This week I spent my time among PICU, CT scanning room, MRI
scanning room, and radiology reading room. This Thursday happened to be a big
day for MRI in PICU. Totally 3 patients were scanned. I shadowed them all the
way from PICU to MRI. One of the patients, a 7-year-old girl, had a brain tumor
removal surgery that Wednesday. MRI was performed as a post-surgery checkup.
Similar to many other pediatric patients, she was sedated during MRI. The drug
used was propofol. Propofol is a short-acting, IV administrated hypnotic agent.
It has very unique milk like appearance. Induction of anesthesia is rapid and ‘clean’,
meaning fast acting upon administration and rapid recovery upon removal. These
properties were well evidence in this case. The patient passed out in a few
seconds after the initial bolus and recovered in less than 2 minutes upon drug
removal. However, the initial compact of the drug was immense. The patient
experienced pain on injection. This was not the pain from the needle insertion but
the drug itself. In addition, the patient stopped breathing for about 30 second
upon administration. Her oxygen saturation dropped briefly below 80. Oxygen
mask was used immediately to recover the oxygen level. I talked to the nurse
afterwards. She said that propofol might weaken or stop patients’ breath during
initial injection. So some oxygen countermeasure must be used. In addition,
propofol has no pain relief effects. So it is very good in some situations, but
very limited in others.
Friday I saw an interesting case in PICU. An 11-year-old
girl had an unknown viral infection. She had a fever for 3 days. Average
resting heart rate was 130 bpm, almost double the normal resting heart at her
age. She also experienced muscle pain through her body. Doctors had no clues what type of virus it was. However, given that she has been to the US for
just 2 years there were good chances that she had viral infections that more
frequently happened in younger child due to the lack of immunity. In addition,
she looked uncomfortable but not toxicated. It implied that it was not life
threatening at the moment. Therefore, until the test results are back, doctors
only recommended supportive care.
How to connect the parts together from Solidworks?
ReplyDeletesolidworks 2012