tre joining internship on 1aug 2008 in paedo things that i learned

a]resuscitation b]intubation c]i/v line in neonate d]n 1 thing that in paed opd
our aim as intern should be not to miss the child with the danger signs viz.1]poor
feeding 2]recurrent vomitting 3]convulsing baby 4]unconcious baby.5]baby gasping
6]umblical sepsis 7]nnj with in 24 hrs of life.8]look for af pf cmf.
baby comes to us with h\o fever keep 3 possibilities a]measles b]malaria
c]meningitis
Giardiasis n worm infestation r very common in set up.
O
of
16Aug 2008 joined casualty dep.
rx of angina complete bed rest
o2 2-3lt/min
inj morphine 3mg i/v stat
inj ntg 25mg in ns at the rate of 6 drops min
tab disprin 1 stat to be chewed then 1/2 od
tab clopidogrel 75mg oD
Tab atenolol 25mg OD [CARDIOSELECTIVE more imp than ENVAS]
Tab envas 5mg OD [more effective in LVF]
TAB STORVAS 40mg 1HS
TAB ANXIT 0.25Mg BD
Inj clexnac 0.6ml
syrup Cremaffin plus 2TSFHS
CARDIAC MONITORING
IF MORPHINE NOT AVAILABLE THEN USE INJ TRAMADOL 50 mg
RX OF PR0LONGED FEVER
INJ CEFTRIAXONE 2gm i/v stat then 1gm i/v BD
CAP DOXYCYCLINE 100mg bd
TAB PCM 500mg SOS
TAB PANTAPRAZOLE -DOMPERIDONE 40mg OD
Signs of Raised ICT REDUCED lEVEL OF CONSC . PAPILLEDEMA ,DIALATED POORLY
REACTIVE PUPILS ,6th nerve palsy ,DECEREBRATE rigidity ,n cushing reflex
[bradycardia,HTN,N irregularrespirations ,Petechial rashes suggestive of
meningococal meningitis.
IN BACTERIAL MENINGITIS PRESSURE Greater thn 180mm of hg Neutrophil increases
,GLUCOSE DEC ,PROTIEN INC. D/D OF BACTERIAL MENINGITIS IS RICKETTSIAL
DIS. A NON
INFECTIOUS DISODER THAT MIMICKS ARE SAH ,DRUG INDUCED HYPERSENSITIVITY MENINGITIS
EMPIRICAL THERAPY FOR MENINGITIS N FOCAL BRAIN INFECTIONS ARE
CEFTRIAXONE 100mg/Kg /day
DOXYCYCLINE 100mg 2 tab stat
VANCOMYCIN 60mg/Kg /day
metronidazole 30mg/Kg /day
STAPH. MENINGITIS VANCOMYCIN IS DRUG OF CHOICE
PSEUDOMONAS CEFTAZIDIME IS DRUG OF CHOICE .
TREATMENT OF RAISED ICT 1]ELEVATE HEAD END OF TTHE BED
2]MANNITOL 25-100g /4hrly
3]dexamethasone 4mg 6hrly
4]sedate patient with PROPOFOL ,MIDAZOLAM ,MORPHINE
5]PRESSOR THERAPY with DOPAMINE,PHENYLEPHRINE
treatment OF INSECT BITE
INJ.HYDROCORTISONE 100mg i/v stat
INJ.AVIL 1AMP I/V STAT
INJ.T.T 0.5ml i/v staT
INJ.ACILOC 50mg i/v stat
TAB.LEVOCITRIZINE 5mg TDS
INJ VOVERAN 75mg i/m stat
treatment of excerbation of asthma inj.hydrocortisone 200mg i/v stat
Nebulisation with duolin respules every 20 minutes
NEBULISATION with budecort respules every 12hrly
o2 inhalation my tata
indicom sim no. is 9218867217.