Acute Diarrhea

• History：
• Travel: E. coli, parasites
• 生海鮮：Vibrio sp.
• 不熟的絞肉（漢堡）：E. coli O157:H7
• 生豬肉：Campylobacter, Salmonella
• Abx: C. difficile
  
• Work up首先看有無：
• severe dehydration
• fever
• 持續>5天
• mucus, pus, blood
• abdominal pain
• 最近用抗生素

Spleen trauma grading

參考：emedicine

• Grade I:
• subcapsular hematoma < 10% 表面積
• Capsular tear 深度 < 1 cm
• Grade II:
• Subcapsular hematoma 10~50 % 表面積
• Intraparenchymal hematoma 直徑 < 5cm
• Laceration 深度1~3 cm，無trabecular vessel involvement
• Grade III:
• Subcapsular hematoma > 50 % 表面積，或expanding and ruptured subcapsular / parenchymal hematoma
• intraparenchymal hematoma > 5 cm 或expanding
• Laceration 深度> 3 cm或involve到trabecular vessel
• Grade IV:
• Laceration involve到segmental 或hilar vessels + > 25% devascularization
• Grade V:
• Shattered spleen or hilar vascular injury

Liver trauma grading

參考: emedicine

• Grade 1:
• subcapsular hematoma < 1 cm thickness
• capsular avulsion
• superficial parenchymal laceration < 1 cm deep
• isolated periportal blood tracking
• Grade 2:
• Parenchymal laceration 1~3 cm deep
• Parenchymal / subcapsular hematoma 1~3 cm thickness
• Grade 3:
• Parenchymal laceration > 3 cm deep
• parenchymal / subcapsular hematoma > 3 cm in diameter
• Grade 4:
• Parenchymal / subcapsular hematoma > 10 cm in diameter
• lobar destruction or devasculariation
• Grade 5:
• Global destruction or devascularization of the liver

兒急小攻略

(轉錄自ptt2 bhboy板，原作者： bhboy)
(限intern,clerk等半專業人士使用XD，感謝R3文發學長等教學，還有survival guide)