Home hemodialysis gives you the flexibility to fit treatment into your lifestyle and may help you feel better with fewer medications and dietary restrictions. Watch this video to find out about how home hemodialysis could be right for you, and visit our website to learn more: www.FreseniusKidneyCare.com/HHD. #HomeDialysis #DialysisTreatment #KidneyDialysis

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In the Dialysis Unit you have an opportunity to provide Dialysis care for a variety of patients, including those with End-Stage Chronic Kidney disease and acutely ill patients requiring dialysis and plasmapheresis.
The Chronic Dialysis Nurse focuses on patients receiving Hemodialysis, Peritoneal Dialysis, or Home Hemodialysis. Our patients range in age from newborns to young adults. The Hemodialysis patient receives their dialysis treatment in the clinic 3-5 times a week. The Peritoneal Dialysis and Home Hemodialysis treatments are provided in the patient’s home once the parent/caregiver is trained to operate the machine. They are followed monthly in clinic. The patient receiving Chronic Dialysis is supported by a multidisciplinary team that consists of a physician, nurses, social worker, nutritionist, pharmacist, child-life therapist, teacher, and counselor. The group works together to meet the medical and emotional needs of the patient and caregiver. Care is specialized to meet the needs of each individual patient.
The Acute Dialysis Nurse focuses on acute dialysis related therapies such as: Continuous Renal Replacement Therapy (CRRT); therapeutic plasmapheresis; or acute peritoneal dialysis. The acute dialysis team works with the multi-disciplinary inpatient nephrology team to provide acute dialysis services to the critically ill ICU patients. The work environment is highly technical and fast-paced.
The Dialysis Unit operates on 12hr shifts 7a – 7p; 7 days a week. Night call is required and shared by the nurses. We provide a detailed orientation plan to the nurse to become proficient in providing hemodialysis, peritoneal dialysis, continuous renal replacement therapy and plasmapheresis. Previous experience in dialysis or pediatrics is not required.

A very funny video showing the other non-bright side of being a doctor

Rhode Island Hospital's outpatient dialysis program cares for patients with chronic kidney disease. Learn more about the program, which includes a new, state of the art dialysis center in East Providence. http://www.rhodeislandhospital.....org/outpatient-dial

Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall. However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion.

If you have an active lifestyle or are often on the go with work, travel or family, then peritoneal dialysis at home may be the right choice. Home peritoneal dialysis offers additional freedom and flexibility as a treatment option that’s closest to natural kidney function and may require fewer dietary restrictions and medications. To learn more about Home PD, visit https://www.FreseniusKidneyCar....e.com/ckd-treatment/

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A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.

Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs

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Body Bizarre is a TLC show with a name I'm not too wild about, but with stories that are nonetheless fascinating. Today we look at separating conjoined twins, a girl with ants crawling out of her ears, a man who nearly lost his hand in a factory accident, a family that all has 6 fingers, and more.

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A video showing the examination of femoral hernia.

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An animation of blood flow inside the Hemodialysis circuit.

About Dr. Rifai:
Dr. Ahmad Oussama Rifai is certified by the American Board of Internal Medicine (ABIM) in the specialty of Internal Medicine and the sub-specialty of Nephrology.

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Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

Describe pre-procedure considerations for administering a subcutaneous injection.

Describe and demonstrate the preparation for administering a subcutaneous injection.

Describe and demonstrate needle and blood safety.

Describe and demonstrate suitable injection sites for subcutaneous injections.

Discuss the appropriate needle and syringe sizes for subcutaneous injection.

Describe and demonstrate the preparation of the substance to be injected.

Describe and demonstrate safe and correct administration of a subcutaneous injection.

Understand and apply Occupational Safety and Health Administration (OSHA) guidelines.

Understand and apply drug administration safety guidelines (seven rights).

Understand correct post-procedure considerations.

Describe and demonstrate correct documentation.

Define and demonstrate correct recording and reporting procedures.

Define and use related medical terminology.

Explain the Patient Privacy Rule (HIPAA), Patient Safety Act, and Patients' Bill of Rights.

