A ventricular assist device (VAD) — also known as a mechanical circulatory support device — is an implantable mechanical pump that helps pump blood from the lower chambers of your heart (the ventricles) to the rest of your body. A VAD is used in people who have weakened hearts or heart failure. Although a VAD can be placed in the left, right or both ventricles of your heart, it is most frequently used in the left ventricle. When placed in the left ventricle it is called a left ventricular assist device (LVAD). You may have a VAD implanted while you wait for a heart transplant or for your heart to become strong enough to effectively pump blood on its own. Your doctor may also recommend having a VAD implanted as a long-term treatment if you have heart failure and you're not a good candidate for a heart transplant.

Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over a few hours or a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care. Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you may recover normal or nearly normal kidney function

If the artery were severed, blood would flow out unimpeded, although the artery wall would contract in an effort to stop the bleeding. After losing >30% of one's blood volume blood pressure would start dropping, and with less pressure the rate of bleeding would go down. At this stage if the blood loss wasn't replaced the person could die. Losing halve to two thirds of one's blood volume is considered to be fatal even if later on blood transfusion is attempted. One's total blood volume at 70ml/kg is estimated to be between 5 to 7 liters, so that makes a blood loss of between 2,5 to 4,7 L.

Watch that video to know if it is safe to have anal Intercourse?

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.

Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling. Testicular torsion is most common between ages 12 and 16, but it can occur at any age, even before birth. Testicular torsion usually requires emergency surgery. If treated quickly, the testicle can usually be saved. But when blood flow has been cut off for too long, a testicle might become so badly damaged that it has to be removed.

Visualization of the larynx by direct or indirect means is referred to as laryngoscopy and is the principal aim during airway management for passage of a tracheal tube. This paper presents a brief background regarding the development and practice of laryngoscopy and examines the equipment and techniques for both direct and indirect methods. Patient evaluation during the airway examination is discussed, as are predictors for difficult intubation. Laryngoscope blade design, newer intubating techniques, and a variety of indirect laryngoscopic technologies are reviewed, as is the learning curve for these techniques and devices.

Health Assessment: Musculoskeletal System- Nursing Skills

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Health Assessment: Musculoskeletal System- Nursing Skills:

In this video we’re going to review a Musculoskeletal Assessment. The Musculoskeletal system involves the muscles, bones, and joints. This means we must assess structure AND function! If the patient cannot stand, assessments should be performed in the bed to the best of your ability. If they cannot perform Active Range of Motion (ROM), use Passive movements to determine ROM.
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Bookmarks:
0.05 Introduction
0:34 Spine assessment
1:02 Range of motion
1:39 Extremity assessment
1:52 Shoulder range of motion
2:10 Elbow & wrist range of motion
2:25 Hand range of motion
2:34 Upper extremity strength
2:54 Lower extremity range of motion
3:02 Hips range of motion
3:20 Knees range of motion
3:30 Ankles range of motion
3:38 Toes range of motion
3:42 Lower extremity strength
4:05 Outro

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The "sunshine" vitamin is a hot topic. You may have recently found out that you are deficient or know someone who is. It's shocking for most people when they have never had a problem before and believe nothing has changed to make it a problem now. The truth is that a lot has changed, and vitamin D deficiency and insufficiency is now a global public-health problem affecting an estimated 1 billion people worldwide. The most well-known consequences to not having enough vitamin D are rickets in children and osteomalacia in adults. These are far from the only problems associated with a vitamin D deficiency.

Cervical artificial disc replacement using the BRYAN Disc, a trusted product of Medtronic. Spine care offices are located in New Jersey, New York, and Florida. Are you experiencing neck pain? Do you think you may have a herniate disc? Learn more about our doctors' 97% success rate for performing BRYAN disc replacement:

Comedone Extraction Video

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Quit Smoking Forever Formula Videos - How To Quit Smoking In As Fast As 1 Week Without Agitation, Cravings Or Withdrawal Symptoms.You're about to uncover the 3 elements that will rapidly boost your chances of success to quit smoking and not only that, you'll learn ways to escape cravings and how to avoid a relapse that can happen in the future even to people with the most willpower.

Urological surgeons have become proficient at performing complex pelvic urological procedures, such as radical prostatectomy, using the laparoscopic approach. Declan Murphy and Daniel Moon share their experience of four less common procedures they have performed recently using laparoscopic techniques. These include: excision of a urachal cyst; partial cystectomy for endometriosis (combined endoscopic-laparoscopic approach); repair of an intra-peritoneal bladder rupture; and repair of a ureteric injury (combined endoscopic-laparoscopic approach).

