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8
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30

Pulse Oximetery

Discussion of the technology of the pulse oximeter  
Jeffrey S. Guy, MD, FACS
about 9 years ago
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1673

Detailed first and second year OSCE stations

Explanations of procedures and signs associated with various OSCE style stations relevant to first and second year MBBS, including pictures of relevant pathology and illustrative diagrams. Includes - resuscitatio - peripheral pulse - blood pressur - cardiovascular exam (including relevant aspects of the general examination - ECG lead placemen - Respiratory exam (including relevant aspects of the general examination - peak flo - vitalograp - abdominal examination (including relevant aspects of the general examination - PNS (motor function - Reflexes alon - cranial nerve exa - Thyroid exa - cervical and lymph node (diagrams only - Shoulder joint exa - Hip joint exam  
Gemma McIntosh
over 8 years ago
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4
128

Pulses of the Lower Limb

A beginner's guide to finding the peripheral pulses in the lower limb -- perfect for the medical student on their first placement. Far from comprehensive, but an excellent starting point if you're not quite sure what approach to take. Part of our series on basic clinical examination. If you enjoyed this video, why not subscribe for all the latest from HippocraTV? And let us know what you'd like us to cover next -- like all good educationalists, we can't get enough of that sweet, sweet feedback. Now get out there and see some patients! Music: Brittle Raille by Kevin Macleod Cool Vibes by Kevin Macleod Dub Feral by Kevin Macleod Local Forecast by Kevin Macleod Groove Grove by Kevin Macleod (all via the wonderful Incompetech.com) Special thanks to Harrison Ferguson Disclaimer: HippocraTV is not affiliated with any medical school or NHS trust. While we make a great effort to ensure our content is correct and up-to-date, watching YouTube is not a substitute for reading a textbook, attending a lecture or seeing a real-life patient.  
Hippocrates
over 5 years ago
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4
71

Taking the Pulse

A beginner's guide to the pulse -- perfect for the medical student on their first placement.  
Hippocrates
over 5 years ago
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23

Airway Support

There are plenty of methods of doing this. Remember that these methods only provide ventilation and thus should only be used when the patient still has a pulse. If they have no pulse, and they are not breathing, then start the ALS protocol. Also note that many of these methods can be used as part of CPR (although you wouldn’t normally intubate with CPR!) – for example the pocket mask, and the bag and mask.    
almostadoctor.com - free medical student revision notes
over 5 years ago
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1
28

Neck and Thyroid Exam

Introduction Wash hands, check right patient, introduce yourself, get permission Ask the patient to sit up straight in a chair, and expose their neck down to the shoulders. You could ask them to look up a little bit. Remove any jewellery.   InspectionInspect the hands Hypothyroidism Lethargic, disinterested Bradycardia (radial pulse)  
almostadoctor.com - free medical student revision notes
over 5 years ago
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1
22

Neck and Thyroid Exam

Introduction Wash hands, check right patient, introduce yourself, get permission Ask the patient to sit up straight in a chair, and expose their neck down to the shoulders. You could ask them to look up a little bit. Remove any jewellery.   InspectionInspect the hands Hypothyroidism Lethargic, disinterested Bradycardia (radial pulse)  
almostadoctor.co.uk
over 5 years ago
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2
22

Introducing MRI: Introduction to Pulse Sequences (30 of 56)

http://www.einstein.yu.edu - The thirtieth chapter of Dr. Michael Lipton's MRI course covers Introduction to Pulse Sequences. Dr. Lipton is associate profess...  
YouTube
about 5 years ago
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23

Introducing MRI: The Spin Echo Pulse Sequence (31 of 56)

http://www.einstein.yu.edu - The thirty-first chapter of Dr. Michael Lipton's MRI course covers The Spin Echo Pulse Sequence. Dr. Lipton is associate profess...  
YouTube
about 5 years ago
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2
28

Introducing MRI: The Gradient Echo Pulse Sequence and Modified Flip Angle (34 of 56)

http://www.einstein.yu.edu - The thirty-fourth chapter of Dr. Michael Lipton's MRI course covers The Gradient Echo Pulse Sequence and Modified Flip Angle. Dr...  
YouTube
about 5 years ago
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2
22

Introducing MRI: Fast Spin Echo Pulse Sequence (37 of 56)

http://www.einstein.yu.edu - The thirty-seventh chapter of Dr. Michael Lipton's MRI course covers Fast Spin Echo Pulse Sequence. Dr. Lipton is associate prof...  
YouTube
about 5 years ago
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1
28

Introducing MRI: Introduction to Pulse Sequences (30 of 56)

http://www.einstein.yu.edu - The thirtieth chapter of Dr. Michael Lipton's MRI course covers Introduction to Pulse Sequences. Dr. Lipton is associate profess...  
YouTube
over 4 years ago
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4
389

