Top videos
Doctors save the life of an unborn baby who was injured along with her mother in a missile attack in the Syrian city of Aleppo. The video shows a team of emergency medical workers delivering the baby by Cesarean section and then treating the newborn for the shrapnel wounds covering her body and one very large gash in her head. “Medics can be seen frantically reviving the baby, after delivering her by emergency cesarean, as she lies motionless,” the article states. “Eventually the tiny newborn begins to cry and seemingly comes to life as she is given an oxygen mask and rubbed vigorously.” “According to Reuters, the woman also has three other children, all of whom were injured in the attack, but are reported by doctors in the hospital to be in a good condition,” the Daily Mirror article states. The article does not provide the gestational age of the baby before it was delivered. The article said the pregnant woman was hit by a barrel bomb – “crude explosives and shrapnel and dropped from helicopters used by [Syrian] President Bashir al-Assad’s regime." The article notes an estimated 7.6 million Syrians have been displaced by the ongoing civil war and that 320,000, including 11,000 children, have been killed in the conflict. The Daily Mirror also reports that the doctors suggested that the tiny girl be named Amal, which means hope in Arabic. UK Daily Mirror: Incredible footage shows Syrian doctors perform lifesaving caesarean after missile strike leaves shrapnel embedded in unborn baby's face
Elbow Exam - Orthopaedic OSCE - Clinical Skills - Dr Gill
The elbow examination is a core skill - in this video, we demonstrate how to perform an elbow EXAM for an Orthopaedic Clinical Skills OSCE, which should be one of the more accessible examination stations for medical students.
For a passing grade in your Clinical Skills OSCE, an elbow assessment should follow the LOOK, FEEL, MOVE approach
Initially looking for erythema, scars, swelling and position
Palpating the elbow - specifically the olecranon, medial and lateral epicondyles, and radial head for heat, oedema and crepitus
Finally assess range of movement with flexion and extension at the elbow, before determining for tennis and golfers' elbows
Watch further orthopaedic examinations for your OSCE revision:
The Elbow - Deep Dive
https://youtu.be/SX5buhtCVDw
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
The Knee examination
https://youtu.be/oyKH4EYfJDM
The Hip examination
https://youtu.be/JC9GKq5nSdQ
The GALS examination
https://youtu.be/5qJaf7gW-B0 - Gait, Arms, Legs, Spine - GALS screen
------------
Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. 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.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people viewing this medical examination video may experience an ASMR effect
#clinicalskills #Elbow #DrGill
Acute mesenteric ischemia (AMI) is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of the bowel wall. Although relatively rare, it is a potentially life-threatening condition. Broadly, AMI may be classified as either arterial or venous. AMI as arterial disease may be subdivided into nonocclusive mesenteric ischemia (NOMI) and occlusive mesenteric arterial ischemia (OMAI); OMAI may be further subdivided into acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT). AMI as venous disease takes the form of mesenteric venous thrombosis (MVT).
Cardiovascular Examination Clinical skills - Medical School Revision - Dr Gill
The cardiac exam is one of the clinical skills that medical students learn completely, as more often than not, patients will consult regularly about chest pain, and it is important to be able to identify key cardiovascular signs
As a junior doctor, the examination of the cardiovascular system can be almost a dreaded examination, as cardiac murmurs can literally take years of exposure in order to gain confidence with their identification through cardiac auscultation.
This video demonstrates not merely the examination of the heart, but the complete cardiovascular system including its peripheries.
I hope these clinical skill revision videos are helpful, please like and subscribe and join the community so that we can create more effective videos to help with your journey through medical school
#ClinicalExamination #ASMR #drgill
Some people have found this video useful for ASMR
Both lower extremities must be evaluated to determine the presence or extent of any disease and to ascertain the pulse status of the patient. The feet are examined for signs of peripheral vascular disease and the anterior and posterior tibial pulses are palpated. Because an intact arch can supply retrograde flow to the major vessels of the foot, it can be helpful to put pressure on the anterior tibial artery when detecting the presence of a posterior tibial pulse and visa-versa. This "modified Allen's test" may detect proximal vessel obstruction masked by an intact foot arch. The need for preoperative angiography in young, healthy patients with a normal physical examination has been hotly debated. Our tendency has been to obtain preoperative angiograms as a guide. Although rare, we have seen lower extremities with a dominant peroneal artery nourishing the foot and distal anterior and posterior vessels, contraindicating sacrifice of the peroneal artery. MRI or CT angiography can also be used in many circumstances.
