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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
Interventional Nephrology is a new and emerging subspecialty of Nephrology that mainly deals with ultrasonography of kidneys and ultrasound-guided renal biopsy, insertion of peritoneal dialysis catheters, tunneled dialysis catheters as a vascular access for patients undergoing hemodialysis as well as percutaneous ...
Mastectomy is surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer. For those with early-stage breast cancer, mastectomy may be one treatment option. Breast-conserving surgery (lumpectomy), in which only the tumor is removed from the breast, may be another option.
Superior vena cava syndrome (SVCS) is obstruction of blood flow through the superior vena cava (SVC). It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. A patient with SVCS requires immediate diagnostic evaluation and therapy.
It involves placing a small, expandable tube called a stent in the narrowed artery. This procedure is also called carotid angioplasty and stenting. There are two carotid arteries-one on each side of the neck-that supply blood to the brain. These arteries can be narrowed and damaged by fatty deposits called plaque.
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Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a child in frustration or anger, often because the child won't stop crying. Permanent brain damage or death may result. Symptoms include irritability, difficulty staying awake, seizures, abnormal breathing, poor eating, bruises, and vomiting. Treatment will vary depending on complications related to shaken baby syndrome. In rare instances, breathing support or surgery may be needed to stop bleeding in the brain.
A liver abscess is a pus-filled mass inside the liver. Common causes are abdominal infections such as appendicitis or diverticulitis due to haematogenous spread through the portal vein. A pyogenic liver abscess (PLA) is a pocket of pus that forms in the liver in response to an infection or trauma. Pus is a fluid composed of white blood cells, dead cells, and bacteria that forms when your body fights off infection.Dec 11, 2015
The gastric balloon procedure (endoscopic intragastric balloon) leaves an inflated silicon balloon in the stomach for 6 months, making less room for food. As a result, patients: Feel full sooner while eating and therefore eat less. Lose about 30% of their excess weight in 6 months.
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This video: The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins (hemorrhoids) can develop from an increase in pressure in the lower rectum. Factors that might cause increased pressure include: Straining during bowel movements.
Management of postpartum hemorrhage at vaginal delivery. The approach to treatment of postpartum hemorrhage (PPH) differs somewhat depending on the cause and whether hemorrhage occurs after a vaginal birth or after a cesarean delivery.
A simple continuous stitch can be a useful technique for skin closure when speed is important, e.g. closing a scalp laceration on a screaming child. The simple running, or continuous suture, is begun in the same way as a simple interrupted suture.
Blind loop syndrome (BLS), commonly referred to in the literature as small intestinal bacterial overgrowth (SIBO) or bacterial overgrowth syndrome (BOS), is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological ...