5 Easy Steps to Patient Management

When a patient comes with a problem:

STEP 1: Assess
-See/inspect.
-Ask (what went wrong, what made him/her to seek medical support)
-History (brief, precise, to the point. No leading question. Take help from the attendant if the patient is minor, dumb, unconscious or psychologically unstable.)
-detect the major symptoms (from the clinical features. This helps to check & elicit the important signs)
-check the vitals: pulse, BP, respiratory rate, temperature.

STEP 2: Examine
>> Local.
>> Systemic.
>> Lab (blood, urine, stool, collections, pus, secretions etc) {consider the financial condition of patient.}
>> Imaging (x-ray, USG, scan, ECG etc) {consider the financial condition of patient.}

STEP 3: Manage
>>GENERAL:
-rest
-remove the factor that caused the disease.
-assurance
>>MEDICAL
-Analgesic (pain, acute inflammation etc)
-Antibiotic (systemic, local and topical: on the basis of lab finding.)
-Antihistamine (allergy, urticaria, mild hypersensitivity, hyper secretion.)
-Steroid (auto-immune, hypersensitivity, chronic inflammation, atrophy etc.)
-Fluid & electrolyte
-others.

Use of drugs is a bit complicated. Such as, there may be circulatory overload or insufficiency. What you going to do? In case of overload you can find edema, lung crepitations etc. You make the heart to beat slowly, use diuretic (if kidney & liver act normal) and monitor vitals, specially input and output. In case of insufficiency infuse fluid and electrolyte orally or I/V and monitor vitals, input, output. There is so much to write about this. But above mentioned are common.

STEP 4: Surgical Intervention
Only if the pathology is non-responsive to medical treatment or it is not treatable medically.

STEP 5: Follow Up & Re-assess
routine follow-up, re-assessment and re-evaluation is good for both, the patient & the doctor. It helps in better prognosis and necessary early intervention to the things that are going other than the normal track.





Md. Mukit Osman Chawdhury
Sunday, 11 July 2010
Chittagong

Rumors are killers

Seasonal Flu is a common phenomenon. Since ages people are being affected by seasonal flu and the best thing is it heals spontaneously.
The media says now-a-days, 25-90 people are being affected by H1N1 virus (responsible for Swine Flu). But, hey, can you remember of any one affected by this? Rather you can see that people are affected by normal seasonal flu.

What are the Sign and Symptoms????

1. Fever, in various degrees but persistent. Not below 100 degree.
2. Sore throat.
3. Pain all over the body.
4. Running nose.
5. Breathing problem is considered as the sign to differ from other types of flu. Though a person having asthma, may also present with breathing problem.

What to do???

1. Don't panic. Stay calm and quite and observe the situation.
2. This is somewhat hot, humid season going on. So better to stay indoor as long as you can. Because as long as you will be outside, you will be vulnerable to dehydration, electronic imbalance, sun stroke and infections.
3. Take enough rest, water, sleep and food.
4. Maintain personal hygiene.

What if you are affected by any type of Flu????

1. Stay home.
2. Take symptomatic treatment. i mean treatment for fever, running nose, sore throat and body ache.
3. Have adequate amount of food and water. Remember, if your body is weak, you can't resist even the simplest of infections.
4. Don't sneeze or cough over another person.
5. Consult any physician and don't go for any treatment via internet or any other media.

Stay fine and safe. Kill the rumors.