舌動脈血栓塞栓症/医療ドラマも役に立つ
・NEJMのIMAGES IN CLINICAL MEDICINEに標題のようなレポートがありました↓
Lingual-Artery Thromboembolism
Robert Humphries, Malcolm Cameron
N Engl J Med 2021; 385:6 July 1
・患者さんの舌が写真のようなら、塞栓を鑑別診断にあげること、当然全身をきちんと診て何か基礎疾患がないか確認することですね。
以下日記
・本日7/11（日）はお休み。ゆっくりと７時３０分起床です。午前中は、認知症サポーター医の研修会のための事前e-ラーニング。受講までに370分のビデオの視聴とテストがありましたが、本日なんとか終えられました。その後来週火曜日のCritical Appraisalの論文読みました。Interrruptede Time Series Studyを使った論文、日本語では分割時系列分析ですね。お昼は冷凍食品のイタリアン。日清製粉グループの製品でしたが、結構おいしかったです。午後からは、「医療疫学講習会」の事前eラーニングを２時間視聴。実は講習会は終わっており、事後に観ました。１７時から１９時３０分まで久々に長時間の草刈り、草抜き。その後入浴、夕食。で、たまたまTVで『TOKYO MER～走る救急救命室～』の第２話を最初の１５分くらい観ました。
そもそもどういう背景のドラマか知りませんが、最初が鉄骨がぶら下がっている下で救命処置をしている場面。そこからしてあり得ないと思いましたが、Chest tubeをいれる場面。そこまでせんでもとりあえず穴開けるだけでエエやろと思いました。（意見は分かれるでしょうね）で、最低なのは中条あゆみ（という女優さん？知らんけど）が演じる研修医。話になりません。ここで、話にならないと思ったのは、まずこのような研修医を配置したことが組織上の問題。（そもそもドラマの背景知らんけど、できない研修医を配置する場所なら納得）で、患者の前で指導医に治療方針に異議を唱える。（異議をとなえるのはよいけど、患者のいないところでしようね）まあ、あり得ない設定だったのですが、ここで一つ勉強になりました。研修医にもノンテクニカルスキルや組織のマネジメント、フォロアーシップをきちんと教えること。単に診断や治療・手技だけはだめだなとあらため思いました。そういう意味ではたった１５分間観ただけでしたが、私には頭のなかにあった問題意識をこのように言語化できてよろしかった。８月になったら研修医がくるので、講義を何コマ担当しますが、ノンテクニカルスキルを講義しようと思います。
・さて、これからDVDで『スパイ大作戦』を観て寝るとします。
2021-07-11 21:52
nice!(0)
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