Cardiac tamponade is a medical emergency that requires urgent drainage of the pericardial fluid. Preferably, patients should be monitored in an intensive care unit. All patients should receive the following: Oxygen Volume expansion with blood, plasma, dextran, or isotonic sodium chloride solution, as necessary, to maintain adequate intravascular volume - Sagristà-Sauleda et al noted significant increase in cardiac output after volume expansion [24] (see the Cardiac Output calculator) Bed rest with leg elevation - This may help increase venous return Positive-pressure mechanical ventilation should be avoided because it may decrease venous return and aggravate signs and symptoms of tamponade. Inpatient care After pericardiocentesis, leave the intrapericardial catheter in place after securing it to the skin using sterile procedure and attaching it to a closed drainage system via a 3-way stopcock. Periodically check for reaccumulation of fluid, and drain as needed. The catheter can be left in place for 1-2 days and can be used for pericardiocentesis. Serial fluid cell counts can be useful for helping to discover an impending bacterial catheter infection, which could be catastrophic. If the white blood cell (WBC) count rises significantly, the pericardial catheter must be removed immediately. A Swan-Ganz catheter can be left in place for continuous monitoring of hemodynamics and to assess the effect of reaccumulation of pericardial fluid. A repeat echocardiogram and a repeat chest radiograph should be performed within 24 hours.

Endotracheal Intubation During General Anaesthesia

Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease. Coronary artery disease (CAD) is the narrowing of the coronary arteries – the blood vessels that supply oxygen and nutrients to the heart muscle. CAD is caused by a build-up of fatty material within the walls of the arteries. This build-up narrows the inside of the arteries, limiting the supply of oxygen-rich blood to the heart muscle. One way to treat the blocked or narrowed arteries is to bypass the blocked portion of the coronary artery with a piece of a healthy blood vessel from elsewhere in the body. Blood vessels, or grafts, used for the bypass procedure may be pieces of a vein from the legs or an artery in the chest. An artery from the wrist may also be used. One end of the graft is attached above the blockage and the other end is attached below the blockage. Blood is routed around, or bypasses, the blockage by going through the new graft to reach the heart muscle. This is called coronary artery bypass surgery. Traditionally, to bypass the blocked coronary artery, a large incision is made in the chest and the heart is temporarily stopped so that the surgeon can perform the delicate procedure. To open the chest, the breastbone (sternum) is cut in half and spread apart. Once the heart is exposed, tubes are inserted into the heart so that the blood can be pumped through the body by a cardiopulmonary bypass machine (heart-lung machine). The bypass machine is necessary to pump blood while the heart is stopped and kept still in order for the surgeon to perform the bypass operation. While the traditional "open heart" procedure is still commonly done and often preferred in many situations, less invasive techniques have been developed to bypass blocked coronary arteries. "Off-pump" procedures, in which the heart does not have to be stopped, were developed in the 1990's. Other minimally invasive procedures, such as keyhole surgery (performed through very small incisions) and robotic procedures (performed with the aid of a moving mechanical device), may be used.

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.

Contact us to find out more http://www.londonvisionclinic.com/contact-us/ Mr Carp explains the risks involved in losing sight as being extremely rare. Only 1 in 5 million may lose sight in one eye.

The purpose of the organs of the male reproductive system is to perform the following functions: To produce, maintain, and transport sperm (the male reproductive cells) and protective fluid (semen) To discharge sperm within the female reproductive tract during sex To produce and secrete male sex hormones responsible for maintaining the male reproductive system

This Basic Laparoscopic Surgery: Abdominal Access and Trocar Introduction course will teach you the steps of Laparoscopic Surgery. View the full course for free by signing up on our website: https://www.incision.care/

