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Dr. Jeffrey Ojemann, director of epilepsy surgery at Seattle Children's Hospital, explains a cutting-edge treatment for epilepsy: minimally invasive MRI-guided laser ablation surgery. Laser ablation surgery is much safer and more precise than other treatments, with fewer side effects.
A special thanks to patient Keoni Giauque.
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The head-to-toe assessment in nursing is an important physical health assessment that you'll be performing as a nursing student and nurse.
Head-to-toe assessments allow nurses to assess the health status of patients by following a checklist of criteria.
On the job, your head-to-toe nursing assessment will be performed much faster, and it may be different or more specialized to accommodate the patients' needs within your nursing specialty.
This assessment represents a general assessment checklist (or cheat sheet) that you might encounter in nursing school. (Note: Always follow your instructor's requirements or your employer's assessment protocols).
This nursing head-to-toe examination video guide will focus on the following areas/skills:
-Vital Signs (pulse rate, respiration rate, temperature, oxygen saturation, blood pressure, pain assessment)
https://www.youtube.com/watch?v=gUWJ-6nL5-8
-Cranial Nerve examination
-Head assessment (hair, cranium, eyes, nose, mouth, ears, sinuses)
-Neck assessment (jugular vein, thyroid, trachea, carotid)
-Heart sounds assessment: https://www.youtube.com/watch?v=H48WsyIjFs0&t=73s
-Lung sounds assessment: https://www.youtube.com/watch?v=KNrcG077brQ
-Abdominal assessment
-Assessing extremities (arms, hands, legs, feet)
-Back assessment
-and more
While performing your comprehensive head-to-toe assessment, you'll want to record your findings in the documentation.
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This poor old lady came with swelling in her left buttock for 10 days.She had history of injection in her buttocks two weeks back. She developed painful swelling and redness in her left gluteal region with difficulty in walking.It was diagnosed as injection abscess left gluteal region which needs incision and drainage under local anesthesia.Patient part painted and drapped.2% Lignocaine with adrenaline was infiltrated around the swelling for proper filed block.I use no-11 blade for stab incision over the swelling at the most fluctuating point of the abscess.You can watch how pus was flowing out from the cavity.The aim is to drain all pus from the abscess cavity.Finger exploration is essential to break all loculi inside the cavity, to know the depth and extend of the cavity and to fascilitate proper drainage of residual pus.after pus evacuation,, the cavity should be irrigated with normal saline and betadine solution.lastly the cavity to be packed with betadine soaked guage pieces.Proper dressing is essential.the dressing to be changed after 24 hours.daily dressing is essential with a good antibiotic coverage.the cavity usually obliterates within a period of seven to ten days.
Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin in cold, windy weather is most vulnerable to frostbite. But frostbite can occur on skin covered by gloves or other clothing.
Pelvic examinations during labor are used for several purposes, among them assessment of cervical dilatation, effacement, station of the presenting part, presentation, position, and pelvic capacity.Instruction in these techniques is particularly important for those health care providers involved in labor management, including physicians, nurses, midwives, paramedics and EMT personnel.
Thalassemia is an inherited blood disorder characterized by less hemoglobin and fewer red blood cells in your body than normal. Several types of thalassemia exist, including alpha-thalassemia, beta-thalassemia intermedia, Cooley's anemia and Mediterranean anemia. Hemoglobin is the substance in your red blood cells that allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause anemia, leaving you fatigued. If you have mild thalassemia, you may not need treatment. But, if you have a more severe form of thalassemia, you may need regular blood transfusions. You can also take steps on your own to cope with fatigue, such as choosing a healthy diet and exercising regularly.
What is a laparoscopic cholecystectomy? Laparoscopic cholecystectomy is a procedure in which the gallbladder is removed by laparoscopic techniques. Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During a laparoscopic surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor.The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.
M.Torabi Nami MD, PhDc Department of Neuroscience Institute for Cognitive Science Studies (ICSS), Tehran 15948 Iran Torabi_m@iricss.org Abstract Sleepiness, tiredness and fatigue are complaints which must be thoroughly analyzed to eliminate blur and ambiguity. Physiological sleepiness (“sleep pressure”) increases while being awake and additionally underlies the circadian rhythm with a lower threshold to fall asleep during night time. Excessive daytime sleepiness (EDS) is considered normal only after sleep deprivation. Clinically, EDS manifests by frequents daytime napping and/or reduced alertness with automatic behavior or - in its extreme form - in recurrent attacks of sudden, uncontrollable compulsion to sleep also in inappropriate situations (= “sleep attacks”). EDS is “objectively” addressed by measuring the mean sleep latency to four to five nap opportunities throughout the day using the multiple sleep latency test (MSLT) or the maintenance of wakefulness test (MWT). EDS denotes both, a ready entrance into sleep as well as difficulty in staying awake during daytime or accordingly in inappropriate situations. These two partially independent aspects of EDS are separately assessed by the “passive” MSLT and the “active” MWT respectively. For that reason the MSLT and MWT only weakly correlate with each other when tested over a broad range of patients with EDS. It is important to keep in mind, that these tests are importantly influenced by a great variety of factors such as mood, anxiety, and motivation. “Vigilance” comprises wakefulness, alertness and attention and therefore is more than just the reciprocal to sleepiness. Cognitive performance tasks such as Steer Clear Reaction Time Test (SCRTT) or driving simulators require the complete integrity of vigilance to achieve normal results. Hypersomnia is usually broadly defined as the combination of abnormally prolonged night-time sleep (regularly >10 h) with EDS during ≥1 months. On the other hand, the term hypersomnia has also been used in a narrower scene for the isolated abnormality of a prolonged night-time sleep need (>10 h). “Tiredness”, also in colloquial language often used for sleepiness, in a broader sense also describes the feeling of lack of energy, motivation and initiative. These patients seek rest rather than sleep. They often cannot fall asleep when given the opportunity in spite of feeling tired, and hence, in an MSLT, do not show an abnormally short sleep latency. Furthermore, tiredness (and fatigue) as opposed to sleepiness has a mental (“central”) and physiological (bodily or “peripheral”) component, which the patients can readily distinguish. Patients with insomnia, mild sleep apnea syndrome, or depression rather suffer from mental tiredness than sleepiness during the day. The simple subjective self-assessment using the Epworth Sleepiness Scale (ESS) quite reliably differentiates between sleepiness and mental tiredness (without sleepiness), which makes it a widely used test. The term “fatigue” is also heterogeneously used. In physiology the “fatigue” implied a “time on task performance decrement” to describe decreasing muscle force during a sustained physical effort. In clinical medicine one distinguishes physical (“peripheral”) from mental (“central”) fatigue and the term usually denotes a chronic and more abnormal situation than tiredness. In a broad sense “fatigue” implies a deficiency in coping satisfactorily with mental and physical work load. The chronic fatigue syndrome entails both mental as well as a physical fatigue (so called “leaden paralysis” of limbs). Depressive states are often associated with insomnia and fatigue, but there are also cases with hypersomnia rather than insomnia ( non organic hypersomnia , “atypical depression” or “hypersom
Inguinal hernia Diagram of an indirect, scrotal inguinal hernia ( median view from the left). Diagram of an indirect, scrotal inguinal hernia ( median view from the left). By far the most common hernias (up to 75% of all abdominal hernias) are the so-called inguinal hernias. For a thorough understanding of inguinal hernias, much insight is needed in the anatomy of the inguinal canal. Inguinal hernias are further divided into the more common indirect inguinal hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the direct inguinal hernia type (1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are more common in men than women while femoral hernias are more common in women.