o係G2學得最多o野, 因為最後一個week part綺淳姑娘, 佢成日都教我o地o野~ 勁好人~~~ 亦見到好多o係其他病房唔會見到o既病, 好多都係真係女人先會有o既婦科病, 亦有好多婦科o既operation
Kabuki Makeup Syndrome, Bilateral dysplasia of hips, Bartholin absess, Hemopenitoneum, Endometriosis, Inevitable abortion, Molar pregnancy, Trophroplastic disease, Ectopic pregnancy, etc
d operation勁多~ d名勁長~ 常見的有:
Marsupialization, SE(Suction Evacuation), STOP(Surgical termination of pregnancy), TOP, MTOP(Medical termination...), Hysteroscopy, laparoscopy+/-laparectomy+/-laparotomy, TAHBSO(Total Abdominal Hysterectomy with/without Bilateral Salpingo-oophorectomy), EB(Endometrium Biopsy), MROP(manual removal of placenta)
仲有d knowledge:
~ventolin 唔可以落得太快, 如果唔係個patient會有allergy, 出rash.
~on PCA一定要有埋NS drip, 仲要有oximeter monitor住, 驚住個patient o既dose太高, 會有distress.
~PCA 機響有三個可能性:1) overdose, 2)morphine almost empty, 3)有occlusion. 若是occlusion, 就要停機先, 然後release syringe pressure, 再restart. 有時亦會因為條drip夾住o係個盒o度, 因此接OT時要check部PCA 機, make sure d drip 無夾住.
~"demand"係patient press o左幾多下; "good"係actually部機俾o左幾多俾patient.
~24hrs內都要Q1H, 若然24hrs後top-up o左, 就要keep on Q1H.
~問patient有無痕係因為有d會allergy to morphine, 若有痕就打piriton
~若patient有nausea, 可以問下佢o地想唔想打定止嘔針先.
~drip rate計法係:125/Q__H = drip rate
e.g. 枝水Q5H o既, 個drip rate就係: 125/5 = 25drops/min, 約5秒3drops.
~去水通常用lasix, 其action係act on renal tubules. 但若然係neuro o既水腫, 就要用mannitol, 因為mannitol係act on brain o既.
~84%sodium bicrbonate會同calcium一齊放o係emergency trolley, 因為可以用o黎"救人"
~cytotac 係用o黎落仔o既藥, 塞入virgina or sublingual
~o係A&E diagnos patient有無pregnant o既procedure:
1)先問有無sexual intercoarse, 2)問有無避孕, 3)問LMP(last menstural period), 4)先會做PT(pregnancy test)
~做trans-abdominal USG要full bladder, for better sound wave transmission. 若做internal o既USG, 就要empty bladder.
~通常post-op D3先做dx(dressing)
~GA 要on fast係prevent regurgitation
~通常d女人去到急症室話肚痛, 你係唔會知咩事. 診斷o既procedure係:1) 問有無urgency, frequency, dys- or haematuria. 若無, 就可以排除UTI o既可能性. 2)deep palpate RLQ abdomin, check rebound tenderness, 睇係咪盲腸炎, 3)做PT, 若pregnant, 就要check 埋beta-HCG, 若48hrs內個result drop 1 fold, indicate Miss carriage; 升一個fold, indicate ectopic pregnancy(宮外孕), 咁就會係emergency case la!
~同patient打完depo-provera contracetive injection, 要話俾patient知打完d M期會好亂, 亦會contraceptive, 唔會有bb, 仲會肥, 因為開胃o左同埋有水腫.
~有endometriosis就唔可以食中藥
~transamine------止血藥, 4-6hrs見效
仲有好多, 數唔o酉ar~~~>0
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