A detailed description of the approach to a use of bleeding disorders. This presentation includes the causes, history, clinical features and diagnosis of specific bleeding disorders. These include Haemophilia, DIC, Von Willebrand Disease and others. The final differentiation is often made on the basis of the Prothrombin Time, activated Partial thromboplastin time and platelet count.

Diabetic ketoacidosis is an acute complication of uncontrolled hyperglycaemia characterised by high anion gap metabolic acidosis, dehydration and other metabolic abnormalities. Upto half of patients with Type 1 diabetes mellitus may have DKA. The incidence in T2DM is also rising. Precipitants include acute illness such as myocardial infarction, trauma and infection. Paitents of diabetic ketoacidosis may present with vomiting, pain abdomen and lethargy. Mental obtundation may also be present. Management of diabetic ketoacidosis revolves around administration of IV normal saline, insulin, replacement of potassium with frequent monitoring of sugars and electrolytes.

Cervical Cap for Birth Control

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This video illustrates an IM injection for deltoid muscle.
Note that vaccines and other medications can be administered through the deltoid muscle. I will give you some tips through this video.

It is important to check your client’s details such as their medication, time, dose, and the route to be used. Different research works are subject to change the protocols for insertion thus, it is necessary to be up to date with the current changes.

Assemble all the supplies and conduct hand sanitation. Usually, I wear gloves before giving any injection in as much as the CDC may state it is optional unless the patient has an open lesion and contact of body fluids is likely to happen.

Use the acromion process landmark to locate the deltoid muscle. Move your fingers about two widths below the landmark. The patient’s adipose tissue determines the choice of needle length. Note that the needle gauge is determined by the type of medication you plan to give to the patient.

The Z-track technique is recommended rather than pinching the patient’s skin. Pull the patient’s skin to the side using one hand. Use a 90 degree angle to insert the needle to the patient’s skin. At the rate of 10 seconds per mL gently depress the plunger.

Remove the needle carefully and engage the safety precautions then dispose of the needle appropriately in the sharps container. Gauzing helps to cover the injection site.

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This is how the real brain looks like. Very flexible like Jelly!

Watch that video to know How to Perform Invisible Skin Sutures Technique

thoracic cavity

While in residency, Marc Pelletier, MD, helped in a bypass surgery and knew it was the field in which he would excel. Watch as the Chief of Cardiac Surgery for University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio explains, in detail, what happens in preparation for heart surgery, in the operating room and the feeling he experiences after surgery.

How does a heart-lung machine work? What is 'efficiency of motion'? These questions and more are answered in this compelling, dramatic look at heart surgery.

To learn more about heart surgery at University Hospitals: https://www.uhhospitals.org/fo....r-clinicians/special

University Hospitals is one of the nation’s leading health care systems, providing patient-centered care that meets the highest standards for quality and patient safety and have received numerous awards and recognitions from some of the most prestigious institutions in the country for our leadership and exceptional patient outcomes. As an accountable care organization, we foster long-term patient-provider relationships that help promote preventive care, increase wellness and healthy behaviors, decrease emergency episodes, and prevent hospitalizations. To learn more: https://www.uhhospitals.org

Large Leg Abscess

Mr Bean visits the hospital for a very peculiar reason!

Testosterone treatment in adolescent boys with constitutional delay

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An AV fistula is a connection, made by a vascular surgeon, of an artery to a vein.Vascular surgeons specialize in blood vessel surgery. The surgeon usually places an AV fistula in the forearm or upper arm. An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong.

Get rid of blackheads

Start of CRRT circuit within ECMO

This video will cover, in detail, the motor, sensory, reflect components of a neurological examination.

This video is created for the UBC Medicine Neurology Clinical Skills curriculum as part of MEDD 419 FLEX projects.

Filmed, written, and directed by:
John Liu
Vincent Soh
Chris Calvin
Kashi (Siyoung) Lee
Kero (Yue) Yuen
Ge Shi

Doctor - Dr. Jason Valerio (Department of Neurology, UBC)

Supervised by:
Dr. Alex Henri-Bhargava (Department of Neurology, UBC)
Zac Rothman (UBC FOM Digital Solutions: Ed Tech)

Edited by:
Stephen Gillis

Produced by UBC FOM Digital Solutions EdTech team facilitates innovation by UBC Medicine learners and faculty.

Website: https://education.med.ubc.ca/
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The Northern Medical Program and the University of Northern BC are situated on the traditional territory of the Lheidli T’enneh, part of the Dakelh (Carrier) First Nations.

With respect the Lekwungen peoples on whose traditional territory the Island Medical Program and the University of Victoria stand and the Songhees, Esquimalt and WSÁNEĆ peoples whose historical relationships with the land continue to this day.

We acknowledge our traditional hosts and honour their welcome and graciousness to the students who seek knowledge here.

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Symptoms of serotonin syndrome include a classic triad of mental status changes (eg, anxiety, delirium, confusion, restlessness), autonomic dysregulation (eg, diaphoresis, tachycardia, hypertension, hyperthermia, diarrhea, mydriasis), and neuromuscular hyperactivity (eg, hyperreflexia, tremor, rigidity, myoclonus, ocular clonus). Serotonin syndrome is clinically diagnosed and laboratory tests are used to rule out other etiologies. It usually occurs due to inadvertent interactions between drugs, therapeutic use of multiple serotonergic agents, or serotonergic medication overdose. Treatment involves discontinuation of serotonergic drugs, supportive measures, and sedation with benzodiazepines. In severe cases, a serotonin antagonist (cyproheptadine) may be used.

Emory has one of the few heart and vascular centers nationally performing robotic cardiac surgery using the daVinci Surgical System. Emory's robotic surgeons have completed numerous cases and are recognized in Atlanta, the Southeast and across the country for their expertise in cardiac surgery. Some of the cardiac and thoracic conditions treated by Emory cardiac surgeons include mitral valve repair and replacement, atrial septal defect repair, atrial myxoma and thrombi, coronary bypass (LIMA to LAD), mediastinal mass excision, thymectomy, epicardial lead placement and pericardial window.

Selective immunoglobulin A deficiency (SIgAD) is a primary immunodeficiency disease and is the most common of the primary antibody deficiencies.[1] Total immunoglobulin A deficiency (IgAD) is defined as an undetectable serum immunoglobulin A (IgA) level at a value < 5 mg/dL (0.05 g/L) in humans. Partial IgAD refers to detectable but decreased IgA levels that are more than 2 standard deviations below normal age-adjusted means.[2, 3] IgAD is commonly associated with normal B lymphocytes in peripheral blood, normal CD4+ and CD8+ T cells, and, usually, normal neutrophil and lymphocyte counts. Anti-IgA autoantibodies of the IgG and/or IgE isotype may be present. Peripheral blood may also be affected by autoimmune cytopenias, eg, autoimmune thrombocytopenia,[4, 5] and patients may have other autoimmune phenomena. IgA was first identified by Graber and Williams in 1952; ten years later, the first patients with IgAD were described. IgAD is a heterogeneous disorder, and the results of intensive study are beginning to elucidate genetic loci and molecular pathogenesis that contribute to various subtypes of this disorder. Several lines of evidence suggest that, in many cases, IgAD and common variable immunodeficiency (CVID) have a common pathogenesis, which is discussed further in Pathophysiology. Other data indicate different genetic risk factors. Family studies show variable inheritance patterns. Familial inheritance of IgAD occurs in approximately 20% of cases,[6] and, within families, IgAD and CVID are associated.[7, 8] Many IgAD patients are asymptomatic (ie, "normal" blood donors) and are identified by finding a laboratory abnormality, without any apparent associated clinical disease. Some patients with IgAD may have the following associated conditions: (1) deficits in one or more immunoglobulin G (IgG) subclasses (this accounts for 20-30% of IgA-deficient patients, many of whom may have total IgG levels within the normal range) or (2) a deficient antibody response to pneumococcal immunization (specific polysaccharide antibody deficiency [SPAD]). Some patients with IgAD later develop CVID, and family members of patients with CVID may have only selective IgAD. Characterization of the receptor for the transmembrane activator and calcium-modulator and cyclophilin ligand interactor (TACI), encoded by the gene TNFRSF13B ( tumor necrosis factor receptor superfamily member 13B), suggests that people with the C104, A181E, and ins204A variants may be at risk for IgAD that progresses to CVID.[9] Primary IgAD is permanent, and below-normal levels have been noted to remain static and persist after 20 years of observation.[10] A recent report documents a rare case of reversion.[11] Environmental factors such as drugs or infections can cause IgAD, but this form is reversible in more than half the cases (see Causes). Although individuals with IgAD have largely been considered healthy, recent studies indicate a higher rate of symptoms. A 20-year follow-up study that compared 204 healthy blood donors with incidentally identified IgAD to 237 healthy subjects with normal IgA levels demonstrated that 80% of IgAD donors and 50% of control subjects had episodes of infections, drug allergy, or autoimmune or atopic disease. Severe respiratory tract infections occurred in 26% of IgAD subjects, in 24% of subjects with decreased IgA levels, and in 8% of control subjects; however, the incidence of life-threatening infections was not increased. IgAD is more common in adult patients with chronic lung disease than in healthy age-matched control subjects.[12] Patients with IgAD are at some increased risk of developing severe reactions after receiving blood products.[13, 14, 15] IgG anti-IgA antibodies may cause severe transfusion reactions if patients with IgAD are given whole blood; therefore, IgA-poor blood or washed red cells are preferred for those patients. IgA-deficient patients with immunoglobulin E (IgE)–class anti-IgA antibodies are at risk for anaphylaxis if they receive blood or intravenous immunoglobulin, but this situation is extremely rare. Individuals with such an unusual profile should receive only low IgA intravenous immunoglobulin preparations. However, caution must be used when administering IGIV to patients with IgAD if their anti-IgA status is unknown. A history devoid of previous blood product administration does not exclude the possibility of anti-IgA antibodies or adverse reactions. Fortunately, appropriate precautions can significantly reduce morbidity (see Treatment). Blood banks can use a simple ELISA screening approach to establish an IgAD blood donor poo