Shraiya Stan

Triage and Early Assessment Managing Emergencies Legal Cases and Documentation Infection Control and PEP Clinical Procedures Teamwork and Referrals Talking with Patients and Families

As a Junior Resident in the Accident and Emergency Department, I work on the frontline of patient care. I see patients with a wide range of urgent medical and trauma-related problems, often being the first doctor to assess and manage them.

Triage is one of my main duties. I assess patients as they arrive and decide how urgent their condition is. I use structured methods similar to the NHS Manchester Triage System. I carry out ABCDE assessments to quickly spot life-threatening conditions and make sure these patients are treated without delay.

I deal with many types of emergencies MI, strokes, breathing problems, sepsis, trauma, fractures, and poisoning. I follow guidelines to give safe and effective care. During busy shifts, I help manage the resuscitation area and support my team in stabilising patients.

I regularly handle medicolegal cases such as road traffic accidents, assaults, and workplace injuries. I document everything carefully and follow the correct legal steps, sometimes working with the police or legal officers in the hospital.

In cases like dog bites or needle-stick injuries, I provide post-exposure prophylaxis, including Anti-Rabies Serum and vaccines. I also follow infection control rules closely and ensure proper care in cases involving HIV or Hepatitis B risk.

I confidently perform IV cannulation, catheterisation, Ryle’s tube and NG tube insertion, ECGs, ABG, wound suturing, and venepuncture. I assist seniors with chest drains and intubations when needed.

I work closely with other departments like medicine, surgery, orthopaedics, and ICU. I make timely referrals and give clear handovers so that care continues smoothly.

I explain things clearly and calmly to patients and their families, even when they’re anxious or upset. I take part in conversations about difficult diagnoses or bad news, always being kind and respectful.

During my rotation in ED, I gained significant hands-on experience in managing a wide range of acute medical and surgical presentations. I worked closely with the trauma team and senior doctors, often being the first point of contact for critically ill patients.

Key responsibilities and experiences:

• Initial assessment and resuscitation: Prompt history taking and formulation of treatment plans using the ABCDE approach for acutely unwell patients, including trauma cases.
• IV access and urgent investigations: Performed urgent IV cannulation, blood sampling (ABG, CBC, LFT, KFT, serum lactate, blood cultures), and initiated fluid resuscitation where indicated.
• Diabetic emergencies: Managed cases of DKA and hyperglycaemia by initiating insulin infusions, fluid replacement, and monitoring electrolytes, particularly potassium.
• Hypoglycaemia and electrolyte imbalances: Prompt identification and management of hypoglycaemia and hypocalcaemia, including IV dextrose, calcium gluconate infusion, and ECG interpretation.
• Acute infections and sepsis: Managed patients with acute gastroenteritis, dengue, malaria, and typhoid, initiating fluids and antibiotics after urgent investigations and referral where needed.
• Heat stroke and environmental emergencies: Initiated cooling measures, IV fluids, and closely monitored vitals.
• Chest pain and MI: Initiated management of myocardial infarction with aspirin, clopidogrel, statins, and anticoagulation, arranged ECGs, troponin testing, and referred for PCI or thrombolysis.
• Respiratory emergencies: Managed acute exacerbations of asthma and COPD, including nebulisation, steroids, oxygen therapy, and chest imaging.
• Anaphylaxis: Administered intramuscular adrenaline promptly and provided supportive care with antihistamines and steroids.
• Arrhythmias and hypertensive emergencies: Assisted in managing atrial fibrillation, atrial flutter, and PSVT under supervision, using medications, vagal manoeuvres, and cardioversion when required.
• Paediatric emergencies: Managed common presentations like fever, stridor, and febrile convulsions; performed nasal suctioning, IV cannulation, and reassured parents during crises.
• Poisoning and medico-legal cases: Identified toxic ingestions, initiated management per ABCDE, and informed the medico-legal officer as appropriate.
• Psychiatric emergencies: Provided initial care and reassurance for patients with panic attacks, anxiety, and behavioural crises.
• Burns and trauma: Managed burn patients with fluid resuscitation using TBSA calculations, airway management, and pain control.
• Coordination and administration: Managed triage, patient flow, shift rotas, and medical supply tracking; entered patient records and contributed to the smooth running of the A&E.
• Emergency procedures performed: Nasogastric tube insertion, wound debridement, dressing, suturing, thoracentesis, urethral catheterisation, arterial blood gas sampling, and ECG interpretation.

I regularly worked 24-hour shifts, often making key decisions independently while maintaining close communication with senior staff when required.

In the Trauma and Orthopaedics department, I developed practical surgical and musculoskeletal skills, with exposure to both outpatient and inpatient care.

