نسخه نویسی پزشکی

جلسات و اوردر هایی که تا این لحظه در کانال قرار داده شد :

#اصول_اوردر_نویسی
#شوک_آنافیلاکسی
#خونریزی_گوارشی
#ACS
#مسمومیت_استامینوفن
#سوختگی
#copdشدید
#DVT
#مسمومیت_الکل
#مسمومیت_اپیوئید
#مسمومیت_TCA

@noskhe_pezeshk

#مسمومیت_TCA

Imp: TCA Poisoning
Cond: EMR
Diet: Npo
Act: CBR

Please
- IV LINE FIX
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR, AST, ALT, ALP
- URINE TOXICOLOGY
- BS GLUCOMETRY
- HEART MONITORING & PULSE OXIMETRY
- ABG
- EKG
- O2 NASAL 5-8L/MIN IF O2 SAT<93
- NG TUBE FIX & GASTRIC WASHING (WITHIN 1H)
- FOLEY CATHETER FIX
- CHECK I/O
- IVF 1L N/S IV STAT
- NAHCO3 7.5% 1-2MEQ/KG IV STAT
- AMP DIAZEPAM 10MG ON BED
- DRIP NORE EPINEPHRINE 1 MC/KG/MIN IF HYPOTENSION REFRACTIVE TO IVF
- CHARCOAL 50GR PO STAT
- SORBITOL 60GR PO STAT


توجه: تجویز شارکول و سوربیتول در یک ساعت اول و تنها در بیماران هوشیار امکان پذیر است.

#مسمومیت_اپیوئید

Imp: Opium Poisoning
Cond: EMR
Diet: Npo
Act: CBR

Please
- IV LINE FIX
- CVS q2h
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR, AST, ALT, ALP
- URINE TOXICOLOGY
- HEART MONITORING & PULSE OXIMETRY
- ABG
- EKG
- BEDSIDE UP
- O2 NASAL 5-8L/MIN IF O2 SAT<93
- CHARCOAL 50GR PO STAT
- SORBITOL 60GR PO STAT
- NALOXONE 0.4MG IV STAT & REPEAT q2-3MIN (MAX: 10MG)
IF APNEIC OR CYANOTIC: 2MG IV STAT
- DRIP NALOXONE 2/3 WAKE UP DOSE/H IV INFUSION

#مسمومیت_الکل

Imp: Alcohol Poisoning
Cond: EMR
Diet: Npo
Act: CBR

Please
- CVS q4h
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR, AST, ALT, ALP, BILI (T/D), CPK, LDH, AMYLASE, LIPASE
- BS GLUCOMETRY
- ABG (EMR) THEN q6h
- CHECK SERUM ETHANOL & METHANOL LEVEL
- CXR
- EKG
- NG TUBE FIX
- HEART MONITORING & PULSE OXIMETRY
- IVF D/S 1L IV STAT
- ETHANOL 40% 2CC/KG PO STAT & 0.5CC/H PO
- PANTOPRAZOLE 40 IV STAT & DAILY
- ONDANSETRON 4MG IV PRN
- FOLLEY CATHETER FIX
- CHECK I/O
- OPHTHALMOLOGY CONSULTATION
- EMR HEMODIALYSIS IF NEEDED
- O2 NASAL 5-8L/MIN IF O2 SAT<93
- NAHCO3 7.5% 1-2MEQ/KG IV INFUSION IF PH<7.25
- FOLIC ACID 1MG/KG IV STAT (MAX: 50MG)

جلسات و اوردر هایی که تا این لحظه در کانال قرار داده شد :

#اصول_اوردر_نویسی
#شوک_آنافیلاکسی
#خونریزی_گوارشی
#ACS
#مسمومیت_استامینوفن
#سوختگی
#copdشدید
#DVT
#مسمومیت_الکل
#مسمومیت_اپیوئید
#مسمومیت_TCA

@noskhe_pezeshk

#DVT

Imp: DVT
Cond: URG
Diet: Po
Act: CBR

Please
- CVS q6h
- IV LINE FIX
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR, AST, ALT, ALP, D-dimer
- CXR
- EKG
- LIMB ELEVATION
- IVF 1/3 2/3 SER 2L IN 24h
- HEPARIN 80U/KG IV STAT THEN 18U/KG/H IV INFUSION
- LIMB XRAY
- COLOR DOPPLER SONOGRAPHY

