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When it comes to medical issues that can arise, one of the nastier things that can arise is an infection. Whether it be regular staph, MSA or others, infections are things that can hurt, kill, maim or at least prolong suffering and recovery. One source of infections that becomes an issue entirely too often would be those that occur because of and during surgery. While it is normal for great pains to be taken to sanitize both the people and instruments involved in a surgery, it is entirely too common for people to come down with infections during the course of surgery. As such, it can and should be the focus of a fully described clinical practice guideline. While accidents and bad things do happen in surgery, infections should be one of those things that should never happen, at least not due to improper practice on the part…
Lopez, J., Prifogle, E., Nyame, T. T., Milton, J., & May, J. J. (2014). The impact of conflicts of interest in plastic surgery: an analysis of acellular dermal matrix, implant-based breast reconstruction. Plastic And Reconstructive Surgery, 133(6), 1328-1334.
Rhee, C., Huang, S. S., Berrios-Torres, S. I., Kaganov, R., Bruce, C., Lankiewicz, J., & ...
Yokoe, D. S. (2015). Surgical Site Infection Surveillance Following Ambulatory
History of Surgery had been started from the prehistoric time with its appropriate technique and tools applicable during the age. There was no sophisticated care of hygiene and anatomic knowledge in the early days; the basic research was started using trial and error on every case and it had set a very strong basic which still makes sense and counts into modern practice.
The following summary of history of surgery is compiled from various sources based on the timeline set in dr. Schell's lecture: The History of Surgery.
The Ancient Medicine (Prehistoric Time)
People had strong magic beliefs and connection to multiple gods during the prehistoric time, so that any cases of illness were also believed as the punishments from angry gods for community's or one's moral failure. Some common cases recorded were respiratory and digestive problems, infections, and gynecologic disorders. Life expectancy low, then 28-35 years was a successful…
13.3 Trephination, An Ancient Surgery. http://www.uic.edu/classes/osci/osci590/13_3%20Trephination%20An%20Ancient%20Surgery.htm. March24, 2002.
Anaesthesia History. The Surgery Door Pain Centre by Neurofen. http://www.surgerydoor.co.uk/coe/paincentre/anaesthesia.shtml. March26, 2002.
Anesthesia: A Brief History. Feb 13, 2001. Simon Fraser Health Region. http://www.sfhr.com/anesthesia/abrief.htm . March26, 2002.
Bune, Matt and Gregor, Pam. Ancient Egyptian Surgery ed. Majno, Guido. The Healing Hand: Man and Wound in the Ancient World. Harvard University Press, Cambridge, 1982. pp. 86-121. http://emuseum.mnsu.edu/prehistory/ancienttech/ancient_egyptian_surgery.html . March26, 2002.
Office-Based Sugey Pactices
Impact of Human Resouces on Office-Based Sugey Pactices
Office-based sugey is defined within the legislation as that in which any sugical o invasive pocedue is pefomed outside of a hospital o diagnostic and teatment cente, in which modeate to deep sedation o geneal anaesthesia is used (Patel et al., 2008). The use of office-based sugey is cuently inceasing, due to the ecognized benefits with which it is associated, fo example shote waiting times, geate convenience and lowe costs (Dalton et al., 2006). The ole of human esouces in office-based sugey is an impotant concen as it may have a significant impact in many aeas of the pactice, including citical aspects such as patient and staff safety. This essay examines the impact of human esouces on office-based sugey, including acceditation issues, the impact on patient and staff safety, and employee and labo elations.
Amid concens fo…
references, satisfaction, and resource use in office evacuation of early pregnancy failure. Obstetrics and Gynecology, 108(1): 103-110.
Galati, M. (2006). Practice management issues in office-based anesthesiology. Seminars in Anesthesia, Perioperative Medicine and Pain, 25(1): 32-39.
Hancox, J.G., Venkat, A.P., Coldiron, B., Feldman, S.R. & Williford, P.M. (2004). The safety of office-based surgery: Review of recent literature from several disciplines. Archives of Dermatology, 140(11): 1379-1382.
Harley, DH & Collins, D.R. (2008). Patient satisfaction after blepharoplasty performed as office surgery using oral medication with the patient under local anesthesia. Aesthetic Plastic Surgery, 32(1): 77-81.
Horton, J.B., Reece, E.M., Broughton, G., Janis, J.E., Thornton J.F. & Rohrich, R.J. (2006). Patient safety in the office-based setting. Plastic and Reconstructive Surgery, 117(4): 61e-80e.
Orthognathic Surgery is a procedure used for patients that have jaws that do not meet properly, which often coincides with teeth that do not seem to fit correctly with their jaws. This procedure is often used in conjunction with orthodontics, which straighten the teeth in preparation for the jaw surgery. People who require orthognathic surgery often have incorrectly positioned jaws, or an improper bite. Often the upper and lower jaws grow at different rates, which can lead to problems that affect speech, chewing, long-term oral health, as well as appearance. Also, jaw alignment can also be influenced by injury to the jaw and birth defects. Orthognathic surgery basically repositions the jaw (Center for Oral and Facial Surgery of Chattanooga, 2000). This type of surgery is also used for patients that require jaw repositioning in order to allow for the reconstruction of the dentition using implants (Jones, 2002).
More specifically, orthognathic…
Center for Oral and Facial Surgery of Chattanooga. Orthognathic Surgery (2000):
Jones, R. "Orthognathic surgery and implants." Annals of the Royal Australasian College of Dental Surgeons 16 (2002): 105-.
Motegi, E., Hatch, J., Rugh, J., Yamaguchi, H. "Health-related quality of life and psychosocial function 5 years after orthognathic surgery." American Journal of Orthodontics and Dentofacial Orthopedics 124.2 (2003): 138-43.
What is it?
LASIK is the acronym for "laser-assisted in situ keratomileusis" (Goldstein 2010). LASIK surgery is a type of surgery conducted on the human eye to correct deficiencies in vision. The human eye is not unlike a camera: "The cornea is a part of the eye that helps focus light to create an image on the retina" (LASIK, 2011, FA). The cornea or lens is often imperfect in shape and contains refractive errors, causing vision problems such as "myopia, hyperopia and astigmatism" or combinations of these conditions (LASIK, 2011, FA). Until the development of LASIK, glasses or contact lenses were the only ways to compensate for the eye's imperfections. But through LASIK surgery, the "precise and controlled removal of corneal tissue by a special laser reshapes the cornea, changing its focusing power" (LASIK, 2011, FA).
uring the surgery, "first, a micro thin flap is created on the front surface…
During the surgery, "first, a micro thin flap is created on the front surface of the eye (cornea) that is then lifted back and preserved. Next, a cool beam excimer laser sculpts the underlying cornea into a new shape to correct the refractive error. The flap is then repositioned and adheres on its own without sutures after only a few minutes" (Vision correction, 2011, LASIK Australia).
Supposedly, the surgery is supposed to be painless and to have no complications -- if conducted on appropriate subjects. The fact that the surgery can and is most often performed at out-patient facilities specifically devoted to LASIK surgery caused a rapid increase in its use, as well as how the surgery is administered -- requiring no extensive hospital stay (Vision correction, 2011, LASIK Australia)
The surgery was immediately popular with athletes and
Cardiovascular surgery includes operations on the heart and blood vessels of the body to repair structural defects of the cardiovascular system. If a patient's heart condition poses a significant risk to their health and livelihood, surgery is the preferred treatment option. There are more than a half million heart surgeries performed in the U.S. each year for heart problems. Heart surgery may be performed on both children and adults. Heart surgery can reduce symptoms, improve quality of life, and increase lifespan (National Heart Lung and Blood Institute).
There are many different types of heart surgery. Surgeries are performed to:
Repair or replace valves controlling the direction of blood flow through the heart's chambers
Bypass or widen blocked or narrowed arteries to the heart
Destroy small amounts of tissue that disturb electrical flow through the heart
Repair damaged or abnormal structures of the heart
Implant medical devices that are used to…
Medline Plus. Heart Surgery. U.S. Department of Health and Human Services. Oct. 2011. Web. January 2012.
National Heart Lung and Blood Institute. What is heart surgery? Apr 1, 2011. Web. January 2012. < http://www.nhlbi.nih.gov/health/health-topics/topics/hs/ >
Schools in the U.S.A.com. Cardiovascular Surgeon. 2003-2012. Web. January 2012.
The figure is somewhat lower for left handers, approximately 70%" (Hemisphere specialization, 2010, Macalester University).
