Internal Medicine Practical Skills

7/30/2019 Internal Medicine Practical Skills

1/8

Inte

1)Atu

1st

2nd

3rd

Indi

Con

Tec

Com

2)Typ

rnalMedici

RYLESTUB

bewithano

arking:eso

arking:pyl

arking:tip

ations:

1) Diagnos Aspi Duo Aspi Dxt Gast

2) Therape For Dec Tor Pois Tor

raindication

Mul Eso Com Skul Sev

nique:

No Posi Mai Toc

ausc

plication:

Perf Goe Trau Goe Disc Trau

URINARYC

:

a) Nondwtempor

b) Foleyscballoon

e:Practical

peningaton

phagealcar

orus

ofduodenu

ic

rationofblo

denalaspira

rationoftox

acheaesop

rintestfollo

utic

eeding

mpression

stbowel

oningcases,

stthestom

:

iplefacialfr

hagealstric

atosepatie

lfracture

resinusitis

eedsedatio

tion:flexhe

resistance

onfirmitisi

ultateforb

oration

sinto

trache

maticnasal

supintothe

omfort

maticinsert

THETER

llingcathet

ryuse

atheterat

atone

end,

Skills

eend&mu

iojunction

odupper

ioneg.G.la

icsubstance

agealfistul

wingvagoto

fthechann

todetoxifie

ach,takeou

actureespc

ure

tgagreflex,

norspecial

dwhendiff

isattheupp

thestomac

rborygmi

a,thus,

aspi

cavity,thus

brainincrib

iongastritis

ratube

ubewith4

asvarious

s

ltiplelateral

ITbleeding,

blia

sfortoxicol

,atresia&

my

el

tgastricsecr

ribriformpla

riskofaspir

reparation

iculttoinser

erendofth

h:1)litmus

rationpneu

pitaxis

iformplate

ithoneope

penings:2a

izes,for

per

openingthe

toconfirm,

gy

iaphragmat

etion

te

ation

t

esophagus

paperturnb

onia

racture

ingatone

ttheend&

anentuse

otherend.

monitor,ac

ichernia

luetored,2

ndandanot

2smalllater

longerperio

ess

)nobubblin

heropenin

alopeninga

d)

g,3)pumpa

attheothe

ttheothere

irusingsyri

end,for

nd,alsohas

ge&

a


2/8

Indi

Con

Tec

Com

3)Indi

4)Indi

ations:

a) Nondw Tem Excl Dxo Dxo

b) Foleysc Con Mea Ins Coll Can

raindication

Rup Infe Uret

nique:

Ase Expl Clea Cho App Hol Hol Pus See Infla Pull Con Stra

plication:

Uret Pres Uret Rup Ret

REDIVACD

Suctations:

Pro Inh Bre Orth

LARYNGOSC

ations:

llingcathet

poraryrelief

deabdomi

fhematuria

fretrograde

atheter

inuousblad

sureurineo

ockpatient,

cturinefor

beusedtor

:

uredurethr

tionof

uret

hrastricture

tictechniqu

aintopatien

nthegenital

seasuitabl

lylignocaine

catheterwi

penisupwa

catheter

as

ifurinecom

teballoonw

cathetertill

ecttheurin

pcathetert

heralruptur

surenarcosi

heralstrictu

uremembr

inedcathet

AIN

iondrainor

hylacticdrai

ad&necko

stop

opedicope

OPE

r

ofcauseuri

almass

cystogram

derdrainage

utput

duringop

UFEME/C&

moveforei

a

ra

e

t

iawithcata

esizeofcat

jellyatthet

thforcep

rds

faras

possi

out

ithwater

eelresistan

ebag

tightwitho

e

s

re

nousurethr

rtip

closesystem

ntopreven

p

.Pelvicop

naryretenti

(CBD)

S

nbodyine

lonanddro

eter

ipofcathet

le

ce

utanyresist

awhilepulli

drainage

hematoma

n

ophagealin

pthearea

r

nce

ngoutthen

andfluidco

children

eckoftheur

llection

ogenitaldiaphragm


3/8

5)

Indi

Com

6)

Indi

Tec

Com

Fori Tov

cerv

TUBE

Conperp

Holl Mad

risk

ations:

Inse3)p

Whpain

(N.Bplications:

Bilia Stric Fist Infe May

CHESTTUBE

Con Theradi Mar

ations:

The Dia For

nique:

Posi Ase Clea Inse Tou Inse Pull Cla Con Stic Che Site

plications:

