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#168
21.07.2006, 20:07
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Ïî íàøèì ïðàâèëàì äâèæåíèÿ, ðåáåíîê äî ãîäà ïåðåâîçèòñÿ â ìàøèíå â ñïåöèàëüíîì êðåñëå íà ïåðåäíåì ñèäåíüå ñïèíîé ê äâèæåíèþ. Ðåáåíîê ñòàðøå ãîäà ïåðåâîçèòñÿ â ìàøèíå â ñïåöèàëüíîì êðåñëå íà çàäíåì ñèäåíüå, çàêðåïëåííîì â ñåðåäèíå.
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#170
21.07.2006, 20:15
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Ïîêà äà. Âîçìîæíî, ÷òî ýòî ïðàâèëî è èçìåíÿò, íî ïîêà ìåøêè åñòü íå íà âñåõ ìàøèíàõ, ïðàâèëî îäíî íà âñåõ.
Õîòÿ, ëîãè÷íåå ïîñàäèòü ðåáåíêà ñçàäè, íî, âèäèìî íàøà ïîëèöèÿ èñõîäèò èç òîãî, ÷òî, åñëè ðåáåíîê ñèäèò ñçàäè, òî âíèìàíèå ìàìû -âîäèòåëÿ áóäåò îòâëåêàòüñÿ íà ðåáåíêà, ÷òî ïðèâåäåò ê âîçíèêíîâåíèþ àâàðèéíîé ñèòóàöèè íà äîðîãå.
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#171
21.07.2006, 20:17
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The correct answer is C. Since motor vehicle injuries are a leading cause of death in children and young adults, the United States Preventive Services Task Force (USPSTF) recommends that counseling to prevent these injuries, is an important part of all periodic health maintenance examinations. Infant safety seats are important for all infants, and it is part of the physician's responsibility to inform the parents as to the safest way to use these seats. It has been shown that the middle of the rear seat is the safest place in the car for the car seat to be placed. The American Academy of Pediatrics states that all infants and children under 12 years of age should ride in the back seat of the car and infants must always ride in rear-facing car seats in the back seat until they are at least 20 pounds and 1 year of age. It may seem silly to you that you need to counsel patients about things like this, but since accidents are one of the leading causes of death, counseling about the prevention of these accidents is one of the most important parts of your job.
It is incorrect for you to advise him to disconnect the passenger-side airbag and place the infant in the infant-seat on the passenger side of the front seat (choice A). While it is true that it is not recommended to place an infant in a rear-facing safety seat in the passenger side of the front seat with an airbag, you should tell him that the safest seating position in the car is the middle of the rear seat. If he tells you that for some reason he needs to always have the baby in the front seat in a rear-facing seat, then he should consider doing something about it. It is important for you to understand that airbags, in conjunction with lap and shoulder belts, have been shown to reduce motor vehicle crash-related morbidity and mortality. Since it is likely that the spouse and other family members will ride in the car, advising him to disconnect the airbag at this time is not the best choice. It is inappropriate to advise him to put the infant in the rear-facing infant seat on the passenger side of the front seat (choice B). The USPSTF specifically says that rear-facing infant safety seats should not be placed in the front seat of a car equipped with a passenger-side air bag. The USPSTF recommends that all children riding bicycles and people on motorcycles wear helmets. They do not recommend that infants wear helmets in the car to reduce the risk for a serious head injury (choice D). Infants should be in safety seats in the car. It is incorrect to tell him that airbags, in conjunction with lap and shoulder belts, have not been shown to reduce motor vehicle crash-related morbidity and mortality (choice E). Airbags, used with lap/shoulder belts, have been shown to reduce morbidity and mortality. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#172
21.07.2006, 20:17
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Öèòàòà:
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#173
21.07.2006, 20:22
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Íà ñòðàøíûõ êàðòèíêàõ ðåá¸íîê òîæå ñïèíîé ê äâèæåíèþ. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
"Studies have shown that placing a child in the back seat can reduce a child’s risk of injury or death in a crash by 30% compared to the front seat, so it always safer to place the child in the rear seat. If your vehicle does not have a back seat, or if the child safety seat does not fit in the rear seat, or if your are transporting too many kids to seat them all in the back seat, first determine if your vehicle is equipped with a passenger front airbag. If it is, determine if your vehicle is equipped with an airbag deactivation switch. Newer vehicles that do not have a rear seat, especially pick-up trucks, are typically equipped with a deactivation switch that is operated using the ignition key. If your vehicle is equipped with a deactivation switch, turn the passenger front airbag “off”, then move the front passenger seat to its rear most position. If your passenger front air bag cannot be turned off, you must never place a rear facing infant seat in the front passenger seat. In the event of a crash, a passenger airbags deploys rapidly and can strike the back of an infant seat with great force that can seriously injure or kill an infant. If you must use this vehicle to transport your infant, first request permission from NHTSA to have your passenger airbag disconnected. Rear-facing child restraints SHOULD NOT be used in the front seat with a passenger airbag. The forces of the inflating airbag against the back of the restraint can cause serious, even fatal head injuries. " [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#174
