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A detailed description of the Arterial Pulse including its waveform and pathological subtypes. Also discussed are the abnormal rates (tachycardia and bradycardia) and their causes, abnormal rhythm (including regularly regular and irregularly irregular pulses) and abnormal character (including pulses bisferiens, pulses parvus et tarsus, pulsus alternans, pulses paradoxus and others.) Description of pulse in various pathological states including Aortic stenosis and aortic regurgitation is also included. Finally there is also a description of the peripheral signs of aortic regurgitation.
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.
Dysmenorrhea is the medical term for pain with menstruation. There are two types of dysmenorrhea: "primary" and "secondary". Primary dysmenorrhea is common menstrual cramps that are recurrent (come back) and are not due to other diseases. Pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt in the lower abdomen, back, or thighs. Pain can range from mild to severe, can typically last 12 to 72 hours, and can be accompanied by nausea, vomiting, fatigue, and even diarrhea. Common menstrual cramps usually become less painful as a woman ages and may stop entirely if the woman has a baby. Secondary dysmenorrhea is pain that is caused by a disorder in the woman's reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea.
Thalassemia is an inherited blood disorder characterized by less hemoglobin and fewer red blood cells in your body than normal. Several types of thalassemia exist, including alpha-thalassemia, beta-thalassemia intermedia, Cooley's anemia and Mediterranean anemia. Hemoglobin is the substance in your red blood cells that allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause anemia, leaving you fatigued. If you have mild thalassemia, you may not need treatment. But, if you have a more severe form of thalassemia, you may need regular blood transfusions. You can also take steps on your own to cope with fatigue, such as choosing a healthy diet and exercising regularly.
Surgery involves removing the cyst as well as part of the involved joint capsule or tendon sheath, which is considered the root of the ganglion. Even after excision, there is a small chance the ganglion will return. A ganglion cyst at the wrist is removed during a surgical procedure called excision.
An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus — or womb — is where a baby grows if you're pregnant. A partial hysterectomy removes just the uterus, leaving the cervix intact. A total hysterectomy removes the uterus and the cervix. Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes, a procedure called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me). A hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions.
A closure device and method to close the abdomen between surgical procedures and maintain a normal physiologic tension on the fascia to prevent undue retraction. In one embodiment, the closure device includes a “needled carabiner” attached to a rubberband of specific tension. The rubberband mimics the physiologic tension the abdominal wall normally experiences during daily activities and allows the abdominal compartment to expand as needed to maintain a healthy intra-abdominal pressure. The bands contract to maintain the intra-abdominal pressure and slowly pull the abdominal fascia back to the midline to facilitate surgical closure of the abdomen. In one embodiment, the “needled carabiner” includes a hinged surgical needle with a protected cap. The hinged needle is placed outside the normal suture line, thereby limiting the amount of surgical trauma the fascia endures. The strength of the rubberbands may be varied to accommodate differently sized individuals.
A needle is inserted into a joint for two main indications: aspiration of fluid (arthrocentesis) for diagnosis or for relief of pressure, or injection of medications. In practical terms, most injections into joints consist of a glucocorticoid, a local anesthetic, or a combination of the two. Occasionally saline is injected into the joint to diagnose a joint injury. This topic will review the basic technique of inserting a needle into a joint and the main indications for intraarticular steroid injections. The same techniques apply for injection of the less commonly used hyaluronate viscosupplementation agents into knees, hips, and perhaps shoulders.
A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. A catheter is often inserted in the arm or chest through the skin into a large vein.
When placement of a urethral catheter is contraindicated or unsuccessful, percutaneous suprapubic urinary bladder catheterization is a commonly performed procedure to relieve urinary retention. [1, 2] This topic describes the Catheter over needle technique. The Seldinger technique is described in the Clinical Procedures topic Suprapubic Aspiration.