z****a
发帖数: 150 | 1 ☆─────────────────────────────────────☆
HappyDoc (快乐一生) 于 (Fri Jul 25 12:37:39 2008) 提到:
我前面的帖子中提到过一个病人：“20多岁的护校学生，她身上贴有3个100mcg/h的
Fentanyl patch，再加上口服Oxycontine 120mg Tid plus Percocet2-3 tab q4h for
breakthrough pain。我粗略地算一下，她使用的剂量大约相当于每日口服morphine
3000-3500mg或是IV Morphine Sulfate 1000-1200mg/day。她一个人一天的剂量就足可
以杀死我自己加上这个版上所有的班长，可她还是活蹦乱跳的，而且一见到医生就喊痛
，全身痛，12/10。”
这个病人是以前我做住院医查房时见到的，她的具体病史记不清了，好像是为了一个
小手术收她入院的。因为她的吗啡类止痛药不单计量高的出奇，而且当时Fentanyl
patch/Oxycontine都是临床开始使用不久的新药，所以印象深刻。
我不知道她的慢性疼痛是从 |
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l*******8
发帖数: 1745 | 2 ☆─────────────────────────────────────☆
yoghurt (log2) 于 (Tue Mar 11 13:34:19 2008) 提到:
up! co-ask!
☆─────────────────────────────────────☆
dokknife (力刀) 于 (Tue Mar 11 13:50:13 2008) 提到:
常看到新来的人(不知你是否最近才进版还是以前是潜水的)问一些基本问题，而其已
被讨论多次，而且版上前人都有极好的文章和帖子论及。
建议，每个新ID发问之前，先看看版头的精华版，和常见问题线。至少每个人都会
检索资料的基本技能吧？
对于LZ这个问题， 这是个对于CMG最常见的问题，也被问烂和被回答讨论过多次的
问题了。
请稍费点自己的时间检索一下这个版的精华区、我的美国医学教育博客，你可以发
现如疯耗子、鞋匠、ZBBH、老土、等被PREMATCH的版友以及我、机密、PATHDOCTOR、
HAPPYDOC等ATTENDINGS写的文章和帖子都有极为详细和近乎标准的回答和应对！
培养自己先动手搜索而不是 |
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M***8
发帖数: 61 | 3 I am kind agree with HappyDoc's comments.
1. normally, for new interns, the first 3 months is the most tough, since in
some programs, everyone, including the RN's will try to give the intern
hard time, asking the intern to do lots of scut work. But usually it will
last 3-6 month during the intern year.
2. yeah, the scut work will not directly contribute to the clinical work
later, but you still can learn lots of things/tricks from it, e.g., how to
deal with NG tube/Foley tube, etc., not to ment |
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M***8
发帖数: 61 | 4 I am kind agree with HappyDoc's comments.
1. normally, for new interns, the first 3 months is the most tough, since in
some programs, everyone, including the RN's will try to give the intern
hard time, asking the intern to do lots of scut work. But usually it will
last 3-6 month during the intern year.
2. yeah, the scut work will not directly contribute to the clinical work
later, but you still can learn lots of things/tricks from it, e.g., how to
deal with NG tube/Foley tube, etc., not to ment... 阅读全帖 |
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c*****0
发帖数: 9 | 5 Thanks.
For a septic shock itself, the , most common consequence is acute renal
failure from acute renal necrosis, ARDS and DIC. All these did not happen to
this patient. Without prompt release of obstruction from kidney stone would
be the first to be blamed for this case. The other thing we need to careful
think about is the risk-benefit of maintaining the optimal level of the Bp
for a shock patient (temporally) and the dosage of epi.( the lowest accepted
level?)
I agree with happydoc, the ambu |
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d******e
发帖数: 2541 | 7 另外，告诉各位令人欣慰的是：正在做住院医生的MITBBS人气最旺的好写手娇娇医生、
原医学职业版的贡献良多深受众待考和MATCH的读者们喜爱和尊敬的JIMMY ZHANG、
SKATE、HAPPYDOC等有着丰富经验和故事、有良好写作能力的医生们已表示愿将主动
贡献出他们宝贵的时间来和我组成写作和研讨、问答集体小组，相信还会不断有新
的医生们参加进来，扩大我们的专业范围使更多读者能得到广泛信息和相应感兴趣
的必要知识，做到知己知彼在今后的考试、面试、住院和FELLOW、以至毕业后找工
作、工作中专业和医学法规等方面有些必要基础知识，以便少犯错，不犯大错，考
试和面试完美、工作和生活皆美满。
我相信这样的俱乐部将对我们大家都有益处。希望我们来建好这样的俱乐部。
谢谢大家的关心和支持！ |
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