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Wow, I can’t believe it’s been 4 weeks already! Time has flown by and so has this placement. About halfway through now and I’ve done a fair amount of work. I think last time I left you I had just attended an MDM, was revising for my UKCAT and I told you all about CT brain perfusion scans. Well, a quick update on the UKCAT – I managed to pass it with an above average score so I am very pleased with that, and it means I have some more time in my evenings for even more fun things like writing personal statements….. Joy.
Since the last post, I’ve managed to do quite a bit with the database. Using a few excel tricks I searched the database for duplicate patient ID numbers, and actually came up with about 7/8 repeats of which I think 2 pairs may be identical events and so need to be deleted. The other duplicates look to be the same people having 2 separate strokes (Very unfortunate people) so these can both be entered onto the database. I’ve managed to get as much information as possible from the various computer programmes where relevant data is stored so now I’ve moved on to physical case notes. It was last week (Friday 30th) when I reserved the first lot of patients notes and they have started trickling into the office today so I’ve managed to complete a few patients event information fully, which is the first step to having a database with no missing data!!
I also went up to Templeman library on the Friday and installed SPSS 21 on my laptop (A statistical analysis software) so that I could start getting accustomed to the techniques I could use to transfer data from the stroke database to the software and then get used to running various tests on the variables. I managed to set up the relevant variables in SPSS and then I started entering the data manually….. Very long and laborious! After about 5 minutes I decided there must be a quicker way, so I linked my laptop up to the monitor of the computer in the office and transferred the database to my laptop. This allowed me to have SPSS on one screen and the database on another, but I was able to control both with the same mouse and keyboard and could simply copy and paste all the data in one fell swoop, which reduced the job time from about a week to 10 minutes – thank goodness!! After doing that I did some initial descriptive analysis as a test to see if I’d done everything correctly, and it returned some believable results which I was pleased with.
There was also a very exciting event for me today (Tuesday 3rd). One of the consultants was answering a thombolysis call and invited me along to observe – which was incredible! We arrived in the clinical setting and the patient was having his CT scan done and a CT angiogram. After looking at all this retrospective data, it really was something to see the actual events happening in front of my eyes. The consultant looked at the CT scan and showed me the area on the brain that looked to be affected, which I’m sure I wouldn’t have found if I had all the time in the world to study the scan, even though he found it in about 3 seconds flat!! Happy with the patient history and the scan results, the decision was made to thrombolyse the patient, which was done so as soon as the patient was moved to the treatment area from the CT scanner. It was very interesting to see the NIHSS being done in front of me and the testing of the limbs to see what side is affected (This patient had left upper limb drift when it was raised in the air and the CT scan showed a dark spot on the right side of the brain – which fits the symptoms). After the tPA infusion was started, the patients symptoms started to worsen and a facial droop appeared, with slurred speech and he was no longer able to keep his left upper limb elevated.
Hopefully tomorrow I’ll be able to find out the progress of the patient and maybe even observe the 24 hour NIHSS being taken (One of my data variables), and I’ll be sure to report to you all next time. For now, I better go as this is telling me I’ve reached a word count of nearly 750!! Which I think is quite enough for one day. Until the next time.