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The 12-lead ECG is a vital tool for EMT’s and paramedics in both the prehospital and hospital setting. It is extremely important to know the exact placement of each electrode on the patient. Incorrect placement can lead to a false diagnosis of infarction or negative changes on the ECG.
Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth. If it remains open, however, it's called a patent ductus arteriosus. A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications. Treatment options for a patent ductus arteriosus include monitoring, medications and closure by cardiac catheterization or surgery.
Severe combined immunodeficiency (SCID) is a life-threatening syndrome of recurrent infections, diarrhea, dermatitis, and failure to thrive. It is the prototype of the primary immunodeficiency diseases and is caused by numerous molecular defects that lead to severe compromise in the number and function of T cells, B cells, and occasionally natural killer (NK) cells. Clinically, most patients present before age 3 months. Without intervention, SCID usually results in severe infection and death in children by age 2 years. A committee of experts, initially sponsored by the World Health Organization (WHO), meets every 2 years with the goal to classify the group of primary immunodeficiency diseases according to current understanding of the pathways that become defective in the immune system.[1] Eight classification groups have been determined, with SCID being one of the best studied. Over the past few decades, the diverse molecular genetic causes of SCID have been identified with progress from studies of the immune system.[2] SCID is considered a pediatric emergency because survival depends on expeditious stem cell reconstitution, usually by bone marrow transplantation (BMT). Appropriate diagnosis is essential because instituting proper treatment is lifesaving. Despite the heterogeneity in the pathogenesis of immune defects, common cutaneous manifestations and typical infections can provide clinical clues in diagnosing this pediatric emergency.[3] Skin manifestations were prevalent in primary immunodeficiency disorders studied in 128 pediatric patients in Kuwait; skin infections were the most prevalent findings, seen in 39 patients (30%), followed by dermatitis in 24 (19%).[4] Skin infections were significantly more prevalent in those with congenital defects in phagocyte number, function, or both, as well as in those with well-defined immunodeficiencies. Dermatitis was evident in all patients with hyper–immunoglobulin (Ig) E syndrome and Wiskott-Aldrich syndrome.[4] Erythroderma of infancy with diffuse alopecia was seen exclusively in patients with SCID disorders, and telangiectasia in patients with ataxia telangiectasia; and partial albinism with silvery gray hair was associated with Chediak-Higashi syndrome. With the advances in BMT and gene therapy, patients now have a better likelihood of developing a functional immune system in a previously lethal genetic disease. However, once an infant develops serious infections, intervention is rarely successful.
Fundoplication Surgery for Gastroesophageal Reflux Disease (GERD) Guide. During fundoplication surgery, the upper curve of the stomach (the fundus) is wrapped around the esophagus and sewn into place so that the lower portion of the esophagus passes through a small tunnel of stomach muscle.
Reduction techniques can vary in terms of required force, time, equipment, and staff. [7] No single reduction method is successful in every instance; therefore, the clinician should be familiar with several reduction techniques. Techniques commonly used to reduce anterior shoulder dislocations include the following [35, 36, 37, 38, 39] : Stimson maneuver Scapular manipulation External rotation Milch technique Spaso technique Traction-countertraction
Thoracentesis is a minimally invasive procedure used to diagnose and treat pleural effusions, a condition in which there is excess fluid in the pleural space, also called the pleural cavity. This space exists between the outside of the lungs and the inside of the chest wall.
An animation of blood flow inside the hollow fiber of a hemofilter, or a dialyzer, and the flow of the dialysate in an opposite direction with increased extraction of waste and small molecules from the blood as the concentration of these molecules is reduced downstream and exposed to new dialysate.
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