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Follow along on a typical day with UCSF Medical Center's chief of cardiothoracic surgery Dr. Tom Nguyen. Take a walk on rounds with his team as they check on patients who are recovering or preparing for heart valve surgeries to treat conditions such as mitral valve prolapse and mitral regurgitation. Get a glimpse into the operating room as Dr. Nguyen and his team use the latest non-invasive techniques to help patients achieve the best outcomes.
0:00 Surgeon begins day with morning report
0:53 Meet with fellows and visit patients
1:28 Surgeon thoughts on his practice
Minimally Invasive Surgeries
2:09 Mitral valve replacement for mitral stenosis
3:11 Mitral valve repair for AFib and mitral regurgitation
3:36 Stopping the heart
4:15 Culture 1 - Everyone's voice matters
4:45 Mitral valve repair for heart murmur
5:12 Culture 2 - Patient first
To view more UCSF videos relating to Mitral Regurgitation Treatment and Aortic Stenosis Treatment view:
Mitral Regurgitation Treatment Options https://youtu.be/7nUUOMx4tJ0
Aortic Stenosis Treatment Options https://youtu.be/A2rZK0oFWcc
If you want to learn more about the Cardiac Surgery clinic and to request an appointment visit: https://www.ucsfhealth.org/cli....nics/cardiac-surgery
#dayinthelife #heartsurgeon #heartsurgery #CardiacSurgery #Cardiology #ucsf #drnguyen#ucsfhealth #Cardiothoracic
Most C-sections are done under regional anesthesia, which numbs only the lower part of your body — allowing you to remain awake during the procedure. A common choice is a spinal block, in which pain medication is injected directly into the sac surrounding your spinal cord
Curious about LASIK eye surgery? NVISION's Dr. Richard Mauer talks risks, life-changing benefits, and outcomes (plus why he loves what he does!).
Want to start your journey to better vision? Schedule your complimentary consult today! https://bit.ly/3H2i0FU
NVISION: The Eye Doctors' #1 Choice in LASIK and Laser Cataract Surgery
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Stoma Care- Changing a Colostomy Bag (Nursing Skills)
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05.01 Stoma Care (Colostomy bag) | NURSING.com
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Stoma Care- Changing a Colostomy Bag (Nursing Skills)
In this video, we’re going to talk about stoma care. Now, the wafer and bag for an ostomy only NEEDS to be changed every 3 days, or if it’s leaking. But, you still need to be able to assess the stoma itself. In this case we’re going to show you how to replace the bag and clean and assess the stoma. Start by putting a towel under the patient on the side of the stoma. We love you guys! Go out and be your best selves today! And, as always, happy nursing!
Bookmarks:
0.05 Introduction to Stoma Care
0:20 Assessing the stoma
0:47 Cleaning the stoma
1:12 Inspecting the stoma
1:25 Measuring and cutting the stoma
2:00 Applying and sealing the bag
2:35 Documentation
2:41 Outro
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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.
In this video, Professor Dan Reinstein performs a bilateral LASIK procedure filmed in real-time to demonstrate the full 8 and-a-half minute procedure from multiple angles. The superior design and experience of the Carl Zeiss Meditec Visumax femtosecond Laser for flap creation is seen, where the patient is only in contact with the device for about 30 seconds with extremely low contract force such that the patient feels effectively nothing, there are no red splodges (subconjunctival haemorages) left behind. From the surgeons' standpoint there is no device that is easier to use or faster for LASIK flap creation. The Carl Zeiss Meditec MEL80 excimer laser portion of the procedure is seamlessly integrated and incorporates all the features that make clinical outcomes so reproducible including the unique cone-for-controlled-atmosphere (CCA) and high efficiency, high sensitivity calibration test which can be performed for each individual patient to compensate for minor changes in energy that occur with excimer laser devices during the course of a day.
For reference to the clinical outcomes for LASIK with the MEL80 in presbyopia using PRESBYOND Laser Blended Vision see:
Reading glasses presbyopia (ageing eyes) only:
LASIK for presbyopia correction in emmetropic patients using aspheric ablation profiles and a micro-monovision protocol with the Carl Zeiss Meditec MEL 80 and VisuMax.
J Refract Surg. 2012 Aug;28(8):531-41. Reinstein DZ, Carp GI, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/22869232
Short sighted, astigmatism and presbyopia (ageing eyes)
LASIK for Myopic Astigmatism and Presbyopia Using Non-Linear Aspheric Micro-Monovision with the Carl Zeiss Meditec MEL 80 Platform.
J Refract Surg. 2011 Jan;27(1):23-37. Epub 2010 Mar 1.
Reinstein DZ, Archer TJ, Gobbe M.
http://www.ncbi.nlm.nih.gov/pubmed/20205360
Long-sighted, astigmatism and presbyopia (ageing eyes)
LASIK for hyperopic astigmatism and presbyopia using micro-monovision with the Carl Zeiss Meditec MEL80 platform.
J Refract Surg. 2009 Jan;25(1):37-58. Reinstein DZ, Couch DG, Archer TJ.
http://www.ncbi.nlm.nih.gov/pubmed/19244952
For more information about laser eye surgery and PRESBYOND Laser Blended Vision, please contact the London Vision Clinic on 020 7224 1005.
Small cell lung cancer, which occurs almost exclusively in smokers, is a malignancy characterised by rapid doubling time, high growth fraction and widespread metastasis at presentation. In this presentation, we will briefly discuss the classification of pulmonary Neuro-endocrine tumours by the World Health Organisation followed by a detailed discussion of the clinical features, lab evaluation and management of SCLC, both limited and extended stage. The frontline therapy in small cell lung cancer is etoposide and cisplatin along with thoracic radiotherapy and prophylactic cranial irradiation in patients who have a good response to therapy. Hyperfractionation of radiotherapy may provide some benefit but is also associated with increase incidence of complications. Newer agents for SCLC include Vandetanib and immunotherapy molecules, such as Iplimumab and nivolumab.
This gentleman has a significant lumbar herniated disc with a positive well straight leg raise test. In this evaluation I test his deep tendon reflexes, sensation, muscle strength, and perform a straight leg raise test, Braggards's test and Well straight leg raise test.
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Soft tissue biopsy from osteolytic lesions is a challenge for the interventionist. The Spirotome Bone is conceived for this intervention. The procedure is straigthforward and produces tissue specimens of high quality in sufficient amounts to allow quantitative molecular biology.