29/08/2013
Hello again! It’s been about a week since I last wrote an entry, so I thought I’d better update you all on what I’ve been doing. Now, I may have written my first entry on the 21st, but due to a number of bumps on the internet road it has only just been published on the same day that I’m writing this one. I think that all the problems have now been ironed out so expect regular updates from me, there’s no stopping me now!!
When I left you last, I was preparing for an MDM at Kent & Canterbury Hospital which Dr. Hargroves invited me to attend. Well I’m pleased to say that the meeting was very interesting. There were multiple patients to discuss and also a few performance reviews and other presentations. One of the most interesting things to see was a mortality audit. There were 3 sets of case notes from the William Harvey Hospital that were reviewed by an unbiased consultant to assess how well the patient was cared for and if there were preventable deaths. I thought this was a brilliant way to keep the standard of healthcare at a very good level, and in fact, 1 of the cases is going to be reviewed again because there were some aspects that weren’t perfect.
The meeting lasted about 4 hours in total (Technically 2 meetings, one from 1pm-2pm and the other from 2-5), after which I was done for the day and made my way home. Another reason for the current scarcity of entries from me (This is only my second entry and I’m nearing the end of my 4th week!) is the fact I am currently muddling my way through an application to graduate entry medicine. This is a time consuming process involving whittling down prospective universities and finding out entry requirements. The universities I think I want to apply for require me to take another test – the UKCAT. I’ve got this booked for this Saturday 31st and so my life now currently consists of work, revision, eating and sleeping – although I haven’t managed much of the sleep!!
Now it’s all very well me talking about my life, but this blog is meant to be about what I’ve been working on. Since the last entry, I’ve been steadily plugging away at the stroke database, going through I don’t know how many reports and case notes. I’ve looked at more brain scans in the last few weeks than I care to remember! In total I’ve managed to get 288 more patients onto the database, although I haven’t filled in every bit of data needed. So that means I’ve looked through 288 different sets of notes, letters, tests and reports – many times more than once, seeing as it’s impossible to glean all the information in one go. I think I’ve gotten as much information as I can get from all the notes available to me on the computer, so in the coming weeks I will be getting out the physical copies of the case files and pouring over them trying to fill in any remaining information.
It’s still an interesting day at work though, I’ve been trying to learn as much as possible when I look through the scans and their corresponding reports, so I can almost analyse a CT perfusion scan myself! The main tests relevant to my study are CT scans, MRIs and CT perfusions, with the perfusion scans being especially important in cases of unknown onset time. CT perfusion scans are based on the central volume principle (CBF = CBV/MTT) where CBF = Cerebral blood flow, CBV = Cerebral blood volume and MTT = Mean transit time. When looking at the results, a ‘mismatch’ of blood flow and blood volume can indicate that the patient is suitable for thrombolytic therapy, and so is extremely useful when trying to evaluate when a SUTO (Stroke of Unknown Time of Onset) patient should be thrombolysed.
I think that’s enough for today, I’d better get back to it now so as always, watch this space!