21.07.2006, 20:44
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A 15-year-old boy is brought to the emergency department by the mother of one of his teammates after he was "knocked out" for 3 minutes during a football game. He is awake and is able to speak, but he is unable to recall the events preceding the incident. All he is able to remember is that he woke up and all of his friends were surrounding him, whispering that "it has happened again." The teammate's mother tells you that this is the second time that he has been injured in a game, both times he was hit in the head with a football and then banged his head on the ground. The last incident occurred 2 months ago and was also followed by a 3-minute loss of consciousness. He says that he has a headache and feels "a bit dizzy" and nauseous. The mother tells you that he vomited in the car on the ride to the hospital. His blood pressure is 110/70 mm Hg, pulse is 65/min, and respirations are 16/min. He is alert and oriented to person, place, and time and he does not appear to have any neurologic deficits. Physical examination is unremarkable. A CT scan of the head is performed and it does not show any abnormalities. At this time the most correct statement about his condition is:
A. He can begin playing football again in 5-7 days assuming that he is completely asymptomatic B. He will not develop a subdural hematoma, epidural hematoma, or an intracerebral hemorrhage C. It is unlikely that he has a subdural hematoma because he did not have a lucid interval after the injury and before his loss of consciousness D. Memory disturbances, personality changes, and poor concentration may be present for up to 6 months E. Repeated concussions are not associated with more severe consequences than a single concussion
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#175
21.07.2006, 21:09
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Â? Êðîâü íà ÊÒ âðîäå äîëæíà áû áûòü âèäíà, äàæå â ìàëûõ êîëè÷åñòâàõ..
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#178
22.07.2006, 00:40
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Öèòàòà:
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#180
23.07.2006, 12:01
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The correct answer is D. This patient most likely had a concussion, which is usually thought of as a transient loss of consciousness following head trauma that is associated with a short period of amnesia. It is a common occurrence and is usually associated with very few long-term consequences. The early signs of a concussion include headache, confusion, nausea and vomiting, and dizziness. Late symptoms include memory disturbances, personality changes, poor concentration, sleep disturbances, irritability, and fatigue. These late symptoms generally subside gradually over a few weeks to months. For this reason, it is often advised that the patient be especially careful driving and performing other tasks after a concussion.
It is generally recommended that a patient not return to sports for up to a month after a second concussion with a loss of consciousness and amnesia. A week (choice A) is sometimes okay for an asymptomatic patient who suffered a single concussion, but some studies recommend that a patient return to play after 2-4 weeks. This patient has had 2 concussions and should not return to play in 5-7days, even if he is asymptomatic. Even though it is unlikely that he will develop a subdural hematoma, epidural hematoma, or an intracerebral hemorrhage, you cannot say that he will not (choice B) develop a bleed. Bleeding may develop even with an initially normal CT scan. It is unlikely that he has a subdural hematoma because he did not have a lucid interval after the injury and before his loss of consciousness (choice C) is incorrect. Even though it is unlikely that he has a subdural hematoma, the presence or absence of a "lucid interval" is not the determining factor. A "lucid interval" is more commonly associated with an epidural hematoma, but it is not common. Most subdural and epidural hematomas are visualized on a CT scan. Repeated concussions are not associated with more severe consequences than a single concussion (choice E) is incorrect. Studies have shown that repeated concussions can result in cumulative neurologic damage.
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