午前:ひとりオリエンテーション、午後:病棟・マナー
午前中は、副院長と1対1でオリエンテーション
午後は、病棟&マナー
●学んだこと
・カルテ記載方法
・個人情報保護
・教材確認(救急・手技)
・資料の紹介
臨床研修実践マニュアル
医師の職業倫理指針 (日本医師会)
・肝膿瘍ドレナージ
第3世代 (スルペラゾン)
カルバペネム (チエナム)
・縫合
吸収糸は異物反応起こることある
→真皮縫合は、ナイロン
皮膚縫合は、ゆるく黒糸で。
傷が真皮までだったら、テープで止める(けっこう難しい…)
・薬
ラクテック ←乳酸リンゲル
T1 :開始液 → 腎機能分かるなどすれば、かえる
パンスポリン :セフェム系(第二世代)
メチロン :視床下部に働き、解熱
ビタメジン(ビタミンB群)
タケプロン(PPI)
・血液培養の重要性
・ボスミン使用:
向精神薬つかっていると、心臓への効果をブロック→降圧!
→ボスミンであがらないときはノルアド
ライン取れなくて困るときは、気道にボスミン
・アトロピン
・維持液: 水分と電解質の補正 ←NaCl低く、K(+)
・Fisher比: 分岐アミノ酸/芳香族アミノ酸
・肝性脳症・昏睡度分類: I度 昼夜逆転など …
・Benign Parozysmal Positional Vertigo 良性発作性頭位めまい
・バトル徴候: 耳介の後ろの出血斑。髄液耳漏,内耳出血,顔面神経麻痺などを合併することあり
・Standerd precaution :一般的感染予防
・肝臓解剖
・Ig → γグロブリン
・あやしかったら、血清を残しておく
●病院システム
・放射線 :月・水 ←読影をきけ
・アンギオ:月 ←見学!
・病理 : 月・木 ←標本聞け!
●診た疾患
・肝膿瘍
・黄疸(ウイルス系ではない)
●今晩準備
・手技ビデオチェック
・肝疾患復習
・輸血マニュアル精読
●明日実行
・採血 →朝6時半
・カルテ記載
・渡航歴
・アメーバ
・腎機能(FENa)
・DIC role out
・病態把握
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