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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.
Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. Due to the peripheral nerve dysfunction associated with diabetes (diabetic neuropathy), patients have a reduced ability to feel pain.
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When Does Implantation Occur in Pregnancy? || Common gynaecological problems in women There are a lot of things going on in early pregnancy. The first thing that you need to understand is the menstrual cycle. A good understanding of this can help you understand how the other parts play into the process. A huge part of the menstrual cycle that is the basis of pregnancy is ovulation. Ovulation typically occurs fourteen days prior to the beginning of menstruation, the point when the uterine lining is sloughed off if no pregnancy has occurred.
Wisdom teeth extractions can rear their ugly head later in life. This is a video of a patient with neck pain and neck weakness. When we stimulated the nerve fibers in the area of the extracted teeth there was an immediate improvement in her ability to control her neck muscles.
If you’ve lost a significant amount of weight, either after pregnancy or through exercise and dietary changes, excess skin and weakened abdominal muscles can leave you self-conscious about your appearance. In this video, Dr. Catherine Hannan and Dr. Lauren Patrick, two of our Board-Certified Plastic Surgeons, are performing a Tummy Tuck (Abdominoplasty) surgery. Tummy Tuck surgery gets rid of the excess skin, as well as tightens your abdominal muscles, resulting in a flatter and smoother abdomen. The results of the surgery are permanent except in cases of large weight gain or pregnancy after surgery.
We are so excited to have taken a part in our patient's body transformation journey!
Before & After Gallery:
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To learn more, visit our website or call (202) 785-4187
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Cardiac anesthesiology is a subspecialty of anesthesiology that entails caring for patients undergoing major heart surgeries, including those that require cardiopulmonary bypass. I made this video to show a cardiac anesthesiologist's typical setup for surgery.
0:00 Start
0:28 IV pole #1
1:18 Perfusionist equipment
1:47 Anesthesia machine
3:01 Medications
3:36 Pacemaker
4:10 Echocardiography
4:34 IV pole #2
4:55 Arterial line
5:25 Defibrillators
5:40 OR table
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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
Website: http://www.MaxFeinsteinMD.com
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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Music
Subtle Swagger by Ron Gelinas Chillout Lounge | https://soundcloud.com/atmospheric-music-portal
Music promoted by https://www.free-stock-music.com
Creative Commons Attribution 3.0 Unported License
https://creativecommons.org/li....censes/by/3.0/deed.e
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#Anesthesiology #Residency #MedicalSchool
Covers the histological structure for adipose tissue and relevant cellular physiology for adipocytes. This video is a part of our Histology Video Course (https://youtube.com/playlist?l....ist=PLnr1l7WuQdDynxT
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