The fact that some people's right hemispheres do possess the ability to 'speak' enabled further illuminating results to be generated by studying split brain patients: in the case of one split brain operation patient 'Paul,' for example, Paul's right hemisphere was able to express itself alone: "Paul's right hemisphere stated that he wanted to be an automobile racer while his left hemisphere wanted to be a draftsman" (Behavior, 2010, Macalester University). It was as if Paul's different hemispheres had different personalities, even different political opinions. The left side of the brain controls the right side of the individual's body and the right side controls the left hand. Paul wrote with his right-dominated left hand that he wanted to be a presumably exciting occupation -- and that he hated ichard Nixon. The left side, using the…
Behavior of split brain patients. (2010). Macalester University. Retrieved April 5,
2010 at http://www.macalester.edu/psychology/whathap/ubnrp/Split_Brain/Behavior.html
A brief history of split brain experiments. (2010). Macalester University. Retrieved April 5,
2010 at http://www.macalester.edu/psychology/whathap/ubnrp/Split_Brain/Pioneers.html
It is the same as the patient not knowing that they had a ghost surgery conducted on them. The patient has the right to know that someone else will be performing the surgery in case they want to decline from having the surgery. The patient may not want a student to be cutting on them. Furthermore, it is wrong for the patient not to know everything before signing the release, which includes the procedures of ghost surgery.
However, in cases like Shorter v. Drury in 1985 where the patient knew the consequences of her procedure, which was major blood loss and she would need blood transfusions in order to recover. She refused to give the physician permission to give her blood if she needed it. Unfortunately, she died because the physician could not give her blood. In this sense, the patient knew what was going on and knew the consequence…
Quinbee. (1963). Retrieved April 21, 2012, from Tunkl v. Regents of the University of California: http://www.quimbee.com/cases/707263
Quinbee. (1985). Retrieved April 21, 2012, from Shorter v. Drury: http://www.quimbee.com/cases/707252
First observation of corneal flattening as a result of traumatic injury by Tsutomu Sato. Conceives of principle of principles of transverse and radial keratotomy but first attempts produce cloudy tissue due to approach from under the cornea.
First attempt at mechanically repairing corneal tissue by surgical removal, reshaping, and replacement of flap by Jose Barraquer.
adial Keratotomy developed and introduced by Svyatoslav
Fyodorov. Approaches incisions from outside the eye and solves cloudy tissue development problem encountered by Sato.
Development of excimer laser technology.
First surgical application of excimer laser on corneal tissue by Stephen Trokel
First excimer laser surgery on human eye by Theo Seiler
First LASIK procedure by Stephen Brint
Excimer laser for refractive surgery (PK) approved by U.S. FDA
for the correction of myopia with or without astigmatism
First excimer lasers approved for LASIK surgery
Excimer laser for…
EDUCASE. (2011). 7 Things You Should Know About LASIK Eye Surgery. Retrieved September 23, 2011 at http://creativecommons.org/licenses/by-nc-nd/3.0/
Find out more. 2011. FDA. Retrieved September 23, 2011 at http://www.lasik.com.au/TreatmentOptions/More-About-Lasik.aspx#experience
Goldstein, Bonnie. 2011. Is LASIK eye surgery safe? Politics Daily. Retrieved September 23, 2011 at http://www.politicsdaily.com/2011/02/10/is-lasik-eye-surgery-safe-fda-scientist-regrets-saying-yes/
Eye surgery developments. 2011. Your Health Counts. Retrieved September 23, 2011 at http://yourhealthcounts.net/lasik-eye-surgery-developments
Hospital for Special Surgery: Continuing Challenges of Growth
Any successful organization must meet the challenges of growing, that is, if it is to continue to be successful. This is true for the organization that we are focusing on for this exercise, the Hospital for Special Surgery. One of the greatest challenges in terms of both expansion and continuation of success is how to balance healthy, well-thought-out expansion against becoming over extending.
The Hospital for Special Surgery, again like other organizations, is subject to both internal and external influences and forces that can either support or disrupt the best-laid plans of managers. Good leaders of an organization try to foresee what forces may be harmful to the organization in the future and put into place defenses against them.
So what are likely to be the most important and potentially damaging forces that the hospital will face in the future. Bearing in…
How Greg Acquired MRSA
Greg had always been an active person, and while playing soccer with some of his friends in the spring of 2016, he tore his anterior cruciate ligament (ACL) in his right knee. Greg got into contact with one of the players, which resulted in him making sidestepping maneuvers because of the pain he was experiencing. Upon admission, it was noted that Greg was experiencing pain and swelling and the knee felt unstable (Castro, Smith, & Daccarett, 2016). The doctors recommended that Greg undergoes surgery in order to repair the torn ACL. The surgery went well without any issues and Greg was recuperating quite well. Three weeks after he was released from the hospital, Greg's recuperation had been progressing so well that the family felt they could go on a weekend getaway.
Greg is married and they have three children aged seven, five, and two years old.…
Carpenter, P. S., & Kendall, K. A. (2017). MRSA chronic bacterial laryngitis: A growing problem. The Laryngoscope.
Castro, C., Smith, P., & Daccarett, M. (2016). Candida Glabrata Septic Arthritis Involving the Right Knee After Anterior Cruciate Ligament Graft Placement. MOJ Orthop Rheumatol, 4(4), 00147.
While it used to be primarily the face, the breasts and more visible parts of the body that people chose to have cosmetic surgery on, today they are taking things a step further. According to Davis (2002) one of the most popular "new sex surgeries" is the "designer vagina." These surgeries are supposed to improve the aesthetics of the vagina as well as make them 'tighter'.
Clearly, people are becoming bolder and surgeries are becoming more invasive. For many people, the effect these surgeries have on their relationships with their bodies is improved self-esteem and confidence. But for many others, it becomes just one part of an endless and futile attempt to attain perfection.
Davis, S.W. (2002, March 22) Loose lips sink ships, Feminist Studies
oyster, F. (2005, July 28) Hee hee: Michael Jackson and the transgendered erotics of…
Davis, S.W. (2002, March 22) Loose lips sink ships, Feminist Studies
Royster, F. (2005, July 28) Hee hee: Michael Jackson and the transgendered erotics of voice, National Sexuality Resource Center
Deep Vein Thrombosis (DVT) is a serious health conditional that has the potential for fatal consequences. This condition basically involves the development of a thrombus in a deep vein and can take place in retinal veins, cerebral sinuses, upper extremities, and hepatic. The prevention of DVT, especially after a hip or knee surgery, is a major issue because of the increased risk of developing the condition in hospitals and community healthcare facilities. Given the increased risk for developing the condition across healthcare facilities, nurses, physicians and other health professionals face the need to understand the condition, identify it, and take suitable measures to prevent it. Consequently, there are some policies, procedures or standards for preventing deep vein thrombosis.
Based on existing policies, procedures and standards, the prevention of DVT should primarily focus on addressing the triad of influential factors. These factors include hypercoagulability, vein wall trauma/dilation, and venous stasis (Bonner,…
The NIH (2014) defines robotic surgery as "a method to perform surgery using very small tools attached to a robotic arm", wherein the surgeon operates the robot. Robotic surgery was developed to enable the performance of surgical procedures through smaller cuts than open surgery. The robot is capable of smaller, more precise movements that would be possible with a human arm. It is also much easier for the surgeon to work with the surgical tools than would be possible with, say, an endoscope. The NIH notes that robotic surgery is used for an increasing range of procedures, including coronary artery bypass, cancer excision, gall bladder removal, hip replacement, hysterectomy, kidney transplants and pyloroplasty (NIH, 2014).
The minimal invasiveness of robotic surgery means that there is lower risk to the patient during the course of the surgery, and that the post-surgery healing time is lower, and less risky as…
Cognitive and Psychomotor Disturbance:
This is the other long-term psychological effect of surgery on children particularly those who undergo heart transplant surgical operations. Similar to the post-hospital distress, cognitive and psychomotor disturbance is usually as a result of extra medical treatments and longer stays in hospital. According to research, patients who undergo complex pediatric surgical operations are likely to exhibit signs of cognitive or psychomotor disturbance (Todaro et al., n.d.). The cognitive and psychomotor disturbance is also as a result of the surgical procedures that a child goes through in the inpatient surgical operations.
However, the effect of cognitive and psychomotor disturbances are not limited to patient who undergo inpatient surgical operations since those who undergo day case surgery are also likely to experience these effects. Nonetheless, as compared to the inpatient surgical operations, the likelihood of these effects are less in day case surgical operations. Poor school attendance and…
Cadena, C. (2007, May 11). The Psychological Impact of Organ Transplants in Children.
Retrieved November 22, 2010, from http://www.associatedcontent.com/article/238567/the_psychological_impact_of_organ_transplants.html?cat=25
Campbell, I.R, Scaife, J.M & Johnstone, J.M. (n.d.). Psychological Effects of Day Case Surgery
Compared with Inpatient Surgery. Retrieved from National Center for Biotechnology Information -- U.S. National Library of Medicine website: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1778819/pdf/archdisch00687-0077.pdf
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique
Cardiac surgery by nature elicits a powerful stress response resulting from activation of stress hormones including epinephrine, norpinephine and cortisol hormones among others. Surgical trauma and blood loss may contribute to this stress response. Some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that results in a stress reaction.