What is Venipuncture? While venipuncture can refer to a variety of procedures, including the insertion of IV tubes into a vein for the direct application of medicine to the blood stream, in phlebotomy venipuncture refers primarily to using a needle to create a blood evacuation point. As a phlebotomist, you must be prepared to perform venipuncture procedures on adults, children, and even infants while maintaining a supportive demeanor and procedural accuracy. Using a variety of blood extraction tools, you must be prepared to respond to numerous complications in order to minimize the risk to the patient while still drawing a clean sample. In its entirety, venipuncture includes every step in a blood draw procedure—from patient identification to puncturing the vein to labeling the sample. Patient information, needle placement, and emotional environment all play a part in the collection of a blood sample, and it's the fine details that can mean the difference between a definite result and a false positive. After placing the tourniquet and finding the vein, it's time for the phlebotomist to make the complex choice on what procedure will best suit the specific situation. Keeping this in mind, it should be noted that the following information is not an instructional guide on how to perform these phlebotomy procedures. Rather, the information below is intended to serve as an educational resource to inform you of the equipment and procedures you will use. Venipuncture Technqiues Venipuncture with an Evacuated or Vacuum Tube: This is the standard procedure for venipuncture testing. Using a needle and sheath system, this procedure allows multiple sample tubes to be filled through a single puncture. This procedure is ideal for reducing trauma to patients. After drawing the blood, the phlebotomist must make sure the test stopper is correctly coded and doesn't contact exposed blood between samples. Venipuncture with a Butterfly Needle : This is a specialized procedure that utilizes a flexible, butterfly needle adaptor. A butterfly needle has two plastic wings (one on either side of the needle) and is connected to a flexible tube, which is then attached to a reservoir for the blood. Due to the small gauge of the needle and the flexibility of the tube, this procedure is used most often in pediatric care, where the patients tend to have smaller veins and are more likely to move around during the procedure. After being inserted into a vein at a shallow angle, the butterfly needle is held in place by the wings, which allow the phlebotomist to grasp the needle very close to the skin. Phlebotomists should be careful to watch for blood clots in the flexible tubing. Venipuncture with a Syringe: This technique is typically only used when there is a supply shortage, or when a technician thinks it is the appropriate method. It uses the classic needle, tube, and plunger system, operating in a similar manner to the vacuum tube but requiring multiple punctures for multiple samples. Additionally, after the blood is drawn it must be transferred to the appropriate vacuum tube for testing purposes. If you choose to use this method, remember to check for a sterile seal, and use a safety device when transferring the sample. Fingerstick (or Fingerprick): This procedure uses a medical lance to make a small incision in the upper capillaries of a patient's finger in order to collect a tiny blood sample. It is typically used to test glucose and insulin levels. When performing a Fingerstick, the phlebotomist should remember to lance the third or fourth finger on the non-dominant arm. Never lance the tip or the center of the finger pad; instead, lance perpendicular to the fingerprint lines. Heelstick (or Heelprick): Similar to the Fingerstick procedure, this process is used on infants under six months of age. A medical lance is used to create a small incision on the side of an infant's heel in order to collect small amounts of blood for screening. As with a Fingerstick, the incision should be made perpendicular to the heel lines, and it should be made far enough to the left or right side of the heel to avoid patient agitation. Before performing a Heelstick, the infant's heel should be warmed to about 42 degrees Celsius in order to stimulate capillary blood and gas flow. Therapeutic Phlebotomy: This involves the actual letting of blood in order to relieve chemical and pressure imbalances within the blood stream. Making use of a butterfly needle, this therapy provides a slow removal of up to one pint of blood. Though the blood removed is not used for blood transfusions, the procedure and concerns are the same as with routine blood donation. As with any phlebotomy procedure, one should pay close attention to the patient in order to prevent a blood overdraw. Bleeding Time: A simple diagnostic test that is used to determine abnormalities in blood clotting and platelet production. A shallow laceration is made, followed by sterile swabbing of the wound every 30 seconds until the bleeding stops. Average bleed times range between one and nine minutes. As a phlebotomist, you should familiarize yourself with the application and cross-application of these procedures in order to recognize when a procedure is necessary, and what the risks are for each.