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How to Check Cervical Mucus

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The products of a surgical abortion.

This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.

In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.

***Thanks to the patient for sharing his history and exam with YouTube world***

The anatomy of the direct and indirect inguinal hernia.


Music:
Berries and Lime by Gregory David
https://www.epidemicsound.com/track/z6iCiiyCPm/

Learn about Bicuspid Aortic Valves in this presentation. Bicuspid Aortic Valves are present in about 2% of the population and are the most common congenital disorder. Find out more about a Bicuspid Aortic Valve by visiting the following link:

Sports Hernia: Causes, Symptoms, and Treatments. Explained by Dr. Tayyaba Ahmed is a doctor of physical medicine and rehabilitation at Pelvic Rehabilitation Medicine.

Topics discussed include:

Description of a sports hernia

Where a sports hernia is located

How this causes pelvic pain

Symptoms that may be experienced

Where pain can radiate

Causes of a sports hernia

Treatment options and recommendations


Dr. Tayyaba Ahmed completed the BS/DO program at New York Institute of Technology and was trained at the New York College of Osteopathic Medicine, Northwell Health Plainview Hospital and the NYU Langone Medical Center/RUSK Institute for Rehabilitation. A board-certified Physical Medicine and Rehabilitation physician, Dr. Ahmed is also a fellow of the Academy of Physical Medicine and Rehabilitation and a member of the International Pelvic Pain Society. Dr. Ahmed is a contributing author to a textbook which is considered a staple during every Physiatrist’s training. The fourth edition has been published in November of 2018. This full chapter title reference is: Ahmed T, Chan I: “Pelvic Pain”, which is included in, Essentials of Physical Medicine and Rehabilitation, 4th edition by Frontera W, Silver J, Rizzo T; Elsevier, Philadelphia, In Press. After spending the last five years honing her skills in outpatient care, Dr. Ahmed is ready to focus on her passion for treating pelvic pain. Dr. Ahmed has chosen a focused practice, because she believes concentrating on a specific field creates the greatest expertise. Chasing that greatness has been her consistent driving force.

At Pelvic Rehabilitation Medicine, our pelvic pain specialists provide a functional, rehab approach to pelvic pain. When you visit one of our offices, you spend an hour with your doctor reviewing in detail your medical history and symptoms. Then, we perform an internal exam (no speculum) to evaluate your nerves and muscles. Together, we'll discuss an individual treatment plan that gets to the root cause of your pain and helps you to feel better. The best part: you can begin treatment the same day!

At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.

LEARN MORE: https://www.pelvicrehabilitation.com/

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****

Very often, we have patients who present with abdominal tenderness which likely is a sports hernia. A sports hernia is a weakness in the soft tissue and muscle area around their pubic symphysis and their lower abdomen. This is important because these muscles are their core muscles, and the core muscles are part of your pelvic floor as well. So if you have a weakness there, you will have a weakness in your pelvic floor and thus causing the pelvic pain. Having a sports hernia can now result into pelvic pain because of their weakness in their abdominal muscles and their core. Then patients may present with pain in their groin, they may present with pain going down their leg, pain in their hip. Pelvic pain does radiate, and it does not just stay in one location, so it can mimic other things like lower back pain.

Patients with sports hernias can attribute this from being very active. Oftentimes, they are athletes or have active lifestyles. We're evaluating their lumbar spine, we're evaluating their hips, we're evaluating their abdomen and checking to see if they could have a potential hernia. When patients have sports hernias, we also have to treat the underlying pelvic floor dysfunction that they may have.

Typically, we do that with pelvic floor physical therapists, possibly some Valium suppositories, maybe a nerve medication for any neurogenic inflammation, if they need, we may do hydrodissection nerve blocks and trigger point injections to their pelvic floor. And at the same time, we're hopefully working with a hernia surgeon to evaluate if there is a need for repair of the sports hernia. When patients present with pelvic pain, we're trying to understand where their pelvic pain is coming from and why they have it. Until we figure out what's causing the issue, the pain won't resolve.