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Practice Makes Perfect

Jeff Jeff Wonoprabowo -- Earlier this quarter I had a pretty busy afternoon. And for a while it was stressful, too. It all started when a 51-year-old man came into the hospital complaining about shortness of breath. On the way in he began to feel some chest pain. I stood by his side as he struggled to breathe and complained about mid-sternal chest pain. Two of my classmates began to auscultate the patient. I looked back at the monitor and read his vitals. He was hypotensive and his pulse was approximately 180.

The interview was over quickly. The ER doc asked what we wanted to do and my classmate suggested a beta blocker. I picked up the book to look up dosing but couldn't find it. It was the first time I had ever opened this particular book and it was frustrating not being able to find a simple drug. And it wasn't in the index, either.

The patient showed no improvement. Another classmate suggested adenosine. I found that dosage: 6 mg, intravenously. No change. I suggested we try a second dose, this time 12 mg. The book was turning out to be of some use.

The man's blood pressure started to increase and his heart rate lowered slightly. Positive signs. But it didn't last very long. Soon his blood pressure dropped again. My classmates and I looked at each other. I opened the pharmacology book again and flipped through the pages. It said that we could give another dose of adenosine. We gave him .76L normal saline instead.

The patient started complaining about trouble breathing. The doctor suggested we give him oxygen. Why didn't we think of that? My classmate fitted a non-rebreather mask over the patient's mouth and nose. But his vitals still weren't looking very good. We tried another drug to no effect.

Finally the doctor suggested electric cardioversion. He adjusted the settings on the defibrillator and moved aside. I picked up the paddles, completely unsure of what to do with them. He told me where to place them and told me to press both buttons simultaneously after everyone was clear.

I called for everyone to be clear and pressed the buttons. The man's vitals began to stabilize and the tracings indicated a return to normal sinus rhythm. The doctor told us we did a good job. Relieved to be done, we walked out and walked to a different room where other classmates had been sitting and watching us on a large flat-screen monitor. We removed our lapel microphones and took a seat.

It was an interesting day in Pharmacology Lab. The patient was a robot, anatomically correct and featuring pulses, breath sounds, heart sounds, and pupillary reflexes. Everything was simulated. And as we discussed the case, I couldn't help but think about the poster up on the wall. It had a quote by Aristotle: "We are what we repeatedly do. Excellence, then, is not an act but a habit."

I thought it quite fitting to see that quote in the university's medical simulation lab -- where students and residents can practice, practice, and practice some more. At least we get to "repeatedly do" on simulated patients before trying our hand at real ones.

January 21, 2009 | Permalink

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Posted by: Medical Advice | Jan 21, 2010 12:16:39 PM

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Posted by: Dissertations quality | Feb 22, 2010 11:17:05 PM

True that practice really makes perfect but there are also many factors to consider. But as a start practice at a constant rate will really make you better at what you do.

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Never frown, even when you are sad, because you never know who is falling in love with your smile.

Posted by: rs gold | Jun 4, 2010 2:50:16 AM

Interesting would be to know how healthy it is to train your breath like that. But it is true about practice makes perfect because this is how people develope their skills not only physical. Actually this is about you - how far are you ready to go to achieve some results.

Posted by: acne scars treatment | Jun 30, 2010 1:53:27 PM

Same happened with me, when I was a medical student my mother was ill. I see her at home at 2:00 night. try some experiment on her. my experiment was successful. I feel happy at this moment.

Really some events teaches us a lot or give us a lot of confidence.

Posted by: EMR Feasability | Jun 30, 2010 10:19:12 PM

Practice Makes Perfect<-- :)) Nice and Great!

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Posted by: rs gold | Oct 19, 2010 8:22:56 PM

Finally the doctor suggested electric cardioversion. He adjusted the settings on the defibrillator and moved aside. I picked up the paddles, completely unsure of what to do with them. He told me where to place them and told me to press both buttons simultaneously after everyone was clear.

Posted by: University Online | Oct 26, 2010 8:42:05 PM

i think the information is just superb to work on.

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I think the practice is main power to get any results.

Posted by: Medical software review | Apr 23, 2011 7:34:03 AM

"We are what we repeatedly do. Excellence, then, is not an act but a habit."

Indeed, Aristotle knew what he is saying. Great things always begin in small things, just like a small step to a great leap. And when we start to do things even in a small amount, we will tend to be not that aware that we are building and making a habit of ours. Learning could definitely be done through practice, eh. In each small amount of practice, even a dull student will consciously and unconsciously build a habit, which is definitely a sign of learning.

Posted by: blood pressure device | May 8, 2011 8:50:08 PM

Good thing that patient was a robot. Anyways best of luck for your future as a doctor.

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I am a medical student and I am practicing in bio-medicine now. Nice to see your blog. Very informative posts. Keep updating. Do stay in touch.

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Well, medical field has been so vast and still searching more innovation in that. Now almost every disease is curable.

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Doctors have got some ethics and if you see businessman ,, they are ethicless,, need to learn some from doctors.

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