#196
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Öèòàòà:
Treatment for Infants Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary. If the infant is distressed, is unable to cry cough, or breathe: Lay them face down along your forearm, with their head low, and support the back and head. Give up to 5 Back Blows, with the heel of your hand. Check the infant's mouth; remove any obvious obstructions. Do not do a finger sweep of the mouth. If the obstruction is still present: Turn the infant onto his back and give up to 5 Chest Thrusts Use two fingers, push inwards and upwards (towards the head) against the infants breastbone, one finger's breadth below the nipple line. The aim is to relieve the obstruction with each chest thrust rather than necessarily doing all five. Check the mouth If the obstruction does not clear after three cycles of back blows and chest thrusts: Dial 03 for an ambulance Continue until help arrives |
#197
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Öèòàòà:
"Ñ äðóãîé ñòîðîíû, ñòîèò çàìåòèòü, ÷òî òàêîå îïèñàíèå âðÿä ëè ïîìîæåò Âàì ïðè îòñóòñòâèè îïûòà. Âû ìîæåòå âûó÷èòü åãî íàèçóñòü, íî ïðè ýòîì íå îñâîèòå ñàì íàâûê." |
#198
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[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#199
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Öèòàòà:
ßíà - ýòî èç âàøåé æå ññûëêè (êñòàòè, îïÿòü î÷åíü êðàñèâîé) À ýòî èç óñëîâèé çàäà÷è: "Ó íå¸ ïðèñòóïîîáðàçíûé êàøåëü; ïîÿâèëàñü îñèïëîñòü ãîëîñà." Âû âåëèêîëåïíàÿ ñïîðùèöà, íî ýòî íå òîò ñëó÷àé . Íå ïðèìåíÿòü ìåòîä Õàéìëèõà äåòÿì ïåðâîãî ãîäà æèçíè - ýòî íå ðåêîìåíäàöèÿ, à ïðàâèëî. ÇÛ: Ïîñëå Âàøåãî çàêëþ÷åíèÿ î òîì, ÷òî äåòñêàÿ ñìåðòíîñòü âîçðàñò¸ò åñëè êòî-íèáóäü ïðèñëóøàåòñÿ ê ìîåé ðåêîìåíäàöèè (çàìåòüòå - ýòî íå ìîÿ ðåêîìåíäàöèÿ, à âåäóùèõ àíåñòåçèîëîãîâ-ðåàíèìàòîëîãîâ, â òîì ÷èñëå è ñàìîãî Õàéìëèõà) ìíå ñòàëî êàê-òî íå ïîñåáå . [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] «CHILDREN The technique in children over one year of age is the same as in adults, except that the amount of force used is less than that used with adults in order to avoid damaging the child's ribs, breastbone, and internal organs. INFANTS UNDER ONE YEAR OLD The rescuer sits down and lays the infant along his or her forearm with the infant's face pointed toward the floor. The rescuer's hand supports the infant's head, and his or her forearm rests on his or her own thigh for additional support. Using the heel of the other hand, the rescuer administers four or five rapid blows to the infant's back between the shoulder blades.» Ðåçþìå - äåòÿì äî ãîäà íå ïðîèçâîäÿò òðè òîë÷êà â æèâîò, à ñòó÷àò ïî ñïèíå ìåæäó ëîïàòêàìè. |
#200
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..Å..
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#201
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Öèòàòà:
Öèòàòà:
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#202
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Íàïîìíþ óñëîâèÿ çàäà÷è:
×åðåç äâà ÷àñà ïîñëå ââåäåíèÿ âàêöèíû ÀÊÄÑ ó ÷åòûð¸õìåñÿöíîãî ìàëü÷èêà ïîäíÿëàñü òåìïåðàòóðà äî 38,3, ïîÿâèëîñü îáùåå áåñïîêîéñòâî. Êàêîâà òàêòèêà âðà÷à ïðè îñìîòðå ïàöèåíòà â 6-òè ìåñÿ÷íîì âîçðàñòå? (A) Îòëîæèòü âàêöèíàöèþ ïðîòèâ êîêëÞøà è ââåñòè ñòîëáíÿ÷íûé è äèôòåðèéíûé àíàòîêñèíû (B) Îòëîæèòü âàêöèíàöèþ ïðîòèâ êîêëÞøà è ââåñòè ñòîëáíÿ÷íûé è äèôòåðèéíûé àíàòîêñèíû â ñíèæåííîé äîçèðîâêå (Ñ) Ââåñòè ïîëîâèíó îáû÷íîé äîçû âàêöèíû ÀÊÄÑ (D) Îòëîæèòü âñå ïðèâèâêè äî 12-òè ìåñÿÿ÷íîãî âîçðàñòà (E) Ââåñòè âàêöèíó ÀÊÄÑ, ðåêîìåíäîâàâ ïðåâåíòèâíîå ëå÷åíèå ñ öåëüþ ïðåäóïðåæäåíèÿ ãèïåðòåðìè÷åñêîé ðåàêöèè Âñå óâëåêëèñü ñïîðîì â Îðäèíàòîðñêîé . OrFun, àêà Ñâåòëàíà