Children are special patients, and their medical needs are unique, including their surgical needs. At UNC Hospitals, an expert and experienced team of physicians treat children in a kid-friendly and family-centered environment. UNC Pediatric Surgeon Dr. Timothy Weiner explains

Warning: This video contains actual surgical footage, which may not be suitable for all viewers.

To learn more about coronary artery bypass surgery, please visit http://cle.clinic/3b7dqpE

Cardiothoracic surgeon Faisal Bakaeen, MD, discusses how he does single and bilateral internal mammary arteries, and the benefits of doing this type of coronary artery bypass.

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Femoral Venous Line Placement

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.

9 Months In The Womb: A Remarkable Look At Fetal Development Through Ultrasound

Endoscopic fenestration of arachnoid cyst in middle fossa

Patellar tendon rupture is a rupture of the tendon that connects the patella to the tibia. The superior portion of the patellar tendon attaches on the posterior portion of the patella, and the posterior portion of the patella tendon attaches to the tibial tubercle on the front of the tibia.

Podalic version is an obstetric procedure wherein the fetus is turned within the womb such that one or both feet present through the cervix during childbirth. It is used most often in cases where the fetus lies transversely or in another abnormal position in the womb.

ACTUAL CATHETERIZATION A clinical view of insertion into the male urethra. A 14 french coude cath was used.

Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).

Additionally, transurethral resection of the prostate is associated with low but important morbidity and mortality.

Manipulation L5/S1 Lumbar Roll and Sacroiliac joint Sidelying

Full examination of the female from head to toe by Loyola Medical School, Chicago. Part 3

A tracheotomy or a tracheostomy is an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done in an operating room under general anesthesia. A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. Breathing is done through the tracheostomy tube rather than through the nose and mouth. The term “tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “tracheostomy,” however; the terms are sometimes used interchangeably.

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.

Loyola Full Male Exam Part 1 A video from Loyola medical school, Chicago showing the full examination of the male

Loyola Full Male Exam Part 4 A video from Loyola medical school, Chicago showing the full examination of the male

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

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Knee Replacement Surgery Video

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Dressing Changes- Wet to Dry (Nursing Skills)

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Dressing Changes- Wet to Dry (Nursing Skills):
In this video we’re going to look at how to do a wet to dry dressing change. Wound care and dressing changes should be performed at least daily or more often depending on orders. Dressing changes should be sterile to avoid introducing any new bacteria to the wound and to promote wound healing.

Bookmarks:
0:05 Introduction
0:10 Wound Assessment link above
0:24 Dressing Change Prep
1:24 Wet vs Dry Gauze
1:37 Soaking Gauze
2:00 Gauze Ring Out
2:25 Packing the wound
3:00 Covering the wound bed
3:37 Dry gauze barrier
4:00 ABD pad application
4:46 Documentation
4:54 Outro

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