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ππ©Έ blood taking
β branula insertion
ππ» sterile blood taking for blood C+S (Culture & Sensitivity)
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ππ©Έ blood taking
β branula insertion
ππ» sterile blood taking for blood C+S (Culture & Sensitivity)
.
Next session will be on Wednesday, 31st July π’
.
Register here for just RM 169 βΆοΈ https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop
More #discount for grouping registration β
Forwarded from Junction Bot
Nota Perubatan
What is the optimum position of tIp of Endotracheal Tube (ETT) post intubation from chest X ray?
πΉAdults: 5 cm Β± 2 cm above carina (with neck in neutral position)
πΉChildren: 1.5 cm above carina
πΉIf carina cannot be visualised, the tip of ETT should be at T2 - T4 (with the neck in neutral position)
Source: https://radiopaedia.org/articles/evaluation-of-endotracheal-tube-position
#ED
@nota_perubatan
https://t.me/nota_perubatan/1505
What is the optimum position of tIp of Endotracheal Tube (ETT) post intubation from chest X ray?
πΉAdults: 5 cm Β± 2 cm above carina (with neck in neutral position)
πΉChildren: 1.5 cm above carina
πΉIf carina cannot be visualised, the tip of ETT should be at T2 - T4 (with the neck in neutral position)
Source: https://radiopaedia.org/articles/evaluation-of-endotracheal-tube-position
#ED
@nota_perubatan
https://t.me/nota_perubatan/1505
Forwarded from Nota Perubatan
"Doktor, ini chest X ray post intubation patient katil 2 tadi"
What to look for in post intubation CXR?
- To look for complication, especially pneumothorax
- To confirm placement of endotracheal tube
The position of tip of ETT should be 5-7 cm above the carina in the neutral position of neck. When the carina is not visible, the tip of the ET tube should lie over the second to fourth thoracic vertebrae (T2-T4) or at the level of medial ends of the clavicles as carina is located between T5 and T7.
Further reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173625
https://www.radiologymasterclass.co.uk/tutorials/chest/chest_tubes/chest_xray_et_tubes_anatomy#top_2nd_img
#ED
@nota_perubatan
What to look for in post intubation CXR?
- To look for complication, especially pneumothorax
- To confirm placement of endotracheal tube
The position of tip of ETT should be 5-7 cm above the carina in the neutral position of neck. When the carina is not visible, the tip of the ET tube should lie over the second to fourth thoracic vertebrae (T2-T4) or at the level of medial ends of the clavicles as carina is located between T5 and T7.
Further reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173625
https://www.radiologymasterclass.co.uk/tutorials/chest/chest_tubes/chest_xray_et_tubes_anatomy#top_2nd_img
#ED
@nota_perubatan
β
how to #present ie inform to MO above new case for admission to Female Ortho Ward
LIST OF IMPORTANT DRUGS & DOSES
S/c Fondaparinox 2.5mg OD/7.5mg OD
S/c Heparin 5000u BD/7500u BD
S/c Morphine 5mg/7.5mg TDS
S/c Clexane 40mg/60mg OD
Mist calminative 15mls TDS
Mist Na Citrate 15mls/30mls OD
T EES 400mg BD
T Zinnat 250mg BD
T Ponstan 500mg TDS
T Voltaren 50mg TDS
T Papase 11/11 TDS
T Gelusil 11/11 TDS
IV Maxolon 10mg TDS
C Celebrex 200mg BD /400mg OD
C Tramal 50mg/75mg TDS
T Arcoxia 90mg OD
Syp MMT 15mls TDS
Syp Benadryl 15mls TDS