Îëåãîâíà, äàëà ïðàâèëüíûé îòâåò - "Å". "Íåçíà÷èòåëüíóþ òåìïåðàòóðíóþ ðåàêöèþ è êðàòêîâðåìåííîå áåñïîêîéñòâî ðàñöåíèâàþò, êàê ñëàáóþ ðåàêöèþ íà ââåäåíèå âàêöèíû, òàêàÿ ðåàêöèÿ íå ÿâëÿåòñÿ ïðîòèâîïîêàçàíèåì ê ïîâòîðíîìó ââåäåíèþ ïðåïàðàòà. Íåîáõîäèìî ïîìíèòü, ÷òî ââåäåíèå âàêöèíû äîëæíî âûçûâàòü ðàçâèòèå îòâåòíîé ðåàêöèè â îðãàíèçìå (äëÿ òîãî îíà è ââîäèòñÿ), è èíäèâèäóàëüíûå âíåøíèå ïðîÿâëåíèÿ å¸ âïîëíå âîçìîæíû (â ò. ÷. íåçíà÷èòåëüíîå ïîâûøåíèå òåìïåðàòóðû, íåäîìîãàíèå è ò. ï.). Ïîýòîìó ñðàçó æå ïðåêðàùàòü íà÷àòûé êóðñ àêòèâíîé ïðîôèëàêòèêè ïðè ïîÿâëåíèè ïîäîáíîé ñèìïòîìàòèêè íå ñòîèò. Ðåàêòîãåííîñòü êîêëÞøíî-äèôòåðèéíî-ñòîëáíÿ÷íîé âàêöèíû ñâÿçàíà ñ êîêëÞøíûì Àã, âõîäÿùèì â å¸ ñîñòàâ. Äèôòåðèéíî-ñòîëáíÿ÷íûé àíàòîêñèí ìàëîðåàêòîãåíåí è ïîòîìó ìîæåò áûòü èñïîëüçîâàí ïðè ïîñëåäóþùåé âàêöèíàöèè è ðåâàêöèíàöèè äåòåé, èìåâøèõ ïîâûøåííóþ ðåàêöèþ íà ðàíåå ââåä¸ííóþ âàêöèíó ÀÊÄÑ. Ïðèìåíèòåëüíî ê äàííîé çàäà÷å å¸ ìîæíî ðåøèòü ñëåäóþùèì îáðàçîì: ÷åðåç 1,5 ìåñÿöà ïîñëå ïåðâîé ïðèâèâêè ââåñòè àíàòîêñèí è ñ÷èòàòü âàêöèíàöèþ çàêîí÷åííîé, ðåâàêöèíàöèþ ïðîâîäèòü â êàëåíäàðíûå ñðîêè." ÇÛ: Ñëåäóþùóþ çàäà÷ó îïóáëèêóþ ÷óòü ïîçæå, êîãäà óëÿãóòñÿ ñòðàñòè. |
#203
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Ìíå êàæåòñÿ, ñðåäè ïåðå÷èñëåííûõ âàðèàíòîâ ïðàâèëüíîãî îòâåòà íåò.
Ó ðåáåíêà áûëà ðåàêöèÿ íà ÀÊÄÑ ñðåäíåé òÿæåñòè. Ýòî íå ÿâëÿåòñÿ ïðîòèâîïîêàçàíèåì ê ïðîäîëæåíèþ êóðñà âàêöèíàöèè. Åñëè ïîñëå âòîðîé âàêöèíàöèè ÀÊÄÑ ïîäíèìåòñÿ òåìïåðàòóðà, ìîæíî äàòü æàðîïîíèæàþùèå (ïàðàöåòàìîë èëè èáóïðîôåí) â âîçðàñòíîé äîçèðîâêå. Íèêàêîãî ïðåâåíòèâíîãî ëå÷åíèÿ íå òðåáóåòñÿ. ×òî âîîáùå ïîíèìàòü ïîä ïðåâåíòèâíûì ëå÷åíèåì? Íàñêîëüêî ÿ çíàþ, ïðåâåíòèâíîå ëå÷åíèå - ýòî íàçíà÷åíèå ýòèîòðîïíîé òåðàïèè â ïðåäïîëàãàåìîì èíêóáàöèîííîì ïåðèîäå äëÿ ïðîôèëàêòèêè çàáîëåâàíèÿ. Íàïðèìåð, äîêñèöèêëèí ïîñëå óêóñà êëåùà. |
#204
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A 2-month-old boy is brought to the office for a routine well-baby visit. The mother tells you that he is doing very well, that he drinks 5 oz of formula every 4 hours, stools twice a day, and sleeps 6 hours at a time. His temperature is 37.0 C (98.6 F). Physical examination is normal and he is growing along the 50th percentile for height and weight. After addressing all of the mothers questions and concerns, the most appropriate next step in management is to
A. administer the DTaP, haemophilus-hepatitis B, inactivated polio, and pneumococcal “conjugate” vaccines B. obtain a bagged urine specimen to check for reducing substances C. order a complete blood count to evaluate for anemia D. send the patient home with his mother for a return visit in 2 months E. send the patient home with his mother and schedule a return visit in 3 weeks |
#205
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Somebody? Anybody? ...
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#206
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Íå ïîìíþ ñðîêîâ (ïîêà íåçà÷åì èõ óòî÷íÿòü , íî äóìàþ, ÷òî ïîðà ïðèâèâàòü ìàëûøà.
À.
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#207
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Åñëè ñëåäîâàòü ðîññèéñêîìó ãðàôèêó ïðèâèâîê, òî, íàâåðíîå, Å.
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#208
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Âàðèàíò À.
Íî ïî íàøåìó ãðàôèêó äåéñòâèòåëüíî Å. |
#209
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Ïîäîæäåì àâòîðèòåòíîe ìíåíèe ìîäåðàòîðîâ ðàçäåëà "Ïåäèàòðèÿ".
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#210
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Ïî "èõ" ãðàôèêó ïðèâèâîê - âàðèàíò À. Çàäà÷à æå "îòòóäà"
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