Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Please refer to the full article on Lumbar Puncture for more details on the lumbar puncture procedure. Lumbar puncture is typically performed via “blind” surface landmark guidance. The surface landmark technique is reported to be successful in a high percentage of attempted lumbar punctures; however, surface landmark identification of underlying structures has been shown to be accurate only 30% of the time. [1] Unsuccessful identification of proper landmarks often leads to increased difficulty in obtaining CSF, if the procedure is performed, and a higher rate of complications. Few alternatives are available in these cases. If available, fluoroscopic-guided lumbar puncture may be performed. If not, treatment is sometimes initiated empirically without obtaining CSF. Disadvantages of using fluoroscopy include limited availability or necessary transport of the patient outside of the emergency department, inability to directly visualize the spinal canal, and inherent radiation exposure

A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein. Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters). It is used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.

A tracheotomy or a tracheostomy: is simply an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done in an operating room under general anesthesia. A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. Breathing is done through the tracheostomy tube rather than through the nose and mouth. The term “tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “tracheostomy,” however; the terms are sometimes used interchangeably.

This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. The surgery may be called a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI).

The human heart has four main valves—two on the left and two on the right. The aortic valve is one of the main valves on the left side of the heart. It is the outflow valve for the left ventricle, which means that it is the valve between the heart and the body. The aortic valve opens when the left ventricle squeezes to pump out blood, and closes in between heart beats to keep blood from going backward into the heart.

A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus. Each of your knees has two menisci — C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone. A torn meniscus causes pain, swelling and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully. Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.

Rotator cuff repair is surgery to repair a torn tendon in the shoulder. The procedure can be done with a large (open) incision or with shoulder arthroscopy, which uses small buttonhole-sized incisions.

Cellulitis (sel-u-LIE-tis) is a common, potentially serious bacterial skin infection. Cellulitis appears as a swollen, red area of skin that feels hot and tender. It can spread rapidly to other parts of the body. Cellulitis isn't usually spread from person to person. Skin on lower legs is most commonly affected, though cellulitis can occur anywhere on your body or face. Cellulitis might affect only your skin's surface. Or it might also affect tissues underlying your skin and can spread to your lymph nodes and bloodstream. Left untreated, the spreading infection can rapidly turn life-threatening. It's important to seek immediate medical attention if cellulitis symptoms occur.

Familial Mediterranean fever is an inflammatory disorder that causes recurrent fevers and painful inflammation of your abdomen, lungs and joints. Familial Mediterranean fever is an inherited disorder that usually occurs in people of Mediterranean origin — including Sephardic Jews, Arabs, Greeks, Italians, Armenians and Turks. But it may affect any ethnic group. Familial Mediterranean fever is typically diagnosed during childhood. While there's no cure for this disorder, you may be able to relieve signs and symptoms of familial Mediterranean fever — or even prevent them altogether — by sticking to your treatment plan.

Rotationplasty is a type of autograft wherein a portion of a limb is removed, while the remaining limb below the involved portion is rotated and reattached. This procedure is used when a portion of an extremity is injured or involved with a disease, such as cancer. Typically, the ankle joint becomes the knee joint.

http://dissolve-kidney-stones-fast.info-pro.co/ No-one knows better than me the physical pain and heartache that’s caused by kidney stones. and for many years I was a fellow sufferer of this nasty affliction. I know that many of you are experiencing an attack right now. Let me tell you -I’ve been there lots of times myself. I know what it’s like: the shooting abdominal pain that can last for hours, the nausea, the burning sensation and the constant water infections. Even when you get some temporary relief, you can never really relax. You’re always looking over your shoulder, waiting for those tell tale signs which signify another kidney stone attack on the horizon. You want to just get on with your life. But you can’t. If you’re anything like I was, you’d do anything for a cure. I decided to utilise my research skills to get to the bottom of the problem. This led me on a mission to find a safe, natural and effective method of defeating kidney stones. The good news: I found it. You too can share in this discovery and rid yourself of kidney stones – the natural way. natural remedy brings instant relief finally a permanent cure for kidney stones. click here. http://dissolve-kidney-stones-fast.info-pro.co/