Introducing MRI: The Spin Echo Pulse Sequence (31 of 56)

http://www.einstein.yu.edu - The thirty-first chapter of Dr. Michael Lipton's MRI course covers The Spin Echo Pulse Sequence. Dr. Lipton is associate profess...  
YouTube
over 4 years ago
Preview
2
26

Introducing MRI: The Gradient Echo Pulse Sequence and Modified Flip Angle (34 of 56)

http://www.einstein.yu.edu - The thirty-fourth chapter of Dr. Michael Lipton's MRI course covers The Gradient Echo Pulse Sequence and Modified Flip Angle. Dr...  
YouTube
over 4 years ago
Preview
4
180

Introducing MRI: Fast Spin Echo Pulse Sequence

The thirty-seventh chapter of Dr. Michael Lipton's MRI course covers Fast Spin Echo Pulse Sequence. Dr. Lipton is associate prof...  
YouTube
over 4 years ago
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Radial pulse being slower than heart rate?

Is it possible to have a slower radial pulse than your actual heart rate. Someone told me it was, but I can't understand how this would be possible!!! Could someone enlighten me, as I can't understand why this would ever occur.  
Andrew Rinley
almost 6 years ago
Foo20151013 2023 zpmqsc?1444774026
3
3772

Assessing Types of Burns and their Severity

This is an excerpt from "Wound Care Made Incredibly Easy! 1st UK Edition" by Julie Vuolo For more information, or to purchase your copy, visit: http://tiny.cc/woundcare. Save 15% (and get free P&P) on this, and a whole host of other LWW titles at http://lww.co.uk when you use the code MEDUCATION when you check out! Introduction A burn is an acute wound caused by exposure to thermal extremes, electricity, caustic chemicals or radiation. The degree of tissue damage caused by a burn depends on the strength of the source and the duration of contact or exposure. Around 250,000 people per year sustain burn injuries in the UK (NBCRC 2001). Because of the specialist care burns require, they are considered here separately from other traumatic wounds. Types of burns Burns can be classified by cause or type. Knowing the type of burn will help you to plan the right care for your patient. Thermal burns The most common type of burn, thermal burns can result from virtually any misuse or mishandling of fire, combustible products, hot fluids and fat or coming into contact with a hot object. Playing with matches, pouring petrol onto a BBQ, spilling hot coffee, touching hot hair straighteners and setting off fireworks are some common examples of ways in which burns occur. Thermal burns can also result from kitchen accidents, house or office fires, car accidents or physical abuse. Although it’s less common, exposure to extreme cold can also cause thermal burns. Electrical burns Electrical burns result from contact with flowing electrical current. Household current, high-voltage transmission lines and lightning are sources of electrical burns. Internal injury is often considerably greater than is apparent externally. Chemical burns Chemical burns most commonly result from contact (skin contact or inhalation) with a caustic agent, such as an acid, an alkali or a vesicant. Radiation burns The most common radiation burn is sunburn, which follows excessive exposure to the sun. Almost all other burns due to radiation exposure occur as a result of radiation treatment or in specific industries that use or process radioactive materials. Assessment Conduct your initial assessment as soon as possible after the burn occurs. First, assess the patient’s ABCs. Then determine the patient’s level of consciousness and mobility. Next, assess the burn, including its size, depth and complexity. Determining size Determine burn size as part of your initial assessment. Typically, burn size is expressed as a percentage of total body surface area (TBSA). The Rule of Nines and the Lund–Browder Classification provide standardised and quick estimates of the percentage of TBSA affected. Memory Jogger To remember the proper sequence for the initial assessment of a burns patient, remember your ABCs and add D and E. Airway – Assess the patient’s airway, remove any obstruction and treat any obstructive condition. Breathing – Observe the motion of the patient’s chest. Auscultate the depth, rate and characteristics of the patient’s breathing. Circulation – Palpate the patient’s pulse at the carotid artery and then at the distal pulse points in the wrist, posterior tibial area and foot. Loss of distal pulse may indicate shock or constriction of an extremity. Disability – Assess the patient’s level of consciousness and ability to function before attempting to move or transfer them. Expose – Remove burned clothing from burned areas of the patient’s body and thoroughly examine the skin beneath.  
Lippincott Williams & Wilkins
over 6 years ago
Foo20151013 2023 1eqve0g?1444774030
1
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LWW: Case Of The Month - May 2013