Second-degree burns (also known as partial thickness burns) involve the epidermis and part of the dermis layer of skin. The burn site appears red, blistered, and may be swollen and painful.

Renal replacement therapies are a set of interventions and techniques aimed at replacement of the filtering function of the kidneys. These include both dialysis and renal transplant. In this presentation we will talk about the indication and modalities of dialysis. This includes hemodialysis, peritoneal dialysis and continuous renal replacement therapies. The circuit diagram of each modalities along with its procedure and complications are also discussed.

-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.

A prenatal ultrasound (also called a sonogram) is a noninvasive diagnostic test that uses sound waves to create a visual image of your baby, placenta, and uterus, as well as other pelvic organs. It allows your healthcare practitioner to gather valuable information about the progress of your pregnancy and your baby's health. During the test, an ultrasound technician (sonographer) transmits high-frequency sound waves through your uterus that bounce off your baby. A computer then translates the echoing sounds into video images that reveal your baby's shape, position, and movements. (Ultrasound waves are also used in the handheld instrument called a Doppler that your practitioner uses during your prenatal visits to listen to your baby's heartbeat.) You may have an early ultrasound at your practitioner's office at 6 to 10 weeks to confirm and date the pregnancy. Or you may not have one until the standard midpregnancy ultrasound between 16 and 20 weeks. That's when you may learn your baby's sex, if you like. (The technician will probably present you with a grainy printout of the sonogram as a keepsake.) You may also have a sonogram as part of a genetic test, such as the nuchal translucency test, chorionic villus sampling, or amniocentesis, or at any other time if there are signs of a problem with your baby. You'll have more frequent ultrasounds if you have diabetes, hypertension, or other medical complications.

A small spontaneous pneumothorax may resolve without treatment; a pneumothorax arising as a result of lung disease or injury requires immediate treatment. Treatment may include insertion of a chest tube or aspiration of the free air in the chest cavity.Feb 19, 2016

The term chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) has been used to identify patients with a chronically progressive or relapsing symmetric sensorimotor disorder with cytoalbuminologic dissociation and interstitial and perivascular endoneurial infiltration by lymphocytes and macrophages. It can be considered the chronic equivalent of acute inflammatory demyelinating polyradiculoneuropathy, the most common form of Guillain-Barré syndrome. Signs and symptoms CIDP typically starts insidiously and evolves slowly, in either a slowly progressive or a relapsing manner, with partial or complete recovery between recurrences; periods of worsening and improvement usually last weeks or months. Most experts consider the necessary duration of symptoms to be greater than 8 weeks for the diagnosis of CIDP to be made. Symptoms reported include the following: Preceding infection (infrequent) Initial limb weakness, both proximal and distal Sensory symptoms (eg, tingling and numbness of hands and feet) Motor symptoms (usually predominant) In about 16% of patients, a relatively acute or subacute onset of symptoms In children, usually a more precipitous onset of symptoms Symptoms of autonomic system dysfunction (eg, orthostatic dizziness) Pertinent physical findings are limited to the nervous system, except when the condition is associated with other diseases. Such findings may include the following. Signs of cranial nerve (CN) involvement (eg, facial muscle paralysis or diplopia) Gait abnormalities Motor deficits (eg, symmetric weakness of both proximal and distal muscles in upper and lower extremities) Diminished or absent deep tendon reflexes Sensory deficits (typically in stocking-glove distribution) Impaired coordination See Clinical Presentation for more detail. Diagnosis Laboratory studies that may be helpful include the following: Cerebrospinal fluid analysis: Elevated protein levels are common (80% of patients); 10% of patients also have mild lymphocytic pleocytosis and increased gamma globulin Complete blood count (CBC), erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) level, biochemistry profile, and serum and urine immunoelectrophoresis (to exclude associated systemic disorders) In certain instances, genetic testing Other tests and procedures that may be warranted are as follows: MRI of the spine with gadolinium enhancement Electromyography (EMG) is a critical test to determine whether the disorder is truly a peripheral neuropathy and whether the neuropathy is demyelinating Peripheral (sural) nerve biopsy (see the image below): This is considered when the diagnosis is not completely clear, when other causes cannot be excluded, or when profound axonal involvement is observed on EMG; biopsy was once commonly recommended for most patients before immunosuppressive therapy, but current guidelines no longer recommend it

Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.