Happy birthday

Today is my younger daughter's birthday.(but it's busy today so we held the birthday party last Saturday.) Her present was Korirakkuma?


Last night it was a little hard because a Pt of Lithium poisoning came in 1:00 am and we had to care her till morning (include hemodialysis). I fell asleep just after coming home. So I couldn't make an enough time to run.


Today's training: 8km run
monthly mileage for November 134km


Today's one point emergency medicine(from today I'll begin one point lecture of ER!!)
" Lithium poisoning"
Lithium carbonate is an effective drug in the treatment of manic depressive illness. However, it may induce multisystem dysfunction which, if not recognized, may be fatal. Findings that may be observed include neuromuscular disorder, seizures,coma and so on. Many text book tell that the plasma lithium concentration is a good parameter of clinical course and treatment,but in most hospitals like us they can't get the result of the plasma concentration timely. So we have to decide how to treat it in terms of clinical presentation.The most difficult point is to decide whether to do Hemodialysis or not. Lithium is the most dialyzable toxin known.