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Showing posts from May, 2021

Anatomy and Physiology of aterial line

  Anatomy and Physiology The arterial pulse may be palpated in the extremities and the neck. With the knowledge of the contour of these vessels, the operator may easily identify the location of the artery. The anatomy of every site of insertion must be analyzed to determine the landmarks, the depth, the relationship to adjacent anatomical structures, and the size of the artery.   The radial artery is superficial in the thenar area of the wrist where the radial bone joins the metacarpal bones. There, the radial pulse is best felt slightly medial to the extensor tendons of the thumb. The radial artery is a preferred site of insertion. The ulnar artery is opposite to the radial pulse in the volar aspect of the wrist at the joint of the ulnar bone to the metacarpal bones. The artery divides into 2 branches, both of which join a similar division of the radial artery to form a rich, collateral network known as the deep and superficial palmar arch. The ulnar artery is smaller and not

Surgical Trolly layout for Brest Cancer

 Trolly layout for Brest Cancer is one of  difficult to maintain.  Bowl with providine iodin solution  swab holder  gauze pics ( uncounted ) machintose sheet  sterile draf towl Towal Clip 4 pics  sterile needle and syringe with lignocain (2%) without adrenalin  harmonic scalpel   Bard - Parkar Handel no . 4 and blade no 22  allise 6 pics  artery 6 pics  lagen back retractor 2 pics  sucction nogel( steel ) and sucction catheter  suture meterial absorable and non absorable too  skin staplar dressing gauze  providine iodin solution 7.5%  bandage 

New Born Care Unit ( Part 3 )

  Levels of care The concept of designations for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in the United States in 1976. Levels in the United States are designated by the guidelines published by the American Academy of Pediatrics In Britain, the guidelines are issued by The British Association of Perinatal Medicine (BAPM), and in Canada, they are maintained by The Canadian Paediatric Society. Neonatal care is split into categories or “levels of care”. these levels apply to the type of care needed and is determined by the governing body of the area . India India has 3-tier system based on weight and gestational age of neonate. Level I care Neonates weighing more than 1800 grams or having gestational maturity of 34 weeks or more are categorized under level I care. The care consists of basic care at birth, provision of warmth, maintaining asepsis and promotion of breastfeeding. This type of care can be given

New Born Care Unit ( Part 2 )

  Pain management  parents with newborns in the NICU have expressed that they would like to learn more about what types of pain their infants are feeling and how they can help relieve that pain. Parents want to know more about things such as; what caused their child’s pain, if the pain that we feel is different than what they feel, how to possibly prevent and notice the pain, and how they could help their child through the pain they were struggling with. Another main worry that was mentioned was the long-term effects of their pain , Relieving pain There are multiple  ways to manage pain for infants. If the mother is able to help, holding the infant in kangaroo position or breastfeeding can help calm the baby before a procedure is done. Other simple things that can help ease pain include; allowing the infant to suck on a gloved finger, gently binding the limbs in a flexed position, and creating a quiet and comfortable environment .  Common diagnoses and pathologies in the NICU include:

New Born Care Unit ( Part1)

 Neonatal Intensive Care Unit or NICU  is known as New Born Care Unit , is a Special Baby Care Unit , for premature new born infant .  Firstly it is introduced by Louis Gluck nearly about 1960s at the American hospital Yale New Haven Hospital . Increasing technology By the 1970s, NICUs were an established part of hospitals in the developed world. In Britain, some early units ran community programmes, sending experienced nurses to help care for premature babies at home. But increasingly technological monitoring and therapy meant special care for babies became hospital-based. By the 1980s, over 90% of births took place in hospital. The emergency dash from home to the NICU with baby in a transport incubator had become a thing of the past, though transport incubators were still needed. Specialist equipment and expertise were not available at every hospital, and strong arguments were made for large, centralised NICUs. On the downside was the long travelling time for frail babies and for par

Complete Blood Count (CBC)

  A complete blood count, also known as a full blood count, is a set of medical laboratory tests that provide information about the cells in a person's blood. The CBC indicates the counts of white blood cells, red blood cells and platelets, why dose cbc tests for ? The complete blood count (CBC ) is a group of tests that evaluate the cells that circulate in blood, including red blood cells (RBCs), white blood cells (WBCs), and platelets (PLTs). The CBC can evaluate your overall health and detect a variety of diseases and conditions, such as infections, anemia and leukemia. In general, the reference ranges are: White blood cells: 4,500 to 11,000 cells per microliter (cells/mcL) Red blood cells: 4.5 million to 5.9 million cells/mcL for men; 4.1 million to 5.1 million cells/mcL for women. Hemoglobin: 14 to 17.5 grams per deciliter (gm/dL) for men; 12.3 to 15.3 gm/dL for women.   Viral Infections   One of the most common causes of a low white blood cell count is a viral in

Fresh Frozen Plasma (FFP)

  Fresh frozen plasma is a blood product made from the liquid portion of whole blood ,  used to treat conditions in which there are low blood clotting factors or low levels of other blood proteins Indications FFP is indicated for bleeding caused by vitamin K deficiency and bleeding (or high risk of bleeding) due to DIC. It is also indicated for the treatment of congenital deficiencies of single clotting factors, when the specific concentrate is not available .  Cpt code P9017 There really does not need to be a separate code for this component as apheresis plasma is reimbursed as fresh frozen plasma. It is billed as P9017 Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit, as apheresis plasma must be frozen within six hours of collection. Dosing A guideline for initial  FFP dosing  is 10-15 mL/kg; this typically translates to at least 4 units of  FFP  to effect a therapeutic response .

Trolly Layout for Inguinal Hernia

  Today we are discussing about trolly layout of Inguinal Hernia  operation . we all know it is the common operation among middle aged man and elder person ;   for that reason we have to manage this instrument trolly  for many times . lets see what are the instrument used here .  one very improtant thing that i s the tolly must be sterile for the instrument should be kept there .  Allies 4 pis Artery 4 pis Needle Holdar 1 pis Towl Clip 4 pics Needle Vicrel & ethelon or turlon ( as the  surgeon need) and cutgut or prolen  Tooth Forcep 1 pics Non Tooth Forcep 1 pics Babcok 2 pics Lagenback Retractor 2 pics  sessior 2  pics ( Tissue Cutting and suture cutting ) Bard Parkar Handle  1 pics  Mops 1 pics  Gauze 2 pics  Dressing gauze and bandage . Some Overview of the instruments are given . Stay safe Stay tuned . 

Patient Shifting from O.T to Post Operative Care ( Part 2)

  Standard of Practice II It is the responsibility of the HCWs to safely transport a patient to the preoperative holding area or operating room. Confirm IV lines, indwelling catheters, monitoring system lines and drains, and any other lines are secure and patent, and IV bag and collection containers are hanging away from the patient’s head..  Ensure head, arms and legs are protected, adequately padded, and patient is comfortable as possible.  . The patient should be transported feet first; rapid movements, particularly when going around a corner should be avoided. Rapid movements, especially if the patient has received preoperative medications, can cause the patient to become disoriented, dizzy, and nauseated, and induce vomiting .. The staff person moving the transportation device should be positioned at the patient’s head in order to look forward for potential hazards. This also allows immediate access to the patient’s airway in case of respiratory distress or vomiting .. It is the

Patient shifting from operation theatre to post operative care unit (Part 1 )

  T he safe care of transporting patients to the operating room and recognizing the possible hazards, in order to prevent injuries to the patient and surgery department personnel. The recommended practices aid in ensuring the transfer and transportation of the patient without tissue injury; avoiding undue physical or emotional discomfort.  Standard of Practice I It is the responsibility of the HCWs to ensure the safe patient transfer of a patient from a bed to a transportation device. The specific needs of the patient should be considered when selecting the method of transport. This includes:  A. Need for IV pole(s)  B. Need to transport oxygen tank  C. Mobility of the patient  D. Conscious, semi-conscious or unconscious patient  E. Size of patient  F. Age of patient  G. Determining the physical abilities and state of health of the patient. Knowing the patient’s state of health and abilities will help in the choice of mode of transportation, decrease the possibility of accidents to th

Cardiopulmonary Resuscitation ( part 2 \ cpr procedure )

Rules     Rate at least 100-120 \mi Compression defth at least 2 inches Allow complete chest recoil after each compression Avoid execessive ventilation Procedure  No response (i.e only gasping and no breathing or suffocating )  Active emergency response system . ( Get AED \ Defribellator  ) or  send rescuer to this .  Cheak pulse and define it within 10 seconds if yes then give 1breath every 5 – 6 sec and recheak pulse if no then begin cycle of 30 compression and 2 breath At that time AED\defribellator must be arrived . Cheak rhythm if shockable then activated AED and give shock if not then resume CPR immediately for next 2 min and recheak again until ALS provider provide takes over . Rescue Breathing                       

Cardio Pulmonary Resatuation (part 1)

      Cardiopulmonary resuscitation is an emergency procedure that combine chest compression often after artificial ventilation    in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest .       emergency procedure   of actions to be conducted in a certain order or manner, in response to a specific class of reasonably foreseeable emergency , a situation that poses an immediate risk to health life property , or the enviroment . C. P .R Quality : 1 . push hard and fast (100 - 120 \ min)and allow chest recoil .  2 . minimize interuption in compression  .  3 Avoid exacessive ventilation . 4 Rotate compression every 2 min  4 Quantative wave from capnography .  consequence : Organ donation ; organ donation  is usally made possible using CPR to the patient . if there is a spontaneous circulation ,  all organ can be considered  for donation . if the patient doesn't w