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In caring for patients who are critically ill, access to the central venous circulation is important. Central venous access allows the placement of various types of intravenous (IV) lines to facilitate the infusion of fluids, blood products, and drugs and to obtain blood for laboratory analysis. It is also an essential procedure in patients in whom placement of a line in a peripheral vein is impossible. A central line may be the only means of venous access in such cases.
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Finger metacarpophalangeal (MCP) joint collateral ligament sprains should not be overtreated. First-degree sprains may require a brief period of protection, usually consisting of buddy taping for 2-3 weeks. Second-degree sprains are immobilized in mid flexion for 3 weeks. Finger MCP joint hyperextension injuries may be treated by gently flexing the proximal phalanx and immobilizing the MCP joint in 30° of flexion for 2-3 weeks. A dorsal extension-block splint protects the healing volar plate while allowing active flexion of the finger. Early protected motion minimizes postinjury stiffness. Thumb MCP joint hyperextension injuries ("locked MCP joint") are immobilized in 20° MCP joint flexion for 3 weeks.
IVC filter is placed to prevent fatal Pulmonary Embolism due to Deep Venous Thrombosis (DVT). This particular patient had extensive DVT of Ilio-Femoral veins leading to massive swelling of left lower limb. The IVC filter was inserted via the Right Femoral Vein. This case was the first IVC filter placement of North Bengal and adjoining areas.
Pericardiocentesis is the aspiration of fluid from the pericardial space that surrounds the heart. This procedure can be life saving in patients with cardiac tamponade, even when it complicates acute type A aortic dissection and when cardiothoracic surgery is not available. [1] Cardiac tamponade is a time sensitive, life-threatening condition that requires prompt diagnosis and management. Historically, the diagnosis of cardiac tamponade has been based on clinical findings. Claude Beck, a cardiovascular surgeon, described 2 triads of clinical findings that he found associated with acute and chronic cardiac tamponade. The first of these triads consisted of hypotension, an increased venous pressure, and a quiet heart. It has come to be recognized as Beck's triad, a collection of findings most commonly produced by acute intrapericardial hemorrhage. Subsequent studies have shown that these classic findings are observed in only a minority of patients with cardiac tamponade. [2] The detection of pericardial fluid has been facilitated by the development and continued improvement of echocardiography. [3] Cardiac ultrasound is now accepted as the criterion standard imaging modality for the assessment of pericardial effusions and the dynamic findings consistent with cardiac tamponade. With echocardiography, the location of the effusion can be identified, the size can be estimated (small, medium, or large), and the hemodynamic effects can be examined by assessing for abnormal septal motion, right atrial or right ventricular inversion, and decreased respiratory variation of the diameter of the inferior vena cava
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Transvenous cardiac pacing, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
A chronic cough is a cough that lasts eight weeks or longer in adults, or four weeks in children. A chronic cough is more than just an annoyance. A chronic cough can interrupt your sleep and leave you feeling exhausted. Severe cases of chronic cough can cause vomiting, lightheadedness and even rib fractures. While it can sometimes be difficult to pinpoint the problem that's triggering a chronic cough, the most common causes are tobacco use, postnasal drip, asthma and acid reflux. Fortunately, chronic cough typically disappears once the underlying problem is treated.