T Piriton 4mg/8mg TDS
IV hydrocortisone 200mg stat, 100mg QID
T Cilostazol (claudication pain) 100mg OD
T Aspirin 150mg OD/300mg STAT
IM nubain 20mg stat
T/IV Bisolvon 8mg TDS
T Labetolol 100mg TDS
T Adalat 10mg TDS
T Methyldopa 250mg TDS
Ural sachet 1/1 BD/TDS
IV/T lasix 20/40/80 mg BD
IM/IV Pethidine 50mg
T Rocaltriol 0.25 mcg OD
T calcium lactate 600mg BD
T levenogestrel 1.5mg stat
Inj Ertapenem 1gm OD
Inj Piptaz 3.375g
T/IV Tranexamic acid 500-1000mg TDS
IV Tramal 50 mg/75mg TDS
IV Maxolon 10 mg TDS
IV Cefuroxime 1.5 stat, 750mg TDS
IV Unasyn 1.5g STAT and TDS
IV Cefobid 2g stat, 1g BD
IV Ceftriaxone 2g stat, 2g/1g OD
IV Cefepime 2g stat, 1g BD
IV Meropenem 500mg tds/qid
IV Imipenem 500mg tds/qid
IV Ampicillin 2gm Stat 1gm QID
IV Cloxacillin 1g STAT, 1g/500mg QID
IV Flagyl 500mg TDS
IV Augmentin 1.2g STAT, TDS
T Augmentin 625 mg BD
T Unasyn 375mg BD
T Doxycycline 200mg stat, 100mg bd
T Cloxacillin 500mg QID
T Azithromycin 500mg OD
T Flagyl 400mg TDS
C Tramal 50mg/75mg TDS
T Maxolon 10mg TDS
T Doxazosin 4mg OD
T Finasteride 5 mg OD
T Cardura 4mg ON
T Hytrin 4mg ON
LYTIC COCKTAIL
IV Actrapid 10u STAT
IV ca gluconate 10% 10cc in 10 minutes
IV Dextrose 50% 50cc
CORRECTION OF ELECTROLYTES:
Corrected Ca : (40-albumin)x0.02 + serum calcium
If <2 , fast correct : IV Calcium Gluconate 1amp in 100cc NS over 1H
K+ correction
K+ deficit : 3.5-serum K x BW(kg) x 0.04
K+ require : (1mmol/kg/d)
1mmol x BW kg
Total req : (K deficit + K require)/ 13.4 mmol
*from mmol change to g divide by 13.3*
*For female :0.6 , male :0.4*
Fast correct : IV 1g KCl in 100cc NS over 1H
Slow dose : T. Slow K 1.2g tds
Mist KCl 15ml tds
Maintainance dose : IV 1g KCL in each pint
Fast PO4 correction
IV Potassium Dihydrogen PO4 (K2H2PO4) 1amp in 100 cc NS/1 H
Fast Mg2 correction
IV MgSO4 2.4g in 50cc NS/30 min
IV MgSO4 1amp in 100cc NS/1H
Na+ correction
Mild : NS drip 3 pint
Mode :
Severe : 3% 100cc NS slow infusion over 6H, repeat Na after fast correct.
Not more than 10mmol/24H
SEDATION
Midazolam 0.1mg/kg
Syrup chlorhydrate 50mg/kg
OAC/PAC REGIME
C Omeprazole 40mg BD
T Ampxicillin 1g BD
T Clarithromycin 500mg BD
Then C Omeprazole 40mg OD
HEMATINICS
T FeSO4 200/400mg OD/BD
T Vit B Co I/I, II/II OD/BD
T Folate I/I, II/II OD/BD
PREMED FOR INTUBATION
Midazolam 5mg
Fentanyl 50mcg = 0.05mg
Scoline 100mg/ Rocuronium 50mg
COVER FOR ACS
T Aspirin 300mg STAT
T plavix 300mg STAT
Maintenance:
T Aspirin 150mg OD
T plavix 75mg OD
S/c fonda 2.5mg OD/ s/c clexane 40mg OD(renal impairment)
BOWEL PREP
2 days before - low residual diet
1 days before:
RP normal - fleet phosphosoda 45ml BD x 1/7
RP abnormal - Foltran 2L/3L
On day of scope:
Ravin enema II/II stat
Or fleet enema I/I stat
Do PR!
Haemorrhoids
Tab. Daflone ll/ll TDS 4/7
Tab. Daflone ll/ll BD 3/7
Tab. Daflone ll/ll OD 1/52
S/c Fondaparinox 2.5mg OD/7.5mg OD
S/c Heparin 5000u BD/7500u BD
S/c Morphine 5mg/7.5mg TDS
S/c Clexane 40mg/60mg OD
Mist calminative 15mls TDS
Mist Na Citrate 15mls/30mls OD
T EES 400mg BD
T Zinnat 250mg BD
T Ponstan 500mg TDS
T Voltaren 50mg TDS
T Papase 11/11 TDS
T Gelusil 11/11 TDS
IV Maxolon 10mg TDS
C Celebrex 200mg BD /400mg OD
C Tramal 50mg/75mg TDS
T Arcoxia 90mg OD
Syp MMT 15mls TDS
Syp Benadryl 15mls TDS
T Piriton 4mg/8mg TDS
IV hydrocortisone 200mg stat, 100mg QID
T Cilostazol (claudication pain) 100mg OD
T Aspirin 150mg OD/300mg STAT