Dam

ntubation

isualizeupp

icalspine

ists2limbs:

endicularto

wtubeofv

eoflatexru

ofbiliaryper

rtoperativel

tencyofbili

ntoremove

,3)ttubec

.:daily

bile

o

ryperitoniti

tureofcom

laformatio

tionofwou

rupturethe

/INTERCOS

istsofmeta

cannulahas

paque

kingatthec

apeutic:to

nostic:type

leurodesis

tion:sitting

tictechniqu

n/drap

gi

rtabovethe

htheribs&

rt1cm

thetrocaou

pthecannu

ectthecan

thecannul

kwithCXR

ofinsertion

agetothen

rrespirator

oneshort&

eachother

arioussize

bber,which

itonitis

yduringCB

arytract,4)

TTube1)d

olangiogra

utputis

500

onbiledu

nd

commonbil

TALDRAIN

ltraceandp

multiplelat

annula

drainair,flu

offluiddrai

orsupine

e

eLA

ribs

slitupward

tbytwitchin

la&remov

ulatounde

:air(2ndICS

eurovascula

tractcauti

onelongw

caninducef

expioration

biledrainag

aytodayw

showsbilia

1000ml)

tiflefttool

eductdurin

GE

lasticcannu

ralhole

&

o

id,blood&

nedsentfor

gthetroca

thetroca

rwaterseale

MCL),blood

rbundle

nwithfract

ichattach

ibrosis,crea

drainage1)

enbileoutp

rytractisp

ong

gremoval

la

peningat

th

us

cytology,C

atthesam

dsystem

/fluid(5thIC

ureof

teatractan

TTubeCho

utisdecrea

tent&ther

eother

end

S,AFB,FEM

etimepush

SMCL)

preventbil

langiogram,

ing,2)clam

isnostone

&lined

up

r

E

cannulatill

eleakage,a

2)removalo

tubeby10

seen

diopaquem

cm

aresultred

fresidualst

postopday,

aterial,its

ti

uce

ones,

no

palso


4/8

7)

Indi

Con

Tec

Com

8)

Indi

Con

Tec

Goe Pun Pun

hem

Infe Slip Bro Sub Frac

SIGMOIDOS

Conations:

Dia The

raindication

Anal Toxi Hirc Chr

nique:

Nos Don Posi 1

st

c

visio

Att Afte Rect Afte

plications:

Perf Mas Prec

SEBGSTAKE

4luations:

Bleeraindication

Uncnique:

Expl Left Sed

sintothelu

tureintom

tureintogr

orrhage

tion(pleuri

in/out

chopulmon

utaneouse

turetother

COPE

istsofmeta

nostic:any

apeutics:ex

s:

stenosis

cmegacolon

hpurgds

nsds

pecialsedat

otnecessar

tion:supine

towards

u

n

esametim

rpassingpu

alvalvemay

rreach152

oration

sivebleedin

ipitate

BLAKEMO

ens:1)gas

dingesopha

s:

operative,

aintopatien

lateralposit

tion:valiu

g

diastinum

atvessel/p

y,empyem

ryfistula

physema

ib

lobturator

atientswith

cisionofpol

ion

bowelpre

,leftlateral

mbilicus,aft

,pumpthe

orectalism

beseen,pu

0cm(rectos

RE?MINNE

tricballoon,

gealvarices

omatose

t

ion

/pethidine

ricardium,i

,pyothorax

airinthesk

ithmetalc

lowerGITs

ps,untwitc

arationunle

positionork

er4cm

relea

airtoinflate

usclepushd

shawayslo

igmoidjunct

OTATUBE

2)esophag

whichunres

ntrathoracic

in

nnula,with

mptomseg

volvolus

sselectivec

neechest

seobturato

thebowelo

ownsacrum

lywithout

ion)withdra

alballoon,

pondtovas

vessel

markingutt

.Chronicdia

ases

&connect

rtopushbl

orce

wslowly&c

)gastricasp

pressin

o30cm,eye

rrhea,PRbl

yepiece,

p

od/fecesa

ounterchec

iration,4)e

pieceandli

eding,biop

shthe

scop

way

kfindings,b

ophagealas

htsource

yofmasses

under

dire

iopsyanyle

piration

ct

ion


5/8

Com

9)Indi

Con

Tec

10)

Indi

Tec

Con

Inse Inse Aspi Infla Pull Infla

clam

necr

Cheplication:

Pres Aspi Asp Rup

PROCTOSC Con

ations:

Dia The

raindication

Anal 3rdd Mas Stra

nique:

Posi Expl Insp DoP Ask Dire The

ENDOTRAC

Hasation:

Eme Elec

nique:

Posi Rem Lary

up

raindication

rtthrunose

rtlikeRyles

rate(make

tecardiacb

tubeout,str

teesophage

p.Useairb

osis

kpressure

surenecrosi

rationpneu

yxia

ure

PE

istsofmeta

nostics:he

apeutics:ru

s:

fissure

egreepile

sivebleedin

ngulated

tion:leftlat

aintopt

ectanalmar

Rexam

pttotakede

ctiontoward

withdrawo

EALTUBE

aballoon

at

rgency:UR

tive

tion:supine

ovealldent

ngoscopeho

s:

(standingte

tube

urethetub

lloonwithn

ongtraction

alballoon,

causeairis

ourly,most

s

onia

lobturator

orrhoid,PR

bberbandin

ral,supine,

ginforanya

epbreath,t

sumbilicus

bturator&

oneend

and

I,respirator

withnecke

re

ldonleftha

chnique)

einstomach

ormalsaline

tothestom

aintain30

compressibl

importantis

ithmetalc

bleeding,re

gforpiles

kneechestp

nalfissure

ouchprocto

hileinspec

another

op

yfailure

tended

nd,insertth

)

100200ml

ach

0mmHgpr

e&prevent

cardiacball

nnula

ctalmasses

osition

copetothe

ionslowlyd

eningat

the

roughtright

ssure&

pressure

oonshould

anus&inse

rawoutcan

otherend

sideofmou

eflateafter

rtslowly&d

ula

th&pushto

24hours

eeplyintoa

nguetothe

alcanal

left,pushin&lift


6/8

11)

Indi

Con

Tec

Com

Trau Aspi

CENTRALVE

Conations:

Mea Hyp Med Bloo Coll Bur Obe Card Tem Inse Pul

raindicaton

Skin Sev Any Chil Ver Ptis Unc

nique:

Nos Posi Leg App Ase LA Site: Mak Use Dire Hitt Asy Pus Con

plications:

Pne Air Infe Hem Atri Inju

maofvocal

rationpneu

NOUSCAN

istsofbran

sureCVP

rlimitation

icationhy

dtransfusio

psedperiph

pt

sept

iaccathethe

porarytrans

rtionof

gas

onaryangio

s:

infectionat

rkyphoscoli

distortiono

ren


7/8

12)

Indi

Typ

Sett

Car

Com

Com

POS

CON

COL

OD

SUR

13)

Indi

STOMA

OpeColo

ations:

Asadist

fistu

cyst

Fees:

Bya Byf Byti Byc

ing:

Cou Inst Avoi Thro

:

Prot Foo Irrit Sup

plications:

Earl Late

(pro

Ca2+

odo

ponentsof

1) Facepla2) Bag/po3) Others

ITION

TENT

OUR

UR

FACEOPENI

HROUGHC

Conation:

ningofintes

stomy,ileos

nalternative

lobstructio

lation,injur

ctomy

inginproxi

natomicloc

nction,eg.

me,eg.Tem

onstruction,

seling,sto

andingand

dskincreas

ughrectus

ectskin,eg.

tion

ortgroup,e

:bleeding,

:1)skin(ex

lapsed,stric

VitaminB1

r)

olostomya

testomaa

uchsticko

stoma

adhe

G

UTNEEDLE

istsofmetal

tineorurina

tomy,gastro

routefordi

eg.Conge

3)postexci

alobstruct

tion

iverting,de

porary,per

eg.Loop,en

anurse

ittingpositi

andfolds,

bdominism

Water&ba

g.Stomaso

ischemia

oriation,inf

ure,retracti

),4)psycho

pliance:

dhesivewat

n(singleuse

sivepaste

&

ILEO

RIFp

Fluid

Yello

Nega

Protr

cannula&

rytractont

stomy,vesic

schargeofe

italmalform

sioneg.APr

ion,anasto

compressin

anent

d,Mickuliez

n

ound,scar

uscle

iety

ection,fistul

on,paracolo

logical(dep

er+/ plastic

)ordetacha

powder,

Ka

TOMY

osition

&digestedf

ish

tive

usion,irritat

etaltroca

eabdomin

ostomy,ure

xcretiondue

ation,tumo

esection,to

osiseg:Ca

continentp

,bonyprom

ationChro

stomyherni

ression,sex

ring

ble,drainab

rayagum

ood

ion

lwalleg.

terstomy

to1)

r2)distal

tal

sophagus

ouch

inence

nsds,varic

a),3)metab

aldysfuncti

leornondr

COLO

Anyw

Soft/

Brow

Positi

Flato

sportalh

olic(fluid&

on,socialdy

inable

TOMY

ereespecia

hardstool

ish/darker

e

ening

pertension)

electrolytes,

sfunction,al

llyLIF

,2)mechan

nutrition,e

teredbodyi

leak,

ical

.Fat,

mage,


8/8

Com

Biop Biop

plications:

Hem Pne Inju

syofliver

syofbreast

orrhage

mothorax

ytodiapragm

Documents

Internal Medicine Practical Skills