid, CPR if possible. If we are more prepared, we won’t panic so much when disaster strikes.
By some coincidence, a few days ago we had lessons and tests on CPR, Choking and AED. That means we are trained to assist in such emergencies. I hope my fellow medics and I will have the courage to help in such incidents when we are outside. And we hope like hell that none of us will screw up the rescue! It is clear that there are two requirements in such a situation: Competence and Courage. We must possess the necessary skills to help out, in order to prevent further harm to the patient. We must also have the daring, to help without any hesitation.
But let us not forget about spiritual matters. Death is so untimely and unpredictable. Let us prepare our souls for its arrival.
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