For more than 25 years, The Children's Hospital of Philadelphia — the first Level 1 Pediatric Trauma Center in Pennsylvania — has provided unparalleled medical and surgical care for all injured children, including those with the most severe injuries.

Learn what makes the Trauma Center at CHOP a Level 1 Pediatric Trauma Center, and how our work toward trauma prevention, research advances and overall trauma awareness provides hope for reduced injuries in the future.

Learn more about the Trauma Center at CHOP: http://www.chop.edu/trauma.

Cervical cerclage can be placed via transvaginal, open transabdominal, or laparoscopic transabdominal approach, preferably before pregnancy. Recurrent late miscarriages may be due to a weak (sometimes called an incompetent) cervix that shortens or opens too early in pregnancy. Cervical cerclage involves placing a stitch around the upper part of the cervix to keep it closed; the operation may be carried out through the vagina, or through the abdomen, as an open or laparoscopic ('keyhole') procedure.

A Fistulotomy is the surgical opening or removal of a fistulous tract. They can be performed by excision of the tract and surrounding tissue, simple division of the tract, or gradual division and assisted drainage of the tract by means of a seton; a cord passed through the tract in a loop which is slowly tightened over a period of days or weeks.

Fistulas can occur in various areas of the human body, and the location of the fistula influences the necessity of the procedure. Some, such as ano-vaginal and perianal fistulas are chronic conditions, and will never heal without surgical intervention.

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A friend group (Kate McKinnon, Mikey Day, Heidi Gardner, Ego Nwodim, Bowen Yang) tensely waits for updates on an injured patient.

A brief description of the mechanisms, types and assessment of chromosomal analyses. Techniques such as standard cytogenetic testing, FISH and array methods are discussed. Indications for testing in prenatal, neonatal and adult periods are also discussed. Deletions, translocations, inversions etc are described, as are mosaicism and aneuploidy.

Four-point gait crutches walking pattern demonstration review for
NCLEX assistive devices and nurses.

One of the gaits that you'll have to learn for crutches is the 4-point gait. An example of a four point gait crutch pattern would be the patient moving the right crutch first (on the injured side), followed by the left foot, then the left crutch, and then the right foot. Then, you'll repeat this pattern.

In addition to this video, we have an entire compilation that features the various crutch gait patterns, as well as walkers and canes:

https://www.youtube.com/watch?v=k2-w3LZlCVk

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Successful External Cephalic Version (ECV) - Turning a breech baby in just 2 minutes!

Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used to get vascular access in trauma and hypovolemic shock patients when peripheral cannulation is difficult or impossible

Removal of large epidermoid cyst from floor of the mouth

plastic surgeon demonstrates the results of a muscle separation(rectus diastasis) repair using 3 dimesional CAT scan and photographic images

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This is a diabetic foot ulcer. The patient reportedly went on vacation and noticed this ulcer upon their return. Debridement (removal of damaged tissue) to the level of healthy bleeding tissue is medically necessary as damaged tissue acts an impediment to wound healing. Due to their diabetic neuropathy, they did not feel any pain or indication that a wound was forming. This ulcer appeared to have penetrated to the level of subcutaneous tissue or even fascia, but turned out to be much deeper than that. These are serious wounds and are the beginnings of what lead to foot and leg amputations if they are not treated promptly by your healthcare provider, AKA Podiatrist.

Start in RLQ (so you don’t miss a giant spleen). Get your fingers set then ask patient to take a deep breath. Don’t dip your fingers or do anything but wait. When patient expires, take up new position. Note lowest point of spleen below costal margin, texture of splenic contour, and tenderness If spleen is not felt, repeat with pt lying on right side. Gravity may bring spleen within reach. “LET THE SPLEEN PALPATE YOUR FINGERS AND NOT THE OTHER WAY AROUND. THERE IS NO GOLD, SO DON’T DIG!”

Watch this video to learn how and when to change a dressing for a child with a hemodialysis catheter. You should change your child's dressing if it becomes soiled with water or blood or if it comes off at home. Keeping a clean dressing on your child will limit risk of infection.

Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.

Describe and demonstrate the protocol for sonographic scanning of the scrotum.

Identify and describe sonographic images of congenital abnormalities of the scrotum.

Identify and describe sonographic images of pathologies of the scrotum.

Identify and describe sonographic images of extratesticular disease processes.

Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.

Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.

Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.

Explain the technique for prostate biopsy.

Define the criteria for an ultrasound appearance of prostate tumor staging.

Explain the technique for radiation seed implantation.

Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).

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Cancer Patient Dances in OR before her Surgery

Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.