Intern complaint

XX~
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Intern ~








Underlying disease Acetaminophen
? NSAID
? Ultracet/Tramtor
Dynastsat

red flag signs Teiria gel
peritoneal sign


? Urticaria? Seborrheic dermatitis?
Anti-histamine (/): homoclomin, xyzal, vena, finska
: elomet, topsym, ichderm, sinbaby
? mycomb, ZnO
finska, homoclomin

Etiology?
:
Medicon-A, compound glycyrrhiza mixture
:
ACC, mubroxol
Normal saline inhalation
Wheezing:
Meptin
Combivent inhalation
Steroid

Underlying disease stroke?
Baseline
Associated symptoms headache, dizziness, chest pain,
oliguria
target organ damage?

: captopril, adalat (low dose)

Hypertensive crisis/emergency
/
lorapseudo
Methylephredine
Antihistamin (finska, vena)

?? Anti-histamine ()
Underlying disease, age Vena

? BZD
Lowen/ Eurodin/ rivotril/ Xanax

stroke, brain injury Z-drug
Respiratory depression COPD Stilnox
Trazodone


Review medication Menthol packing
Smecta Kascoal
Trancolon
Imolex

Senoside ()
Bisacodyl
Lactulose
Evac

? ?
NG decompression?
Abdomen PE

Primperan/prometin, novamin

Fluid supply

Primperan
Novamin
Baclofen
Binin (haloperidol)
~
: Dexa orabase
: xylmol

Intern ~
GI bleeding
New onset fever
/
Coffee ground & UGI bleeding
Check vital signs
: &
Check underlying disease EV? Prolonged INR? GU? DU?
NG?NG?
Irrigation?
NPO???
Propanazole q12h IVD oral PPI
Arrange EGD
New onset fever ?
Fever survey
PE
Urine routine Normal saline
CBC/DC, CRP Acetaminophen
Blood culture NASAIDs /
Throat swab Voren ()
CXR
?neutropenia?
Call R for advice on antibiotics
/
? Whipple triad
1U RI ?
Recheck blood sugar? ?


?Steroid use?


bedside!
Intern ~

Conscious change
Shock

vital signscheck SpO2
O2
DD: AAA
Physical examination
Chest x-ray
ABG
EKG
CALL FOR HELP!!!!!!

Typical angina?
Musculoskeletal pain?

Physical examination
EKG!
CXR
Conscious change
Baseline?
Underlying disease
AEIOU TIPS
CALL FOR HELP!!!
Shock
Fluid challenge normal saline full run
Check vital sign, SpO2
EKG
Septic shock? Cardiogenic shock? Hypovolemic shock?
CALL FOR HELP!!!



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/ intern note