Doc Venu Passion & Profession

Dear Faculty  Kerala sociocultural scenario is totally different from other parts of the state .  A huge number of our population are working abroad or away from core family . Parents are alone in many families . Renal disease , Cancer ,Complicated diabetes , COPD , Stroke , CAD etc are so rampant in our state . Old age and related issues are common . Emergency departments has got its own impact due to this health profile. Emergency doctor has likely to phase a lot of decision issues and forced to a huge emotional interface while managing patients with end stage diseases . Each one of you should learn how to de-escalate aggressive EM approaches and higher end resuscitation mode to comfort care . You must receive special training in this field . As you know we can not document DNR in case sheets . What we can document only as "palliative care only " . But this decision should come from primary physician and he should take this decision after discussing with blood relatives of

LEMON approach in one of the most commonly used tools to evaluate airway difficulty in ER . Very often we are all so fascinated about Mallampatti which is the 3rd letter in the Lemon . Interestingly it has got limited or no role in real emergency like unresponsive patients . Practically LEON is more appropriate in ER . But in trauma cases N "Neck Mobility" assessment going to be  disastrous and contraindicated . So LEO will be enough in such situation . Don't forget alteast to do LEO in all cases before airway management and document if any .. Essentially each and every one should fill the airway check list including assessment sheet before airway interventions DrVenu 29.12.16

RSI is a process to be executed with extreme caution and precaution. It can be the potential minefield for many airway disasters. The agents used in RSI is highly potent and potential for dangerous complications. RSI in ER may likely to cause errors in execution. The in depth knowledge of drugs using RSI is absolutely essential. The drugs must be handled by doctors only and faculty supervision is mandatory. Once a drug administrator through IV route means it is similar to throwing a stone. No way to get back. So what is needed is double caution . Follow safe practice. Follow syringe protocol while performing RSI. Load depolarising agents like Scoline in 2cc syringe, non Depolarizing Angents like Vecuronium in 5cc syringes and Induction agents like Etomidate , Propofol etc in 10cc syringes. Lebel it appropriate way and check three times before its administration. If you are not following it ,kindly follow this now onwards  DrVenu/28.11.201

Gum elastic bougie can use if there is some visibility of glottis at least tip of epiglottis. An external laryngeal manipulation can covert a gr 4 larynx to 3  or more . This will facilitate bougie usage . You cannot use bougie in a totally non visible larynx . DrVenu

Dear colleague, Airway errors are so common , rampant, especially tube displacement. Every transport is prone for such airway disasters. Recently we had a displaced tube issue in the group which was accompanied by a faculty. Displacement was identified by Icu people . We were not able to identify the displaced tube. This phenomenon is universal. That is why NAP 4 study emphasis the use of capnography in all intubations and all transports should be under capnographic monitoring only. I ask you to keep this standard in all of your airway interventions and transports irrespective of intra or inter hospital transports. If your department is not equipped to this level , urgently raise a CAPX and implement it.  Personally you must look into it and the needful to make it happen. DrVenu  25.11.16

http://m.timesofindia.com/city/kozhikode/docs-to-study-ill-effects-of-irumban-puli/articleshow/55536348.cms

Came Buvaneswar as GWU faculty in emergency medicine. Visiting Oddissha first Time. Very beautiful and clean city. First time I am meeting Dr.Sajid HOD emergency medicine , AMRI hospital.  A lovable person and great emergency physician with family medicine background. Surprisingly, he was following me very closely  since last 10 years . He told me that he is one my great fan and he was waiting to meet me for years. Now it has happened incidently. It was great honour for me. He is observing closely EM and Angels activities in Kerala. .. Yes

Survivor felicitates saviors Aster DM health care 7th Batch 3years  Master program in emergency medicine under GWU: convocation ceremony at aster mims calicut. Mr.Adarsh is a survivor of cardiac arrest brought in Calicut mims and received 45 minutes cardiac pulmonary resuscitation and 30days ICU stays and discharged from mims with out any neurological deficit.  It is another mile stone in our resuscitation history. Mr.Adarsh was the chief guest in the function and he is distributing certificates to graduating residents. SURVIVOR FELICITATES SAVIORS.

