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Biopsy etc. Procedures and Bronchography.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Such a needle can take both aspiration or small tissue samples. Using it the author never had any complications, but it was often advisable to introduce a little extra local anaesthetic when feeling the periosteum to avoid pain when screwing-in the needle, and at the same time adjust the guard and fix it to about 3mm from the skin surface to avoid it going deeper with penetration of the outer cortex. (This needle is also useful for intraosseous venography and a modification with 'wings' and a detachable handle was formerly used for infusion therapy.).
Pests Involved in Mechanical Disease Transmission
Published in Jerome Goddard, Public Health Entomology, 2022
Cockroaches are well-known mechanical transmitters of disease agents. They are dorsoventrally flattened, fast-running insects that generally live in warm, moist, secluded areas. Cockroaches have prominent, multisegmented filiform antennae, cerci on the abdomen, and two pairs of wings. The front wings are typically hardened and translucent, whereas hind wings are membranous. In some species, wings are rudimentary or absent. Cockroaches are variously colored, with most domestic species being reddish brown, brown, or black, while the Cuban cockroach is bright green. Many species can fly, but the domestic U.S. species rarely do so; however, the imported Asian cockroach in the southeastern United States can fly and may come to lights.7 Adult German and brown-banded cockroaches are approximately 15 mm long (Figure 19.8), whereas the American and oriental cockroaches are 30–50 mm long (Figure 19.9).
Animal Models of Tendon Repair
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Euthanasia is performed using an overdose of pentobarbital or intravenous potassium chloride. Good quality veins for injection are readily found in the neck. Additional veins are easily located in the wings, but are usually more fragile than neck veins.
Pinch points in the consultation – and how to avoid them
Published in Education for Primary Care, 2023
Patients frequently give cues as to which wing(s) they want to visit. Cues such as ‘I was just a bit worried’; ‘I don’t want to waste your time’ or ‘I know I shouldn’t but I looked up on Google’ all suggest a wish for increased understanding, while cues including ‘this can’t go on’; ‘it’s stopping me being able to work’ and ‘I just need a good night’s sleep’ all suggest a wish to find a solution. Being alert to these cues, checking what the patient is looking for with phrases like ‘did you want to talk about stronger pain killers?’ and even overtly asking ‘so did you just want to have a better understanding of what is going on here, or were you looking for a solution?’ can all help the doctor avoid this pinch point altogether and make sure they travel with the patient to the right destination in the decision-making process (Figure 2).
Appropriate Air Medical Services Utilization and Recommendations for Integration of Air Medical Services Resources into the EMS System of Care: A Joint Position Statement and Resource Document of NAEMSP, ACEP, and AMPA
Published in Prehospital Emergency Care, 2021
John W. Lyng, Sabina Braithwaite, Heidi Abraham, Christine M. Brent, David A. Meurer, Alexander Torres, Peter V. Bui, Douglas J. Floccare, Andrew N. Hogan, Justin Fairless, Ashley Larrimore
Air medical services involve providing medical care in transit while using either fixed wing (airplane) or rotor wing (helicopter) aircraft to move patients between locations. The modern use and availability of air medical services has expanded access to various health system resources, including specialty care. While this is generally beneficial, such expansion has also contributed to the complexity of health care delivery systems (1, 2). Since the publication of the 2013 joint position statement Appropriate and Safe Utilization of Helicopter Emergency Medical Services (3), research has shown that patient benefit is gained from the clinical care capabilities of air medical services independent of potential time saved when transporting patients (4–6). Because the evidence basis for utilization of air medical services continues to evolve, NAEMSP, ACEP, and AMPA believe that an update regarding the appropriate utilization of air medical services is warranted, and that such guidance for utilization can be divided into three major categories: clinical considerations, safety considerations, and system integration and quality assurance considerations.
Effect of extracorporeal membrane oxygenation transport on short- and long-term survival in patients with acute respiratory distress syndrome
Published in Baylor University Medical Center Proceedings, 2020
Desiree A. Steimer, Omar Hernandez, Gerald Ogola, David P. Mason, Gary S. Schwartz
Our ECMO program was established in 2012. One year later, our mobile ECMO team was created and consisted of a cardiothoracic surgeon, perfusionist, and advanced paramedic. Referrals were discussed with the on-call cardiothoracic surgeon; ECMO was considered for patients with reversible causes of respiratory failure or lung transplant candidates with ARDS. Decisions regarding initiating ECMO followed Extracorporeal Life Support Organization guidelines for respiratory failure.13,14 Patients accepted for transfer were classified as either stable or unstable for transport. Patients who were too unstable for transport were cannulated at the referring hospital by our mobile ECMO team. Stable patients were transferred on mechanical ventilation, and cannulation was performed upon arrival to our institution if deemed appropriate. Patients were transported by ambulance, helicopter, or fixed-wing plane.