A very funny video

A flail chest occurs when a segment of the thoracic cage is separated from the rest of the chest wall. This is usually defined as at least two fractures per rib (producing a free segment), in at least two ribs. A segment of the chest wall that is flail is unable to contribute to lung expansion. Large flail segments will involve a much greater proportion of the chest wall and may extend bilaterally or involve the sternum. In these cases the disruption of normal pulmonary mechanics may be large enough to require mechanical ventilation.

he inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen.

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

complications from using a urinary catheter include: allergic reaction to the material used in the catheter, such as latex. bladder stones. blood in the urine. injury to the urethra. kidney damage (with long-term indwelling catheters) septicemia, or infection of the urinary tract, kidneys, or blood.

The anatomy of the direct and indirect inguinal hernia.


Music:
Berries and Lime by Gregory David
https://www.epidemicsound.com/track/z6iCiiyCPm/

Depression is a very serious mental illness that affects millions worldwide. Could a small brain implant cure it?

Olympus has extended the value of its award-winning combined surgical energy device, THUNDERBEAT, to open surgical procedures. Watch Dr. Francois Blaudeau master use of THUNDERBEAT Open Extended Jaw (OEJ) in a total abdominal hysterectomy.
http://medical.olympusamerica.com/products/thunderbeat?utm_source=youtube&utm_campaign=Total%20Abdominal%20Hysterectomy%20Surgery%20-%20THUNDERBEAT&utm_medium=description&utm_term=energy&utm_content=surgical

This condition is seen in imperforate hymen or transverse vaginal septum. Pt presents with primary amenorrhea. Dr Hemant Damle Prof Dept of OBGYN SKNMC Pune India

When the colon and rectum are removed (due to ulcerative colitis or familial adenomatous polyposis), another reservoir must be created for bowel contents (stool) to exit the body. Surgically creating a “J” shaped reservoir (called a J-pouch) is an option for selected patients to store and pass stool.

The G-SHOT® (clinical description: G-Spot Amplification™ or GSA™), is a simple, nonsurgical, physician-administered treatment that can temporarily augment the Grafenburg spot (G-Spot) in sexually active women with normal sexual function.

The fetal circulation is the circulatory system of a human fetus, often encompassing the entire fetoplacental circulation that also includes the umbilical cord and the blood vessels within the placenta that carry fetal blood.

The fetal circulation works differently from that of born humans, mainly because the lungs are not in use: the fetus obtains oxygen and nutrients from the mother through the placenta and the umbilical cord.

Train with some of the region’s very best pediatric general surgeons — in a two-year, pediatric surgical fellowship training program at Nemours/Alfred I. duPont Hospital for Children. Our hospital’s Division of Pediatric Surgery is offering this program in affiliation with Sidney Kimmel Medical College at Thomas Jefferson University .

The goal of the fellowship is to give individuals who have completed an accredited general surgery residency advanced knowledge and training in the management and surgical treatment of newborns, infants and children.

Our Fellowship Program
This fellowship will help you prepare for certification by the American Board of Surgery, and is accredited by the Accreditation Council for Graduate Medical Education (ACGME).

The Pediatric Surgery Fellowship aims to:

train a well-rounded, empathetic, safe pediatric surgeon who is confident managing all aspects of the surgical care of children.
steward our fellow in quality improvement projects and methodology, and provide research opportunities.
provide a rigorous didactic curriculum for our fellow utilizing 360 degree feedback.
cultivate opportunities for our fellow to educate residents and students.
encourage our fellow to collaborate across specialties.
develop our fellow’s presentation skills during M&M conferences and multi-disciplinary educational meetings.
The program features the full participation of all nine of the pediatric surgical division’s full-time faculty members. Each of these physicians will contribute greatly to your education. Your training will include operating room and outpatient clinic experience, as well as bedside evaluation of children. You’ll also play a role in the organization of formal teaching conferences, held weekly. Formal rotations will be spent on Pediatric Urology, PICU and Neonatology during the first 12 months. The last year will be spent entirely on the Pediatric Surgical Service.
The majority of your inpatient consultative time will take place at Nemours/Alfred I. duPont Hospital for Children, a freestanding children’s hospital in Wilmington, Del. The hospital:

is nationally ranked by U.S. News & World Report in eight pediatric specialties
recently opened expansion with 260 beds
performs more than 2,800 inpatient and 9,300 outpatient surgical procedures each year in our operating rooms
has an on-site delivery center for newborns with complex congenital anomalies
receives more than 50,000 annual visits in our Emergency Department (ED)
is accredited by The American College of Surgeons as a Level One Pediatric Trauma Center
is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)


Visit https://www.nemours.org/educat....ion/gme/fellowships/ to learn more.

Testicular Self Exam

Watch that video to know How To Firm And Lift Your Sagging Breasts Naturally

A myringotomy is a procedure in which your doctor creates a small hole in the eardrum so fluids such as water, blood, or pus can drain out. In many cases, your doctor will put in a tube so it won't get backed up again. The tube, which will usually fall out on its own in about six to 18 months, lets air flow through and keeps the middle ear dry. Tubes also: Reduce pain Improve hearing Cut down on the number of infections your child may have

Hand hygiene for healthcare workers: Learn how to perform hand washing with soap and water (nursing procedures).

There are two ways to perform hand hygiene as a nurse. You can use soap and water or an alcohol-based hand rub (also called hand sanitizer or hand gel).

Hand hygiene is essential for providing safe patient care. If hand hygiene is not performed regularly, germs can be easily be spread to patients, other healthcare workers, and even yourself.

Hand hygiene is ALWAYS performed before and after patient care, after coming into contact with any type of body fluid or open wounds, when touching any object that is near a patient (hand railing, bedside table etc.), removing gloves, prior to eating, or after using the bathroom.

This video discusses when you should use soap and water versus an alcohol-based hand gel, when to perform hand hygiene, and demonstrates how to perform hand hygiene using soap and water.

Notes: https://www.registerednursern.....com/how-to-perform-h

More nursing skills: https://www.youtube.com/watch?v=DBHnd3N-5Ns&list=PLQrdx7rRsKfUhd_qQYEbp0Eab3uUKhgKb

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#handhygiene #handwashing #nursingskills

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General Examination - Clinical Skills OSCE - Dr Gill

The general examination is one of those early exams, which is essentially used to start medical students off with their clinical skills studies.

In the real world, it's mainly used with regard to gaining an overview of a patient, such as for a medical check up, or a baseline examination, for example, a health report.

They have been a couple of comments about the pulse monitor used in the video. For those who are interested. I’ve reached out to the manufacturer, and they’ve requested that the following code is provided to viewers, in order to get 20% off, if they decide on themselves.

Product model number: Vibeat SP20
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Special 20% OFF code: JAMES

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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.

Some people watching this video may experience an ASMR effect

#DrGill #Asmr #Clinicalskills

#drgill #clinicalskills #asmr

Dr. Alex Campbell and Dr. Carolina Restrepo of Premium Care Plastic Surgery in Cartagena, Colombia perform a Mommy Makeover on an international patient. Watch the procedure as Dr. Campbell and Dr. Restrepo work together to offer this patient more surgery in less time, which leads to a quicker recovery and better results.