MEM EXIT EXAM- Calicut- a bird's eye view. Today It was my pleasure to monitor the MEM exam in calicut. With good grace of Dr Venu sir, who has organised the event so well. It was flawless Multiple choice question paper with 200 questions. We had all the 3 batches from 1st year to final year EM residents of  around 50 in number sitting with writing pads, pencil & eraser at 9.30am. Final years were writing their exit exam and others were giving year exam. There were different sets of questions for each batch. All candidates were provided with juice packets as refreshment before onset of exam to keep them charged up, which was innovative effort. Than Examiner's team brought sealed packets of question papers from Ronald Reagan Institute- George Washington University. At 10am sharp, we distributed the question papers & answer sheets. Every candidate was looking confident, comfortable, and excited to score the best in exam. Exam was well arranged in seminar hall w

Final day of MEM Exit Exam in Calicut- Day of Triple Celebration. On the auspicious occasion of Eid today, we started scrutinizing the 3 yr period Logbooks of MEM candidates describing their 5 P’s:- -Performance skills in handling patients in ED. -Participation in academic activities.   -Progress in Research & paper presentation. - Personality development by extracurricular activities. - Public awareness work in sort of organizing camps & trainings.  Everyone was out-forming in their own way, someone in ATLS/ ACLS instructor, some had cleared their MRCEP part 1/2/3, some had attended all the conferences, some had organized workshops. Than all the MEM 3rd year were called to Seminar hall to present their academic thesis in 20 min duration for each.Examiners were happy to see good quality clinical research on innovative topics- -Identifying high risk factors of Hep A infected progressing to Fulminant hepatic failure. -Upper airway USG for locating ETT correctly. -Use of

This issue has to be taken and to be considered very seriously. A patient with acute chest pain is very serious and detrimental to life in emergency medicine point of view. Such cases should never go to doctors home for consultation. Even if it reached in home it must be referred to a hospital when the facility to evaluate, observe and to do necessary treatments . More importantly, no justification for manhandling a doctor.  What the people should ask for better facilities in PHC and CHC.  Government must come forward to implement quality emergency medicine set up in all health care provider centers and insist core competency training in doctors and nurses to detect and manage acute life threatening emergencies. Proper emergency medicine approach can solve 80 to 90 percent issues like . We had several such issues reported from various parts of Kerala. No doctor can kill a patient . It happen by chance as an  incident

MEM EXIT EXAM- Calicut- a bird's eye view. Today It was my pleasure to monitor the MEM exam in calicut. With good grace of Dr Venu sir, who has organised the event so well. It was flawless Multiple choice question paper with 200 questions. We had all the 3 batches from 1st year to final year EM residents of  around 50 in number sitting with writing pads, pencil & eraser at 9.30am. Final years were writing their exit exam and others were giving year exam. There were different sets of questions for each batch. All candidates were provided with juice packets as refreshment before onset of exam to keep them charged up, which was innovative effort. Than Examiner's team brought sealed packets of question papers from Ronald Reagan Institute- George Washington University. At 10am sharp, we distributed the question papers & answer sheets. Every candidate was looking confident, comfortable, and excited to score the best in exam. Exam was well arranged in seminar hall w

10 REASONS TO LOVE Your CO-PRACTITIONER 1. He is also practicising for Bread and Butter like you. 2. He is also creating awareness among people. 3. He is also giving employment to many people like you. 4. He is also suffering with patients with wrong attitude. 5. Sometimes you may get his patients for second opinion. 6. You may get chance to treat the patients of your copractitioner, because treatment failures are common with anyone. 7. Sometimes we may learn different technics adopted by our copractitioner. 8. Unless there are copractitioners, you feel lazy and can't adopt new procedures and equipment. 9. Ultimately every practitioner must respect and love copractitioners, according to ethics code. 10- Better get a friend, if not possible better avoid  an enemy Let's give DUE RESPECT to our colleagues and friends.

