At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for

FemTouch Vaginal Rejuvenation Laser

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

Funny Video from hospital waiting room

Ellis demonstrates how to connect an NG tube to suction.

#NCLEX #ClinicalSkills #HESI #Kaplan #ATI #NursingSchool #NursingStudent⁠ #Nurse #RN #PN #Education #LVN #LPN #NurseEducator

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🗂️ Our Ultimate Nursing School Survival kit is your number 1 resource to get through nursing school and to pass the NCLEX. Whether you're just starting school or you’re already prepping for the NCLEX, this bundle of flashcards is the best you can buy. It covers all the information you need to know to pass all your exams and it has FREE shipping!
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All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.

An appendectomy (sometimes called appendisectomy or appendicectomy (British English)) is the surgical removal of the vermiform appendix. This procedure is normally performed as an emergency procedure, when the patient is suffering from acute appendicitis. In the absence of surgical facilities, intravenous antibiotics are used to delay or prevent the onset of sepsis; it is now recognized that many cases will resolve when treated perioperatively. In some cases the appendicitis resolves completely; more often, an inflammatory mass forms around the appendix, causing transruptural flotation. This is a relative contraindication to surgery.

The gold standard treatment for bladder outlet obstruction.This is an endoscopic procedure in which a resectoscope is placed transurethrally and the obstructing lobes of the prostate are removed as chips of tissue. TURP results in improvement of flow rate, and symptom scores are superior to that of other minimally invasive therapies

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage. Many women have uterine fibroids sometime during their lives. But most women don't know they have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

http://www.utexas.edu

Nursing students practice their skills on mannequins and each other in the Nursing Skills Lab.

Ellis demonstrates how to insert and then remove an NG tube. This includes drawing gastric residual and checking the pH. After the demonstration, Ellis provides additional tips about clamping the NG tube and using the blue pigtail.

Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.

#NCLEX #HESI #Kaplan #ATI #NursingSchool #NursingStudent⁠ #Nurse #RN #PN #Education #LVN #LPN #ClinicalSkills #NGTube #nurseeducator

00:00 What to expect
00:30 Preparing NG tube patient
00:56 Preparing NG tube equipment
1:29 Measuring the NG tube
2:02 Preparing for NG tube insertion
2:28 Inserting the NG tube
3:17 Checking placement with pH
4:23 Anchoring with split-tape
5:32 Connecting to suction
6:05 Disconnecting from suction
6:17 What to do before removal?
7:03 Removing NG tube
7:40 Additional tips on clamping
8:31 The blue pigtail

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👇👇👇👇👇👇👇👇👇👇
👉 https://bit.ly/clinicalnursingskills 👈
☝️👆☝️👆☝️👆☝️👆☝️👆

This is your one-stop-shop for materials to help you LEARN & REVIEW so you can PASS Nursing School.

🤔🤔🤔 DO YOU WANT TO PASS your classes, proctored exams and the NCLEX? 🤔🤔🤔 Our resources are the best you can buy. They are built with a single goal: help you pass with no fluff. Everything you need, and nothing you don’t. Don’t take our word for it, though! Check out our hundreds of ⭐️⭐️⭐️⭐️⭐️ reviews from nurses who passed their exams and the NCLEX with Level Up RN.

🗂️ Our Ultimate Nursing School Survival kit is your number 1 resource to get through nursing school and to pass the NCLEX. Whether you're just starting school or you’re already prepping for the NCLEX, this bundle of flashcards is the best you can buy. It covers all the information you need to know to pass all your exams and it has FREE shipping!
➡️ https://bit.ly/TUNSSK ⬅️

L👀king for EVEN MORE resources to survive Nursing School? Make your Nursing School experience your own! Life’s difficult enough—learning shouldn’t be.
🪅 Games https://nursesquad.com
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📅 Organizational tools https://bit.ly/OrganizingSchool

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All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.

Ellis demonstrates how to clean a reusable inner cannula, care for a tracheostomy site, and suction a tracheostomy.

Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.