Aortoiliac occlusive disease (AIOD) occurs commonly in patients with PAD. Significant lesions in the aortoiliac arterial segment are exposed easily by palpation of the femoral pulses. Any diminution of the palpable femoral pulse indicates that a more proximal obstruction exists. Obstructive lesions may be present in the infrarenal aorta, common iliac, internal iliac (hypogastric), external iliac, or combinations of any or all of these vessels. Occasionally, degenerated nonstenotic atheromatous disease exists in these vessels and may manifest by atheroembolism to the foot, the "blue toe" or "trash foot" syndrome. Generally, patients with aortoiliac PAD have a poorer general prognosis than those with more distal PAD.
External jugular vein cannulation is an integral part of modern medicine and is practiced in virtually every health care setting. Venous access allows sampling of blood, as well as administration of fluids, medications, parenteral nutrition, chemotherapy, and blood products. [1] This topic describes placement of an intravenous (IV) catheter into the external jugular vein. A similar technique can be used for placement of IV catheters at different anatomic sites.
Pulmonary edema is usually caused by a heart condition. Other causes include pneumonia, exposure to certain toxins and drugs, and being at high elevations. Depending on the cause, pulmonary edema symptoms may appear suddenly or develop over time. Mild to extreme breathing difficulty can occur. Cough, chest pain, and fatigue are other symptoms. Treatment generally includes supplemental oxygen and medications.
Fibroadenomas (fy-broe-ad-uh-NO-muhz) are solid, noncancerous breast tumors that occur most often in adolescent girls and women under the age of 30. You might describe a fibroadenoma as firm, smooth, rubbery or hard with a well-defined shape. Usually painless, a fibroadenoma might feel like a marble in your breast, moving easily under your skin when touched. Fibroadenomas vary in size, and they can get bigger or even shrink on their own. Fibroadenomas are among the most common breast lumps in young women. Treatment may include monitoring to detect changes in the size or feel of the fibroadenoma, a biopsy to evaluate the lump, or surgery to remove it.
The lateral approach is used for insertion of fixation devices after closed reduction of a proximal femoral fracture. Reduction of a displaced fracture is usually done with a fracture table, or alternatively a large distractor spanning the hip joint. After satisfactory reduction is confirmed by image intensifier, the lateral approach can be used for insertion of a sliding hip screw or multiple screws. The approach provides limited access to the lateral surface of the femur sufficient for hardware placement. The incision can be extended proximally to accommodate a trochanteric stabilizing plate (TSP), or even anteriorly so that it becomes an anterolateral approach with direct, although limited, access to the femoral neck.
The digestive system is a group of organs working together to convert food into energy and basic nutrients to feed the entire body. Food passes through a long tube inside the body known as the alimentary canal or the gastrointestinal tract (GI tract).
When you’re trying to conceive a baby it is worth giving anything a go which you think will boost your chances. This includes considering that there may be better positions for getting pregnant. But it pays to bear in mind that the human race has been around for over 200,000 years and most of us were probably conceived without our ancestors investing too much thought into the mechanics. Science has proven that successful conception isn’t so much about sexual position as the frequency of sex between a fertile couple. Basically, if you want to fall pregnant, don’t use contraception and have frequent, active and enjoyable sex. Importantly, don’t stress too much about whether you’re doing it the right way. Women can, and do, conceive in any position. Nature has a way of making sure of that.