The role of the anesthesiologist in cardiac surgery is to as much extent as possible, to reduce the stress response that results form cardiac surgery. Stress response can be mitigated by a variety of anesthetic technique, including use of opioids and epidural anesthesia. These ideas are explored in greater detail below.
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique
INTRODUCTION stress response may…
Cook, Richard I. "Adapting to New Technology in the Operating Room." Human Factors, Vol. 38, 1996.
Cook, R.I., Woods, D.D., Howie, M.B., Horrow, J.C. & Gaba, D.M. (1992). "Unintentional delivery of vasoactive drugs with an electromechanical infusion device." Journal of Cardiothoracic and Vascular Anesthesia, 6, 238-244.
Cuschieri, R.J., Morran, C.G., Howie, J.C., & McArdle, C.S. (1985). "Postoperative pain a dpulmonary complications: comparison of three analgesic regimens." British Journal of Surgery, 72, 495-499.
Glaser, J., Kiecolt-Glaser, MacCallum P., Marucha, P., & Page, G. "Psychological Influences on Surgical Recovery: Perspectives from Psychoneuroimmunology." American Psychologists, Vol. 53, 1998.
Does taking Metoprolol before cardiac surgery reduce the incidence of post-op atrial fibrillation
Postoperative atrial fibrillation (POAF) remains a prevalent supraventricular arrhythmia. PoAF has associated effects such as deteriorating hemodynamic, increased risk of stroke and increased probability of death. Beta-blockers have been recommended as effective intervention mechanism of preventing PoAF. Metoprolol is one such beta-blocker that is commonly administered to prevent the incidence of PoAF. The systematic review below entails an analysis of six clinical trials that explore the effectiveness of metoprolol. The analysis identifies reduced hospitalization length, reduced mortality and reduced financial burden as the beneficial impact associated with the administration of prophylactic. The small number of studies reviewed limits the validity of the conclusion warranting future large sample size research.
Annually, approximately 750,000 cardiac surgery are performed globally with postoperative atrial fibrillation (PoAF) being the prevalent complications (George, et al., 2018). With the increasing proportion of elderly population…
Interdisciplinary Care Providers
CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been…
PICO Question: Bariatric Surgery
As the obesity rate continues to be an issue of great concern in America, the question arises as to the best ways to reduce the BMIs of individuals already suffering from the condition, as well as how to enact preventative means. Although the ideal is for people to never become obese at all, the fact remains that there is a need to develop proactive measures to facilitate weight reduction. For most patients, modifications in diet and exercise is recommended but, as even people who have attempted casual weight loss know, deploying such techniques in an effective and consistent fashion is far easier said than done.
The PICO question for the purpose of this study is, from the perspective of a family nurse practitioner, when treating patients with type 2 diabetes and obesity, can bariatric surgery be more effective than standard medical therapy at increasing…
Temporomandibular Joint Surgery: A Comparison
Between Arthrocentesis And Arthroscopic Approaches
Background and Historical Perspective:
Temporomandibular Syndrome is a somewhat general descriptive term comprising several distinct pathologies, all related to the various structures of the temporomandibular joint. TMJ symptomatology ranges from general myofascial discomfort which can often be addressed by conservative (non-invasive) approaches to profoundly pathological interarticular mechanical malfunctions requiring extensive surgical repairs.
In general, the vast majority of TMJ symptoms are temporary in duration and resolve either spontaneously, or with conservative treatment consisting of rest, anti- inflammatory agents, muscle relaxants, physical therapy, dental devices and/or bite adjustments, behavior modification and external application of thermal compresses.
A comprehensive evaluation is essential to accurate diagnosis, particularly since stress management problems and repressed aggression sometimes manifest as myofascial pain.
Surgical intervention should therefore always be considered as a last resort and limited to intracapsular pathology associated with significant pain and mechanical malfunction. Where…
9. Sanders B: Arthroscopic management of internal derangements of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:259-269
10. Sanders B: Arthroscopic management of internal derangements of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:259-269
11. Kuwahara T, Bessette RW, Maruyama T (1994). A retrospective study on the clinical results of temporomandibular joint surgery. Cranio 12:179-183
Plastic surgeons refer to the practice of genital surgery for women as Female Genital Cosmetic Surgery (FGCS). However disruptive to sexual self-esteem needless genital surgery may be, the procedures can enormously benefit those who suffered from involuntary genital mutilation. A euters press report details the experiences of women from Burkina Faso whose tribal traditions condoned genital mutilation. Far from the mainly benign effects of male circumcision, female genital mutilation can completely diminish the pleasure of sex to the point where intimate encounters may be thoroughly "painful," (Schwarz 2007). Genital mutilation is a form of surgery that diminishes pleasure, and the reconstructive version can help victims regain their interest in sex and renew appreciation for their bodies.
Fitzpatrick, L. (2008). Plastic Surgery Below the Belt. Time. etrieved Feb 25, 2009 at http://www.time.com/time/health/article/0,8599,1859937,00.html
Freistag, A. Interview data.
Labiaplasty." etrieved Feb 25, 2009 at http://www.labiaplastysurgeon.com/
Schwarz, N. (2007). BUKINA FASO: Genital Surgery…
Fitzpatrick, L. (2008). Plastic Surgery Below the Belt. Time. Retrieved Feb 25, 2009 at http://www.time.com/time/health/article/0,8599,1859937,00.html
Freistag, A. Interview data.
Labiaplasty." Retrieved Feb 25, 2009 at http://www.labiaplastysurgeon.com/
Schwarz, N. (2007). BURKINA FASO: Genital Surgery Helps Burkina's Mutilated Women. The Female Genital Cutting Education and Networking Project. Retrieved Feb 25, 2009 at http://fgmnetwork.org/news/show_news.php?subaction=showfull&id=1187811902&archive=&template
School of Podiatric Medicine & Surgery
Admission Essay: Gelareh Noenifard
Thank you for the opportunity to submit a learning portfolio for you to consider my application to enroll for the Podiatry B.Sc. degree. I trust that the information provided will convince you of my passion for the medical profession. I believe that knowledge is power and it is my desire to explore every learning opportunity to broaden my education toward attaining this qualification. It is my goal to offer my services free of charge - while I am studying - to podiatry practices to gain work experience. I have attended a podiatry taster day and found it to be a rewarding and challenging career. My interest was sparked when I received medical attention for an injured ankle. I regularly visit the podiatric office to gather information about the profession, learn by observing the treatment procedures, and ask questions about podiatric…
Hospital for Special Surgery
In America there a wide variety of healthcare organizations, that have specialized in addressing the needs of various patients. Part of the reason why this occurring, is many facilities are unable to address the challenges facing those individuals requiring some kind of specialty care. As a result, a number of hospitals have evolved to deal with these issues. One such example of this is with Massachusetts General Hospital (MGH). Even though the facility was established as a community hospital in 1811, their overall mission has evolved. What has been happening is the hospital has become more focused on: offering specialized care and innovative health solutions. This is an effort by the administration to build upon their outstanding reputation through: improving the overall quality of care that patients are receiving. ("Hospital Overview," 2011)
As a result, the facility has become known for the specialty care and the…
Health Care Uncovered. (2011). Connect With Partners. Retrieved from: http://www.connectwithpartners.org/2011/04/14/%E2%80%9Chealthcare-uncovered%E2%80%9D-program-highlights-mgh%E2%80%99s-care-management-program/
Hospital Overview. (2011). Massachusetts General. Retrieved from: http://www.massgeneral.org/about/overview.aspx
Monagan, D. (2000). MGH and MGPO. Massachusetts General. Retrieved from: http://www2.massgeneral.org/pubaffairs/Issues/081100CPM.htm
Valencia, M. (2011). MGH Faces Suit. Boston. Retrieved from: http://articles.boston.com/2011-03-10/news/29339649_1_hospital-staff-hospital-report-hospital-officials
Surgery is a traumatic and often dangerous event. While tonsillectomies are somewhat common in the history of surgical procedures, it is necessary to investigate the problems of Amy as listed in the case study following a post operative procedure in which her tonsils were removed. In order to determine the patient's pathophysiology it is necessary to identify the problematic or typical physiological processes that are occurring with the patient.
The first step in discussing this problem should identify any problems or situations that are out of the normal set of circumstances for a tonsillectomy. Most of these types of surgeries are simple and require little to no healing time and prescriptions to finish the process. Here in Amy's case however, there seems to be a definite problem. The main problems deals with the patient's mental state and her fear of not healing. This fear has no doubt complicated…
Audit, N.P.T., & van der Meulen, J. (2004). Tonsillectomy technique as a risk factor for postoperative haemorrhage. The Lancet, 364(9435), 697-702.
Aukburg, S.J., Ketikidis, P.H., Kitz, D.S., Mavrides, T.G., & Matschinsky, B.B. (1989, November). Automation of physiologic data presentation and alarms in the post anesthesia care unit. In Proceedings of the Annual Symposium on Computer Application in Medical Care (p. 580). American Medical Informatics Association.
