3/20(火)
◆今日の気持ち
(脳外科 4週目)
・眠い…。入りたい整形のopeがあったけれど、病棟管理と救急外来への押しかけに集中することにする。
・今の母親って、何が安全なのか、何が問題あるのか習ってないから、子育ては難しいよな…
●今の目標
・脳外科を味わいきる
●今日の新患・診断
・憩室出血
・小児頭部打撲
・運動での腹筋断裂
・尿管結石?
・上腕骨骨折、DM、肋骨骨折
●今日の病院滞在時間
当直〜22時
●今日行ったこと・見たこと・知ったこと
・V-Pシャント
頭蓋形成術後は2週間は待つ必要あり。頭蓋形成術の怖い合併症は、硬膜下血腫。頭蓋に硬膜が張り付くまでは、脳脊髄液の圧を下げてはだめ。
・羽ばたき振戦。
手・足関節を過伸展させると出やすい
・小児の頭部打撲。普段と違う嘔吐、が危なさで親にわかりやすい
・憩室出血と虚血性腸炎の見分け方
憩室出血は、出血と刺激からの下痢以外には症状なし。虚血性なら腹痛がある。虚血の粘膜への深さによって痛みの強さは変わるけれど。
・頭の打撲。冷やすと脳を冷やしすぎる。頭蓋内に問題があったときに、まずい。
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