林口長庚醫(yī)院外放見聞

1、林口長庚醫(yī)院外放見聞,Presented by R2 林至芃2000.10.24,林口長庚醫(yī)院外放見聞,兒童醫(yī)院門診常規(guī)手術(shù)兒童醫(yī)院兒童顱顏異常整型TraumaCVSChest surgeryNeurosurgery,兒童醫(yī)院門診常規(guī)手術(shù),No IV line, Gas induction<2 y/o Nurse 抱進(jìn)開刀房<10 Kg Bain circuit所有小兒科的刀都捏BAG，不用VENTILAT

2、OR 打CHEST 會被遮到的刀，都會在左胸前貼precordial stethoscope, frequent check!,兒童醫(yī)院兒童顱顏異常整型,頭顱異常部分-常見診斷: craniosynostosis 1.Cruzon disease 2.Apert syndrome術(shù)式: cranio-orbital plastymajor hemodynamic change:a.頭骨拿下時(shí)-release IICPb

3、.頭皮夾拿掉後開始關(guān)頭皮c.hemovac 放入後開始吸血-dura irritationA-line+Neck CVP+ large bore IV line,兒童醫(yī)院兒童顱顏異常整型,Cleft lip and palate在外科醫(yī)師準(zhǔn)備的過程中 NA必須持續(xù)用手固定TUBE！以防被弄掉！小孩若預(yù)期會困難插管要用fiber時(shí)應(yīng)給atropine, midazolam, gas讓病人自呼等十到十五分鐘後再Nasal fiber

4、intubationVPI白色 stylet for 高位 glottis,林口長庚大開刀房- Trauma,Very large case numbers!!Trauma GSTrauma orthoEffective resuscitation,林口長庚大開刀房- CVS,Induction drugsPA catheterNGTEEBy-pass perfusionistPost-bypass medicati

5、onbeating heart CABG - CTS,林口長庚大開刀房- Chest,Nothing particular for Lung CaTrachea surgery team!Rigid bronchoscopyPain control,林口長庚大開刀房- Neurosurgery,InductionCVPBrain mappingEvoked potentialsTCDNo SjVO2 , no cere

6、bral oxymetryVS- NS, Pain,,林口長庚醫(yī)院外放怪聞,Radical Hysterectomy- No CVPHypotensive anesthesiauniversal F V.S RAE tubeNasal intubation- jelly only! Tube suture!CPR溫血器,林口長庚醫(yī)院外放見聞,長庚麻醉部分科：a.心血管胸腔麻醉科 7b.神經(jīng)外科麻醉與疼痛控制 9c

7、.一般麻醉科 9d.兒童醫(yī)院麻醉科 （VS８名）每月平均開刀量8000,林口長庚醫(yī)院外放見聞,Teaching activity:7:30 amW2: journal meeting by VSW3: POR QC meetingW4: 全院grand roundW5: journal meeting W6: M/M conferenceResident training course,Thanks for your