2/19(月)
◆今日の気持ち
(整形外科 4週目)
・改めて感じた。小さな病院って職員全員できもちよく挨拶できるのがいいな
・眠い。鼻炎がひどい。
・日直・当直明けの夜から緊急ope二つ、は朦朧としてくるなぁ
・後何回脳に触れるのかな…
・「根無し草になってはいけない。医局に所属しなさい」と町の他の病院の医師に語っていただいた。たしかに、根を持つことは大切で。医局を崩壊させたい世の力の強まりを感じるけれど、一部の強い医師はいけれど、そうでない医師はどうすればいいのだろう…。
・神経症状のない、何か変、は硬膜下血腫の確率高まる
・内臓をおさえること。単純なことが難しい。
●目指す医師像
まずは、医者
●今の目標
・整形外科を味わいきる
・もっと本読みたい
●今日の新患・診断
・胃穿孔
・急性硬膜下血腫
・視床出血
・肺炎
・喘息発作
・痙攣
・過換気症候群
・交通外傷
●今日の病院滞在時間
当直〜23時
●今日行ったこと・見たこと・知ったこと
・視床出血ope
・胃穿孔ope
・高齢者の膿尿は特異度低い。あっても症状なく感染源でもないことも多い
・痙攣。アシドーシスやWBC上昇あることが。
・抜管抜くときのカフ、注意しすぎなことはない…
・頭皮でメスはよく切れすべりうる…
・癲癇返すとき、phenobarbital im, diazepam 坐薬
・DM四肢壊死→切除はdemarcation後。肺血症のリスクより、再手術のリスクが大きいと考える
・圧迫骨折。寝返りが痛くなくなる、がひとつの指標
・肺炎。脱水だとX-rayに写りにくい
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