پزشکی بالینی

Abscess Incision and Drainage

Incision and drainage is the primary therapy for cutaneous abscess management, as antibiotic treatment alone is inadequate for treating many of these loculated collections of infectious material. Most localized skin abscesses without associated cellulitis can be managed with simple incision and drainage and do not require antibiotic treatment. Cutaneous abscesses have been described in all areas of the body, but are most commonly found in the axillae, buttocks, and extremities. This outpatient procedure is appropriate for many office settings, as well as for urgent care and emergency department practice environments

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Chest-Tube Insertion

The insertion of a pleural chest tube is often done in a setting where immediate action is required. Nonetheless, adherence to sterility, analgesia, sound technique, and safety are always warranted. Indications The most common indications for chest-tube drainage are: Pneumothorax that is recurrent, persistent, under tension, or bilateral; any pneumothorax in a patient on positive-pressure ventilation; hemothorax; recurrent or symptomatic large pleural effusion; empyema; and chylothorax. Contraindications There are relative contraindications, mainly based on hematologic abnormalities such as bleeding diatheses or coagulopathy

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Positive-Pressure Ventilation with a Face Mask and a Bag-Valve Device

 Providing positive-pressure ventilation with a face mask and a bag-valve device can be a lifesaving maneuver. Although seemingly simple, the technique requires an understanding of the airway anatomy, the equipment, and the indications. Developing manual skills is necessary to provide adequate face-mask ventilation. While endotracheal intubation is frequently the definitive airway management approach for patients in respiratory failure, it is not always feasible. In these circumstances, ventilating a patient with a face mask can be an invaluable temporizing measure

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Pelvic Examination

This video will demonstrate how to perform a comprehensive pelvic examination, which includes an examination of the external genitalia, a Papanicolaou test, a bimanual examination, as well as a rectovaginal examination. Indications Women should undergo a pelvic examination when they have vulvar and or vaginal complaints such as pain, discharge, abnormal bleeding, itching, and/or a mass. A pelvic examination is also indicated when pregnancy is suspected or proven, and in women who have been exposed to sexually transmitted infections

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