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A surgeon begins the PPH stapled hemorrhoidectomy by inserting a circular anal dilator and obturator into the anal canal and then securing the dilator in place with four sutures. The surgeon then inserts a PPH anoscope into the obturator. Next, he places a circumferential purse-string suture of 2-0 Monocryl on a UR-6 needle 4 cm proximal to the dentate line. The surgeon opens a PPH stapler and places its anvil across the purse string. The stapler is then closed and fired; it is held closed for two minutes to improve hemostasis. Prior to firing the stapler in a female patient, the surgeon places a gloved finger in the vagina to ensure the vaginal mucosa and rectal-vaginal septum are not trapped within the jaws of the closed stapler. The surgeon then opens and removes the stapler.
Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.
Asthma was originally described as an inflammatory disease that predominantly involves the central airways. Pathological and physiological evidence reported during the past few years suggests that the inflammatory process extends beyond the central airways to the peripheral airways and the lung parenchyma. The small airways are capable of producing T-helper-2 cytokines, as well as chemokines, and they have recently been recognized as a predominant site of airflow obstruction in asthmatic persons. The inflammation at this distal site has been described as more severe than large airway inflammation. These findings are of great clinical significance, and highlight the need to consider the peripheral airways as a target in any therapeutic strategy for treatment of asthma.
A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein. Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters). It is used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.
Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Please refer to the full article on Lumbar Puncture for more details on the lumbar puncture procedure. Lumbar puncture is typically performed via “blind” surface landmark guidance. The surface landmark technique is reported to be successful in a high percentage of attempted lumbar punctures; however, surface landmark identification of underlying structures has been shown to be accurate only 30% of the time. [1] Unsuccessful identification of proper landmarks often leads to increased difficulty in obtaining CSF, if the procedure is performed, and a higher rate of complications. Few alternatives are available in these cases. If available, fluoroscopic-guided lumbar puncture may be performed. If not, treatment is sometimes initiated empirically without obtaining CSF. Disadvantages of using fluoroscopy include limited availability or necessary transport of the patient outside of the emergency department, inability to directly visualize the spinal canal, and inherent radiation exposure
What Is a Paronychia (Nail Infection)? An infection that develops along the edge of the fingernail or toenail is called a paronychia (pear-ah-NIK-ee-ah). It is the most common hand infection and, if left untreated, can progress to a more severe infection of the entire finger or toe. Paronychia is distinguished from other infections such as onychomycosis and herpetic whitlow by its location and appearance.
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Intramuscular Injection Techniques (Nursing Skills)
In this video, we’re going to look at proper administration techniques for intramuscular medication administration. Of course, always follow your 5 rights and calculate the correct volume for administration. We love you guys! Go out and be your best selves today! And, as always, happy nursing!
Bookmarks:
0.05 Introduction to Intramuscular injections
0.16 site and needle selection
0.35 site sterilization
0.43 Z track method
0.58 needle insertion
1.10 medication injection
1.14 needle removal
1.25 bandaging and needle disposal
1.30 documentation and patient monitoring
1.35 Outro
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-Traumatic amputation of a body part requires rapid transport of the appendage, which should be wrapped in a saline-moistened gauze, placed in a plastic bag, and transported in a container filled with ice mixed with either saline or sterile water to best preserve the body part and attempt replantation.
The menstrual cycle is the regular natural change that occurs in the female reproductive system that makes pregnancy possible. The cycle is required for the production of oocytes, and for the preparation of the uterus for pregnancy.
This is the incredible moment a new-born baby arrived still inside its amniotic sac, completely intact. The tiny infant can be seen moving and stretching still inside the sac, as medics prepare to snip the new born free. The amniotic sac is a thin but durable membrane filled with fluid which helps keep a baby warm and safe from bumps during pregnancy. When it breaks, this is typically referred to as a woman's 'waters breaking' shortly before she gives birth. But in rare cases, less than 1-in-80,000 births, the baby is delivered with the membranes still intact and this is known as a 'caul birth'. Some babies are born with part of the membrane still attached to them, but to be born completely encased in the intact membrane is incredibly rare. Many people still believe the phenomenon to be a good omen for the child's infancy and it is has even been suggested, but not proven, that caul babies will always have a natural affinity for water. The video was taken in Spain on Saturday and captures the rare moment the baby was born with the membrane covering its entire body, just minutes after its twin was delivered normally.
World-renowned surgeons at Shriners Hospitals for Children – Northern California provide complex pediatric surgery for children one-year and older with congenital and acquired conditions. Children from throughout the Western United States with chest wall malformations, gastro-intestinal disease, ano-rectal disorders, urologic conditions and other complex surgical needs benefit from the expert care. The pediatric surgery team is devoted to the development of innovative and minimally invasive surgical techniques.