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Sean Langenfeld, M.D., UNMC College of Medicine

Arterial line placement is a common procedure in various critical care settings. Intra-arterial blood pressure (BP) measurement is more accurate than measurement of BP by noninvasive means, especially in the critically ill. [1] Intra-arterial BP management permits the rapid recognition of BP changes that is vital for patients on continuous infusions of vasoactive drugs. Arterial cannulation also allows repeated arterial blood gas samples to be drawn without injury to the patient.

Pulmonary Physical Examination Lecture

Watch that video of a Model's Leg and Butt Cosmetic Implants Exploded Inside Her

The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.

"I’m essentially taking care of the baby right now to give them 60 or 70 or 80 years of life so I have to perform my best every time. Every single time. That is a commitment that I have to the parents."

The highest standard. That’s what cardiothoracic surgeon Sergio Carrillo demands of himself every time he steps into the OR. Dr. Carrillo and his Heart Center team at Nationwide Children’s Hospital treat patients with congenital heart disease with the simplest to the most complex procedures.

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Head Eye and ENT Physical Examination

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Instruments at work, innovation at play. 🔍

Watch on to discover the behind-the-scenes instruments utilised by our NUHCS cardiac surgery expert, A/Prof Theodoros Kofidis, Head of NUHCS' Department of Cardiac, Thoracic & Vascular Surgery (CTVS), for keyhole heart operations. 🔑

To find out more about Minimally Invasive Heart Surgery @ NUHCS, visit: https://[a]www.nuhcs.com.sg%2FOur-Services%2FSpecialties%2FPages%2FMinimally-Invasive-Cardiac-Surgery-Programme.aspx[/a]

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Devi Shetty, founder of Narayana Health in India, reflects on the remarkable fact that, after 26 years of operation, the cost of heart surgery at Narayana Health has come down dramatically, and shares some of the strategies used to maintain high quality with low patient cost.

Learn more about the Creating Emerging Markets Project and explore its many compelling interviews: https://www.hbs.edu/creating-e....merging-markets/Page

A computed tomography (CT) scan uses a special X-ray machine to take detailed pictures of the body’s organs and tissues. In a biopsy, a small piece of tissue is removed from your body. This tissue sample is then examined in the lab. A needle biopsy is the safest and easiest way to remove this tissue safely from the body. To do a needle biopsy, the radiologist will insert a needle through your skin and into your tissue. A syringe or an automated needle may be used to take the tissue sample.

Ever wanted to see an open heart surgery? Dr. Sandwith, the only open-heart surgeon in the tri-county area, takes you into the OR to improve the life of a gentlemen with congenital heart disease.

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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.

The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.

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