INTERNSHIP DIARIES : GENERAL MEDICINE


FROM A GENERAL MEDICINE INTERN


 



5 DAYS OF WARD DUTY 


Have taken venous samples

Have inserted IV cannula

Setting up of IV drip

Learnt Thorough examination of CNS,CVS,RESPIRATORY SYSTEM,ABDOMEN from PGs(Dr. Lohith Varna,Dr. Prachetan)

And tried to explain all examinations (whatever I have learnt) to the UGs.

Vitals monitoring


    

CNS EXAMINATION ON PATIENT



TEACHING AND LEARNING 



SHOWING UGS HOW TO CHECK VITALS QUICKLY 










5 DAYS OF NEPHROLOGY DUTY

I was posted in CKD ward, dialysis ward and casualty as well.


In dialysis ward -

Saw plenty of CKD  patients who come for dialysis 2-3 times every week.
Thorough monitoring of patients during Dialysis,Looking after the complications (chills,sudden raise of BP, fever) and managing accordingly(Under Dr. Navya,PGY1 
And Dr. Pavan,PGY2)

Learning points-

1.Causes of death during dialysis-

.Commonly due to hypotension
-how can we prevent ? 
Just by monitoring vitals regularly for the patients with lo BP(=110/70 or less)

.Patients with comorbidity ( mainly cardiac disease)

2.How do we manage high BP during dialysis?
We can ask patients to take their regular medication, if they have missed the dose.
Or we can give Inj.Lasix 40 mg (or 80mg) IV/STAT

3. How do we manage high fever?
By giving PCM 1 gm IV /STAT

4.How do we manage chills?
Inj.Avil IV/STAT
Inj. Hydrocortisone IV/STAT





NEPHROLOGY CASUALTY DUTY:


Have inserted IV canula

One of the cases I saw I would like to mention -
Patient came to casualty around 7:40 PM with C/O SOB(difficulty in breathing) since 10 days,
Fever since 10 days and altered sensorium since 2 days.
On investigation,She had severe metabolic acidosis which was corrected by giving Inj.Sodium bicarbonate IV STAT slowly(if we give fast,it may cause pulmonary edema)
From this case I learnt  how fast we should diagnose and take action.

Performed CPR for the above mentioned case.

Helped in intubation (under Dr. Pavan) for the above mentioned case.




CKD WARD DUTY 

Have taken venous sample

Have taken ABG sample

Have inserted IV cannula 

Gave IV injections

Checked vitals and managed any raise of BP(under Dr. Pavan)

FEW CASES ADDING HERE THROUGH MY BLOG :


Case 1:  casualty case 

http://stimitamaity132.blogspot.com/2023/07/65-years-old-female-with-sob-and.html


Case 2:


Case 3:








MY 30 DAYS OF UNIT DUTY






Case 1 :


http://stimitamaity132.blogspot.com/2023/06/25-years-male-with-dm-with-generalized.html



Case 2 :

http://stimitamaity132.blogspot.com/2023/07/this-is-online-e-log-book-to-discuss.html




Case 3 :

http://stimitamaity132.blogspot.com/2023/07/blog-post.html



Case 4:

http://stimitamaity132.blogspot.com/2023/07/37-years-old-male-with-sob.html



Case 5:
http://stimitamaity132.blogspot.com/2023/08/50years-old-homemaker-with-generalized.html


Case 6 :
http://stimitamaity132.blogspot.com/2023/08/17-years-old-male-with-altered.html



PROCEDURE  I PERFORMED 

MY FIRST AND SECOND  ASCITIC TAP UNDER THE GUIDANCE  OF DR. LOHITH SIR














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