1、医学查房-床边教学模式杨明山BED SIDE TEACHINGContents 1.一条路线一条路线2.二个功能二个功能3.三个等级三个等级4.四个入口四个入口5.五个程序五个程序6.六个人物六个人物7.七个思路七个思路8.八个业务八个业务1.Significance-bilingualism2.Functions3.Tertiary system ground l 一级查房：经治医师查房，分晨、午、晚三次。普查全组病人，为“医患对话”。l 二级查房：主治医师查房，外称 Teaching Attending Rounds，每天一次。轮流检查所辖各组病人，除医患对话，尚需“医医对话”。大查房：g
2、reat rounds 英美普及，除本科室外，其他相关科室均参加，国内称大型会诊讨论。4.Functions 纠错纠错Missing 病史不全病史不全 Have you noticed his light color of his stool?Uh,Im sorry I havent.Mistakes 检查不规检查不规 Dr Li,is there any rales that you heard in this patient?I heard no rales in this patient.Please listen to it again.Can you hear fine moist
3、rale?Yes,I got it.lD:Why didnt you hear it?(No response)You only paid attention to the front chest and neglect the auscultation on base of the back.Misdirect 诊断不清诊断不清 Is it necessary for us to do a liver biopsy?Maybe its unnecessary.Sorry.You should answer me its necessary because the confirmed diag
4、nosis of hepatic lesion often depends on the liver biopsyin addition to ultrasound.However it will be decided by the director.Misdeal 治疗不当治疗不当 I assume that you blocked the neurogenic phase with atropine.How did you block the hormonal phase?I put down a Levin tube,and the patient on constant gastric
5、 suction.This will keep the gastric contents from entering the duodenum and the production of secretin,which,in turn,would increase the liberation of pancreatic enzymes,thus adding to the insult.5.procedures 6.figuresl Director 主任主任 l Visiting physician 主治医师主治医师l Chief resident 住院总医师住院总医师 l Residents 住院医师住院医师l Interns 实习医师实习医师 l Patient 病人病人 Requirements for playTHANK YOU
