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Watch as Dr. Benjamin Carson performs risky brain surgery on young Payton to remove a brain tumor. Dr. Carson, director of pediatric neurosurgery, is just one of the many reasons why Johns Hopkins Children's Center was recently ranked #1 in neurology and neurosurgery in America's Best Children's Hospitals 2008
Symptoms of serotonin syndrome include a classic triad of mental status changes (eg, anxiety, delirium, confusion, restlessness), autonomic dysregulation (eg, diaphoresis, tachycardia, hypertension, hyperthermia, diarrhea, mydriasis), and neuromuscular hyperactivity (eg, hyperreflexia, tremor, rigidity, myoclonus, ocular clonus). Serotonin syndrome is clinically diagnosed and laboratory tests are used to rule out other etiologies. It usually occurs due to inadvertent interactions between drugs, therapeutic use of multiple serotonergic agents, or serotonergic medication overdose. Treatment involves discontinuation of serotonergic drugs, supportive measures, and sedation with benzodiazepines. In severe cases, a serotonin antagonist (cyproheptadine) may be used.
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What does a fistula for dialysis look like?
A fistula for dialysis is a surgical connection between a vein and an artery.
In this video, I will show you a real fistula and how we should evaluate it before a dialysis connection.
Additional videos:
💉How to properly cannulate a fistula: https://youtu.be/IqoHnzFyhJQ
💉 What is a fistula for dialysis treatment: https://youtu.be/B5EEf-MklFk
💉 The 10-second assessment for fistulas: https://youtu.be/Uqo0LhjZSI8
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Additional resources:
What Does a Healthy AV Fistula Look Like? | Azura Vascular ...
www.azuravascularcare.com infodialysisaccess healt...
Jul 17, 2018 — An AV fistula is a surgically-created permanent access located under the skin, making a direct connection between a vein and an artery. An AV fistula is typically created in the non-dominant arm. If the veins in your arm are not large or healthy enough to support a fistula, it may be created in your leg.
Preparing for Dialysis (AV Fistula) Fact Sheets Yale ...
www.yalemedicine.org › conditions › preparing-dialysi...
To undergo dialysis, patients need a surgical procedure to create an access point for the dialysis machine. An AV fistula is the most common access point.
Vascular Access for Hemodialysis - Life Options
lifeoptions.org living-with-kidney-failure vascular-a...
Jump to How a Catheter Looks and Feels — This makes a pattern that looks a bit like a rope ladder. The next best way—for fistulas ONLY—is the “Buttonhole ...
Fistula or Graft Surgery · Needle Fear · How a Fistula or Graft Looks...
Taking Care of Your Fistula - DaVita
www.davita.com dialysis preparing-for-dialysis › ta...
An arteriovenous (AV) fistula is a type of access used for hemodialysis. ... access because it utilizes the patient's own vessels and does not require permanent placement of foreign materials such ... Look for redness or swelling around the fistula area. ... This sound may change from a whooshing noise to a whistle-like sound.
Vascular Access for Hemodialysis - Department of Surgery
surgery.ucsf.edu conditions--procedures vascular-ac...
The patient does not need anesthesia for this procedure. ... A vascular surgeon performs AV graft surgery, much like AV fistula surgery, in an outpatient center or ...
Frequently Asked Questions about Dialysis Access Surgery ...
www.bidmc.org transplant-institute frequently-aske...
Dialysis access surgery creates the vascular opening so a needle can be inserted for ... fluid and to correct electrolytes like potassium, sodium, phosphate and calcium, to name a few. ... Where are AV fistulas located and how long do they last?
Fistula and Graft Placement (Eric K. Peden, MD) - YouTube
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Mar 28, 2016 — ... Bootcamp 2015 August 14 - 16, 2015 "Dialysis Access" Fistula and Graft Placement (Eric K. Peden, MD) DICET@Houstonmethodist.org.
Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.
A young patient undergoes state of the art robotic surgery for Ovarian Cancer and Endometrial Cancer in Chicago, IL. The surgery is performed by noted gynecologic oncologist and expert robotic surgeon M. Patrick Lowe MD. Dr Lowe has been performing robotic surgery since 2006 and is one of a few gynecologic oncologist in the United States who utilizes robotics for ovarian cancer.
A brain (cerebral) aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. In most cases, a brain aneurysm causes no symptoms and goes unnoticed. In rare cases, the brain aneurysm ruptures, releasing blood into the skull and causing a stroke. When a brain aneurysm ruptures, the result is called a subarachnoid hemorrhage. Depending on the severity of the hemorrhage, brain damage or death may result. The most common location for brain aneurysms is in the network of blood vessels at the base of the brain called the circle of Willis. What causes a brain aneurysm? A person may inherit the tendency to form aneurysms, or aneurysms may develop because of hardening of the arteries (atherosclerosis) and aging. Some risk factors that can lead to brain aneurysms can be controlled, and others can't. The following risk factors may increase your risk for an aneurysm or, if you already have an aneurysm, may increase your risk of it rupturing: Family history. People who have a family history of brain aneurysms are more likely to have an aneurysm than those who don't. Previous aneurysm. People who have had a brain aneurysm are more likely to have another. Gender. Women are more likely to develop a brain aneurysm or to suffer a subarachnoid hemorrhage. Race. African Americans are more likely than whites to have a subarachnoid hemorrhage. High blood pressure. The risk of subarachnoid hemorrhage is greater in people who have a history of high blood pressure. Smoking. In addition to being a cause of high blood pressure, the use of cigarettes may greatly increase the chances of a brain aneurysm rupturing.
Cholestatic liver disease is a condition that results from an impairment of bile formation or bile flow to the gallbladder and duodenum (first section of the small intestine). ... The effects of cholestasis are profound and widespread, leading to worsening liver disease and systemic illness.
When foreign organisms such as bacteria enter the body, the immune system sends white blood cells to fight the infection. This causes swelling (inflammation) at the site of infection and the death of nearby tissue, creating a hole called a cavity, which fills with pus to form an abscess.
Johns Hopkins Children’s Center Surgeon-in-Chief David Hackam provides information about general pediatric surgery and when it is time to see a general pediatric surgeon. #PediatricSurgery #JohnsHopkins
For more information on general pediatric surgery at Johns Hopkins Children's Center, visit https://www.hopkinsmedicine.or....g/johns-hopkins-chil
FAQ's
0:02 What is a general pediatric surgeon?
0:31 When is it time to see a pediatric surgeon?
1:02 What are some of the most common surgical problems seen by general pediatric surgeons?
1:43 Describe research being done in the field.
2:15 Why choose Johns Hopkins Children's Center for general pediatric surgery?