Berry, J.G., Blaine, K., Rogers, J., McBride, S., Schor, E., Birmingham, J., ... & Feudtner, C. (2014). A framework of pediatric hospital discharge care informed by legislation, research, and practice. JAMA pediatrics, 168(10), 955-962.
Brar, M.S. (2009). Airway management in a bleeding adult following tonsillectomy: a case report. AANA J, 77(6), 428-430.
Music and Pain
The use of music in relation to relaxation and pain control is universal in application. Many cultures use music, tones, chanting, drums, or other forms of biofeedback to treat patients in acute pain, women in labor, recovery, and now, most recently, in pre- and post-operative care. In fact, the therapeutic value of music has been recognized as vital and powerful since Ancient Times; archaeological evidence shows flutes carved from bone in pictures of physicians healing patients, Greek physicians used music and vibration to heal, aid in digestion and induce sleep; the Early Egyptians used musical incantations to help with the healing process; and certainly, numerous native tribes use singing and chanting as part of their healing rituals (Nilsson, 2008).
Further, most postoperative patients have pain, despite the use of analgesia. Nurses are constantly trying to be more effective in delivering pain medication. One study showed that patients…
Ghetti, C. (2011). Active music engagement with emotional-approach coping to improve well being in liver and kidney translplant recipients. Journal of Music Therapy. 48 (4): 463-85.
Good, M., et.al. (2010). Supplementing Relaxation and Music for Pain After Surgery. Nursing Research. 59 (4): 259-69.
Goodwin C.J. (2010). Research in Psychology: Methods and Design. New York: John
I have been performing surgery on electronics since I was five years old, and I figured out how to unscrew the back of my old stereo. Harvesting tubes from discarded stereos became my number one hobby, before I learned how to drive. The nice old man at my local electronics store used to save up boxes of freebies for me, because he knew I could not afford to buy my own parts. Using discarded materials, I would create what I now call "franken-machines," using my self-taught, rudimentary knowledge of electronics and electronics design. The architecture of electronics continues to fascinate me, and I have even made some pocket money helping my friends, or their friends, fix broken devices. For me, these things came easy. I have had to challenge myself to learn beyond the old technologies and now, I have a working command of circuit boards and even larger-scale…
Banks, G. (2010). Revolutionary diode design cracks 50-year-old electronics speed barrier. GizMag. Retrieved online: http://www.gizmag.com/mim-diode-breaks-speed-barrier/16827/
"Current Course Offerings." Princeton University. Retrieved online: http://www.princeton.edu/ee/courses/
Teen Plastic Surgery: A Controversial Medical Practice
According to the American Society of Plastic Surgeons, in 2007, more than 87,000 teenagers had cosmetic surgery; and that number has grown exponentially since. Although aesthetic cosmetic surgery is popular amongst United States teens, physicians and plastic surgeons worry that such invasive surgery on teens' still growing bodies can be dangerous. Other developed countries, including Germany and Australia, are considering banning all but medically necessary plastic surgery for anyone under the age of 18. However, the question remains, if such a measure were taken like that in the United States for minors stem the tide of teenagers going under the knife? This paper will address the controversy associated with teenagers and aesthetic cosmetic surgery in the United States, and the business of plastic surgery for teens, from a legal, ethical, and social responsibility standpoint.
In a country, and dare say…
Ali, K., & Lam, T. (2008). Teens under the knife: Is plastic surgery too dangerous for teens? Current Events, 108(1), 7-14.
American Society for Aesthetic Plastic Surgery (2003). National totals for cosmetic procedures. Cosmetic Surgery National Data Bank.
www.surgery.org/download/2003-stats.pdf:10. Accessed 25 July, 2011.
Bourdieu, P 1977, Outline of a Theory of practice, Cambridge University Press, Cambridge.
In support of the Terminal Objective, several key learning objectives will drive the content and curriculum for nurses undergoing the present training course. Primary among them, the training course is designed to create a standardized set of behaviors amongst nurses that conform with existing and evolving best practices in the perioperative care of CABG patients. This means that course content and design will be geared toward achieving procedural and professional consistency amongst attending nurses where preoperative, intraoperative and postoperative care are concerned.
An additional learning objective is to ensure that outgoing students are informed in the ethical and personal dimensions of the profession. Coronary surgical procedures are inherently serious in nature as are the heart and circulatory conditions that typically require such procedures. Therefore, it is of critical importance that nurses are trained in the proper bedside manner to approach patients, families and extended support systems with potentially…
Aroesty, J.M. (2010). Patient information: Recovery after coronary artery bypass graft surgery (CABG). Up To Date, 19(2).
Cleveland Clinic (CC). (2011). Diseases and Conditions. my.ClevelandClinic.org.
Kulick, D. & Shiel, W.C. (2011). Coronary Artery Bypass Graft Surgery. MedicineNet.com.
National Heart Lung and Blood Institute (NHLBI). (2010). What is Coronary Artery Bypass Grafting. National Institute of Health.
To verify this diagnosis, a doctor may then order either an X-ray of the area, or more likely, an MRI, which is better at imaging tears in soft tissues. hen surgery is required, these symptoms persist for several weeks after surgery.
Surgery is a common treatment for a rupture to the Achilles tendon; and most often consists of making an incision to the back of the lower leg and stitching together the torn section of the tendon. ("Surgery for an Achilles Tendon Rupture") if the rupture is complete, then the repair may be reinforced by connecting the torn tendon to other nearby muscles. hile the surgery is often performed through an open surgery procedure, if a patient has heart, circulatory, or poor healing risk factors, a percutaneous surgery will be performed. This surgical procedure differs in that it requires a number of small incisions instead of a single large one.…
"Everything About Achilles Tendons." AchillesTendon.com. Web. 26 Mar. 2012.
S. government has promoted breast implants, at the taxpayers' expense: According to the Army, between 2000 and 2003 its doctors performed 496 breast enlargements (women must pay for the silicon implants) (Schaler 29).
Health safety does not seem to have an impact on those desiring cosmetic surgery, nor does the comments of authority figures. In 1958 Pope Pins XII warned that operations for mere "vanity" or to enhance the "power of seduction, thus leading others more easily into sin," or "to hide a criminal from justice" were not in keeping with the church's teachings (Feldman 66). Some Christian and Jewish clergy agreed. However, not even the clergy could fight the studies saying that people with better looks had a greater chance for success (Feldman 66).
Last month, the FDA reneged on its earlier findings about breast augmentation; after a 14-year ban, it decided that silicone implants do not pose any…
Nursing - Discharge planning
Discharge Planning in Nursing
Mr. Trosack's Case
The three main health issues include movement hindrance where by Mr. Trosack will move with the help of a walker. Mr. Trosack diabetic condition is main health issue. Mr. Trosack is depressed and lonely and requires a special care and assistance. Mr. Trosack lives in a crowded apartment located at a second floor in a 3-storey building. The building does not have an elevator and thus Mr. Trosack has to use the stairs to reach to his apartment. The house has furniture and personal valuables and thus making it hard for him to use his walker once inside the room. e takes the garbage by himself since he lives alone because his wife died two years ago. e fears climbing up the stairs because of pain that emanate from the strain. is family works for 60 hours a week…
Hip fracture is a main health issue that happens in the United States. This study uses the baseline (1993) and data collected in 2006 in order to evaluate the aftermath of hip placement discharge. Patient discharge depends on the status code from the Medicare inpatient claim. They categorize discharge status depending on the condition of the patient. Mr. Trosack would fall for nursing facility because he would not get the required professional assistance from his family. In this study, most of the hip fracture patients went to a nursing facility.
An evaluation in this study reveals that at the time of placement, the patients had gone home for 90 days, and 180 days for patients discharged at a nursing facility. The evaluation of the care of hip placement patients needs consideration when choosing a discharge placement for them. Mr. Trosack, in addition to the surgery, is diagnosed with diabetes, hypertension, and obesity. The family, despite knowing all this, does not provide or hire a medical officer for a regular check up on him.
In order for Mr. Trosack to get well, it is crucial to refer him to a nursing facility. In this study, the home and rehabilitation discharge seems to decline while many people opt for the nursing placement, which increased. In these nursing facilities, patients are not likely to report any health issue compared to those placed at their homes. In addition, these nursing facilities offer functional needs to patients and may reduce hip fractures in elderly people.
Hygiene in Medical Settings
My message will be on hand hygiene for everyone that comes to the hospital.
Hand hygiene for hospital guests is just as important as it is for hospital personnel. Everyday interactions and activities can lead to exposure to a variety of bacteria that can create illness. In a hospital setting, this means that guests with good intentions towards loved ones can inadvertently make an illness worse or introduce new germs into clinically sanitized environments. Bacteria and other illness causing agents are often picked up from external environments and surfaces and then transported through body parts such as the nose, throat, skin, and hair. Because the hands are one of the most active parts of the body, we also carry germs between our fingers and underneath fingernails. Therefore, it becomes important that everyone wash their hands properly and frequently to decrease the transmission of bacteria and other…
Kuo, C.C. (2011). What's your hand hygiene?. AAOS Now, 5(10), 17-18.
Smith, S.S. (2009). A review of hand-washing techniques in primary care and community settings. Journal of Clinical Nursing, 18(6), 786-790. doi:10.1111/j.1365-2702.2008.02546.x.
Maxton, F.J.C., Justin, L. & Gillies, D. (2004). Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. Journal of Advanced Nursing 45(2): 214-22.
What is the research question? If it is not explicitly written, but is implicit in the article, suggest null and alternative hypotheses.
Which temperature-taking site yields the most accurate readings in babies and young children following cardiac surgery? Temperature is usually measured using the pulmonary artery as a "gold standard." However, the authors hypothesize that because the pulmonary artery cannot be used in the majority of the patients in the target population, other methods can and should be used. In addition to pulmonary artery temperature, the temperatures can be taken at the rectal, bladder, nasopharyngeal, axillary, and tympanic sites.
List the variables used in the study and identify each of them as either independent or dependent variables. Also describe the level…
Maxton, F.J.C., Justin, L. & Gillies, D. (2004). Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. Journal of Advanced Nursing 45(2): 214-22.
When I went home, I made a sandwich for dinner and ate it with an apple and some chips. I did not feel that I even wanted to try to cook anything or do dishes afterward.
Taking a shower that night was challenging. I thought I would just stand in the shower with my left leg resting on the floor outside the tub, but then I realized I had a "cast" on my right arm that I could not get wet. I ended up wrapping both simulated casts with plastic trash bags so I wouldn't get them wet. I still ended up getting a considerable amount of water on the bathroom floor. Just before going to bed, I removed the elastic bandages. Being disabled for one day was enough.
What surprised me most about the experience was the difficulty of even the simplest tasks. I had not realized how often…
In the case of breast augmentation, the parent must guide the minor to the right decision -- and that is usually not to have the surgery unless it is necessary for the teen's overall health. It is up to the adult to think responsibly. There are dangers to any surgery and infections are not among the least of them. Perhaps low self-esteem is a reason for counseling by a professional, but not necessarily reason to alter one's body artificially.
The ethical responsibilities of the parent in a discussion with their underage teen regarding whether or not to have her breast augmented, are even greater and more impacting than the legal issues.
The 1800 girls under the age of 18 who had their breasts augmented last year alone are under the ethical (and rational) reasoning of the parent. These are the parents who are taking out financing to do the surgery…
Agence France-Presse Newswire Service. Germany to Ban Cosmetic Surgery for Children. Paris, 23 April 2008.
Annas, George. The rights of patients: The basic ACLU guide to patient rights. New York City: Humana Press, 1992.
Clough, Craig. "Doc Urges Caution on Teen Breast Implants." 4 April 2008. lifewhile.com. 3 August 2009 .
Duenwald, Mary. "How Young is Too Young to Have a Nose Job and Breast Implants." New York Times 28 September 2004: F5.
The brain while expanding pushes the skull outward in the same perpendicular to the closed structure. This will be marked by the occurrence of 'papilledema' 'pseudoproptosis' as also 'optic atrophy.' (39) This results in the orbital socket being smaller and the eyes getting 'protoposed'. The intercranial pressure is bound to be high. The symptoms in such cases will be optic atrophy, head ache and papilledema. Or in the case of 'Crouzon's disease' where occurs a marked hooked nose and a frontal lobe which makes the disease also called the parrot head disease. Surgery in both these types of situations become mandatory as the result of the cranial pressure could result in death. (39)
egarding the facial surgery discussions always centre on perfecting features and cosmetic changes. The debate must rather be on the goals of the surgery and the overall benefits that can accrue to the patient in terms of…
1. Buncke HJ. Facial Paralysis - Reanimation. California Pacific Medical Center. [online]. 2007 [cited 2008 Feb 16]. Available from: URL:
2. Sataloff J, ThayerSataloff R. Occupational Hearing Loss. CRC Press. 2006.
Kim JYS, Bienstock a, Ketch L. Facial Nerve Paralysis, Dynamic Reconstruction. [online]. 2007 [cited 2008 Feb 16]. Available from: URL:
For candidates not considered good prospects for conventional LASIK because of extreme nearsightedness and who are leery of the long recovery period of PRK, phakic intraocular lenses can be implanted. "In these cases, a phakic intraocular lens may be used. This lens is implanted inside the eye and can effectively treat nearsightedness up to -20 diopters" (Randleman & Payne 2010, p.4). Intracorneal rings (thin plastic segments) implanted into the peripheral cornea to flatten the cornea can be used for individuals wary of the side effects of the surgery. hile visual recovery is less predictable with the intracorneal rings, the procedure has the advantage of being reversible. However, it is only able to correct up to -3 diopters of myopia (Randleman & Payne 2010, p.4).
Because it is not considered necessary surgery, and because the conditions it is designed to treat can be corrective with less expensive glasses and contacts, most…
Boyles, S. "LASIK Surgery: Safer than contacts?" WebMD. 2006. May 15, 2010.
Cloud, Daniel. "Perfect vision is helping." 'The New York Times. June 6, 2006.
May 15, 2010. http://www.nytimes.com/2006/06/20/us/20eye.html?fta=y
The procedure itself and the hospital stay associated with it is only one small chapter in the patient's life. They will eventually go home and will have many years after the procedure. It is important for the nursing staff to make a positive impact on how they feel about the procedure. The procedure will represent a lasting memory to the patient. If the patient perceives this to be a time of strength and care from nurturing individuals then it will help them to be able to develop the coping mechanisms necessary to learn to live with the after-effects of the procedure.
If the patient sees this as a negative experience, then it could produce unwanted effects such as depression, post-traumatic stress disorder, or other emotional problems that could have an effect on their ability to cope with the life changes. Those that develop appropriate coping mechanisms will be more likely…
Knoll, N., Rieckmann, N., & Schwarzer, R. (2005). Coping as a mediator between personality and stress outcomes: A longitudinal study with cataract surgery patients. European Journal of Personality, 19, 229-247.
Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2004). Initiation and maintenance of physical exercise: Stage-specific effects of a planning intervention. Research in Sports Medicine, 12, 221-240.
Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2004). Behavioral intentions and action plans promote physical exercise: A longitudinal study with orthopedic rehabilitation patients. Journal of Sport & Exercise Psychology, 26, 470-483.
Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2005). Stage-specific adoption and maintenance of physical activity: Testing a three-stage model. Psychology of Sport & Exercise, 6, 585-603.
Theatre Nurses Equipped With the Skills equired to Perform Pre-Operative Visits
To Perform Pre-Operative Visits?
Are Theatre Nurses Equipped With the Skills equired
To Perform Pre-Operative Visits?
Are Theatre Nurses Equipped With the Skills equired
To Perform Pre-Operative Visits?
Pre-operative assessment is part of the E process that many medical professionals believe can be accomplished on the part of nurses in the unit.. The objective listed for pre-operative assessment is that special requirements for the surgery as well as the peri-operative stay should include identification and coordination of all essential resources, should inform the patients and prepare them to proceed and to ensure the patient's fitness for the procedure(s) scheduled. . The nursing team clinically examines as well as assessing all emergency patients before surgery to ensure the fitness of patients to the greatest possible extent. Strategies include, "redistributing cases from emergency to elective theatre schedules, day case emergency…
Walsgrove H, Fulbrook P.(2005) Advancing the clinical perspective: a practice development project to develop the nurse practitioner role in an acute hospital trust. J Clin Nurs. 2005 Apr;14(4):444-55. PMID: 15807751
Walsgrove H. (2004) Piloting a nurse-led gynaecology preoperative-assessment clinic. Nursing Times. 2004 Jan 20-26; 100(3):38-41. PMID: 14963959
Byrne JP (2000) The South Australian Nurse Practitioner Project: a midwife's perspective on a new initiative.Collegian. 2000 Jul;7(3):37-9. PMID: 11858406
Le-Mon B. (2000) The role of the nurse practitioner. Nurs Stand. 2000 Feb 9-15;14(21):49-51. No abstract available. PMID: 11971310
Sampling method -117 patients with primary breast cancer; all who had same-day surgery as part of their treatment.
Appropriateness of sample -- Appropriate for circumstances under consideration.
Results (when applicable: credibility, transferability, dependability, & conformability)
Study found significant differences between the control and experimental group in terms of post-surgery mood, confusion, tension, and home management.
Ethical considerations -- All ethical considerations; privacy, etc. followed- professional study.
Relative strengths of each publication -- Peer reviewed strong work and sense of issues surrounding pain, fatigue and emotional disturbances after surgery.
Relative weaknesses of each publication -- Larger sample than previous study, but still limited in scope, demographics, psychographics and geographic extrapolation.
