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EART (Health Education and Rescue Training) Wilderness First Aid is an intensive course that covers patient examination and evaluation, body systems and anatomy, wound care, splinting, environmental emergencies, and backcountry medicine. Hands-on simulations provide first-hand training in treating patients. This is an excellent course taught by experienced Wilderness First Responders and Emergency Medical Technicians and is highly recommended to all wilderness travelers. People who pass the courses will receive a Wilderness First Aid certification from the Emergency Care and Safety Institute (ECSI) which is good for 2 years. Participants who successfully pass CPR and HEART Wilderness First Aid will have met the First Aid requirements for OA Leader Training.
The objective of carotid endarterectomy (CEA) is to prevent strokes. In the United States, stroke is the third leading cause of death overall and the second leading cause of death for women.[1] Among patients suffering a stroke, 50-75% had carotid artery disease that would have been amenable to surgical treatment. Several prospective randomized trials have compared the safety and efficacy of CEA with those of medical therapy in symptomatic and asymptomatic patients. Data from these prospective trials have confirmed that CEA offers better protection from ipsilateral strokes than medical therapy alone in patients presenting with either symptomatic or asymptomatic carotid artery disease.
Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease Smoking is the leading cause of emphysema. Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream. When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.
Complications. Mechanical ventilation is often a life-saving intervention, but carries potential complications including pneumothorax, airway injury, alveolar damage, and ventilator-associated pneumonia. Other complications include diaphragm atrophy, decreased cardiac output, and oxygen toxicity.
In this instructional video, Director of Critical Care Nephrology, Sevag Demirjian, MD goes over the steps for in-hospital production of ultra-pure continuous hemodialysis fluid.
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The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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During the examination, the doctor gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area. A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland .