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Conscious Sedation for Minor Procedures in Adults

This supplement provides a summary of the teaching points that appear in the accompanying video, which demonstrates the equipment and techniques used to provide intravenous conscious sedation for minor procedures in adults. Practice guidelines for sedation and analgesia may vary in different regions of the world. The American Society of Anesthesiologists has developed such guidelines for use by physicians

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Fiberoptic Intubation

Fiberoptic intubation plays an important part in the management of a difficult airway and is recommended by many societies of anesthesia. It is primarily important for the management of the anticipated difficult airway, but can also be used to secure the airway in an unexpected situation. There are different techniques for both situations -- the nasal and oral approach in the awake and anesthetized status, respectively. The choice of the equipment and medication is primarily dependent on personal preference. This video will demonstrate a nasal approach in an awake patient with a difficult airway and will also demonstrate an oral technique in an anesthetized patient whose

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این فیلم مروری در مورد جایگذاری کاتتر ورید پولموناری سیرکومفرنسیال (محیطی) جهت درمان فیبریلاسون دهلیزی می باشد. این فیلم با فرمت فلاش پلیر و به حجم ۱۰.۳ مگابایت می باشد.

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این فیلم کاربرد استفاده از محلول ایندیگوکارمین برای تشخیص آدنومای مسطح و غیر پولیپوئید پس از رزکشن اندوسکوپیک ضایعه را نشان می دهد. این فیلم با فرمت فلاش پلیر و به حجم ۹.۴۱ مگابایت می باشد.

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در این فیلم شما می توانید انیمیشن های ترمیم باز و اندوواسکولار آنوریسم آئورت شکمی را ببینید. این فیلم ها با فرمت فلاش پلیر و به حجم ۲.۹۰ و ۳.۶۶ مگابایت می باشد.

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در این فیلم شما می توانید یک مدل اینتراکتیو از عملکرد واحد اسپاینال L4-L5 را ببینید. این فیلم با فرمت فلاش پلیر و به حجم ۲.۲۹ مگابایت می باشد.

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در این فیلم شما می توانید قسمت های مختلف بینی از جمله توربینیت ها و مجرای استاش را که به وسیله اندوسکوپی بینی دیده می شود را مشاهده نمایید. این فیلم با فرمت فلاش پلیر و به حجم ۲.۲۶ مگابایت می باشد.

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Pulse Oximetry

Pulse oximetry has become the standard of care in operating rooms, intensive care units (ICUs), and hospital wards in the United States and many other nations.1 Before pulse oximetry was available, physicians relied on invasive procedures, such as arterial puncture for blood gas analysis, to identify the presence of hypoxemia. Unlike arterial blood gas analysis, pulse oximetry allows for noninvasive and continuous monitoring of arterial blood oxygen saturation. Although the pulse oximeter is easy to use, the clinician must understand the principles of pulse oximetry and must know how the equipment works in order to interpret the information it provides

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Hand Hygiene

Health-care associated infections are a threat to patient safety and the most common adverse events resulting from a stay in the hospital.1 Approximately 5 to 10% of hospitalized patients in the developed world acquire such infections, and the burden of disease is even higher in developing countries. Proper use of hand hygiene is a critical to the prevention of these infections, but compliance among health care workers is most often below

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Intraosseous Catheter Placement in Children

Obtaining vascular access in acutely ill or injured children can be challenging. Intraosseous access provides a means for delivery of medications, crystalloid fluids, colloids, and blood products during pediatric resuscitation. In addition, when intraosseous access is achieved, blood samples can be obtained for laboratory analysis. Numerous studies show that an intraosseous catheter can be placed more rapidly than a central venous catheter and that this technique is more reliable than venous cutdown

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Arterial Puncture for Blood Gas Analysis

This is a Video in Clinical Medicine from the New England Journal of Medicine. Arterial Puncture for Blood Gas Analysis Overview Radial arterial puncture for arterial blood gas analysis is a common procedure performed in medicine. It is a fundamental skill that all medical trainees need to acquire. This video will review radial arterial puncture in the adult population. Indications Puncture of the radial artery is the preferred method of obtaining an arterial blood sample for blood gas analysis. The chief indication for measurement of arterial blood gas level is to obtain values for the partial pressures of oxygen and carbon dioxide and for arterial pH

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Tympanocentesis in Children with Acute Otitis Media

This is a Video in Clinical Medicine from the New England Journal of Medicine. Tympanocentesis in Children with Acute Otitis Media Overview Tympanocentesis is defined as needle aspiration of fluid from the middle ear. In children with acute otitis media, drainage of pus from the middle ear results in a rapid and marked improvement in symptoms and enables the clinician to prescribe tailored antimicrobial therapy. This video will demonstrate the technique of tympanocentesis. Indications Tympanocentesis is recommended in children with refractory acute otitis media, in immunocompromised children with otitis media, and in children with suppurative complications of acute otitis media

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Clinical Evaluation of the Knee

 The knee is one of the most complex joints in the body. Knee complaints are the second most common musculoskeletal symptom evaluated by the primary care physician. Anatomy The anatomy of the knee joint consists of three bones — the femur, tibia, and patella — with three areas of articulation. Some of the unique features include menisci, intra- and extraarticular ligaments, and the patella itself. The menisci are fibrocartilagenous structures located between the tibiofemoral articulations; they increase stability and distribute contact forces on the articular cartilage

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Diagnosing Otitis Media — Otoscopy and Cerumen Removal

 Pneumatic otoscopy and cerumen removal will be discussed in this video. Mastery of otoscopic examination techniques is necessary for the accurate diagnosis of otitis media. Otitis media is a general term for middle-ear inflammation and may be classified clinically as either acute otitis media or otitis media with effusion. In general, acute otitis media is diagnosed when the tympanic membrane is bulging, and otitis media with effusion is diagnosed when the tympanic membrane is neutral or retracted. Otoscopic examination is indicated in children who have an upper respiratory tract infection

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Ultrasound-Guided Internal Jugular Vein Cannulation

Traditionally, when internal jugular vein cannulation has been performed, external anatomical landmarks and palpation have been used to guide insertion of the needle into the vessel. However, depending on the operator's experience and the patient's anatomy, this procedure may be difficult or unsuccessful. Over the past decade, the increased use of ultrasound to guide internal jugular vein cannulation has improved success rates, reduced the time required to perform the procedure, and resulted in fewer complications

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Endometrial Biopsy

Endometrial biopsy is an office-based method for evaluating the tissue lining the uterus. There are a number of indications for which the American College of Obstetricians and Gynecologists recommends endometrial evaluation. This video will demonstrate the technique of endometrial biopsy. The many indications for endometrial biopsy include abnormal uterine bleeding, postmenopausal bleeding, and amenorrhea for a year or longer. Additional indications include endometrial dating to define the phase of the menstrual cycle, evaluation of infertility, and evaluation of uterine response to hormone

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Ankle–Brachial Index for Assessment of Peripheral Arterial Disease

Peripheral arterial disease affects more than 10 million people in the United States. In advanced stages, it may cause claudication and critical leg ischemia, defined as the presence of pain at rest in the leg or foot, ischemic ulcers, or gangrene. The presence of peripheral arterial disease leads to substantial morbidity in individual patients and results in early mortality. It also incurs high costs for the health care system. Because of its critical impact on health, accurate diagnosis of peripheral arterial disease is important

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Bone Marrow Aspiration and Biopsy

This video will demonstrate the procedure for bone marrow aspiration and bone marrow biopsy from the posterior iliac crest. Obtaining a bone marrow aspirate and core biopsy is often necessary when evaluating a patient who has a hematologic abnormality. Examining bone marrow is also useful in the diagnosis of metastatic spread of nonhematologic malignancies and to diagnose metabolic disorders. Gather the necessary equipment prior to performing the procedure. You will require equipment for sterile skin preparation and a sterile field, 1 percent lidocaine buffered with sterile sodium bicarbonate, a 25-gauge needle and 5-ml syringe, a bone marrow aspiration needle

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Blood-Pressure Measurement

Evaluation of blood pressure is essential in assessing cardiovascular health. It is used in screening for hypertension, and for monitoring the effectiveness of treatment in patients with established hypertension. In the routine outpatient setting, blood pressure is measured indirectly. Thus, it is important that proper techniques be used in order to produce consistent and reliable readings. In adults, a normal blood pressure is less than 120 mm Hg for systolic and less than 80 mm Hg for diastolic blood pressure. Higher levels are classified as prehypertensive

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