#ClinicalSkills #NCLEX #tracheostomy #patientcare #ATI #Kaplan #LVN #PN #RN #nurseeducator #nurse #nursingstudent #murse #clinicals #clinicalnursingskills

00:00 What to expect Tracheostomy Care and Suctioning
0:33 Explaining the process Tracheostomy Care and Suctioning
1:10 Positioning patient for a Tracheostomy Care and Suctioning
1:33 Opening tray
1:46 Pouring saline
1:58 Removing inner cannula
2:14 Removing clean gloves
2:25 Donning sterile gloves
3:16 Showing tray contents
3:53 Removing previous dressing
4:06 Pouring saline
4:27 Cleaning stoma
5:10 Cleaning faceplate
5:20 Drying site
5:30 Cleaning inner cannula
6:00 Drying inner cannula
6:20 Reinserting inner cannula
6:40 Placing new gauze
7:00 Replacing ties
8:00 Replacing oxygen
8:13 Preparing for suction
8:58 Checking suction
9:30 Opening saline
9:42 Opening kit
9:58 Donning sterile gloves
11:04 Setting up saline container
11:20 Pouring saline
11:52 Connecting catheter to suction
12:46 Inserting catheter
13:10 Removing catheter
13:24 Rinsing catheter
13:40 Reoxyginating
14:05 Reinserting catheter
14:17 Removing catheter
14:29 Rinsing catheter
14:44 Reoxyginating
14:55 Cleaning up
15:09 Chatting about sterility
17:00 Checking a tie

🚨 Reminder: shipping deadlines are looming 👀
🎁 Regular Shipping: Order by Friday, December 15
🚀 Expedited Shipping: Order by Monday, December 18
🔍 Still searching for last-minute gifts? Consider a Level Up RN Gift Card! 💌 It’s not only a thoughtful present but also the perfect way to share treasures like Pharmacology Flashcards OR digital treasures like Flashables Digital Nursing Flashcards & the Level Up RN membership. Give the gift of knowledge this holiday season! 🧠⚡️💖 bit.ly/LevelUpRNGC

🚪 Access our Cram Courses, Quizzes and Videos all in one ad free space with Level Up RN Membership https://bit.ly/LevelUpRNMembership

Want more ways to MASTER Clinical Skills? Check out our flashcards & videos!

👇👇👇👇👇👇👇👇👇👇
👉 https://bit.ly/clinicalnursingskills 👈
☝️👆☝️👆☝️👆☝️👆☝️👆

This is your one-stop-shop for materials to help you LEARN & REVIEW so you can PASS Nursing School.

🤔🤔🤔 DO YOU WANT TO PASS your classes, proctored exams and the NCLEX? 🤔🤔🤔 Our resources are the best you can buy. They are built with a single goal: help you pass with no fluff. Everything you need, and nothing you don’t. Don’t take our word for it, though! Check out our hundreds of ⭐️⭐️⭐️⭐️⭐️ reviews from nurses who passed their exams and the NCLEX with Level Up RN.

🗂️ Our Ultimate Nursing School Survival kit is your number 1 resource to get through nursing school and to pass the NCLEX. Whether you're just starting school or you’re already prepping for the NCLEX, this bundle of flashcards is the best you can buy. It covers all the information you need to know to pass all your exams and it has FREE shipping!
➡️ https://bit.ly/TUNSSK ⬅️

L👀king for EVEN MORE resources to survive Nursing School? Make your Nursing School experience your own! Life’s difficult enough—learning shouldn’t be.
🪅 Games https://nursesquad.com
💻 Digital resources https://bit.ly/NursingStudyCourses
📅 Organizational tools https://bit.ly/OrganizingSchool

✨Want perks? Join our channel!
https://youtube.com/leveluprn/join

🏷 Head to https://leveluprn.com/specials for all our latest deals!🥳️

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➡️ https://leveluprn.com/signup ⬅️

⚕ 👩 LEVEL UP NURSE SQUAD 👩⚕️
All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.