Application of each article in nursing practices -- Using any intervention that helps patient's after a traumatic surgery is helpful; especially if that patient can ventilate their emotions, angst, and stages of healing. Short-term telephone intervention using the AFSMI technique proves…
Yarbo, C., Wujcik, D., Holmes-Gobel, B. (2010). Cancer Nursing: Principles and Practices.
Philadelphia, PA: Jones and Bartlett Learning.
5 | Page
It was noted that factors affecting the removal of third molars vary from country to country depending on the stakeholders (Esposito, 2005).
In this section, we discussed the origins of third molars, as well as the different types of impaction that can occur. The effects of the type of impaction were found to be a factor in the ease if removal and the complications that may occur. Understanding types of impactions and the affect that they can have on the potential for complications is an important step in preventing complications before and after surgery. The following section will discuss the surgical procedures for removal of mandibular impactions.
Surgical Extraction of Impacted Mandibular Third Molars
Surgical extraction of third molars is performed for a number of reasons. They are sometimes performed to prevent surgery in older patients, although this reasoning is questionable (Valiati, Ibrahim, & Poli, et al., 2009). It can…
Al-Asfour, a. (2009). Postoperative Infection After Surgical Removal of Impacted Mandibular
Third Molars: An Analysis of 110 Consecutive Procedures. Med Princ Pract 18:48-52.
Bernard, G. & Mintz, V. (2003), Evidence-based means of avoiding Lingual Nerve Injury
following Mandibular Third Molar Extractions. Brazilian Journal of Oral Science. 2 (5):
In year 1799 anesthetic properties of Nitric Oxide were discovered by Humphery Davy (1778-1829) he advised that the by using nitric oxide, pain and shock of the surgical procedure can be negated. Third person who continue with Morton and ells philosophy was Charles T. Jackson. The Fourth man who contributed to anesthetics was Thomas Mortan (Blatner, 2009). In the year 1848 James Simpson used chloroform in obstetric surgery, he used diethyl ether to anesthetize a women with a pelvic deformity for delivery (kodali, 2009) and in year 1853 John Snow did a successful induction of chloroform to her Majesty Queen Victoria at the time of Prince Leopold's Birth and also on Fenny Longfellow who wrote to her poet brother that this use of ether is certainly the greatest blessing of this era (Longfellow, 1956). In the year 1885-illiam Halsted introduced the nerve block. In 1891 Heinrich Quincke demonstrated the process…
Bergman, Norman. History of Anesthesia. chua2.fiu.edu. http://ahahq.org/Bulletin/AHA_GB_1991-10.pdf .Retrieved from 14th Jan 2013.
Conquering surgical pain: Four men stake their claims. (2012). Massachusetts General
Blatner, Adam. The discovery and invention of Anesthesia. Blatner.com. http://www.blatner.com/adam/consctransf/historyofmedicine/4-anesthesia/hxanesthes.html . Retrieved on 14th Jan 2013.
Fadden, John. Cultural, Environmental and Genetical influences on drug therapy. Jbpub.com. http://samples.jbpub.com/9780763786076/86076_CH03_FINAL.pdf . Retrieved on 14th Jan 2013.
Healthcare in Marketing (Lasik)
Lasik's Methods in Other Health Care Organizations
Customer profiling is a vastly unexplored marketing method in the health industry. While it has been used to target very specific markets, such as potential consumers of elective surgery, other markets have been largely neglected (arber 2001). The reasons for this are many, but mostly they include difficulties with medical data gathering, and legal issues regarding potential customer profiling.
Despite the above-mentioned difficulties, there are several organizations that can and do benefit from customer profiling. One such entity is the pharmaceutical industry (Winterhalter 2002). Here the customer being profiled is normally the health care professional, rather than the patient. y gathering geo-demographic data as well as customer loyalty information from a group of health professionals, pharmaceutical companies can significantly enhance the effectiveness of their marketing practices. This will further benefit not only the professionals, but also the healthcare consumer,…
Barber, F.A., R.K. Thomas, M. Huang. "Developing a profile of LASIK surgery customers." Marketing Health Services, Iss. 2, Vol 21. Chicago: Summer 2001.
Business Wire. "New Customer Wins Position Lawson as Dominant Enterprise E-business Solution Provider to Healthcare Industry." New Orleans, 2001.
Winterhalter, K. "Customer profiling in the healthcare industry." Weber Shandwick, 2002. http://www.browna2.fsnet.co.uk/PMLive/doctor_who_frame.htm
For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings.
The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane based inhalation "may be a suitable technique for thoracic surgery in achalasia due to sclerodermic patients." The reason for this conclusion is that the study found that this procedure "can provide a smooth anesthesia course and a rapid recovery, with hemodynamic stability, and also having pain-free postoperatively." More so, the study found that providing anesthesia without neuromuscular blockade and non-intravenous opioids has "provided a shorter recovery time."
Clearly this specific case study has important and practical implications to the practice…
Erol, Demet Dogan, M.D. (2006): "Thoracic Epidural Blockade in an Elderly with Achalasia Due to Scleroderma for Thoractomy, Esophageal Myotomy and Cystotomy-Capitonnage. The Internet Journal of Anesthesiology. Vol. 11, Number 1.
hat produces value in managed care is a good health outcome rather than medical intervention. Not every visit to a doctor is necessary; nor is every test conducted, every medication prescribed, or every placement in an intensive care unit going to produce an effective outcome. Ideally, medicine should be ruled by rationality and efficiency in the choice and implementation of evaluations and treatments. This means that the variability between providers not only should be but can be eliminated, and the only factors that should make a difference in deciding who to treat and what treatment to undertake is the nature of the patient's disease or injury (Birenbaum, 14)."
hat these opposing views tell the insured, the uninsured, and those of us who rely on the expertise and ethical practices in an industry that has our very lives in their hands, is that they're not making decisions in our best interest…
Beck, Christina S., Sandra L. Ragan, and Athena DuPrae. Partnership for Health: Building Relationships between Women and Health Caregivers. Mahwah, NJ: Lawrence Erlbaum Associates, 1997. Questia. 23 Mar. 2009 http://www.questia.com/PM.qst?a=o&d=78592347 .
Birenbaum, Arnold. Managed Care: Made in America. Westport, CT: Praeger Publishers, 1997. Questia. 23 Mar. 2009 http://www.questia.com/PM.qst?a=o&d=27467039 .
For a fifty-seven-year-old man with a fairly unremarkable past medical history, surgery was recommended. Also, performing the surgery could have a positive impact upon his diverticulosis, urinary hesitation, Gerd, BPH (benign prostrate hyperplasia, or enlarged prostate) and mild anemia. A surgery to correct the inguinal hernia had been successfully performed in 1998 without incident, as did the patient's other surgeries, including his varicose vein stripping done in 1987 and eye surgery in 1995.
During an inguinal hernia repair procedure, first, the surgeon makes an incision and separates the muscle and tissues to expose the hernia sac. The sac is cut open and the contents are replaced into the abdomen, the neck of the hernia sac is tied, and the muscles and tissues are sutured. During a laparoscopic procedure the procedure is performed through tiny incisions, using an instrument with a camera attached and a video monitor to guide the repair.…
Culvert, Lee L. (2004). "Inguinal Hernia Repair." Gale Encyclopedia of Surgery.
General Anesthesia Information." (2007). Surgery. Retrieved 15 Sept 2007 at http://www.justbreastimplants.com/surgery/general_anesthesia.htm
Goverman, Jeremy (23 Jan 2006). "Hernia" Medline Encyclopedia Online. Retrieved 15 Sept 2007 at http://www.nlm.nih.gov/medlineplus/ency/article/000960.htm
R'os, J. Rodr'guez, P. Munitiz, D. Alcaraz, P. Perez, Flores. (Sept 2001)."Parrilla using a prosthesis." Hernia. 5(3): 1265-4906 (Print) 1248-9204 (Online). http://www.springerlink.com/content/a04wbnfjp82v60t2/
Given the projected demographic trends and the actual statistics from the surrounding hospitals considered above, it is obvious that the "business" for open heart surgery is moving into the Cabarrus Memorial Hospital area. In the interim however, the hospital administrators on the Board will have to consider possible alternative strategies before making a "go/no-go" decision on the possible addition of the open heart program. Unfortunately, a helicopter medevac average price is $7,500-$8,000. This will of course vary based upon the medications and supplies used during trip ("How much does," 2011).
First of all, in the opinion of the author, we have identified an access problem for the present CMH area residents to the existing open heart surgery facilities at the surrounding hospitals. As noted in the case study text, driving to Charlotte is a major problem. The immediate issue will be relieving this before an open heart surgery center is…
Heart. (2011). Retrieved from http://www.cmc-northeast.org/body.cfm?id=51 .
How much does a ride in a medevac helicopter cost? (2011). Retrieved from http://answers.yahoo.com/question/index?qid=20100329055051AAbYeqW .
Nilsson, J., Algotsson, L., Hoglund, P., Luhrs, C., & Brandt, J. (2006). Comparison of 19 pre-operative risk stratification. European Heart Journal, 27, 867 -- 874.