This month’s case is by Barbara J. Mroz, M.D. and Robin R. Preston, Ph.D., author of Lippincott’s Illustrated Reviews: .Physiology (ISBN: 9781451175677). For more information, or to purchase your copy, visit: http://tiny.cc/PrestonLIR, with 15% off using the discount code: MEDUCATION. The case below is followed by a choice of diagnostic tests. Select the one lettered selection that would be most helpful in diagnosing the patient’s condition. The Case A 54-year-old male 2 pack-per-day smoker presents to your office complaining of cough and shortness of breath (SOB). He reports chronic mild dyspnea on exertion with a daily cough productive of clear mucus. During the past week, his cough has increased in frequency and is now productive of frothy pink-tinged sputum; his dyspnea is worse and he is now short of breath sometimes even at rest. He has had difficulty breathing when lying flat in bed and has spent the past two nights sleeping upright in a recliner. On physical examination, he is a moderately obese male with a blood pressure of 180/80 mm Hg, pulse of 98, and respiratory rate of 22. His temperature is 98.6°F. He becomes winded from climbing onto the exam table. Auscultation of the lungs reveals bilateral wheezing and crackles in the lower posterior lung fields. There is pitting edema in the lower extremities extending up to the knees.  Question Which if the following tests would be most helpful in confirming the correct diagnosis? A. Spirometry B. Arterial blood gas C. Complete blood count D. B-type natriuretic peptide blood test E. Electrocardiogram Answer? The correct answer is B-type natriuretic peptide blood test. Uncomfortable breathing, or feeling short of breath, is a common medical complaint with multiple causes. When approaching a patient with dyspnea, it is helpful to remember that normal breathing requires both a respiratory system that facilitates gas exchange between blood and the atmosphere, and a cardiovascular system that transports O2 and CO¬2 between the lungs and tissues. Dysfunction in either system may cause dyspnea, and wheezing (or bronchospasm) may be present in both cardiac and pulmonary disease. In this patient, the presence of lower extremity edema and orthopnea (discomfort when lying flat) are both suggestive of congestive heart failure (CHF). Elevated blood pressure (systolic of 180) and a cough productive of frothy pink sputum may also be associated symptoms. While wheezing could also be caused by COPD (chronic obstructive pulmonary disease) in the setting of chronic tobacco use, the additional exam findings of lung crackles and edema plus systolic hypertension are all more consistent with CHF. What does the B-type natriuretic peptide blood test tell us? When the left ventricle (LV) fails to maintain cardiac output (CO) at levels required for adequate tissue perfusion, pathways are activated to increase renal fluid retention. A rising plasma volume increases LV preload and sustains CO via the Frank-Starling mechanism. Volume loading also stimulates cardiomyocytes to release atrial- (ANP) and B-type (BNP) natriuretic peptides. BNP has a longer half-life than ANP and provides a convenient marker for volume loading. Plasma BNP levels are measured using immunoassay; levels >100 pg/mL are suggestive of overload resulting in heart failure. How does heart failure cause dyspnea? Increasing venous pressure increases mean capillary hydrostatic pressure and promotes fluid filtration from the vasculature. Excess filtration from pulmonary capillaries causes fluid accumulation within the alveoli (pulmonary edema) and interferes with normal gas exchange, resulting in SOB. Physical signs and symptoms caused by high volume loading include: (1) Lung crackles, caused by fluid within alveoli (2) Orthopnea. Reclining increases pulmonary capillary hydrostatic pressure through gravitational effects, worsening dyspnea when lying flat. (3) Pitting dependent edema caused by filtration from systemic capillaries, an effect also influenced by position (causing edema in the lower legs as in our ambulatory patient or in dependent areas like the sacrum in a bedridden patient). What would an electrocardiogram show? Heart failure can result in LV hypertrophy and manifest as a left axis deviation on an electrocardiogram (ECG), but some patients in failure show a normal ECG. An ECG is not a useful diagnostic tool for dyspnea or CHF per se. Wouldn’t spirometry be more suitable for diagnosing the cause of dyspnea in a smoker? Simple spirometry will readily identify the presence of airflow limitation (obstruction) as a cause of dyspnea. It's a valuable test to perform in any smoker and can establish a diagnosis of chronic obstructive pulmonary disease (COPD) if abnormal. While this wheezing patient is an active smoker who could have airflow obstruction, the additional exam findings above point more to a diagnosis of CHF. What would an arterial blood gas show? An arterial blood gas measures arterial pH, PaCO¬2, and PaO2. While both CHF and COPD could cause derangements in the values measured, these abnormalities would not necessarily be diagnostic (e.g., a low PaO2 could be seen in both conditions, as could an elevated PaCO¬2). Would a complete blood count provide useful information? A complete blood count could prove useful if anemia is a suspected cause of dyspnea. Test result BNP was elevated (842 pg/mL), consistent with CHF. Diuretic treatment was initiated to help reduce volume overload and an afterload reducing agent was started to lower blood pressure and improve systolic function.  
Lippincott Williams & Wilkins
over 6 years ago
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Jugular Venous Pulse (JVP) Explained Clearly | 2 of 2

Further discussion on jugular venous pulse waveforms, interpretation, and specific diseases and pathology with this clear explanation by Dr. Roger Seheult. I...  
youtube.com
over 4 years ago
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Jugular Venous Pulse (JVP) Explained Clearly | 2 of 2 - YouTube

Further discussion on jugular venous pulse waveforms, interpretation, and specific diseases and pathology with this clear explanation by Dr. Roger Seheult. I...  
youtube.com
over 4 years ago