1/19(金)
◆今日の気持ち
(外科 4ヶ月目)
・ルンバールに敗北。ひさびさにルンバールをやらせてもらえた。高齢な患者さんではあったけれど一発でスルっと入り、やった!と思ったのだが麻酔の効きが悪かった…。高齢だから少しだけ麻酔の量を減らしたことはあったけれど…。針の向きも意識できていなかったし…。1ml/sec。「ルンバールの効きは場所よりも早さ」との指導をいただく。基本、基本、基本。
・ラパコレでスコピスト。癒着がひどくてわけがわからなかったのはあるけれど、眠気が…。不覚。
・胆管結石。膵頭部に落ちていたら膵炎はおきて当然なのに、すぐにみていなかった…。次回こそは…。
・外科上級医の手つき。気楽な見た目で実はぱっぱと微細な処置をしている職人の手つきにすごいと思えるようになってきた。
・点滴・バルーンしていないひとのin/outはきちんと注意していないと見逃す…。老人は口渇中枢が壊れていることが…
・コミュニケーションとれなかったり、もとから状態が悪いひとは状態の更なる悪化に気づくことは難しいなと、ルーチンな検査の必要性を感じた
●目指す医師像
まずは、医者
●今の目標
・外科を味わいきる
・「マクギーの身体診断学」を読み終える
●今日の新患・診断
・陳旧性の大腿骨頚部骨折
●今日の病院滞在時間
8時〜21時半
●今日行ったこと・見たこと・知ったこと
・鼠径ヘルニアope ルンバール
・ラパコレ 麻酔導入・スコピスト
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