Transcript: Title Number Three Here are some bullet points Because everyone loves these Also, mustache Another Title Body of the conclusion. Title Number One subtitle Concluding Title ... and subtitle Insert Title Body of the point With BIGGER points.
Transcript: Problem Statement Problems Analysis and Application of Knowledge Presented by: Shirley Chen,Nathan Cheung,Johnny Lam,Rolie Prasad, Andree Ziswiler Recommended Solutions and Actions Problems Analysis and Application of Knowledge Alternatives with explanations
Transcript: 3 T's Thromboemboilc Prophylaxis Observations Fluid balance HDU/ITU After assessment of the airway, you move onto assessment of breathing. What key piece of information has been missed / not mentioned at the moment? C-spine immobilisation What is the typical circulatory blood volume in a human? Case scenario URINALYSIS Which of the following signs change earliest in shock? HR rise and decrease in urine output RR rise BP decrease What is the simplest way of assessing airway patency? The "3 T's" Epigastric / RUQ Pain Initial Management Specific bloods (eg Pancreatitis) Radiology - USS / CT / MRCP Endoscopy - OGD / ERCP / Flexi sig Pancreatitis leading to definative Dx TRAUMA On completion of your primary survey, name three further things you would do for this patient Case continued… In what situations of head injury would you consider a CT head? LIF PAIN (if unwell) Initial treatment Monitoring Further Inx RIF PAIN BUGIE ECG Causes Fresh Haemorrhoids Angiodysplasia Left colonic tumours Mixed (with stools) Malaena GAS Team Hepworth strongly advise you book onto an upcoming ATLS course. Even if you will not be a surgeon, trauma is vital for anaesthetists, emergency doctors, and in fact for any doctor, given it is the 3rd leading cause of death world wide For available course dates, please see RCS website THANK YOU Causes PUD/GORD Gallstone disease Pancreatitis Liver disease / Hepatitis Myocardial infarction Basal pneumonia Anatomical causes Bowel 1) Appendicitis 2) Colitis 3) Caecal tumours (old) / Mesenteric adenitis (young) Gynaecological 1) Ectopic pregnancy 2) Ovarian cyst 3) PID Urological 1) Pyelonephritis / UTI 2) Ureteric colic 3) Renal colic Management of PR Bleeding In grade 1 shock, ie upto 15% of blood volume loss (ie 750mls) which of the following signs would change? RR HR Urine output BP Further investigations Circulation Give 5 key life threatening A and B problems to pick up on primary survey Airway obstruction Flail chest and pulmonary contusion Tension pnemothorax Open pneumothorax Massive haemothroax Examination GCS does not return to 15 within 2 hours Focal neurological signs Open depressed scull # Basal scull # CSF rhinorrhoea Battle’s sign (bruising behind the ears Blood from ears Periorbital bruising After assessment of the airway, you move onto assessment of breathing. What key piece of information has been missed / not mentioned at the moment? The paramedics bring him into resus as a trauma call. His GCS is 15 ad he has blood on his face. You are holding the on-call SHO bleep. Vital RR O2 Saturations General Cyanosis Resp distress / Accessory muscles Neck Tracheal deviation Distended neck veins Chest Inspection Chest bruising / deformity Unequal chest expansion Chest Palpation Surgical emphysema Tenderness Chest Percussion Hyperresonance (eg pneumothorax) / dullness Chest Auscultation Decreased air entry (eg pneumothorax) BLOODS Give 5 key life threatening A and B problems to pick up on primary survey The paramedics bring in a 60 year old male who fell from the loft onto the first floor landing, and then down a flight of stairs to the ground floor into a glass cabinet, lacerating his forehead. There was a 10 minute period of LOC. The paramedics bring bring him into resus as a trauma call. His GCS is 15 and he has blood on his face. You are holding the on-call SHO bleep. 3 T's IMAGING To ensure all FY1s are equipped with the knowledge for progression to FY2. To be able to give advice on common surgical presentations when asked for a specialty opinion Be able to make good quality referrals to surgical teams as non-surgeons A Review of GI Surgical Emergencies Dr M. Rahman ARNG Mr Daniel Boctor Leg ENd Dr Samantha Low HyP Er Mr Ibnauf Suliman Don Treat the symptoms BUGIE What is the simplest way of assessing airway patency? Is the patient talking? After conducting your primary survey, your findings are as follwed: A. The pt is talking B. RR=16, O2 sats=96% OA, equal chest expansion, resonance and good air entry bilaterally C. Normal assessment D. GCS=15. Pupils equal and reactive E. Abdomen soft, non-tender. No pelvic / long bone injury The paramedics bring in a 60 year old male who fell from his loft on to the first floor landing, and then down a flight of steps to the ground floor into a glass cabinet, lacerating his forehead. There was LOC for a period of ten mins. If the pt is not verbalising, what signs should be looked for that may indicate airway compromise / obstruction? 1) Snoring / gurgling sounds 2) Stridor 3) Facial / neck injuries On completion of your primary survey, name three further things you would do for this patient 1. CT Head and C-spine (due to mechanism of injury) 2. Take an AMPLE hx A allergies Medications PMHx and Pregnancy Last meal (when) E events (ie the mechanism of injury) 3. Perform a secondary survey (ie. head to toe examination) 1 in 3 people will have had PR bleeding BUGIE 3 “T”s Monitoring Catheter / Fluid balance Consider HDU Further investigations Bloods
