医学メモ 090320
・小児科説明
危ないのは
「ぐったりして意識がおかしい」
「頭痛が激しい」
「吐いたり、痙攣をおこしたりする」
具体的には、髄膜炎や脳炎（意識がおかしい）、肺炎や喘息様気管支炎やのどの腫れ（呼吸困難やチアノーゼ）、下痢や嘔吐による脱水
⇒様子をまずは見る
ポイント１ まめに着替えさせる
ポイント２ 水分補給
ORSで（水1リットル ＋ 砂糖大さじ4 ＋ 塩小さじ半分）
少し涼しくすれば、熱は下がることが多い。寒くて震えないようにする
熱の上がり際で寒くて震えていたり青ざめているなら温めてあげる
大丈夫なのは
「ちょっとした鼻水とせきぐらいで、熱以外にあまり症状がない」
「熱が多少下がったときは、元気に遊んでいる」
「食事や水分が十分にとれている」
・脂漏欠乏性皮膚炎
ヒルドイド ＋ リメックスコーワ
・左後頭葉の脳梗塞→認知能の低下
・花粉症がある場合には、小青竜湯、苓甘姜味辛夏仁湯、大青竜湯などをベースにする。
顔面の掻痒感・発赤がある場合には、温清飲、黄連解毒湯、消風散を組み合わせて対処。
・大青竜湯（麻杏甘石湯7.5ｇ 合 桂枝湯7.5ｇ）
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