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Following Dr. Eric Skarsgard on his grueling 19-hour day at BC Children's Hospital, we meet several of his patients -- some of who need surgery that day, and some who have chronic conditions and need regular check-ups with him -- and learn how he works with medical students and on research projects as time allows.
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.
Mastitis is inflammation of tissue in one or both mammary glands inside the breast. Mastitis usually affects lactating women - women who are breastfeeding, producing milk. Hence, it is often referred to as lactation mastitis. The patient feels a hard, sore spot inside the breast.
Most people develop several moles (nevi) throughout adulthood. Moles can be found anywhere on the body, usually in sun-exposed areas, and are usually brown, smooth, and slightly raised. In most cases, a nevus is benign and doesn't require treatment. Rarely, they turn into melanoma or other skin cancers. A nevus that changes shape, grows bigger, or darkens should be evaluated for removal.
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.
At each level of the spine, there is a disc space in the front and paired facet joints in the back. Working together, these structures define a motion segment (Fig. 1A). Back pain may result when injury or degenerative changes allow abnormal movement of the vertebrae to rub against one another, known as an unstable motion segment (Fig. 1B). Two vertebrae need to be fused to stop the motion at one segment. For example, an L4-L5 fusion is a one-level spinal fusion (Fig. 1C). A two-level fusion joins three vertebrae together and so on.
Closed Reduction of Distal Radius Fractures - Discussion: (distal radius fracture menu) - closed reduction & immobilization in plaster cast remains accepted method of treatment for majority of stable distal radius frx; - unstable fractures will often lose reduction in the cast and will slip back to the pre-reduction position; - patients should be examined for carpal tunnel symptoms before and after reduction; - carpal tunnel symptoms that do not resolve following reduction will require carpal tunnel release; - cautions: - The efficacy of closed reduction in displaced distal radius fractures. - Technique: - anesthesia: (see: anesthesia menu) - hematoma block w/ lidocaine; - w/ hematoma block surgeon should look for "flash back" of blood from hematoma, prior to injection; - references: - Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia. - Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia. - methods of reduction: - Jones method: involves increasing deformity, applying traction, and immobilizing hand & wrist in reduced position; - placing hand & wrist in too much flexion (Cotton-Loder position) leads to median nerve compression & stiff fingers; - Bohler advocated longitudinal traction followed by extension and realignment; - consider hyper-extending the distal fragment, and then translating it distally (while in extended position) until it can be "hooked over" proximal fragment; - subsequently, the distal fragment can be flexed (or hinged) over the proximal shaft fragment; - closed reduction of distal radius fractures is facilitated by having an assistant provide counter traction (above the elbow) while the surgeon controls the distal fragment w/ both hands (both thumbs over the dorsal surface of the distal fragment); - flouroscopy: - it allows a quick, gentle, and complete reduction; - prepare are by prewrapping the arm w/ sheet cotton and have the plaster or fibroglass ready; - if flouroscopy is not available, then do not pre-wrap the extremity w/ cotton; - it will be necessary to palpate the landmarks (outer shaped of radius, radial styloid, and Lister's tubercle, in order to judge success of reduction; - casting: - generally, the surgeon will use a pre-measured double sugar sugar tong splint, which is 6-8 layers in thickness; - more than 8 layers of plaster can cause full thickness burns: - reference: Setting temperatures of synthetic casts. - position of immobilization - follow up: - radiographs: - repeat radiographs are required weekly for 2-3 weeks to ensure that there is maintenance of the reduction; - a fracture reduction that slips should be considered to be unstable and probably require fixation with (pins, or ex fix ect.) - there is some evidence that remanipulation following fracture displacement in cast is not effective for these fractures; - ultimately, whether or not a patient is satisfied with the results of non operative treatment depends heavily on th
This 35 years old man lost his right wrist in metal lathe cut machine. the video is taken about 2 years after replantation. You can see another videos in my site: https://drliaghatclinic.com, https://instagram.com/liaghatclinic, https://t.me/liaghatclinic
First aid steps to help stop or shorten a seizure or prevent an emergency situation. This may involve giving a rescue treatment (often called "as needed" medicine or treatment) that has been recommended by your health care team. The rescue treatments described here can be given by non-medical people who are not in a hospital setting. They are intended for use by anyone (the person with seizures, family member or other observer) who has been trained in their use. These therapies can be given anywhere in the community
A bone marrow biopsy is part of a bone marrow test that takes a sample of your solid bone tissue. This test looks for abnormalities in your blood cells and signs of any diseases. You can request anesthesia or a sedative before the biopsy, and manage any pain afterward with over-the-counter medications.
Golfer's elbow causes pain that starts on the inside bump of the elbow, the medial epicondyle. Wrist flexors are the muscles of the forearm that pull the hand forward. The wrist flexors are on the palm side of the forearm. Most of the wrist flexors attach to one main tendon on the medial epicondyle.