Hypertensive emergencies encompass a spectrum of clinical presentations in which uncontrolled blood pressures (BPs) lead to progressive or impending end-organ dysfunction. In these conditions, the BP should be lowered aggressively over minutes to hours. Neurologic end-organ damage due to uncontrolled BP may include hypertensive encephalopathy, cerebral vascular accident/cerebral infarction, subarachnoid hemorrhage, and/or intracranial hemorrhage.[1] Cardiovascular end-organ damage may include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary edema, and/or aortic dissection. Other organ systems may also be affected by uncontrolled hypertension, which may lead to acute renal failure/insufficiency, retinopathy, eclampsia, or microangiopathic hemolytic anemia.[1] With the advent of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to approximately 1% of patients with hypertension.[2] In addition, the 1-year survival rate associated with this condition has increased from only 20% (prior to 1950) to a survival rate of more than 90% with appropriate medical treatment

Perdre Du Poids, Perte De Poids Rapide, Perdre Son Ventre, Pilule Pour Maigrir, Soupe Minceur ---- http://perte-poids-rapide.info-pro.co -- Comment maigrir sans efforts ? Maigrir sans efforts est la promesse de la plupart des régimes. Seulement, ce n’est pas souvent vraiment le cas. C’est tout simplement une promesse qui attire car nous sommes nombreux et nombreuses à rechercher la solution pour perdre du poids sans se prendre la tête ! Alors comment maigrir sans efforts ? Maigrir sans efforts c’est quoi au juste ? Tous ceux ou celles qui veulent se débarrasser de leurs kilos espèrent trouver comment y arriver sans avoir à faire des tonnes d’efforts. Maigrir est souvent compliqué et difficile. Il faut tenir et donc être motivé. La plupart des régimes demandent beaucoup d’efforts…trop d’efforts. Et c’est pourquoi la plupart ne marchent pas ou ne durent qu’un temps. Ils sont trop durs à tenir sur du long terme et soit on craque avant la fin de la méthode soit on reprend ses kilos aussi vite qu’ils sont partis. Alors pourquoi ne marchent-ils pas et pourquoi maigrir sans efforts est une réelle demande ? Parce que pour perdre du poids, ces régimes en demandent trop. Perdre du poids sans efforts c’est avant tout : Ne pas compter les calories de tout ce que l’on consomme Ne pas être frustré Ne pas se priver de tout ou de plusieurs groupes d’aliments Ne pas passer des heures à déchiffrer les étiquettes dans les magasins Ne pas se fixer des objectifs inatteignables Ne pas s’en vouloir dès que l’on fait un écart Ne pas s’isoler pour ne pas être tenté Lorsque l’on regarde cette liste, cela peut paraître impossible de maigrir sans faire d’efforts. Pourtant c’est tout à fait possible…. commencer à mincir sainement ET durablement maintenant ! Cliquez ici: http://perte-poids-rapide.info-pro.co

Local anaesthetic injection prior to tumescence ready for varicose vein surgery

A video showing breast examination after breast implants

Diastasis recti often occurs during pregnancy and can persist after pregnancy. It affects core strength and the appearance of the abdominal muscles.

Dr. Erick Sanchez repairs the abdominal muscles with every tummy tuck. This short video shows the muscle repair portion of the surgery with a bonus after photo at the end!

To request a consultation with Dr. Sanchez, visit sanchezplasticsurgery.com and click Request a Consultation. Fill out the form and someone will get in touch with you to answer all your questions.

Expected cost can be found at the bottom of each procedure page on our website.

Examination of Peripheral Vascular System - Clinical Skills OSCE Revision - Dr Gill

In this video, we demonstrate the peripheral vascular examination - a less common examination, but still vitally important, particularly amongst the older population

Starting with the examination of the hands looking for clinical signs of vascular compromise, we then check the pulses of the major arteries of the upper body - the radial, brachial and carotid arteries, before moving down to assess for an abdominal aortic aneurysm.

At this point, I feel it's a practical step to check the femoral pulses before doing the overview of the legs.

After visually assessing we must examine the major vascular areas of leg.- namely the popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses

For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s

#PeripheralVascular #ClinicalSkills #DrGill

Watch this clinical examination video to learn how to diagnose inguinal related groin pain.

This video clip is part of the FIFA Diploma in Football Medicine and the FIFA Medical Network. To enrol or to find our more click on the following link http://www.fifamedicalnetwork.com

The Diploma is a free online course designed to help clinicians learn how to diagnose and manage common football-related injuries and illnesses. There are a total of 42 modules created by football medicine experts. Visit a single page, complete individual modules or finish the entire course.

The network provides the opportunity for clinicians around the world to meet and share ideas relating to football medicine. Ask about an interesting case, debate current practice and discuss treatment strategies. Create a profile and log on to interact with other health professionals from around the globe.

This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.