Một phác đồ tiếp cận chẩn đoán và điều trị điếc đột ngột

Theo nguồn từ Abushara.com,

Được share từ Prof. Abushara, Kuwait.

*THE CASE IS CONSIDERED AS [SSNHL] IF DEAFNESS TO OCCUR UP TO OVER 3 DAYS.
*TREATMENT COULD BE INITIATED UP TO A PERIOD OF 2 WEEKS FROM PRESENTATION.
*FOLLOW UP AUDIOGRAMS AFTER TREATMENT AND AFTER 1, 2, 4, 6 WEEKS. FROM DISCHARGE.
=======…============================================================================

NAME: AGE: SEX:
NATIONALITY: OCCUPATION:
DATE OF ADDMISSION: FILE NUMBER:
WARD: PHONE:
===================================================================================
PRESENTATION AND HISTORY:

ONSET: DURATION: UNI OR BILATERAL:
TINNITUS: VERTIGO: HIST. OF URTI:
RELATED DRUG INTAKE: ACOUSTIC TRAUMA:
HEAD TRAUMA:
ANY NEUROLOGICAL SYMPTOMS: BAROTRAUMA:

===================================================================================
PAST HISTORY:

PREVIOUS ATTACK:
D.M.: HYPERTENSION:
BLOOD DISEASE: PREVIOUS ILLNESS:
PREVIOUS SURGERIES (WITH DATE):

===================================================================================

FAMILY HISTORY FOR HEARING LOSS:

===================================================================================
EXAMINATION:

GATE: NYSTAGMUS:
POSITIONAL TEST:
OTOSCOPY:
TUNNING FORK TESTS:
CRANIAL NERVES:

===================================================================================
INVESTIGATIONS:
URINE ROUTINE:
CBC: WBC: HB% S. IRON:
AUDIOGRAM:
ACOUSTIC REFLEXES:
SISI:
TONE DECAY:
X-RAY: CERVICAL SPINE:
IAM:
C.T. AND BERA IN SUSPICIOUS CASES:

===================================================================================
TREATMENT:

*REASSURANCE AND DISCUSSION OF TREATMENT.

*CHECK FOR ANY CONTRAINDICATIONS TO CORTICOSTEROIDS, DEXTRAN, OR CARBOGEN.

START:

=HYDROCORTISONE 50-200 mg I.M OR I.V
=PREDNISOLONE 5 mg TABLETS 2X4X4 1X4X3 1X3X3 1X2X2 1X1X2
=STUGERON 75 mg / DAY
=DUXIL TAB 1X2.
=DEXTRAN ONE PINT IN 5 % GLUCOSE I.V ONCE DAILY OVER 8 HOURS RUN TIME.
=PATIENT TO BE ASSESSED BY ANAETHETIST FOR CARBOGEN INHALATION.
4 SESSIONS EACH ONE IS FOR TWO HOURS WITH 4 HOURS REST IN-BETWEEN.
IN EVERY SESSION THE PATIENT RECEIVED 8 LITTERS OF CARBOGEN [5% CO2]
VIA A MASK WITH MONITORING AND IMMEDIATE XYLOCAIN I. V INJECTION IF ANY ARRHYTHMIA TO OCCUR.

 

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