Key responsibilities and experiences:

• Outpatient clinics: Assessed and treated patients with chronic orthopaedic conditions such as frozen shoulder, cervical and lumbar spondylosis, rheumatoid arthritis, gout, osteoporosis, fibromyalgia, and ankylosing spondylitis.
• Fracture and injury management: Performed clinical examinations to assess deformities, range of motion, and neurovascular status; ordered and interpreted X-rays; applied plasters, slabs, and performed buddy strapping for specific fractures.
• Minor procedures:
  Independently removed ganglion cysts
  Performed corticosteroid injections for tennis elbow and plantar fasciitis
  Released trigger thumb and trigger finger
• Emergency trauma care:
  Assisted in the closed reduction of dislocations and nursemaid's elbow
  Prepared patients for the operating theatre (sampling, pre-anaesthetic checks)
  Assisted in skeletal traction, Thomas splints, and application of POP casts
  Prepared patients for OT
• Medical management: Prescribed calcium, Vitamin D, and bisphosphonates based on DEXA scans, and initiated DMARDs under supervision for rheumatoid arthritis.
• Joint procedures: Assisted with joint aspirations and steroid injections.
• Team collaboration: Worked alongside physiotherapists to develop rehabilitation plans for patients with chronic pain and mobility issues.
• Administrative duties: Managed patient admissions, discharges, referrals, and obtained informed consent for surgical procedures such as total hip or knee replacements.
• Paediatric orthopaedics: Managed acute orthopaedic issues in children, including nursemaid’s elbow reductions and trauma care.

This rotation significantly improved my confidence in musculoskeletal examination, minor procedures, and collaborative care. The experience has also proven invaluable in my current A&E role, where I confidently manage orthopaedic emergencies, apply immobilisation techniques, and identify red flag signs needing urgent surgical referral.

Key Clinical Responsibilities: Community Medicine & Public Health: Clinical Procedures Performed: Additional Training: Core Competencies Developed:

I did a full one-year internship in a highly
reputable, busy 1500-bed teaching and tertiary
care hospital, where I rotated through 19
different departments. These included Internal
Medicine, Surgery, Paediatrics, Orthopaedics,
Obstetrics and Gynaecology, Emergency
Medicine, Anaesthetics, Psychiatry,
Dermatology, ENT, Ophthalmology, Radiology, Community Medicine, Blood
Transfusion, and Intensive Care. This gave me
a wide range of experience and built a solid
foundation in clinical work, similar to
Foundation Year 1 (FY1) in the UK.

• Took detailed histories and performed full clinical examinations.
• Actively participated in ward rounds, documentation, and discharge planning.
• Managed acute and chronic conditions under supervision.
• Assisted in emergency care, trauma, and OT procedure.
• Gained ICU and anaesthesia exposure.
• Engaged in rural and urban community health roles.
• Provided care at primary health centres (infectious & chronic disease focus).
• Conducted antenatal clinics, family planning counselling.
• Participated in vaccination drives and health education outreach.
• Developed cultural competence and resource management skills.
• Venepuncture, IV cannulation, ABG sampling, IV,IM,ID,SC Injections, blood transfusion
• Urinary catheterisation, NG tube insertion
• Basic suturing, wound care, casting, splinting
• Assisted: Chest tube insertion, lumbar puncture, joint injections, intubation
• ECG interpretation, imaging review (X-ray, CT)
• Diagnostic & lab result interpretation
• Blood Transfusion Medicine (crossmatching, transfusion safety)
• Certified in Biomedical Waste (BMW) Management
• NABH lectures on hospital quality and patient safety
• Strong clinical assessment and management skills
• Teamwork and communication in multidisciplinary teams
• Prioritisation, time management under pressure
• Culturally sensitive, patient-centred care
• Understanding of public health and preventive medicine

Rural Posting – Kanjhawala PHC Urban Posting – GTB Polyclinic and Sarojini Nagar PHC Family Planning and Women’s Health Public Awareness and Community Outreach School Health Visits Skills Gained

I completed my rural posting at Kanjhawala Primary Health Centre, where I experienced the challenges of providing care in under-resourced areas. I managed patients with infections, malnutrition, and long-term illnesses. We focused on prevention, early treatment, and improving general awareness. I also helped with antenatal clinics and routine vaccination drives in nearby villages.

My urban training took place at GTB Polyclinic and Sarojini Nagar Primary Health Centre. These were much busier, with a wider range of cases like diabetes, hypertension, and skin diseases. I worked alongside doctors, nurses, and health visitors to provide care and advice. This helped me understand the pressures of urban healthcare and how to manage high patient loads efficiently.

I worked in the family planning OPD, where I counselled women about contraception and reproductive choices. I created a calm and respectful environment, which helped build trust. I made sure patients understood all their options, and I supported them in making choices that suited their needs and values.

I regularly took part in public health campaigns aimed at improving community awareness. This included hygiene education, nutrition talks, and safe sex practices. We also organised poster presentations in the clinics and local gatherings, using simple messages to reach people from all backgrounds.

We visited local schools to talk to students about basic hygiene, nutrition, and puberty-related changes. I helped prepare posters and presentations to make the sessions engaging and easy to follow. These visits were a great opportunity to educate children early and promote healthy habits from a young age.We were also invited for a local school annual day programme.

This posting improved my confidence in speaking to different groups, patients, families, and children. I strengthened my public speaking and teaching skills and learned to communicate clearly in both one-on-one settings and large gatherings. It also reinforced the importance of empathy, prevention, and teamwork in public health work.