Intramuscular (IM) injection Tutorial for Nurses Video

An estimated 12,500 spinal cord injuries occur in the U.S. every year, leaving the injured people, their friends, and their family, to cope with the aftermath of the catastrophe. For many, navigating the challenges of the health care system can feel a bit like going to medical school. Suddenly you're learning a veritable cornucopia of new terms, and may be spending endless hours Googling spinal cord anatomy to fill in the gaps in your knowledge. An educated patient is better equipped to advocate for his or her needs and interests. An education in spinal cord anatomy helps you understand what your doctor is saying, ask intelligent questions, and detect medical errors before they endanger your health.

If you're pregnant or might become pregnant, it's critically important to get enough folic acid, the synthetic form of vitamin B9, also known as folate. Folic acid helps prevent neural tube defects (NTDs) – serious birth defects of the spinal cord (such as spina bifida) and the brain (such as anencephaly).

To get started, you need to find your pelvic floor muscles by stopping urination in midstream. If you succeed, you have located the right muscles. Once you have located your pelvic floor muscles, tighten the contraction for about 5 seconds, before relaxing for another 5 seconds.

A Beautiful Smile at Lake Pointe is Sugar Land premier dentistry practice. Dr. Lance Jue has been serving patients' preventive, restorative and cosmetic dental needs here in Sugar Land for over 19 years. Book an appointment online now with Dr. Lance Jue

Preparing Syringes for Injections

What is hemodialysis, and why would someone need it? How does hemodialysis work? Can people perform hemodialysis at home? John Kevin Tucker, M.D., Nephrologist at Brigham and Women's Hospital and Vice President for Education at Mass General Brigham, discusses hemodialysis and how it helps people who have lost their kidney function to maintain normal lives.

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0:00 - Intro
0:26 - The Condition
2:06 - Hemodialysis: How It Works
4:37 - In-Center Hemodialysis Care Team

About Mass General Brigham:
Mass General Brigham combines the strength of two world-class academic medical centers, five nationally ranked specialty hospitals, 11 community hospitals, and dozens of health centers. Our doctors and researchers accelerate medical breakthroughs and drive innovations in patient care. They are leaders in medical education, serving as Harvard Medical School faculty and training the next generation of physicians. Mass General Brigham’s mission is to deliver the best, affordable health care to patients everywhere. Together, we transform the health of our communities and beyond.

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Kidney Failure: Signs, Dialysis Options, and Hemodialysis Explained | Mass General Brigham
https://youtu.be/azy7yc19QYQ

Wow Must Watch & Share wound Repair in 60 seconds

Vaccines are extremely safe. Adverse reactions are uncommon. The most common reaction is pain and swelling at the vaccine site, which is easily treated, and has no longterm problems. An allergic reaction to vaccines are rare. Dr. Michael Davis dispells this and other vaccine myths, including myths about autism and vaccines.

When you’re trying to conceive a baby it is worth giving anything a go which you think will boost your chances. This includes considering that there may be better positions for getting pregnant. But it pays to bear in mind that the human race has been around for over 200,000 years and most of us were probably conceived without our ancestors investing too much thought into the mechanics. Science has proven that successful conception isn’t so much about sexual position as the frequency of sex between a fertile couple. Basically, if you want to fall pregnant, don’t use contraception and have frequent, active and enjoyable sex. Importantly, don’t stress too much about whether you’re doing it the right way. Women can, and do, conceive in any position. Nature has a way of making sure of that.

An Echocardiography showing an Acute Pulmonary Embolism

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 a normal person, when a muscle tendon is tapped briskly, the muscle immediately contracts due to a two-neuron reflex arc involving the spinal or brainstem segment that innervates the muscle. The afferent neuron whose cell body lies in a dorsal root ganglion innervates the muscle or Golgi tendon organ associated with the muscles; the efferent neuron is an alpha motoneuron in the anterior horn of the cord. The cerebral cortex and a number of brainstem nuclei exert influence over the sensory input of the muscle spindles by means of the gamma motoneurons that are located in the anterior horn; these neurons supply a set of muscle fibers that control the length of the muscle spindle itself.

A grand mal seizure causes a loss of consciousness and violent muscle contractions. It's the type of seizure most people picture when they think about seizures. A grand mal seizure — also known as a generalized tonic-clonic seizure — is caused by abnormal electrical activity throughout the brain. Usually, a grand mal seizure is caused by epilepsy. But sometimes, this type of seizure can be triggered by other health problems, such as extremely low blood sugar, a high fever or a stroke. Many people who have a grand mal seizure never have another one and don't need treatment. But someone who has recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures

Phacolytic glaucoma usually is associated with a mature or hypermature cataract and typically occurs in elderly patients. Today, phacolytic glaucoma is rare in the United States, found primarily in areas where access to care is poor. Will the increase in the number of under- and uninsured patients lead to an increase in this condition? Evaluation and Diagnosis Signs and symptoms. Patients typically report acute-onset pain, decreased vision, tearing and photophobia. Examination will reveal injection, corneal edema, elevated IOP, anterior chamber reaction with or without pseudohypopyon, particles on the lens capsule and anterior capsule wrinkling. Patient history. The duration of symptoms should be elicited; a delayed presentation of more than five days since onset can result in glaucomatous disc damage and poorer prognosis.¹ The ocular history may reveal that the patient decided against removal of an advanced cataract. Prior intraocular surgery or trauma may have left residual lens material that could cause phacoanaphylactic glaucoma or exacerbate infectious endophthalmitis. Visual acuity and visual potential should be assessed. Exam essentials. A complete ophthalmologic examination should be done. The eye should be inflamed, and the cornea may be edematous due to the high IOP. The anterior chamber will demonstrate massive inflammation and/ or pseudohypopyon. Gonioscopy is essential; it will help rule out angle closure due to phacomorphic glaucoma or neovascularization of the angle. Assess ment of the posterior pole should be performed to rule out vitreous hemorrhage (which can result in ghost-cell glaucoma) or vitritis (which may be associated with infectious endophthalmitis or panuveitis). If the view to the fundus is obstructed, B-scan ultrasonography also should be performed. Differential diagnosis. The differential diagnosis includes infectious endophthalmitis, phacoanaphylactic glaucoma, inflammatory glaucoma, glaucoma secondary to intraocular tumor, phacomorphic glaucoma, acute-angle closure glaucoma and neovascular glaucoma. Management Medication. Medical management is used to temporarily control the glaucoma and inflammation. Initial treatment consists of hyperosmotic agents, aqueous suppressants, anti-inflammatory drugs and cycloplegics. Surgery. Definitive treatment is removal of the lens via extracapsular cataract extraction with or without an IOL. Some ophthalmologists defer placement of an IOL until after the inflammation subsides; however, there is no significant difference in final visual acuity between those patients who did receive an IOL and those who did not.¹ If the phacolytic glaucoma is of long duration (more than seven days), a combined trabeculectomy may be needed to prevent postoperative IOP spikes.² In eyes with hypermature Morgagnian cataracts, one must be especially careful, as the capsule is fragile, the zonules are weak and the view is difficult due to the white, milky cortex. Vision limited to light perception on presentation is not a contraindication to performing cataract extraction. Surgical Tips For a planned extracapsular cataract extraction with a posterior chamber IOL, fashion a superior fornix-based conjunctival flap.³ Make a partial-thickness incision along the sclerolimbal junction superiorly for 120 degrees with a No. 69 blade. Forty-five degrees away, a paracentesis should be done to decompress the eye. The anterior chamber fluid can be withdrawn for analysis, to look for macrophages and high molecular-weight proteins. Inject balanced salt solution in a cannula to wash out any residual particulate matter, then inject Healon or viscoelastic into the anterior chamber. Make an incision entering the anterior chamber at the 12 o’clock position with a keratome. A 26-gauge cystotome mounted on a syringe is then introduced through the 12 o’clock incision and used to puncture the capsular bag. The milky cortex should be aspirated as much as possible, until the nucleus is visible. Withdraw the needle through the keratome incision, then inject Healon through the 12 o’clock incision into the capsular bag. Next, enlarge the corneoscleral keratome incision with curved Westcott scissors to 120 degrees. Perform a partial V-shaped capsulotomy; this can be done either with the cystotome or with an angled Vannas scissors. Place viscoelastic under the nucleus to float the nucleus and sever any adhesions between the nucleus and the capsule. The nuclear portion of the lens can then be removed with an irrigating vectis (lens loop) with or without gentle pressure at the inferior limbus (6 o’clock). Irrigate and aspirate the residual cortex with the Simcoe cannula. Inspect the capsular bag; if it is intact, place a posterior chamber IOL into the bag. Close the incision with several interrupted 10-0 monofilament nylon sutures and reattach the conjunctival flap. Potential Sequelae and Prognosis Postoperatively, the patient should be managed with topical steroids and/or aqueous suppressants and hyperosmotics if necessary. Vitreous opacification behind the posterior capsule occurs in a small percentage of eyes. These vitreous opacities are typically absorbed by one to two weeks postoperatively. IOP usually is controlled without antiglaucoma medications after the cataract removal. A detailed glaucoma evaluation (including repeat gonioscopy to assess for peripheral anterior synechiae, visual field and optic nerve status) should be done to assess the extent of glaucomatous damage. The prognosis is dependent on the duration of elevated IOP, PAS and optic nerve damage. In one study, patients who were older than 60 and whose glaucoma was present for more than five days did significantly worse than a comparison group of younger individuals with shorter disease duration.

Neurogenic shock is a distributive type of shock resulting in low blood pressure, occasionally with a slowed heart rate, that is attributed to the disruption of the autonomic pathways within the spinal cord. It can occur after damage to the central nervous system such as spinal cord injury.

The lateral approach is used for insertion of fixation devices after closed reduction of a proximal femoral fracture. Reduction of a displaced fracture is usually done with a fracture table, or alternatively a large distractor spanning the hip joint. After satisfactory reduction is confirmed by image intensifier, the lateral approach can be used for insertion of a sliding hip screw or multiple screws. The approach provides limited access to the lateral surface of the femur sufficient for hardware placement. The incision can be extended proximally to accommodate a trochanteric stabilizing plate (TSP), or even anteriorly so that it becomes an anterolateral approach with direct, although limited, access to the femoral neck.

How to diagnose digital ulceration in out patient clinic.

Cleft palate is among the most common birth defects affecting children in North America. The incomplete formation of the roof of the mouth can occur individually, or in addition to cleft lip. Cleft palate repair is a type of plastic surgery to correct this abnormal development both to restore function and a more normal appearance. This video explains what to expect for families scheduled for cleft palate surgery at the Craniofacial Anomalies Program at University of Michigan C.S. Mott Children's Hospital.

Learn more about our program at http://www.mottchildren.org/craniofacial