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Transcript: Wisdom does not flow like water Plato’s Critique of Pederasty Pederasty Background Symposium Pederasty My Project Pausanias' Speech Pausanias' Speech Two Aphrodites Uranian Heavenly Pandemos Common Text Text Pictures Pictures "Here, Socrates, lie down alongside me, so that by my touching you, I too may enjoy the piece of wisdom that just occurred to you while you were in the porch. It is plain that you found it and have it, for otherwise you would not have come away beforehand." Agathon and Socrates “It would be a good thing, Agathon, if wisdom were the sort of thing that flows from the fuller of us into the emptier, just by our touching one another, as the water in wine cups flows through a wool thread from the fuller to the emptier. For if wisdom too is like that, then I set a high price on my being placed alongside you, for I believe I shall be filled from you with much fair wisdom. My own may turn out to be a sorry sort of wisdom, or disputable like a dream; but your own is brilliant and capable of much development, since it has flashed out so intensely from you while you are young; and yesterday it became conspicuous among more than thirty thousand Greek witnesses." "You are outrageous, Socrates," Agathon said. "A little later you and I will go to court about our wisdom, with Dionysus as judge, but now first attend to dinner." how water flows Principle at play When they do engage in a contest about love Timeline YEAR Alcibiades' Speech Socrates, he claims, is like “those silenuses that sit in the shops of herm sculptors, the ones that craftsman make holding reed pipes or flutes; and if they are split in two and opened up they show they have images of gods within.” (215b) Alcibiades' Speech You, in my opinion,' I said, 'have proved to be the only deserving lover of mine; and it seems to me that you hesitate to mention it to me. Now I am in this state: I believe it is very foolish not to gratify you in this or anything else of mine—my wealth or my friends—that you need; for nothing is more important to d me than that I become the best possible; and I believe that, as far as I am concerned, there is no one more competent than you to be a fellow helper to me in this. So I should be far more ashamed before men of good sense for not gratifying a man like you than I should be before the many and senseless for gratifying you.' Seduction Scene 'Really, my dear Alcibiades, you're no sucker if what you say about me is really true and there is some power in me e through which you could become better. You must see, you know, an impossible beauty in me, a beauty very different from the fairness of form in yourself. So if, in observing my beauty, you are trying to get a share in it and to exchange beauty for beauty, you are intending to get far the better deal. For you are trying to acquire the truth of beautiful things in exchange for the seeming and opinion of beautiful things; and you really have in mind to exchange "gold for bronze." But blessed one do consider better: Without your being aware of it—I may be nothing. Thought, you know, begins to have keen eyesight when the sight of the eyes starts to decline from its peak; and you are still far from that.' Conclusion conclusion If Socrates were to have sex with Alcibiades, he would perpetuate: 1) the idea that people can make each other wise. impact: prevent Alcibiades from realizing his ignorance about wisdom 2) Alcibiades belief that his physical attractiveness is the most important thing about him impact: the belief could harm Alcibiades as he begins to decline from his physical peak, when “Thought begins to have keen eyesight.” (219a) 3) Socrates would be no better than the sophists who cannot acknowledge the ways in which they are ignorant, and thus, risk self-deception. Advantages Advantages to my account: -Fits with the well-known picture of a Socrates who: 1) proclaims his own ignorance. 2) critiques the Sophists for i. both not acknowledging what they do not know ii. exchanging money for wisdom -Makes explicit the way Plato critiques the customs of his time -Throws into question a vision of Socrates as someone who consistently denies bodily urges -Makes clear that the container model is supposed to function in opposition to the image of pregnancy and birth. Accounts of “Plato’s Appropriation of Reproduction” run these two images together.