Swayne, L.E., Duncan, W.H., & Ginter, P.M. (2007). Strategic management of health c are organizations. Malden, MA: Blackwell, MA.
Spinal vs. General Anesthesia
The outcome of patients after undergoing transurethral resection of the prostate is examined under varying clinical situations to assess whether spinal anesthesia is associated with greater likelihood of positive outcome. Also examined in great detail are the potential for increased morbidity and mortality based on whether patients underwent general or spinal anesthesia during surgery. A large body of evidence indicates that there is no statistically significant difference between patient outcomes regardless of choice of anesthetic technique. This paper concludes that patients should be well educated and informed so they may make the choice most appropriate to their personal situation and comfort level preferences. An equal number of adverse side effects are associated with each anesthetic technique; as such patients should choose the technique that will result in the greatest post-operative satisfaction. The implications for practice suggest that physicians and anesthetists have an obligation to educate and…
Dobson, PM., Caldicott, LD., Gerrish, SP., Cole, JR., & Channer, KS. Changes in haemodynamic variables during transurethral resection of the prostate: comparison of general and spinal anaesthesia. British Journal of Anaesthesia. Mar; 72 (3): 267-71
Edwards, ND., Callaghan, LC., White T., & Reilly, CS. (1995). Perioperative myocardial ischaemia in patnets undergoing transurethral surgery: a pilot study comparing general with spinal anaesthesia. British Journal of Anaesthesia. Apr; 74 (4): 368-72
Gravenstein, D. (1997). Transurethral resection of the prostate syndrome: a review of the pathophysiology and management. Anesthesia Analg. Feb; 84 (2): 438-36
Hosking, MP., Lobdell, CM., Warner, MA., Offord, KP., & Melton LJ. 3rd. (1989).Anaesthesia for patients over 90 years of age. Outcomes after regional and general anaesthetic techniques for two common surgical procedures. Anaesthesia. Aug; 44 (8): 697-8
he researcher was able to pull up information on Venous hromboembolism hospitalizations by utilizing ICD-10 (Maynard & Stein, 2010)
he clinical diagnosis of Venous hromboembolism is defective; people that are suffering with signs and symptoms of Venous hromboembolism, just 20% have thrombosis confirmed by diagnostic testing.13Clinical prediction rules have been developed to improve the probability of an accurate diagnosis. he most widely used model classifies patients into a high, moderate, or low probability of deep vein thrombosis (Maynard & Stein, 2010). When joined with research laboratory and radiological imaging tests, this method is superior to the old-style method of executing a diagnostic test in all patients with suspected Venous hromboembolism (Martinez- 2008).
Prognosis, broken down by risk groups
A lot of the Deep Vein hrombosis is occult and most of the time resolves instinctively without there being a problem. he main longstanding illness from Deep Vein hrombosis is PS,…
Takahashi, H., Yokoyama, Y., Iida, Y., Terashima, F., Hasegawa, K., Saito, T., . . . Wada, a. (2012). Incidence of venous thromboembolism after spine surgery. Journal of Orthopaedic Science, 17(2), 114-7.
Wolowacz, S.E., Hess, N., Brennan, V.K., Monz, B.U., & Plumb, J.M. (2008). Cost-effectiveness of venous thromboembolism prophylaxis in total hip and knee replacement surgery: The evolving application of health economic modelling over 20 years. Current Medical Research and Opinion, 24(10), 2993-3006.
Zalavras, C.G., Giotopoulou, S., Dokou, E., Mitsis, M., & al, e. (2002). Lack of association between the C677T mutation in the 5, 10-methylenetetrahydrofolate reductase gene and venous thromboembolism in northwestern Greece. International Angiology, 21(3), 268-71.
obsesses over achieving the perfect look. There are some who have been blessed with great bodies and great looks. Then there are some who doesn't have great figures or great looks. However this is all an illusion. Most of the people with perfect looks aren't natural. They employ the services of cosmetic surgeons to transform their looks. Everybody wants to join the rat race. Nobody wants to be left behind. Women spend billions of dollars on fashion accessories, beauty products, surgical procedures, etc. every year. We have the media to blame for showcasing women with perfect body features and perfect looks. This leads women to believe that they don't have a perfect body. They tend to spend a lot of money to transform their looks. They invest a lot of money in Cosmetic surgery so that they can improve their "imperfect" body features.
People have gone to extreme measures in…
. he American Journal of Sports Medicine, 35(3), 384-394.
2 groups of 70 patients with patellar tendon and hamstring tendon autografts were assessed 2 years following surgery. No significant differences were noted in terms of activity, although more patients in the P group experienced pain and loss of motion for a longer span of time than did patients in the hamstring tendon group. On the whole, patients with hamstring tendon grafts performed similarly to patients with patellar tendon grafts although more beneficial results seemed to incline towards the groups that had experienced hamstring tendon graft replacements.
Monaco, E., Labianca, L., Conteduca, F., De Carli, a., & Ferretti, a. (2007). Double bundle or single bundle plus extraarticular tenodesis in acl reconstruction?: a caos study. Knee Surgery, Sports raumatology, Arthroscopy, 15(10), 1168-1174.
he goal of this study was to evaluate the effect on the internal rotation of the tibia of lateral reconstruction…
This technical study was intended to measure the in situ force applied to the ACL during load and injury. The medial collateral ligament (MCL), anterior cruciate ligament (ACL), posterolateral structures (PLS), and posterior cruciate ligament (PCL) were measured in response to 110 N. anterior tibial loading. Changes in knee kinematics associated with ACL deficiency and combined MCL and ACL deficiency were also evaluated. Findings demonstrated that impact is equally shared between the various bone ligaments and anterior bones during tibial loading of the knee leading researchers to conclude that the MCL and osteochondral surfaces may also be at significant risk during ACL injury.
Smith, F., Rosenlund, E., Aune, a., MacLean, J., & Hillis, S. (2004). Subjective functional assessments and the return to competitive sport after anterior cruciate ligament reconstruction. . British Journal of Sports Medicine, 38(3), 279-284.
The objective was to examine return to competitive sport and general recuperation of ligaments within 12 months of ACL reconstruction. A postal questionnaire 43 months after surgery was mailed to 109 selected athlete patients, 77 of whom responded. The Cincinnati sports activity scale (CSAS) and Cincinnati sports function scales were used as instruments. 62 patients had returned to activity 12 months following treatment, whilst 55 patients had regained their former level of ability. 12 patients admitted to major problems, whilst 38 patients were actively involved in sports at least four times a week. Competitive and male patients had higher scores at restoration than did non-athletic and female patients respectively. Results supported the researchers' hypothesis.
Against Odds: Australian Women's Experiences ecovery Breast Cancer
Elmir, , Jackson, D, Beale, B., & Schmied, V 2009. Against all odds: Australian women's experiences of recovery from breast cancer. Journal of Clinical Nursing, 19, pp.2531-2538.
Elmir, Jackson, Beale & Schmied (2009, p.2531) investigates the younger female's experiences following breast cancer-linked breast surgery. The purpose of the study was to create an understanding of the experiences of women who under-go breast cancer surgeries. Elmir et al. (2009, p.2533) study aimed at contributing to the base of knowledge for clinicians practicing in the field of breast cancer. The underlying principle behind the study carried out by Elmir and associates is the prevalence of breast cancer among younger women and inadequate studies concerning recuperating from breast cancer-linked surgery.
McMurray & Clendon (2010, p. 241) assert that breast cancer is affecting younger women between 20 and 40 years given the better surveillance and earlier…
Willig, C 2013. Introducing qualitative research in psychology. New York: McGraw-Hill International.
Pequegnat, W., & Stover, E 2010. How to write a successful research grant application: A guide for social and behavioral scientists. New York: Springer.
McMurray, A., & Clendon 2010. Community health and wellness: Primary health care in practice. Australia: Elsevier Australia.
Mott, D 2008. Emergency room use: A phenomenological study of community-based healthcare. Texas: ProQuest.
Technological Fix and natomical Body
19th and 20th Century Surgical Fixes
During the 1800s, surgery had become a common medical procedure due to the discovery of anesthesia which was used in reducing pain during surgery.[footnoteRef:1] In addition, technological fixes were in place for correcting medical conditions such as the removal of tumors. During this period, medical practitioners were able to describe the locations of structures in relation to other structures in the body which ensured they knew the organ's positions and could conduct surgery of various body parts easily. [1: Porter, R. (1999). The Greatest Benefit to Mankind: Medical History of Humanity from ntiquity to the Present. Fontana Press.]
Following the in-depth understanding of human anatomy and use of antiseptics as well as anesthesia, towards the end of the 19th century, surgeons started performing new types of surgery including dissection of the abdomen, brain, and spinal cord.[footnoteRef:2] In line with…
Additionally, the patient's illness was an exaggeration by the doctor according to critics. The statements by the doctors were inaccurate since the patient was constantly agitated, cried a lot, and never cooperated in anything her sister did for her. Besides, the patient had had three-week admission in a private sanitarium and medication from other medics which never helped her. Besides, she protested medical exams always refusing to undergo intelligence tests.
