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This particular video is intended as a demonstration of a physical exam that may be useful in evaluating a patient with shoulder pain.
It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction. It is also intended not as a perfect example of a physical exam that would be performed for a patient in clinical practice, but is designed to optimize function and efficiency for a OSCE testing setting.
Instead, it should be treated as a supplement to independent learning using primary Osteopathic Physical Examination instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.
Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.
Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Medical Education Training (MET) facilities and equipment during the production of this video.
Additional thanks to the UNTHSC-TCOM learner and faculty volunteers who participated in this production and provided permission for the use of their image in this video.
Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle.
SCOOP transtracheal oxygen is indicated for patients with chronic hypoxemia which persists in spite of optimal medical therapy. Arterial blood gases obtained while breathing room air should show a PaO2< 55 mm Hg. SCOOP transtracheal oxygen is also indicated for patients with a PaO2 of 56-59 mm Hg ...
if they also have: 1) dependent edema suggesting congestive heart failure, 2) "P" pulmonale on EKG (P wave greater than 3mm in standard leads II, III or AVF), or 3) erythrocythemia with a hematocrit of >55%.
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.
in this patient the aneurysm wasarising from middle cerebral artery M1 segment dividng into three branches,it is mandatory topreserve all three divisions,as was done in this case,this pt 25 yrs young man presented with sub arachnoid haemorrhage
Contact us to find out more http://www.londonvisionclinic.com/contact-us/ A video of an actual lasik eye surgery procedure taking place, using VisuMax and MEL 80 at the London Vision Clinic.
Visit http://www.londonvisionclinic.....com/are-you-suitable to find out more about the laser eye surgery process.
HIV gradually destroys the immune system by attacking and killing a type of white blood cell called a CD4 cell. CD4 cells play a major role in protecting the body from infection. HIV uses the machinery of the CD4 cells to multiply (make copies of itself) and spread throughout the body. This process, which is carried out in seven steps or stages, is called the HIV life cycle. HIV medicines protect the immune system by blocking HIV at different stages of the HIV life cycle. Antiretroviral therapy or ART is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines from at least two different HIV drug classes every day. Because each class of drugs is designed to target a specific step in the HIV life cycle, ART is very effective at preventing HIV from multiplying. ART also reduces the risk of HIV drug resistance. ART can’t cure HIV, but HIV medicines help people with HIV live longer, healthier lives. ART also reduces the risk of HIV transmission (the spread of HIV to others).
The diffuse lung diseases tend to cause infiltrative opacification in the periphery of the lung. As the name of the group of diseases suggests, they are diffuse. While the consolidation or ground-glass change is usually bilateral, it may be localised, e.g. radiation pneumonitis.
www.diabetes.org > Living With Diabetes > Treatment and Care > Medication > Insulin & Other Injectables Share: Print PageText Size:A A A Listen How Do Insulin Pumps Work? If you have been diagnosed with diabetes, you may feel overwhelmed by all the new information you have learned and will continue to learn about managing your diabetes. You already know your main goal should be to get your blood glucose (sugar) levels under control in order to increase your chances of a complication-free life. Many people know this, but need to know how to achieve good diabetes management, while balancing the day-to-day demands of diabetes with other life demands. An insulin pump can help you manage your diabetes. By using an insulin pump, you can match your insulin to your lifestyle, rather than getting an insulin injection and matching your life to how the insulin is working. When you work closely with your diabetes care team, insulin pumps can help you keep your blood glucose levels within your target ranges. People of all ages with type 1 diabetes use insulin pumps and people with type 2 diabetes have started to use them as well. - See more at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/how-do-insulin-pumps-work.html?referrer=https://www.google.com/#sthash.XD56v351.dpuf
Adenocarcinoma of the Transverse Colon taken by Dr. Julio Murra Saca This is the case of a 42 year-old male, with no significant past medical history presented with abdominal pain and no weight loss was reported. Adenocarcinoma of the colon is a primary cause of mortality and
morbidity in North America and Western Europe. Colonic cancers are the most common GI carcinomas and have the best prognosis. The 5-year survival rate is approximately 50%.
Survival rates may be improved by screening and removal of adenomatous polyps. Almost all colonic cancers are primary adenocarcinomas.