Dr. Dev (Fictional name), while still an MBBS student, appeared for his Anesthesia department’s end of posting practical exam. Dr. Dev had been irregular in going to the practical posting classes. Dr. Raageshwari (Fictional Name) was taking the exam.
As part of the exam, Dr. Raageshwari asked Dr. Dev to demonstrate the external cardiac massage part of the CPR (Cardio-Pulmonary Resuscitation) on the electronic life-size dummy. The dummy was equipped with sensors and gave an indication if the CPR was being done properly or not, such as the palms/ hands are in right position and whether adequate force is being applied or not.
For Non-Medicos: In external cardiac massage the lower part of the central chest bone (the sternum) is pressed down with hands. The bone moves downwards and compresses the heart lying below it to passively pump blood from it to the body via the aorta, the biggest artery in the body. When the pressure is released the heart passively expands, like a hollow ball, sucking the blood from the body via the veins. This ensures that blood keeps circulating in the body when the heart has stopped due to some disease, until the time the doctors get it to start working again.
Dr. Dev went to where the dummy was kept on the bed. He checked and placed his hands, palms on over another at the location which he had learned from the books, elbows extended (straight) and locked and applied pressure.
A warning beep sounded and red indicator light turned on indicating that Dr. Dev was not giving the external cardiac massage properly. Dr. Raageshwari looked at Dr. Dev with an amused look on her face. A worried Dev re-checked the position of his hands; they were in proper anatomical site. He re-checked his elbows and body position and once again applied pressure more than previously. Again the warning beep and red light turned on. The look of amusement on Dr. Raageshwari face broadened. She asked Dr. Dev, “What is the problem? Why are you not able to give a proper cardiac massage?”
Dr. Dev frantically raced his mind to crack this mystery of inadequate cardiac massage. Suddenly it dawned on him the reason for the inadequacy of the cardiac massage.
Dr. Raageshwari had the dummy intentionally placed on a particularly soft mattress with spring bed. So whatever the force Dr. Dev applied to push the chest bone down to compress the heart, it used to get absorbed by the mattress and spring bed. So the heart was not getting compressed adequately despite proper technique on Dr. Dev’s part.
Dr. Dev answered to Dr. Raageshwari, “Ma'am, the dummy is lying on a soft mattress which is absorbing the force being applied. Therefore there is not adequate compression of the heart.”
Dr. Raageshwari asked, “Did you not attend the class on CPR during the posting?” “Yes ma'am, I did attend the CPR class during the posting” promptly replied Dr. Dev.
“It was told clearly in the class to check the surface the patient is laying on before starting the CPR. It was clearly told in class to put the patient on floor or put a hardboard below the patient if the bed or mattress is soft. If you had really attended the class then how come you do not remember this?” asked a perplexed Dr. Raageshwari.
Dr. Dev tried to salvage his practical exam going downhill. He raced his brain for some plausible explanation and replied, “Ma'am, I did attend the class, but it was taken quite some back and I had therefore forgotten this point.”
Dr. Raageshwari informed Dr. Dev, “The CPR class was held just yesterday and I know this very well as I had taken it.”
Needless to say, Dr. Dev was rendered speechless.
But luckily for Dev, Dr. Raageshwari was a kind teacher and did not cut his marks for his tall tale of attending CPR class and gave him marks commensurate with his overall performance.
Tip: Always attend all your classes.
Tip: If you do not attend all classes than at least attend those classes which are near your exams.
Tip: If not possible then at least do attend all classes taken by your future potential examiner/s.
Tip: If even that is not possible for you then at least find out beforehand which class was taken when and who was the faculty taking them before going to exam.
Tip: If even that is not possible then at least find out beforehand which class was taken and when by the examiner.
— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behaviour illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost.
DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behaviour illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm.
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