"Examination disclosed a well-nourished woman, about 60 years old, with the classical mien of agitated depression. The tissues were flabby, and there were enormous circles below the eyes. 'There was no significant alteration in the neurologic examination; the retinal arteries showed a mild degree of sclerosis; the blood pressure was 222/128 and the heart was somewhat enlarged. Quite frequently she snorted and cleared her throat with a loud noise (a phenomenon observed in at least three other patients of this series). The hands were warm and dry, and the agitation seemed to be rather superficial"[footnoteRef:6]. [6: Ogren, K, and M. Sandlund. "Psychosurgery in Sweden 1944-1964." Journal of the History of the Neurosciences, 14 (4), 2005: 353-367.]
Dr. Freeman's invasive surgery method made the procedure risky, bringing about several side effects. This surgical intervention was ultimately banned since it never treated the condition and with the discovery of better medications led to its decline[footnoteRef:7] while new methods of treating mental illness are present at present, frontal lobotomy should not be disregarded since during this time, it was the only treatment methods available. [7: ibid]
esearchers believe that incorporating evidence-based prevention methods can decrease the incidence of ACL ruptures, but an understanding of the etiology and mechanisms of sports injury are a necessary to do this (Posthumus, 2009).
The highest prevalence of extrinsic ACL injuries tends to occur in organized sports especially adolescents participating in pivoting type sports such as football, basketball, and team handball (Bahr & Krosshaug, 2005). In addition to any intrinsic factors and adolescent may have, or predisposing factors, environmental factors surrounding organized sports can also play a role in injury. For example, weather conditions (slippery surface), type of surface sport is played on (grass vs. pavement), proper footwear, and protective bracing (Posthumus, 2009).
A growing concern regarding these injuries and the populations that incur them is that these injuries increase the risk of osteoarthritis (Bahr & Krosshaug, 2005). In fact, after ten years, around half of all people that have suffered…
Ageberg, E., Thombe, R., Neeter, C., Gravare Silbernagel, K., Roos, EM. Patients With Anterior Cruciate Ligament Injury Treated With Training and Surgical Reconstruction or Training Only: A Two to Five-Year Followup. Arthritis Care & Research. 2008; 59(12):1773-79.
Bahr, R., Krosshaug, T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J. Sports Med. 2005; 39:324 -- 329.
Grindstaff, TL., Hammill, RR., Tuzson, AE., Hertel, J. Neuromuscular Control Training Programs and Noncontact Anterior Cruciate Ligament Injury Rates in Female Athletes: A Numbers-Needed-to-Treat Analysis. Journal of Athletic Training. 2006; 41(4):450 -- 456.
Health Information Publications (2011). What is the anterior cruciate ligament? eHealthMD retrieved from http://ehealthmd.com
However, proper treatment may restore fertility. During pregnancy, existing fibroids may grow at a greater pace due to the increased blood flow and estrogen levels but they usually return to their original size after delivery.
Pelvic Inflammatory Disease
Definition & Cause: Pelvic inflammatory disease (PID) is a general term for infection of the lining of the uterus, the fallopian tubes. It is a very common disease and in the United States alone, nearly 1 million women develop PID each year and more than 100,000 women become infertile as a result of PID (NAID Fact sheet, 2005). It is caused in a majority of cases through sexually transmitted diseases such as Chlamydia and gonorrhea but PID-causing bacteria may also cause infection through other means such as during childbirth, abortion, or IUD insertion.
Complications: PID can damage the fallopian tubes, ovaries, uterus, and cervix, leading to chronic pelvic pain and serious damage…
Carson-DeWitt, R., and Odle, T.G. (2006). "Infertility.." The Gale Encyclopedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. 5 vols. Farmington Hills, MI: Thomson Gale, 2006.
Frequently Asked Questions About Infertility." (2006). American Society of Reproductive Medicine. Retrieved on November 6, 2006 at http://www.asrm.org/Patients/faqs.html
General Infertility FAQ." (2006). The InterNational Council on Infertility Information Dissemination (INCIID). Retrieved on November 6, 2006 at http://www.inciid.org/faq.php?cat=infertility101&id=1
Mallari, B. (2001). "Polycystic Ovarian Syndrome." 3 RX.com. Retrieved on November 6, 2006 at http://www.3-rx.com/polycystic-ovarian-syndrome/default.php
Planned Change in a Department
Change within the Medical surgery department
There are various factors that occasion change within any organization, some may be due to change in the operations of an organization, some due to expansion, relocation, takeovers, mergers, external forces in economies, internal changes in operation modes or even unprecedented needs as unforeseen at the initial stages. This last one seems to be case within the medical surgery unit in our hospital.
The prevailing condition at the moment that needs a change approach that would improve the conditions within the medical surgery unit and the entire hospital in general is the imbalanced ration between the nurses and the surgery patients currently realized within the unit. The prevailing rate is one nurse within the medical surgery unit handling an average of 6-7 patients which has proven to be too high for a single nurse. The other pertinent problem within…
American Nurses Association, (2011). Effects of Nurses Shortage. Retrieved July 4, 2013 from http://ana.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/NurseShortageStaffing/NursingShortage/Effects.aspx
Honor Society of Nursing, (2013). Facts on the Nursing Shortage in North America. Retrieved July 4, 2013 from http://www.nursingsociety.org/Media/Pages/shortage.aspx
Nursing Theories, (2011). Change Theory by Kurt Lewin. Retrieved July 4, 2013 from http://currentnursing.com/nursing_theory/change_theory.html
National Foundation for American Policy (2007). Deadly Consequences: The Hidden Impact of America's Nursing Shortage by Stuart Anderson. Pp 4. Retrieved July 4, 2013 from http://www.nfap.com/pdf/0709deadlyconsequences.pdf
Moreover, EBSCO, U.S. National Library of Medicine National Institutes of Health, PubMed, and Sage Publication databases also contain thousands of research articles on the TEDs, DVT, Pulmonary Embolism, Anti-Embolism Stockings and the safe use of TEDs within the clinical units.
To identify the articles and research papers relevant to the study, the paper uses the keywords to search for data from the database and the keywords include:
Deep Vein Thrombosis (DVT )
TEDs (thromboembolic disease stockings)
PE (Pulmonary Embolism).
TEDs Anti-Embolism Stockings
Prevention of DVT,
The goal of using the keywords is to search the articles and research papers relevant to the study. When the author submits the keywords to the database, numerous articles come out from the database and the study only selects the articles that relevant to complete this study. Using the relevant search strategies, the author has been able to source for the quality research papers to…
Agu, O., Hamilton, G., and Baker, D. (1999). Graduated compression stockings for the prevention of venous thromboembolism. British Journal of Surgery, 86- 992-1004.
Covidien. (2012).T.E.D. ™ Anti-Embolism Stockings. Fastus Library. Covidien Company.USA.
National Health and Medical Research Council (2009). Guideline of Clinical practice for the prevention of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to Australian hospitals. Commonwealth of Australia 2009.
Miller, J.A. (2011). Use and wear of anti-embolism stockings: a clinical audit of surgical patients. International Wound Journal. 8 (1):74-83.
St. Jude Children's Research Hospital
Founded by entertainer Danny Thomas, St. Jude Children's Research Hospital is celebrating its fiftieth year of operation; in that time the hospital has conducted important research and cured / saved the lives of numerous children with cancer and other diseases. This paper reviews the organization from a number of important perspectives.
Board of Directors and Governors
The chairman / president of St. Jude's Board of Directors is Camille Sarrouf, who is an attorney in Boston with the law practice, Sarrouf Law. The First Vice Chair is Richard "Rich" M. Unes, from Memphis, Tennessee. Second Vice Chair is Paul Ayoub and the Secretary of St. Jude's Fred R. Harris. As to the Board of Governors for St. Jude's, Robert Breit is the chairman and president and Terry Burman is the First Vice Chair. Martha Perine Beard is the Second Vice Chair for the Board of Governors…
St. Jude Children's Research Hospital. "50 Years / Finding Cures / Saving Children." Retrieved
November 26, 2012, from http://www.stjude.org .
Poor socio-economic background and conditions mixed with the HIV / AIDS crisis can only mean even more socio-economic and political upheaval, the regression of development and the collapse of societies: beginning with families, communities, regions and into subsequently economic social systems. "Likewise, one can rank the importance of quality of care and seriousness of condition for the insured and uninsured, respectively. Thus, there are arrows connecting kind of patient to these two clusters. The quality of care clearly matters differently for the various levels of seriousness, so there is an arrow connecting seriousness of condition to quality of care. The question in the other direction is whether conditions of varying degrees of serious are more or less important for the given levels of quality. Finally, excellent care evidently matters more for self-selected medical tourism than for government-sponsored medical tourism, so there is an arrow connecting the alternatives to the quality-of-care…