- Maintenance of ventilator settings as guided by the respective PG.
- Taken ABGs and have taken samples for lab investigations.
- monitored patients who came for dialysis
- Handled Day care patients who came for dialysis.
- Learnt about dialysis machine and what all infections a pt can get by not maintaining proper hygiene of the central line
- Learnt about central line and fistula for dialysis.
- Have removed 3 patients central line
- Assisted my PG in putting central line
-Have learnt how to give NTG to the patients and gave for 3 patients
- Have learnt how to maintain patients BP and GRBS while dialysis is going on
- Learnt about drugs used in hypo and hypertension.
24/10/22 to 26/10/22
WARD DUTY :
- Helped my co interns in putting SOAP notes
- Have put cannulas and taken samples of ward patients
- Monitored patients in the ward as guided by concerned unit PG and helped them by updating the ward patients.
- Have helped PG in his thesis of Fat to Muscle ratio
Procedure:
For mid arm circumference we measured from acromian process to olecrenon process and took the midway measurement between the two bony points And then measured the skin fold thickness with our callipers and then subtracted the mid arm circumference with the callipers value to get our muscle mass.For Visceral fat we took umbilicus as our reference and measured it’s girth After getting both values we divided visceral fat with Mac(mac-skinfold thickness) to get our ratio.
27/10/22 to 11/11/22
PSYCHIATRY POSTING:
PSYCHIATRY DUTY:
- Learned about importance of history taking and how by history we can reach to a provisional diagnosis.
- Saw different patients and learned how to take basic history
Examples like :
1. Schizophrenia
2.OCD
3.ALCOHOL DEPENDENCE SYNDROME
4. TOBBACO DEPENDENCE SYNDROME
5. Depression
6. Psychosis
7. Panic attack
- learnt the medications given to the patients and their side effects
- Went for DAC saw how pgs interact with the patients
12/11/22 to 11/12/22
UNIT DUTIES :
1) https://chippaakhila23.blogspot.com/2022/11/28year-old-female-with-pyelonephritis.html
- patient came to OPD with fever history since 3 days then patients investigations were sent and usg showed pyelonephritis
1) Triad of pyelonephritis?
Loin pain , fever, tenderness over kidney region
2) Cause of fever which was continuous and not got subsided for a 4 days ?
PYELONEPHRITIS
We thought Cause of the fever could be pyelonephritis and started her on antibiotic zostum 1.5g but her symptoms were not subsided so we took urology referral where they suggested to put on piptaz 4.5 g then after 3 days her fever got subsided
2) https://chippaakhila23.blogspot.com/2022/11/35-year-female-with-vertigo-secondary.html
1) cause of her Dizziness and headache?
BPPV
Dix hallpick manoeuvre was done -positive
Done epleys manoeuvre where patient felt relieved
3) https://chippaakhila23.blogspot.com/2022/11/65-year-old-female-with-pyrexia-with.html
What is cause of abdominal Pain in dengue ?
- Gastric erosions or ulcer , acute hepatitis Gall bladder thickening ,acute a calculus cholecystitis, acute pancreatitis
https://apps.who.int/iris/bitstream/handle/10665/164137/dbv29p85.pdf;sequence=11)What is the criteria to diagnose dengue ?
The criteria for diagnosing probable dengue fever are living in or travel to a dengue endemic area, fever and two of the following criteria: nausea, vomiting, rash, aches, a positive tourniquet test, leukopenia and any warning sign. The warning signs are abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy, restlessness, liver enlargement of >2cm and increase in haematocrit concurrent with a rapid decrease in platelet count.
2)What are the indications for platelet transfusion?
Indications for platelet transfusion :
-Platelet transfusion is not the mainstay of treatment in patients with DF. In general, there is no need to give prophylactic platelets even if at platelet count >10 000/mm3.
-Prophylactic platelet transfusion may be given at levels of <10 000/mm3 in the absence of bleeding manifestations
-Haemorrhage with or without thrombocytopenia- transfuse platelet
- Prolonged shock with coagulopathy and abnormal coagulogram
-In case of systemic bleeding, platelet transfusion may be needed in addition to red cell
transfusion. Whole fresh blood transfusion doesn’t have any role in managing thrombocytopenia.
3)Criteria to discharge dengue patient ?
The admitted patients who have recovered from acute dengue infection with visible clinical improvement having no fever forat least 24 - 48 hours, normal blood pressure, no respiratory distress from pleural effusion or ascites, improvement in clinical status (general well-being, return of appetite, adequate urine output, no respiratory distress),persistent platelet count >50,000/cu.mm should be discharged from hospital
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