Obstructed inguinal hernia
Protocols
Clinical Features:
- 1)acute pain that comes on suddenly and may get more severe.
- 2)bloody stools.
- 3)constipation.
- 4)darkening or reddening of the skin over the 5)hernia.
- 6)fatigue.
- 7)fever.
- 8)inability to pass gas.
- 9)inflammation or tenderness around the hernia.
Investigation :
- 1)CBC
- 2)Usg of W/A
- 3)X-ray abdomen
- 4)CT scan abdomen
Rx:
- Bed rest
- Diet: NPO TFO
- NG Suction - 2 hourly
- Continuous Catheterization
1. Inf Hartsol ([post
id="506" title="Hartmann"]) (2L)+5% DNS (1L)
- I/V@30 d/min
2. Inj. Ceftron([post
id="398" title="Ceftriaxone"]) (1gm)
- 1 vial ...I/V..... BD
3. Inj. Filmet([post
id="406" title="Metronidazole"]) (500mg/100ml)
- 1 bag/bottle... I/V .......TDS
4. Inj. Maxpro([post
id="392" title="Esomeprazole"]) (40mg)
- 1 vial ........I/V ..........BD
5.Inj. Torax ([post id="450"
title="Ketorolac"])(30mg)
- 1amp 1/M
........stat& sos
if Severe pain
Inj.Nalbun-2([post id="457"
title="Nalbuphine"])
1 ample .I/M .......stat
+(plus)
Inj. Vergon([post id="505"
title="Prochlorperazine"] (12.5mg)
- 1 amp I/M- stat & sos
If Vomiting
Inj.Emistat([post id="509"
title="ondansetron"])
- 1 ample I/V stat & sos
6. Monitor vitals sign
7.Follow-up
Pre-Operative Order:
1.Diet: NPO ,TFO
2. Inf. Hartman solution ([post id="506" title="Hartmann"])(1000ml)
- ……10-20 drop/min
3.Inj.Ceftron([post id="398" title="Ceftriaxone"]) (1gm)
- … 1 vial I/V ….stat
4. Inj.Sergel ([post id="392" title="Esomeprazole"])(40mg)
- …1 vial I/V stat
5.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)
- ….1 ample I/M OR I/V stat & SOS
6.Clean the operative area .
7.send the patient OT table 30 min before operation .
8. Counsel the patient party & written consent must be taken.
Post Operative Order:
1.Diet: NPO, TFO(Till further order)
2.Inf.Hartman ([post id="506" title="Hartmann"])(1L) +
Inf.5%DNS([post id="510" title="DNS"])(1L) +
Inf.5%DA ([post id="511" title="Dextrose "])(1L)- ….I/V 30 drop/min.
3. Inj.Ceftron([post id="398" title="Ceftriaxone"]) (1gm)- … 1 vial I/V ….BD
4. Inj.Sergel ([post id="392" title="Esomeprazole"])((40mg)- …1 vial I/V ….BD
5.Inj.Filmet([post id="406" title="Metronidazole"])(500mg/100ml)- …1 bottle I/V….stat.& TDS
6.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)- ….1 ample I/M OR I/V stat & TDS
OR
Inj.Anadol([post id="453" title="Tramadol"]) (100mg/2ml)- ….1 ample I/M OR I/V stat & TDS
7.Nalbun-2([post id="453" title="Tramadol Hydrochloride"])- …1 ample I/M stat
OR
Inj.G-Pethidine([post id="456" title="Pethidine"](100mg/2ml)- …..1 ample I/M stat
With
Inj.Vergon([post id="453" title="Tramadol"]) (12.5mg/ml)- …1 ample …I/M stat
8.Voltaline ([post id="448" title="Diclofenac"])suppository (50mg)- ….1 stick Per rectal –SOS
9.Monitor all Vitals…any abnormality then call doctor
Fresh Order :
1. Diet: Sips of water → Liquid to soft Then Normal.
2. Inj. Ceftron 2gm/Ceftriaxone
- 1 vial I/V ....Daily
3. Tab. Filemet 400mg/Metronidazole
- 1+1+1
4.Tab. Torax 10mg/Ketorolac
- 1+1+1..... (A/M)
5. Cap. Nexcap 20mg/esomprazole
- 1+0+1 (B/M)
6.Tab. Ceevit 250 mg/vit-C
- 1+0+1
7.Supp. Voltalin 50mg/Diclofenac
- 1 stick P/R sos
- Continious Catheterization 3 days.
- Keep Drain Tube untill collection is nill.
If Constipation:
Syp. Avolac/Lactulose
- 4 চামচ..... ৩ বার
If constpation not relief:
Supp. Glysup 2.3 mg
- 4 stick P/R stat & sos
Discharge
Treatment:
1.Cap.Denver([post id="399"
title="Cefixime"]) (200mg)
- 1+0+1……...7 days
2. Tab.Fimet ([post id="406" title="Metronidazole"]) (400mg)
- 1+1+1………..5 days
3.Cap.sergel ([post id="392"
title="Esomeprazole"]) (20mg)
- 1+0+1………..14 days
4.Tab.Rolac([post id="450" title="Ketorolac"]) (10mg)
- 1+0+1(after meal) ….5 days
5.Tab.Rivotril([post
id="474" title="Clonazepam"]) (0.5mg)
- 0+0+1……..15 days
6.Tab.CEEVIT([post id="466"
title="Ascorbic"] Acid)(250mg)
- 1+0+1……...10 days
7.Tab.Xinc-OT([post id="470"
title="Zinc"])
- 1+0+1…………1 month
উপদেশঃ
- ১ মাস বিশ্রামেে থাকবেন।
- ১ মাস কোন ভারী কাজ করবেন না।
❣️❣️নিরবতা এক ধরনের অলস্কার যা মহিলাদের জন্য অত্যন্ত শোভনীয়-হেনরীডেজন।❣️❣️