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9
510

CXR - left sided pneumothorax and surgical emphysema

In this Chest X-Ray we can identify a left sided pneumothorax - there is absence of lung markings in the periphery and we can also see a shadow which outlines the edge of the lung. A pneumothorax is caused when air enters the potential space between the viceral and parietal pleura and causes the lung to collapse down under the pressure of it's elsatic recoil. In this case it is likely that the pneumothorax has been caused by trauma as we can see air in the soft tissues on the left side (surgical emphysema - clinically feels like bubble wrap). A pneumothorax can be a life threatening condition. The patient presents in respiratory distress with decreased expansion on the affected side. There will be hyperresonance to percussion on that side but absent breath sounds. The emergency treatment is decompression with a large bore cannula in the 2nd intercostal space mid-clavicular line followed by insertion a chest drain in the 5th intercostal space mid-axilllary line  
Rhys Clement
about 10 years ago
548
8
213

Cannulation

In this video Rhys Clement demonstrates how to insert a cannula. More content can be found on www.surgeryandmedicine.com  
Rhys Clement
about 10 years ago
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6
137

treatment of uti

this file contains the management of the uti with catheter without catheter and antibiotic of preferrence in asymptomatic and severe cases  
sampath kumar
over 6 years ago
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4
116

Prerenal Acute Renal Failure with High FENa (Fractional Excretion of Sodium)

Very good case in showing a frequently overlooked issue of diuretics. Remember, there is almost never a reason to give both fluids and diuretics...make up your mind. IV fluids are the #1 method to try in oliguric pts NOT Lasix.Do not agree with Foley cath placement if patient is able to urinate and can check creatinine to know pt is improving. Any catheter is a foreign body and increases infection risk.It is also very uncomfortable for patients.Not sure why U/S of kidney needed right away either unless the patient has chronic kidney disease or does not improve with fluids.Unnecessary tests add to the expense of healthcare which all of us pay for. This increases insurance costs, medicaid costs, etc so much it can put companies (and gov't in the future?) out of business.  
clinicalcases.org
over 4 years ago
7
2
66

Focus On: Treatment Options for Pneumothorax

Define the various types of pneumothoraces. Describe the indications for needle aspiration and small-bore catheter placement in the management of pneumothoraces as outlined by the ACCP and BTS. Discuss the controversies surrounding needle aspiration and small-bore catheter placement for management of pneumothoraces. Identify the characteristics of those patients with pneumothoraces unlikely to be successfully treated with needle aspiration and small-bore catheter placement. Identify sub-sets of patients who have had their pneumothoraces successfully treated with needle aspiration and small-bore catheter placement.  
American College Of Emergency Medicine
over 9 years ago
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2
38

Clinical Cases and Images: ClinicalCases.org: Prerenal Acute Renal Failure due to Volume Depletion

This is a good practical case and very useful for new clinicians. For any clinician:No foley catheter unless oliguric, anuric, obstructed since any catheter is a foreign body and increases infection risk.Rehydrate if U/A has high spec gavity, mucous membranes dry, or if BUN is >30 times the creatinine as in this case. Even CHF pts get dry if not in heart failure. If in doubt, do CXR, BNPT, listen for crackles.Start with 250cc IVF if BNPT not less than 150 or give carefully while checking lung bases posteriorly after each bolus along with pulse ox, etc as above. Half of pts in acute renal failure are septic. Look for and eliminate source such as pneumonia, foreign body, pyelonephritis, joint infections. May be afebrile/ low temp or low WBCs with sepsis. Do cultures, check lactate ASAP to detect sepsis BEFORE the BP drops. Lactic acid "the troponin of sepsis." If septic, give a lot of fluids (up to 10 liters often) since capillary leak syndrome will lead to severe hypotension. If septic expect edema to develop with IV boluses yet be aware pt is intravascularly depleted. No pressors without fluids "pressors are not your friend" as per lecturers on Surviving Sepsis campaign.  
clinicalcases.org
over 4 years ago
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2
40

Shock: Lesson 2 - Distinguishing Shock Types (Hypovolemic/Distributive/Cardiogenic/Obstructive)

How to use physical exam (e.g. JVP, ultrasound, passive leg raise, and extremity temp) to identify the subtype of shock. Disadvantages of PA catheters are al...  
youtube.com
over 4 years ago
11
1
29

That peripheral IV can kill you: Suppurative Thrombophlebitis

<p>All the recent emphasis on venous catheter infections has been on central lines. &nbsp; Those peripheral IVs are also dangerous. &nbsp;</p>  
Jeffrey S. Guy, MD, FACS
over 9 years ago
0
1
52

Catheter-Related Bloodstream Infection: Diagnosis

Discussion of what is the difference between a CVC infection and a catheter-related blood stream infection. They are treated differently so it is important to know the difference.  
Jeffrey S. Guy, MD, FACS
over 9 years ago
4
1
25

Some Swan Stuff

<p>A brief discussion regarding some of the commonly used values obtained from a pulmonary artery catheter.&nbsp; </p>  
Jeffrey S. Guy, MD, FACS
over 9 years ago
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1
21

Angiography

Angiography This is a technique used to visualise the inside of vessels, in this case, those of the heart.  It is basically used to assess the extent of angina. It involves cardiac catheterisation. Once the catheter is in place, an iodine based dye is injected into the coronary vessels, and the extent of narrowing (atheroma) can be asses by –x-ray.  
almostadoctor.com - free medical student revision notes
over 5 years ago
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1
41

Cardiac Catheterization

Cardiac catheterization This is not necessarily the same as coronary angiography, although the two terms are sometimes used interchangeably. Cardiac catheterisation is the process by which you gain catheter access to the veins or arteries of the heart. Thus, in the procedures of coronary angiography, and angioplasty, you perform cardiac catheterisation as part of the procedure.    
almostadoctor.com - free medical student revision notes
over 5 years ago
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1
34

Pediatric Cardiology-Cardiac cath lab catheters Quiz

Pediatric Cardiology Teaching,lecture conducted by Dr Krishna Kumar. The topic is - Cardiac cath lab catheters Quiz.  
YouTube
over 5 years ago
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1
20

Pediatric Cardiology-Cardiac cath lab catheters Quiz

Pediatric Cardiology Teaching,lecture conducted by Dr Krishna Kumar. The topic is - Cardiac cath lab catheters Quiz.  
YouTube
about 5 years ago
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1
34

Atrial Fibrillation Care: Put the Catheter (and Rx Pad) Down

Electrophysiology's watershed moment is the growing acceptance that AF is not fixable with ablation and drugs as long as the underlying causes are left untreated.  
medscape.com
over 4 years ago
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1
37

Industry 'must do more' to improve urinary catheters - BBC News

A leading researcher says industry must "wake up and invest more" in urinary catheters  
bbc.co.uk
over 4 years ago
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1
540

Normal arterial line waveforms

The arterial pressure wave (which is what you see there) is a shockwave; it travels much faster than the actual blood which is ejected. It represents the impulse of left ventricular contraction, conducted though the aortic valve and vessels along a fluid column (of blood), then up a catheter, then up another fluid column (of hard tubing) and finally into your Wheatstone bridge transducer.  
derangedphysiology.com
almost 4 years ago
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1
10

Simple Education essential guide - Advances in Coronary Physiology March 2016

The Advances in Coronary Physiology is the most comprehensive 5* rated course series providing the core background content required to develop a comprehensive understanding of the rationale and underlying meaning of physiological measurements widely used in the catheter laboratory.   
simpleeducation.co
over 3 years ago
12
0
213

Priapism and Hematuria

<p>Why is a 12 hour erection a bad thing? How should we manage the patient with bloody urine? A curbside consult with urologist Brian Shaffer, MD.&nbsp;</p <p>Your emails</p <p>An unusual southern accent</p <p>and much more...</p <p>&nbsp;</p <p><em><strong><span style="font-size: x-large; color: #0000ff;">Urology Primer</span></strong></em></p <p>&nbsp;</p <p><strong><span style="font-size: large;">Priapism<span style="font-size: 10px; font-weight: normal;">&nbsp;a rare condition that causes a persistent, and often painful, penile erection.</span></span></strong></p <p>&nbsp;</p <p>Priapism is drug induced, injury related, or caused by disease, not sexual desire. As in a normal erection, the penis fills with blood and becomes erect. However, unlike a normal erection that dissipates after sexual activity ends, the persistent erection caused by priapism is maintained because the blood in the penile shaft does not drain. The shaft remains hard, while the tip of the penis is soft. If it is not relieved promptly, priapism can lead to permanent scarring of the penis and inability to have a normal erection.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Clot retention</span></strong></p <p>blood clots in the bladder prevent urine emptying</p <p>&nbsp;</p <p><span style="font-size: large;"><strong>Coude Catheter</strong></span></p <p>a semi-rigid catheter that has a curve or bend at the tip. The curved tip allows it to navigate over the curvature of the prostate or any other urethral obstruction it may encounter. A Coude catheter is specifically designed for this purpose. Coude catheters are available in size 8 French to size 26 French.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">De Novo</span></strong></p <p>The Latin expression de novo literally means something akin to "from the beginning" or "anew"</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Interstitial cystitis</span></strong></p <p>also called painful bladder syndrome &mdash; is a chronic condition characterized by a combination of uncomfortable bladder pressure, bladder pain and sometimes pain in your pelvis, which can range from mild burning or discomfort to severe pain.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Cystoscopy</span></strong></p <p>the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery).</p <p>&nbsp;</p <p><strong><span style="font-size: large;">CT Urogram</span></strong></p <p>A urogram is a radiograph, or X-ray image, of the urinary tract.&nbsp;</p <p>&nbsp;</p <p><strong><span style="font-size: large;">TURP</span></strong></p <p>transurethral resection of the prostate</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Foley catheter</span></strong></p <p>a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to hold it in place. The urine drains into a bag and can then be taken from an outlet device to be drained</p <p>&nbsp;</p <p>&nbsp;</p>  
Rob Orman, MD
over 9 years ago
11
0
57

How to prevent air from entering IV line when changing IV bag?

The bag is completely emptied. Patients needs another bag. Without disconnecting the line from the catheter, what has to be done to ensure that no air enters the line when changing the IV bag? In the case that air has entered the line, how do I clear it from the line?  
Rama Raja
almost 7 years ago