woensdag 9 oktober 2013

Day 7 Pediatric ER & Urology

Patient 1: Baby with fever and a tick-could be neurological
Take blood; ESR, CBC, electrolyte, Calcium ect

Patient 2: Fell and hit head on sandbox-needed stitches.
Obicularis orbit and Frontal muscle intact-squint eye and raise eyebrow.
(almost passed out watching it for some reason...this makes the second time, I checked my BP: 91/59...maybe my BP was too low and made me dizzy)

Patient 3: Stone in each kidney, came to ER because no urine for 24 hrs. Diabetic heavy patient.
Left has a small stone that responded to stent. After stent was put in, the creatine value went from 6 to 1.9 and to 1.2 in 24 hrs (normal is around 0.7-1.3 in woman). Right has a large stone 4cmx5cm and completely blocking the right kidney.
US- Both kidneys have hydronephrosis
Needs surgery to remove kidney because DMSA test results conclude that right kidney functions at 20% while left is at 80%. Right kidney is useless and will be removed to minimize infection.

Patient 4: Renal Colic; Came to ER for pain in left Kidney
Had a stone removed months ago and has returned pain wants a CT scan but Dr. ordered another US.
Omnic enlarges/dialates ureter and releases stone.
US two weeks after stone removal normal.

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