Transcript: Surgical Technology The Backbone of the Operating Room Topic What is a Surgical Technologist???? What is a surgical technologist???? Surgeon's right-hand man or woman! Anticipates the needs of the surgeon! Patient advocate! Protector of the sterile field! Anything that is blue or green!!! Double click to edit What is the sterile field? FIRST!!! Finish High School/Earn Your GED!!! SECOND!!! Enroll at Howard College in San Angelo!!! How can you become a Surgical Technologist??? THIRD!!! Take a few classes!!! What classes should you take ??? Anatomy & Physiology I Anatomy & Physiology II Microbiology Medical Terminology We are limited to 10 students per cohort. Other Criteria Grades in prerequisite courses, an A earns you 3 points a C 1 point. Manual dexterity test Panel Interview (Remember to Dress to Impress!) 2 YEARS!!! How long is the program ??? How long does the program take once accepted? According to bls.gov...... Median Average Yearly Salary is $49,710 Median Average Hourly Wage is $23.90 How much money will you make ??? The profession of surgical technology is expected to grow 9% by the year 2030. Now Let's Take a Tour!!! Double click to edit
Transcript: Surgical Presentation: Scrub Role AAA Abdominal Aortic Aneurysm AAA An abnormal enlargement of the abdominal aorta. HOW? Different Ways To Surgically Treat A Abdominal Aneurysm. Open Surgery Minimally-Invasive Procedure With Interventional Radiology ENDOVASCULAR ANEURSYM REPAIR (EVAR) IR Minimally invasive procedure where stent grafts are supported by metal wire stents that reinforces the weak spot in the aorta. prevetning the aneursym from growing larger or rupturing. Using image-guided technology, the surgeon will insert a catheter into the femoral atery, using this as a pathway to the aorta. Then a implanted graft will be placed in the weak part of the aorta. General Anesthesia Anesthesia? SUPPLIES SUPPLIES LAPS VESSEL LOOPS SYRINGES LABELS BOVIE BOOTIES HEMACLIPS NEEDELS BLADES SHEATHS WIRES GRAFTS DRAPES HEMASTATS (CURVED) VASCULAR TRAY SUPPLIES WE DID NOT USE SUPPLIES WE DID USE EXTRA SUPPLIES PATIENT POSITION POSITION Supine, Arms tucked at side with pink foam padding, NO SCD'S OR SOCKS (per surgeons preference), Legs down, Head pillow. PREP Chloraprep from nipple line all the way down to the kness. PREP Puncture site/incision site was closed with just surgical glue. Holding pressure for the amount of minutes that the surgeon stated. INCISION SITE IMPLANTS GORE EXCLUDER AAA Endoprosthesis IMPLANTS CONTAINATION WHAT COULD GO WRONG? Our vascular Tray was contaminated with blood. Thought it could have been rust and a second opinion agreeed it was blood. We had someone come take the tray then we took off the sterile supplies off of our backtable put it on IR backtable and redrapped our table then reorganized our set-up. VIDEOS TO SHARE https://www.youtube.com/watch?v=j9aK2ECcFEY https://www.youtube.com/watch?v=lqmTVecKQu0 VIDEOS
Transcript: SURGERY Topic 1 Where was this MOTO developed/created? - The earliest from of surgery was "trephening" (drilling a hole in the skull of a living person) - Was discovered in 5000 BCE in Ensisheim, France - Was used to cure migraines, to "let-out" illnesses Topic 2 Topic 2 Subtopic 1 Subtopic 1 Topic 3 Topic 3 Subtopic 1 Subtopic 1 Topic 4 Topic 4 Subtopic 1 Subtopic 1 Topic 5 Topic 5 Subtopic 1 Subtopic 1
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