What is Laparoscopic Surgery:
Laparoscopic surgery describes procedures performed using one or multiple small incisions in the abdominal wall in contrast to the larger, normally singular incision of laparotomy. The technique is based around principles of minimally invasive surgery (or minimal access surgery): a large group of modern surgical procedures carried out by entering the body with the smallest possible damage to tissues. In abdominopelvic surgery, minimally invasive surgery is generally treated as synonymous with laparoscopic surgery as are procedures not technically within the peritoneal cavity, such as totally extraperitoneal hernia repair, or extending beyond the abdomen, such as thoraco-laparoscopic esophagectomy. The term laparoscopy is sometimes used interchangeably, although this is often reserved to describe a visual examination of the peritoneal cavity or the purely scopic component of a laparoscopic procedure. The colloquial keyhole surgery is common in non-medical usage.

Surgical Objective of Laparoscopic Surgery:
The objective of a laparoscopic approach is to minimize surgical trauma when operating on abdominal or pelvic structures. When correctly indicated and performed, this can result in smaller scars, reduced postoperative morbidity, shorter inpatient durations, and a faster return to normal activity. For a number of abdominopelvic procedures, a laparoscopic approach is now generally considered to be the gold-standard treatment option.
Definitions

Developments of Laparoscopic Surgery:
Following a number of smaller-scale applications of minimally invasive techniques to abdominopelvic surgery, laparoscopic surgery became a major part of general surgical practice with the introduction of laparoscopic cholecystectomy in the 1980s and the subsequent pioneering of endoscopic camera technology. This led to the widespread adoption of the technique by the early- to mid-1990s. The portfolio of procedures that can be performed laparoscopically has rapidly expanded with improvements in instruments, imaging, techniques and training — forming a central component of modern surgical practice and cross-specialty curricula [2]. Techniques such as laparoscopically assisted surgery and hand-assisted laparoscopic surgery have allowed the application of laparoscopic techniques to a greater variety of pathology. Single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and minilaparoscopy-assisted natural orifice surgery continue to push forward the applications of minimally invasive abdominopelvic techniques; however, the widespread practice and specific indications for these remain to be fully established. More recently, robotic surgery has been able to build on laparoscopic principles through developments in visualization, ergonomics, and instrumentation.

This Basic Laparoscopic Surgery: Abdominal Access and Trocar Introduction course will teach you:
- How to access the abdomen using an open, closed, and direct optical-entry technique
- Principles underlying safe abdominal insufflation
- The vascular anatomy of the abdominal wall and its implications for trocar placement
- How to introduce trocars into the peritoneal cavity
- The principle of triangulation and how this can be applied to organizing a laparoscopic surgical field

Specific attention is given to these hazards you may encounter:
- Intravascular, intraluminal, or extraperitoneal needle position
- Limitations of a closed introduction technique
- Abdominal surgical history
- Limitations of an open introduction technique
- Optical trocar entry in thin individuals
- Visualization of non-midline structures
- Limitations of direct optical-entry techniques
- Limitations of clinical examination to confirm intraperitoneal insufflation
- Leakage of insufflation gas

These tips are designed to help you improve your understanding and performance:
- Alternative left upper quadrant approach
- Testing Veress needle before use
- Lifting the abdominal wall for Veress needle introduction
- "Hanging-drop test"
- Palmer's test
- Confirming intra-abdominal insufflation
- Subcutaneous tissue retraction
- Anatomy of the umbilicus
- Retraction of abdominal wall fascia
- Finger sweep of anterior abdominal wall
- Lifting the abdominal wall for optical trocar introduction
- Identification of venous bleeding at the end of a procedure
- Identification of inferior epigastric vessels by direct vision
- Peritoneal folds of the anterior abdominal wall
- Transillumination of superficial epigastric vessels
- Infiltration of local anesthetic at port sites
- Aiming of trocars
- Selection of trocar size
- Maintaining direct vision

Most retinal tears need to be treated by sealing the retina to the back wall of the eye with laser surgery or cryotherapy (a freezing treatment). Both of these procedures create a scar that helps seal the retina to the back of the eye. This prevents fluid from traveling through the tear and under the retina, which usually prevents the retina from detaching. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office. With laser surgery, your ophthalmologist uses a laser to make small burns around the retinal tear. The scarring that results seals the retina to the underlying tissue, helping to prevent a retinal detachment.

The pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch.

Learn about the structural unit of compact bone (the osteon) and it's four basic parts: central canal, lamellae, lacunae, and canaliculi

a video discussing the tattoo removal using LASRER

There is no sure way for women to avoid their most common type of cancer. But when breast cancer is found early, the survival chances are the greatest. Here is October’s survivor story:
It has been 25 years since a woman very dear to us here at CBS 11 News found out she was a living cliché. Following in her birth mother’s footsteps, she discovered breast cancer on her own. Today she’s alive, urging every woman she can reach to do a self-check.

We here at CBS 11 News have come to know Juneil Jones-Flemming’s soft, warm greeting.
Some of you may have too

Scientists Create Artificial Womb

These older clinical skills videos are being retired, but rather than delete them, I decided to archive them here

In this video, we demonstrate how to perform a clinical examination of the CARDIAC SYSTEM for your medical school Clinical Skills OSCE. As the gastrointestinal exam is a core skill when it comes to examining patients, students should assume that an abdominal assessment is a high yield station for any clinical exams or clinical assessments.

For a passing grade in your Clinical Skills OSCE, for the cardiac exam follow the approach of:
- Inspection
- Palpation
- Percussion
- Auscultation

HOWEVER, an cardiac examination OSCE station does not just involve listening to the heart this video also demonstrates some of the specialised examination techniques required in examining cardiology patients

Chest, pain and general concerns about the heart are common reasons for patients to see a doctor, and in any speciality, the cardiac exam will be needed

This video has five other Cardiology system-focused videos associated with it:

https://youtu.be/dxUHp85M8kQ - cardiac deep dive

https://youtu.be/CyQqxXZyQVw - cardiac demo

https://youtu.be/DdF2cbpE6mQ - cardiac murmurs

https://youtu.be/UdT9Aj5Cujo - ecg demo

https://youtu.be/g-4DlFzmI1k - ecg lead placement


-------------------
Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.

Some people viewing this medical examination video may experience an ASMR effect

#clinicalskills #DrGill #cardiology

Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.

Otto Placik MD. a board certified Chicago Illinois based plastic surgeon presents instructional video on post genital surgery (labia minora reduction aka labiaplasty or labioplasty or clitoral hood reduction) massage exercises for treatment of labum minora psot surgical fibrosis or hypersensitivity. Photos pictures and video of anatomic models are reviewed . Great for patients thinking about or planning labiaplasty or vaginal cosmetic surgery

"The act of cutting off the prepuce or foreskin of males, or the internal labia of females." Webster's Revised Unabridged Dictionary (1913)

#abdomenliposuction #laserskintightening #drprashantyadav #cosmeticsurgery #plasticsurgery #dezireclinicindia #weightloss #shorts #360degreeabdomenliposuction #lowerbackliposuction

Weight Loss After 360° Abdomen liposuction result, Abdomen Liposuction, lower back liposuction, 360 degree abdomen liposuction

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Dezire Clinic is a top searched clinic surgical and nonsurgical cosmetic procedure in India when comes to “Cosmetic, Skin ,Laser and Hair transplantation”.

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Loa loa filariasis (also known as loiasis, loaiasis, Calabar swellings, Fugitive swelling, Tropical swelling and African eyeworm) is a skin and eye disease caused by the nematode worm, loa loa. Humans contract this disease through the bite of a Deer fly or Mango fly (Chrysops spp), the vectors for Loa loa. The adult Loa loa filarial worm migrates throughout the subcutaneous tissues of humans, occasionally crossing into subconjunctival tissues of the eye where it can be easily observed. Loa loa does not normally affect one's vision but can be painful when moving about the eyeball or across the bridge of the nose.The disease can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva.