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Preview 300x246
7
432

CXR - perforated viscus

This image shows the cardinal sign of a perforated abdominal viscus. There is air under the diaphragm indicating air within the peritoneal cavity which can occur from a perforated abdominal viscus, following a laparoscopic abdominal procedure (where air is pumped into the peritoneal cavity to improve the views) and after more obscure events such as vigorous waterskiing in a female. When this appearance is seen it should be treated as a surgical emergency until proved otherwise.  
Rhys Clement
almost 10 years ago
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6
840

Designer Babies - Physiology and Ethics

An essay I wrote for my course, with which I received an Honours grade (75%). I have an interest in Medical Ethics, and this essay discusses the possible physiology and ethics surrounding the controversial topic. **Introduction** (taken from the essay): My topic is designer babies. A designer baby is defined by the Oxford Dictionary of English as, “a baby whose genetic make-up has been selected in order to eradicate a particular defect, or to ensure that a particular gene is present” (1). In this essay, I shall be exploring the arguments and ideas surrounding the selection of a baby’s genes, which in modern times has become a highly controversial subject. This essay will start by describing the methods by which designer babies may be produced, namely pre-implantation genetic diagnosis (PGD) and pro-nuclear transfer, also coined the ‘three-parent baby’ by some (2). Once these procedures have been presented, ethical considerations forming both sides of the debate will be discussed. Whilst the typical argument used is ‘autonomy vs. playing god’, other ideas include whether such procedures will have a drastic effect on the future, and change the world as we know it, as suggested in the science-fiction film Gattaca (3). The ‘nature vs. nurture’ debate is also described: whether we are defined by our genes as shown in Gattaca, or if the environmental influence we are subjected to can cause our genotype to be negligible, i.e. our genes have no impact on our traits; personality, looks etc. The expectations placed upon our offspring; the definition of disease and disability; the fear of the rate of medical development – will all be discussed in this essay. The conclusion will summarise the arguments of both sides, and will attempt to answer the following question: should we be allowed to design our babies?  
Jonathan Chernick
almost 7 years ago
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6
132

What is the Whipple Procedure?

In this video, Washington University surgeon William Hawkins, MD, explains the Whipple procedure, which is performed to remove cancer from the head of the pancreas. Hawkins and his colleagues complete about 125 Whipples a year, making the Siteman Cancer Center one of the highest-volume centers for this type of surgery nationwide. These surgeons pioneered a modification to the Whipple procedure that has resulted in the lowest fistula rate any large group (1.5 percent compared to 15 percent).  
Nicole Chalmers
over 5 years ago
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5
149

Femoral Nerve Block – A Guide for Medial Students and Junior Doctors.

I completed this article in collaboration with a senor registrar whilst studying as an undergraduate medical student in Dundee. This article outlines the proposed introduction of a technique that employs ultrasound to visualise the femoral nerve whilst performing a femoral nerve block. This procedure is performed on patients in both the emergency dept and surgical theatres. Traditionally this procedure has been performed using a 'blind technique' which has an increased association with side effects including inadvertent damage to local structures and systemic toxicity related to local anaesthetic. In the article we give a brief outline of both the the traditional and ultrasound guided techniques and allow readers to understand the benefits of using the proposed technique. We believe that this article will be of great interest to senior medical student and junior doctors who are interested in careers in emergency medicine and anaesthesia. This  
michael jamison
over 7 years ago
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5
132

Cannulation - Leicester Clinical Skills

Cannulation performed following official University Hospitals of Leicester (UHL) Guidelines Stage 1 - Consent 0:40 Stage 2 - Equipment 1:53 Stage 3 - Procedure; Treatment Room 3:25 Patient Area 8:01 Stage 4 - After Care 13:23 http://leicesterclinicalskills.weebly.com/  
Leicester Clinical Skills
over 5 years ago
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5
151

10 Tips for Studying Anatomy

Professor Paul Krieger from Grand Rapids Community College's Biology Department shares some methods for students on how to improve their retention of the sub...  
YouTube
over 5 years ago
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5
198

Hartmann's Procedure Explained

Eponymously named operations give you little clue as to what they are or what they're for. One of the most commonly performed eponymous procedures is Hartman...  
YouTube
almost 5 years ago
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5
70

Female Catheterisation Procedure

Female catheterisation performed following the official University Hospitals of Leicester (UHL) guidelines.  
youtube.com
over 4 years ago
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5
40

Psoriasis: assessment and management | Guidance and guidelines | NICE

Following the recent surveillance review which checks the need to update CG153, this guideline should not be updated at this time. This guideline will be checked again for update at its scheduled time point according to the methods described here.  
nice.org.uk
almost 4 years ago
10
5
116

Aortoiliac Occlusive Disease

Slideshow includes overview, clinical picture, diagnosis, treatment and procedures.  
youtube.com
almost 4 years ago
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5
119

Shoulder Arthritis and Replacement

Although used less commonly than knee or hip replacement, shoulder replacement surgery removes diseased or damaged bone in the shoulder and replaces it with an artificial joint. If arthritis pain is unrelieved by other methods, you may need replacement surgery.  
youtube.com
over 3 years ago
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4
175

Fracture-Dislocation right shoulder

This image shows a dislocated shoulder with a fracture through the surgical neck of humerus. The patient is at high risk of axillary nerve injury. The axillary nerve supplies deltoids but this is difficult to test in these conditions - luckily it also supplies an area of skin over the shoulder known as the regimental badge - this must be tested before and after any procedure involving the shoulder.  
Rhys Clement
almost 10 years ago
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4
33

Male Catheterisation - Procedure Only

Male catheterisation performed following the official University Hospitals of Leicester (UHL) guidelines. This video only covers the procedure part of this skill. View our video of the Full Process for more information. Find more videos and resources at our website: www.leicesterclinicalskills.weebly.com  
Leicester Clinical Skills
over 5 years ago
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4
43

Cannulation - Procedure Only

Cannulation Procedure performed following University Hospitals Leicester (UHL) guidelines. Gathering equipment 0:16 Performing procedure 2:59 http://leicesterclinicalskills.weebly.com/  
Leicester Clinical Skills
over 5 years ago
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4
52

Lumbar Puncture Procedure

A lumbar puncture procedure video which highlights techniques examined in both the MCEM & FCEM exam.  
YouTube
over 5 years ago
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4
127

Laparoscopic Myomectomy for Fibroids

Dr. William H. Parker performs a laparoscopic myomectomy for a woman with an 8 cm fibroid. The operation took one and half hours to perform, but the procedure is edited to 4 minutes to show the key steps.  
YouTube
almost 5 years ago
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4
552

Lumbosacral Plexus - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing easy methods for remembering the lumbosacral plexus Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on...  
YouTube
over 4 years ago
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4
76

Do hacks really work?

Well I think they do. In 2012 I attended the #digidoc2012 conference in London. This was a conference aimed at bringing clinicians and technology enthusiasts together to learn how better to use technology to help in a clinical setting. Part of the day included tutorials and lectures, but my favourite part was the ‘hack’ session. In groups, we pitched ideas about potential apps which could be created to help different groups i.e. clinicians, patients, providers etc. From this session the initial concept of PhotoConsent was formed. The problem: Medical photography in a hospital setting can be relatively straight forward. A clinician can call up the medical photography department, get them to sort out the forms and details, patient consented, picture taken...done. The main issue with this is the time taken to access the medical photography department. Medical photography in a moderately acute setting or primary care is considerably less straight forward. Issues on how you document the consent, what methods used (verbal or written) and how this is stored need to be considered. There exists some guidance on the matter (see Good Medical Practice: Making and using visual and audio recordings of patients), however actual practice is variable. The added issue of social media and the ease of which images can now be shared can add to the confusion. The solution - PhotoConsent: I am involved in several on-line forums and governance groups. With seeing interactions about patient images in social media and various online clinical groups, I felt a more complete solution was needed which gave better protection and governance for both patients and clinicians. Following the #digidoc12 conference (https://thedigitaldoc.co.uk/), I met some innovative colleagues including Ed Wallit (@podmedicsed). We took this brainstormed idea further and now we have a finished product- PhotoConsent app. PhotoConsent is a new application designed to help you as a clinician to safely and easily take photos of a patient and then obtain the relevant consent for that photo quickly and efficiently. It is currently available on iOS. How does it work? Upon opening the app you can take a photo from the home screen. Once you have confirmed you have the best possible image, you and the patient are shown the consent options. Using PhotoConsent you can choose to obtain consent to use the photo for assessment, second opinion or referral, educational use or publication. In real time with the patient you can then select each consent option to explore in more detail to allow informed consent. This consent can then be digitally signed and emailed to the patient instantly. The image and consent can then be used by the clinician in accordance with GMC guidance. This can be via the app, email or via the online portal: PhotoConsent.co.uk. What makes PhotoConsent unique is that the consent is digitally secure in the metadata of the image. So proof of consent is always with the image. Why should I use PhotoConsent? It is important if taking a medical image of a patient, that consent is obtained and recorded. Written consent is considered the best option. PhotoConsent allows you to take consent with the patient in real-time, forward the patient a copy of the consent so they can stay informed, and be safe in the knowledge that consent is secure within the image metadata. All this is possible through your own iOS device making it convenient and effective for all involved. What is next for PhotoConsent? The first release of PhotoConsent is out, but there can always be progression. In the future I hope to bring the app to the Android platform to make it more accessible to a wider audience. We are also working on expanding the app to include consent for non-medical use. We have a few other ideas but time will tell if these are possible. About the owner: Dr Hussain Gandhi (@drgandalf52) is a GP and GP trainer working in the Nottingham area. He is a RCGP First5 lead, Treasurer of RCGP Vale of Trent faculty, co-author of The New GPs Handbook, owner of PhotoConsent and egplearning.co.uk – an e-learning portal; and a member of Tiko’s GP group on Facebook (@TheVoiceofTGG). All Images taken via PhotoConsent.  
Hussain Gandhi
about 6 years ago
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4
20

NEJM Procedure: Deployment of an Endovascular Graft in an Abdominal Aortic Aneurysm

Aneurysm repair is a mechanical solution to the problem of progressive expansion of abdominal aortic aneurysm and the risk of rupture. Although open surgical...  
youtube.com
over 4 years ago