9.2 End the laboratory trip and start the neurosurgery research trip. Chinese medicine students come to neurosurgery, mainly western medicine. On the first day, everything was strange, but full of freshness. The appearance of the tutor made me feel that I was in the emergency department.
First of all, I am familiar with the instruments in the treatment room: trauma suture kit, lumbar puncture kit, scissors, gas cutting pliers, single fine scissors, disposable dressing change tray and so on. There are also some common items: hand sanitizer, gauze, bandage, vaseline gauze, blades, etc.
Then go with the teacher to change the medicine for the patient. Prepare a trolley with hand sanitizer, iodophor, gauze and disposable dressing change tray.
Wash your hands first, and then tear the dressing tray when your hands are dry, but don't tear it completely from one side. Pick up a pair of tweezers with a blue cloth pad, pull out the plastic sleeve in front, then pick up another pair of tweezers with the tweezers you are holding and remove the plastic sleeve; Tweezers take out the curved plate filled with gauze and cotton balls and put it aside; Pick up some cotton balls with tweezers and put them in a rectangular tray. Raise your hands, make sure you don't touch anything in the dressing tray, and start pouring iodophor. The right hand uses tweezers to help cotton balls soak iodophor; Clamp the middle position of the cotton ball with right tweezers, and clamp the upper or lower end of the cotton ball with left tweezers to squeeze out excess iodophor; Point at the wound, and then rub it around from the center (note: don't rub it back and forth, but rub it in one direction); With tweezers as the hand, spread gauze on the wound and fix it with a headnet bag or bandage. That's it for today! ! Hand sanitizer, cart back to the treatment room, put two tweezers in the sharps box, and throw the rest into the yellow garbage bag. Hand sanitizer+hand washing. It's done.
Finally, learn the doctor's advice from the teacher, double-click the patient, double-click the doctor's advice, create new, enter initial, double-click to select, save and upload. The doctor's orders have been completed, or you can save and upload all the doctor's orders you need.
In the afternoon, because the teacher was on duty the day before, I had a rest. Review the steps of doctor's advice by yourself, and learn the indications, usage and dosage of drugs in the current patient's medical record and doctor's advice.
Ginkgo dipyridamole injection can be anticoagulated. Low molecular weight heparin calcium needle has the functions of anticoagulation and prevention of thrombosis. 0.9% sodium chloride injection 250ml+ vitamin C injection+vitamin B6 injection can prevent infection (ps: "old aunt" Ben saw several drugs, and the result can only be recalled, and his heart really collapsed! )
9.3 is the second day of turning to neurosurgery. Deputy director of the department, obedient, doing everything, practicing debridement and changing medicine.
The first debridement exercise was a little nervous and slow, but the whole operation process was smooth and qualified.
I met vaseline gauze. When using this gauze, you need to use a small blade. By observing the size of the wound, cut off vaseline gauze with appropriate size, cover the wound, cover it with gauze, and finally wrap it with bandage. It's done. ! !
Then follow the teacher to ICU to transfer patients. In ICU, I learned to make a patient list, first choose the bed number to determine the patient, and then print the list. Check the patient's status, understand the latest trends of the patient, and remove some unnecessary equipment to prepare for transporting the patient; Go to the duty room to get a medical record bag and print out the doctor's advice on the computer. Before printing the doctor's advice, check whether the number of pages to be printed is 1 line 0. If so, the instructions have not been printed yet. Otherwise, you need to find the corresponding number of pages and put them in the printer. Observe whether you can see clearly after typing. If you can see clearly, you don't have to call. If you can't see clearly, you need to cancel the original doctor's advice and reprint this page, and find the corresponding teacher to sign it. Note: when you continue typing, you should print continuously, preferably without interruption. The newly printed doctor's orders need to be signed by the relevant teachers.
Then put a small piece of paper on the Ruimei system, first enter the patient's hospitalization number, find the corresponding number of test results against the previously printed test results list and print the test report, and finally check whether it is the patient's test report against the list.
Everything is ready to start transporting patients. It is necessary to observe the patient's state, expression, complexion, etc. All the way was smooth, and the patient was safely transferred to the department. (scattered flowers)
Intensive care unit, ECG monitoring, observing patients, then handling doctor's orders, starting medication and continuing treatment.
The patient suffered a head injury and used a steel needle similar to a staple (just don't understand the specific medical name, describe it temporarily) and a small amount of thread to sew the head. Therefore, suture removal and dressing change need to be prepared: handcart, disposable dressing change tray, special scissors with "steel needle" (thin small circle on one side and small scissors with half-moon machete on the other), gauze, head mesh bag, suture removal scissors, iodophor and hand sanitizer. Disinfect the wound first, then disinfect the wound and its surroundings twice, and then start to lift the steel needle. First put one end of the small circle under the steel needle, then press the scissors down and lift them up, and a steel needle will come down. Take each steel needle to the last one, then cut the thread with thread-taking scissors and take it out. Finally, wrap it in gauze and carry it with a net bag. Tell it not to take it off again. (Episode: I didn't bring stitches scissors when I stocked the goods before, but later I listened to the teacher and became stitches pliers. I didn't find it for a long time, and finally I pulled my face and asked again before I found it. Inner os: I feel like a mental retardation every day, and I can't understand anything. ? ())
In the afternoon, the teacher asked for a rest and said that he was full of joy and could learn a lot from the teacher on duty. If you don't understand, you can also ask when the night shift is not very busy. & gt？ & lt？ )
However, the doctor's orders on the screen are all western medicines. Most of them don't know the indications, usage and dosage, and they don't know the adverse reactions. So they go back to the department to work overtime, hoping to remember something and understand something ... ("Old Aunt" started again when she was having a hard time studying? )