This week so far, I’ve learned quite a bit about being a doctor. Earlier in the week, I learned how to take vital signs in preparation for volunteering at SB Home, a free clinic in Islip. First, you take the pulse lateral to the radial artery. Then, you take the breathing rate, by ‘pretending’ to take the pulse, but really watching and counting their breaths (if patients know you’re counting their breaths, they might increase their breathing rate). Except, when I did it on my friends, it didn’t really work out right. They just looked like they were not breathing, but obviously, they’re alive and breathing.
Next, the exciting part was taking blood pressure. I’ve never operated the cuffs and bulbous toy; I’ve only been worked on by my doctors. Anyway, you find the brachial artery, immediately lateral and inferior to the biceps tendon. So when the patient flexes their arms, you can easily see the tendon, and you press right next to it, medially. Then, you put the cuff on, stick in the stethoscope at the site of the arterial pulse, and pump up the pressure to around 140-160 for an average person.
Basically, blood flows smoothly, naturally; that’s why you cannot hear anything with a stethoscope on an artery. However, with added pressure, blood flow becomes turbulent and resistance increases (remember Bernoulli’s fluid dynamics in physics?), and that’s how you hear a pulse. Now, when the pressure increases on the cuff, you will not hear anything initially because the blood supply is cut off. Once the pressure is released, the first beat you hear is at the systolic pressure. Gradually, the turbulent flow and resistance decreases. At the diastolic pressure, no sound is heard anymore because smooth blood flow is restored. Normal blood pressure is 120/80, and I got around ~100/70, so I’m at least normal. And, I have a slow heart rate, so that’s good too.
I kept fumbling around with the stethoscope. I’m a natural klutz, so things end up in the wrong hands and I drop stuff. Plus, the stethoscope hurts so much in the ears and it is so sensitive to sound. One minor touch or move, the sound is magnified into my poor ears. Hmm, I guess I’ll be looking forward to my pink stethoscope soon =/
And today, I learned how to gown up for surgery and… inserting catheters into model dummies- male and female. That was… a new experience, wiping iodine on the openings and inserting a rubber tube that balloons at the end, into the ‘urethra.’ When I got to the female urethra, it got stuck and I could not really open the labia to guide it into the bladder. When I got to the male urethra, the path was rather long, so it just kept going, until I was told that you know you’re in the right area when the ‘urine’ comes out of the tube (really just water). After removing the tube, some remnant water squirted out like the model gonad was peeing… oops.
On a less awkward note, gowning was a pain. Playing with sterile stuff, is a pain in the butt. When you get in the oversized gown, your hands are balled up in the cuffs while you try to put on sterile gloves. You’re wiggling around unsuccessfully most of the time. It’s like using a stump of a hand to put on winter gloves. Anyway, I managed and gowned up successfully and won the mini-battle with the surgical gear.