IM nubain 20mg stat
T/IV Bisolvon 8mg TDS
T Labetolol 100mg TDS
T Adalat 10mg TDS
T Methyldopa 250mg TDS
Ural sachet 1/1 BD/TDS
IV/T lasix 20/40/80 mg BD
IM/IV Pethidine 50mg
T Rocaltriol 0.25 mcg OD
T calcium lactate 600mg BD
T levenogestrel 1.5mg stat
Inj Ertapenem 1gm OD
Inj Piptaz 3.375g
T/IV Tranexamic acid 500-1000mg TDS
IV Tramal 50 mg/75mg TDS
IV Maxolon 10 mg TDS
IV Cefuroxime 1.5 stat, 750mg TDS
IV Unasyn 1.5g STAT and TDS
IV Cefobid 2g stat, 1g BD
IV Ceftriaxone 2g stat, 2g/1g OD
IV Cefepime 2g stat, 1g BD
IV Meropenem 500mg tds/qid
IV Imipenem 500mg tds/qid
IV Ampicillin 2gm Stat 1gm QID
IV Cloxacillin 1g STAT, 1g/500mg QID
IV Flagyl 500mg TDS
IV Augmentin 1.2g STAT, TDS
T Augmentin 625 mg BD
T Unasyn 375mg BD
T Doxycycline 200mg stat, 100mg bd
T Cloxacillin 500mg QID
T Azithromycin 500mg OD
T Flagyl 400mg TDS
C Tramal 50mg/75mg TDS
T Maxolon 10mg TDS
T Doxazosin 4mg OD
T Finasteride 5 mg OD
T Cardura 4mg ON
T Hytrin 4mg ON
LYTIC COCKTAIL
IV Actrapid 10u STAT
IV ca gluconate 10% 10cc in 10 minutes
IV Dextrose 50% 50cc
CORRECTION OF ELECTROLYTES:
Corrected Ca : (40-albumin)x0.02 + serum calcium
If <2 , fast correct : IV Calcium Gluconate 1amp in 100cc NS over 1H
K+ correction
K+ deficit : 3.5-serum K x BW(kg) x 0.04
K+ require : (1mmol/kg/d)
1mmol x BW kg
Total req : (K deficit + K require)/ 13.4 mmol
*from mmol change to g divide by 13.3*
*For female :0.6 , male :0.4*
Fast correct : IV 1g KCl in 100cc NS over 1H
Slow dose : T. Slow K 1.2g tds
Mist KCl 15ml tds
Maintainance dose : IV 1g KCL in each pint
Fast PO4 correction
IV Potassium Dihydrogen PO4 (K2H2PO4) 1amp in 100 cc NS/1 H
Fast Mg2 correction
IV MgSO4 2.4g in 50cc NS/30 min
IV MgSO4 1amp in 100cc NS/1H
Na+ correction
Mild : NS drip 3 pint
Mode :
Severe : 3% 100cc NS slow infusion over 6H, repeat Na after fast correct.
Not more than 10mmol/24H
SEDATION
Midazolam 0.1mg/kg
Syrup chlorhydrate 50mg/kg
OAC/PAC REGIME
C Omeprazole 40mg BD
T Ampxicillin 1g BD
T Clarithromycin 500mg BD
Then C Omeprazole 40mg OD
HEMATINICS
T FeSO4 200/400mg OD/BD
T Vit B Co I/I, II/II OD/BD
T Folate I/I, II/II OD/BD
PREMED FOR INTUBATION
Midazolam 5mg
Fentanyl 50mcg = 0.05mg
Scoline 100mg/ Rocuronium 50mg
COVER FOR ACS
T Aspirin 300mg STAT
T plavix 300mg STAT
Maintenance:
T Aspirin 150mg OD
T plavix 75mg OD
S/c fonda 2.5mg OD/ s/c clexane 40mg OD(renal impairment)
BOWEL PREP
2 days before - low residual diet
1 days before:
RP normal - fleet phosphosoda 45ml BD x 1/7
RP abnormal - Foltran 2L/3L
On day of scope:
Ravin enema II/II stat
Or fleet enema I/I stat
Do PR!
Haemorrhoids
Tab. Daflone ll/ll TDS 4/7
Tab. Daflone ll/ll BD 3/7
Tab. Daflone ll/ll OD 1/52
Forwarded from Dr Iliana9
Template for post natal #review (after SVD in labour room, before we transfer out patient to postnatal ward)
Source; Ampang HO guide
Download the full guide here; https://t.me/nota_perubatan/164
Source; Ampang HO guide
Download the full guide here; https://t.me/nota_perubatan/164
Forwarded from Advance HO 2023
A) Unstable case in medical ward, call your MO stat & inform about this patient
Forwarded from Advance HO 2023
B) New case just admitted to SCN. You clerked this case & need to present it to oncall MO during oncall round
Forwarded from Dr Iliana9
O&G cases simulation 21.3.2022.pdf
269.2 KB
Obstetric cases; whole ward simulation