സ്ത്രീയും പുരുഷനും തമ്മില്‍ പലവിധ ബന്ധങ്ങളുണ്ട്. അതില്‍ ഒന്നു മാത്രമാണ് സെക്സ്. സെക്സ് കൂടാതെ സൗഹൃദം, ഇഷ്ടം, ഇന്‍ഫാക്ച്വേഷന്‍, പരിചയം, ആരാധന, ബഹുമാനം, പ്രണയം, ആശ്രയത്വം, ബിസിനസ് ബന്ധങ്ങള്‍ തുടങ്ങി ആയിരമായിരം ബന്ധങ്ങള്‍ സ്ത്രീയും പുരുഷനും തമ്മിലുണ്ട്.. കടല്‍ത്തീരത്തു പോവുന്നത് ആളൊഴിഞ്ഞ ഇടത്തു വച്ച് ഉമ്മ വക്കാനായിരിക്കും എന്നു കരുതുന്നത് വിഡ്ഡിത്തരമാണ്. അവര്‍ സംസാരിക്കുന്നത് കടലിലെ തിരകളെകുറിച്ചായിരിക്കാം... പൂര്‍വ ജന്മത്തേയോ പുനര്‍ജന്മത്തേയോ കുറിച്ചായിരിക്കാം. മഴ പെയ്യുമ്പോള്‍ ഒരു കൂരയിലോ ബസ് സ്റ്റാന്‍ഡിലോ കയറി നില്‍ക്കുമ്പോള്‍ അവര്‍ സംസാരിക്കുന്നത് കാമസൂത്രയെകുറിച്ചായിരിക്കില്ല... മഴയില്‍ നനഞ്ഞൊലിച്ചു നടക്കുന്ന നാളുകളെക്കുറിച്ചായിരിക്കാം... മഴ പെയ്യുമ്പോള്‍ ചോരുന്ന തന്‍െറ കൂരയെക്കുറിച്ചായിരിക്കാം... ബസില്‍ ഒന്നിച്ചു യാത്ര ചെയ്യുന്നത് തൊട്ടുരുമ്മാനായിരിക്കില്ല... ഇഷ്ടമുള്ള കാര്യങ്ങള്‍ പരസ്പരം പങ്കു വക്കാനായിരിക്കും... ചിലപ്പോള്‍ ഇഷ്ടമുള്ള യാത്രകളെ കുറിച്ച്... മറ്റു ചിലപ്പോള്‍ കഴിച്ച ഭക്ഷണത്തെക്കുറിച്ച്.... ചിലപ്പോള്‍ കുട്ടിക്കാലത്തെക്കുറിച്ച്...... അങ്ങനെ മാനസിക രോഗികളായ നിങ്ങള്‍ക്ക

First time in India : Aster Mims did a complete simulation of final exam for out going residents. It include mcq , oral board including triple encounter and thesis presentation. This mock exam aimed to prepare residents to appear final exams with confidence Residents feedback is like this Mock exams conducted for the 1st time in any centre in India before the MEM boards.. the best part was the review that took place after the 3 sessions - theory oral boards n thesis presentation.... we could get 2 know our weak areas n now can strengthen those.... Frankly saying we were not happy wen this was announced as we thot we would be wasting 2 days of our prep.... But this was really awesome.... Thanks venu sir for the wonderful initiative... Thanks all the faculty... Prem sir for conducting this in an efficient way.... ahmed shafi sir binu sir n sabeer..... really appreciate ummer n alex for comng all d way 4m kochi n wayanad for this... really was an eye opener n a morale booster...👍🏻

Wonderful safe vascular access one day  workshop has been conducted for newly joined GWU Residents at aster med city Kochi in association with BD . We received excellent feedbacks from delegates .

[6/26, 12:11 AM] Pinto K Baby: This is to raise the pride of emergency department of  "Aster Mims CALICUT" There was an 18 year old boy Adarsh who came to our ed on 31/5/16 with alleged history of electrocution. he was brought in pre hospital arrest ,our team led by Dr Ahmed Shafi started resuscitation as per ACLS protocol. Fortunately,we attained ROSC and shifted patient to MDICU. The surprising and unforgettable moment was when the patient came back to our ed today to extend his heartfelt gratitude to the ed team. This was the time his tears of happiness made us proud and happy. So I congratulate the team: Dr  .Ahmed Shafi, Dr Remya, Dr Shanu , ems staff Mr Nidhin pg ,Mr Sajan ,Arun k, Vysak,Anand ravi ,Akhila and ambulance assistant Sreejesh. I conclude that this team management has always come in light with leadership of Dr Venugopalan and supervisor Nirmala Thomas. By                               Binto. K Baby                  Ed coordinator [6/26, 6:34 AM] V

Great Time with my Aster CMI collegues in Emergency Medicine Dr.Shailesh Shetty S and Dr . Mohammed Imran . I am so fortunate to have most lovable people in the group. They made me so attached with a home away home.

I had two days wonderful time with emergency medicine residents at Calicut through longest clinical sessions.  Happy to see that highly motivated emergency medicine residents in making em in India.

8 candidates were cleared MRCEM part A from Aster DM health care group.  It is an ever time record. MRCEM part A is the toughest exam among the series. Happy to see the growth and achievements EM in our area. Thank you for your contribution in making EM in India and congratulations to all winners. I strongly belive the quote by Nelson Mandela " I never fail, I will win or learn" This is for those  who could not get through this time. Congratulations Dr.Sabeer Mohammed, Dr.Ummer Farooq, Dr.Ranjth Velayudhan Nair,Dr.Rose Kunnath, Dr.Ganesh, Dr.Abhishek Sharma , Dr.Arun Raja and Dr.Reneesh for this achievements.