#copd
شدید

Imp: COPD Exacerbation
Cond: EMR
Diet: Npo
Act: CBR

Please
- CVS q1-2h
- IV LINE FIX
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR, AST, ALT, ALP, ESR, CRP, U/A
- ABG (EMR)
- O2 NASAL 2-3L/MIN
- SEMISITTING POSITION
- IVF 1/3 2/3 SER 1L IN 24h
- SPRAY SALBUTAMOL 6-12 PUFF q20min IN 1h THEN 2PUFF q1h
- SPRAY ATROVENT 6-12 PUFF q20min IN 1h THEN 2PUFF q1h
Or
NEB DOULINE 1 STAT q20MIN × 3
- CXR AFTER STABILIZATION
- EKG
- HYDROCORTISONE 200MG IV STAT
OR
METHYL PREDNISOLONE 40-60MG IV STAT
- CEFTRIAXONE 1GR IV STAT & BID
- AZITHROMYCIN 500MG PO STAT

#سوختگی

Imp: Burn Injuri
Cond: EMR
Diet: Npo
Act: CBR

Please
- IV LINE FIX ×2
- CVS q6h
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR
- EKG
- HEART MONITORING & PULSE OXIMETRY
- ABG
- O2 NASAL 5-8L/MIN IF O2 SAT<93
- IVF RINGER LACTATE (PARKLAND FORMULA)
- NG TUBE FIX
- FOLEY CATHETER FIX
- CHECK I/O
- TOXOID 0.5CC IM STAT
- M.S 5MG IV SLOW INFUSION
- SURGERY CONSULTATION

#مسمومیت_استامینوفن

Imp: Acetaminophen Poisoning
Cond: EMR
Diet: NPO
Act: RBR

Please
- IV LINE FIX
- CVS q4h
- CBC, BUN, CR, NA, K, AST, ALT, ALP, PT, PTT, INR, U/A
- VBG STAT & DAILY
- NG TUBE FIX AND NG WASHING
- CHARCOAL 50GR PO STAT
- SORBITOL 60GR PO STAT & 20GR TDS
- NAC 8GR PO STAT THEN 4GR q4h ×3days
- IVF 1/3 2/3 SER 3L IN 24h
- ONDANSETRON 4MG IV STAT PRN

#ACS

Imp: ACS
Cond: EMR
Diet: NPO
Act: CBR

Please
- IV LINE FIX
- CBC, BUN, CR, NA, K, BS, PT, PTT, INR, TROP 0 & 3
- SERIAL EKG q1h × 3
- HEART MONITORING & PULSE OXIMETRY
- ASA 325 MG PO STAT
- OSEVIX 300 MG PO STAT
- ATORVASTATIN 80 MG PO STAT
- DRIP TNG 5-10 MICRO/MIN INF IF SBP > 100
- HEPARIN 60 U/KG IV STAT IF SBP < 150 (MAX: 4000U)
- PANTOPRAZOLE 40 IV STAT
- M.S 5MG IV SLOW INFUSION

#خونریزی_گوارشی

Imp: GI bleeding
Cond:EMR
Diet: Npo
Act: CBR

Please
- IV LINE FIX ×2
- CVS q4h
- CBC, BUN, CR, NA, K, AST, ALT, ALP, PT, PTT, INR, HBsAg, HCVAb
- EKG
- VBG
- CXR
- BEDSIDE UP
- SERUM N/S 1L IV STAT IF ORTHOSTATIC HYPOTENSION DETECTED
- NG TUBE FIX & GASTRIC WASHING
- RESERVE 4U PACK CELL ISO GP & RH
- OCTEROTIDE 100 MICRO IV STAT & 50 MICRO/H IV INFUSION
- CBC q6h
- S/E ×3
- PANTOPRAZOLE 80MG IV STAT & 8MG/H IV INFUSION
- CEFTRIAXONE 1GR IV BID
- IVF 1/3 2/3 3L/24h
- SURGICAL CONSULTATION IN SEVERE ACUTE BLEEDING
- HEART MONITORING & PULSE OXIMETRY
- FOLEY CATHETER FIX
- CHECK I/O