Maybe you're just really eager to get pregnant, or maybe you hope that your baby will be born at a certain time of year. Here are five ways to boost your chances of conceiving quickly – along with tips for a healthy pregnancy and guidelines on when to be concerned about a fertility problem. Tip #1: See your healthcare provider You can lay the groundwork for a healthy pregnancy even before you get pregnant. You're more likely to have a successful pregnancy when your body is up to the task. Schedule a preconception checkup with a doctor or midwife to find out whether you're in your best baby-making shape – and to learn what changes may help. You may not be able to get an appointment right away or resolve any health issues immediately, but taking these steps as soon as possible can help you conceive more easily in the long run. Tip #2: Plan for a healthy pregnancy When you're trying to conceive, eat nutritious foods, maintain a healthy weight, get regular exercise, and try to kick any bad habits (like drinking, smoking, or using drugs). Limit your caffeine intake to less than 200 milligrams a day (about 12 ounces of coffee). Any more than that may contribute to fertility problems. At your preconception appointment, discuss any medications you're taking and find out if they'll be safe to use during pregnancy. You can dramatically reduce the risk of certain birth defects if you begin taking folic acid at least one month before you start trying to conceive. Find out what else you can do ahead of time to give your baby a healthy start. Tip #3: Figure out when you ovulate The biggest secret to getting pregnant quickly is knowing when you ovulate (release an egg from your ovary). You ovulate only once each menstrual cycle, and there are just a few days during that time when it's possible to conceive. Knowing when you ovulate means that you and your partner can time intercourse to have the best chance of getting pregnant that cycle. You can use a few different methods to figure out when you ovulate. Our article on predicting ovulation walks you through them. This ovulation calculator also does the math for you by determining when you're most likely to be fertile. (If you have irregular periods, pinpointing ovulation could be difficult. Ask your provider for advice.) Tip #4: Have sex at the right time Once you know the timeframe your egg is likely to be released from your ovary, you can plan to have sex during your most fertile days, which is usually about three days before ovulation through the day you ovulate. You have a range of days for baby-making sex because sperm can survive for three to six days in your body. (Your egg survives for only about a day.) That means if you have sex on Monday, sperm can survive in your fallopian tubes until Thursday – or even as late as Sunday. If you're not sure when your fertile period will be, just have sex every other day. This means you'll have healthy sperm in your fallopian tubes whenever your egg gets released. (If you want to have sex more often than every other day, that's fine. It won't improve your chances any more, but it won't hurt, either.) Another tip: If you and your partner are waiting to have sex until your most fertile time, make sure you haven't gone through too long of a dry spell beforehand. Your partner should ejaculate at least once in the days just before your most fertile period. Otherwise there could be a buildup of dead sperm in his semen. (Ed. note: Vaginal lubricants including saliva, olive oil, and most water-based lubricants can slow down sperm. Ask your provider to recommend one that's safe to use when trying to conceive. Canola oil can be a good alternative.) Tip #5: Give sperm a boost Sperm have the best shot of fertilizing an egg when they're healthy, strong, and plentiful. Your partner can do several things to help: Cut back on alcohol. Studies show that drinking daily can lower testosterone levels and sperm counts, increasing the number of abnormal sperm. Skip tobacco and recreational drugs. These can cause poor sperm function. Try to maintain a healthy weight. Obesity can lower sperm count and slow down sperm. Get enough of certain key nutrients – like zinc, folic acid, calcium, and vitamins C and D – that help create strong and plentiful sperm. Don't use hot tubs and saunas or take hot baths because heat kills sperm. (Testicles function best at 94 to 96 degrees Fahrenheit, a couple of degrees cooler than normal body temperature.) The sooner your partner can make these changes, the better: Sperm take a while to mature, so any improvements now will yield better sperm specimens about three months from now. How long to try before getting help If you're going to get pregnant naturally, it's very likely to happen within the first six months. About 8 out of 10 couples have conceived by then. After that, how long you should keep trying before you seek help from a fertility specialist depends in large part on your age. Fertility declines as you get older, so if you're age 40 or older, get help from an expert right away. If you're 35 to 40, talk to a specialist after you've tried for six months with no luck. And if you're younger than 35, it's probably fine to keep trying for a year before seeking assistance. Of course, if you know of a reason you or your partner are more likely to have a fertility problem, make an appointment right away. There's no reason to wait in that case.

Can a Vaccine Give Me the Disease It’s Supposed to Protect Me Against?

Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as stomach "flu" viruses that cause diarrhea and vomiting. For most people, influenza resolves on its own. But sometimes, influenza and its complications can be deadly. People at higher risk of developing flu complications include: Young children under 5, and especially those under 2 years Adults older than 65 Residents of nursing homes and other long-term care facilities Pregnant women and women up to two weeks postpartum People with weakened immune systems People who have chronic illnesses, such as asthma, heart disease, kidney disease and diabetes People who are very obese, with a body mass index (BMI) of 40 or higher Your best defense against influenza is to receive an annual vaccination.

The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters).

Chest pain is a frequent complaint of patients seeking urgent medical assistance, and accounts for an estimated 2-4 per cent of all A&E visits in the UK (Becker, 2000). Generally, acute chest pain should be considered cardiovascular in origin until proven otherwise and it is common in clinical practice to err on the conservative or ‘safe’ side when evaluating people with chest pain. Individuals with suspected ischaemic chest pain must be evaluated rapidly for several reasons: - Myocardial ischaemia, if prolonged and severe, can cause myocardial infarction (necrosis); - Treatment strategies that achieve myocardial salvage (thrombolytic therapy or primary coronary angioplasty) are available for patients with acute coronary syndromes and these treatments reduce morbidity and mortality;

More than 1 million Americans suffer a heart attack every year. Traditional symptoms—chest pain or pressure, cold sweat, extreme weakness—are well known. But there are more subtle signs you’re having or are about to have a heart attack that can be easy to miss. If you experience any of the following symptoms, see a doctor. Noticing heart attack signs early and getting prompt treatment can save your life.

Many women with hair loss suffer in silence, altering their hairstyle to hide thinning or patches. But the sooner you seek care, the better the chances of successfully treating it, says Mary Gail Mercurio, MD, associate professor of dermatology at the University of Rochester in Rochester, N.Y. It's not as uncommon as you may think: As many as 5% of women under 30 and 60% of those older than 70 are affected, she says. At the recent meeting of the American Academy of Dermatology in Miami Beach, Fla., Mercurio discussed common forms of hair loss in women and treatment options.

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. The normal level of hemoglobin is generally different in males and females. For men, a normal hemoglobin level is typically defined as a level of more than 13.5 gram/100 ml, and in women as hemoglobin of more than 12.0 gram/100 ml. These definitions may vary slightly depending on the source and the laboratory reference used. Continue Reading