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Microneedling in Clinical Practice
Published in Boris Stoeber, Raja K Sivamani, Howard I. Maibach, Microneedling in Clinical Practice, 2020
Aunna Pourang, Kourosh Beroukhim
Begin by ensuring there is a brand-new disposable needle cartridge in place. Apply the chosen topical agent to the skin in an adequate amount to minimize epidermal injury. Lower the device so that the needles are perpendicular to the skin while providing mild traction nearby with a free hand, taking care not to inflict a needlestick injury. Glide the device over the skin in all directions (horizontal, vertical, oblique) until pinpoint bleeding is visible, which usually occurs after 3–6 passes depending on the area treated. It may be helpful to treat thicker, less sensitive areas first to allow the patient to adjust to the pain he or she may experience. Once the procedure is complete, remove blood and the topical agent with sterile water-soaked gauze. Apply a post-procedure serum, also often provided by the manufacturer, to the treatment areas. Cooling masks without active ingredients may also be used to soothe any pain and swelling.
Case 35
Published in Edward Schwarz, Tomos Richards, Cases of a Hollywood Doctor, 2019
Edward Schwarz, Tomos Richards
A needlestick injury is an injury caused by penetration from a sharp instrument or needle. If this needle is contaminated with infected blood, then there is a potential for this to be transmitted to the injured person. Although there is a risk of passing any infectious organism, the main concerns are HIV, hepatitis B and hepatitis C.
Surviving ‘on take’
Published in Sam Mehta, Andrew Hindmarsh, Leila Rees, Handbook of General Surgical Emergencies, 2018
Sam Mehta, Andrew Hindmarsh, Leila Rees
In certain parts of the world this is a major problem. Transmission of HIV in the hospital is a relatively rare event. The highest risk is to nurses and laboratory personnel. Furthermore the rate of HIV transmission following a needlestick injury is about 0.3%. If you receive a needlestick injury remember to report it and follow your hospital’s protocol.
Hepatitis B-C and human immunodeficiency virus: seroprevalence and associated factors among health students in Saudi Arabia
Published in Hospital Practice, 2021
Nouf A AlShamlan, Malak A Al Shammari
Vaccination for vaccine-preventable infections is crucial especially for health track students who are at a high risk of exposure to infections during contact with sick patients. For that reason, pre-admission screening for health track students is important to assess their immunity against many infections, in order to protect them and assess their infectious status to protect their patients [6,9]. A study that was conducted among 2742 nursing students from 12 universities in Italy and Albania revealed that 11.8% of students experienced at least one needle stick injury [10]. Another study in Ethiopia among 408 medical and health science students showed that 49.8% were exposed to a needlestick injury, of which, only 53.2% reported the incidence and 39.4% performed screening tests for viral hepatitis [11]. A study conducted among 261 medical students at a university in Emirates revealed that 48% of students had protective levels of anti-HBs antibodies [9]. A cross-sectional study among 300 health college students (HS) and 300 health care workers (HCW) in Najran, Saudi Arabia, showed that 66.7% of HS and 23.3% of HCW were susceptible to HBV infection [6]. A study was conducted between 2000 and 2007 among 16,570 health students from 12 male and 17 female colleges and institutions in Saudi Arabia showed that the prevalence of HBsAg was 0.17% for males and 0.78% for females aged 18–21-year-old. The prevalence of anti-HCV was 0.03% among males and 0.07% among females in similar age groups [3].
How Integrated Anesthesia Communication Leads to Dependable IONM Data
Published in The Neurodiagnostic Journal, 2021
Veronica O. Busso, John J. McAuliffe
On the heels of this culture change, multiple providers were experiencing IONM needle sticks either during patient positioning or during the loss of an IV or an arterial line. Several additional strategies were implemented to decrease these events. The development of an IONM time out prior to patient positioning. The IONM technician reviews the areas of IONM needle placement with all parties participating in patient positioning. In addition, the IONM technician will remove the electrodes from the patient’s head prior to positioning. Once the occurrence of needlestick injury decreased from the positioning of the patient we continued to have rare instances of reports. Upon further investigation, the trend for these injuries was related to the loss of an IV or arterial line typically in the hands. Upon removal of the dressing, an IONM electrode would often be dislodged and the provider attempting to replace the IV or arterial line would be injured. If the team loses access after positioning, the IONM technician will first remove the electrodes in the adjacent area prior to the anesthesia or nursing team taking down a dressing and attempting access again.
Dyspnea in homosexual male patients: throwback to an occasionally forgotten but severe clinical presentation of HIV/AIDS
Published in Acta Clinica Belgica, 2020
Koen Verbeke, Roel Verbuyst, Christiane Brands, Hans Slabbynck
A 34-year-old male patient had been sent to the emergency unit by a general practitioner because of progressive dyspnea. His shortness of breath was mostly exertional. There was no important medical history. The patient was a wine merchant and had recently made an eight hour drive. He had a male partner. The GP had already tried a beclomethasone/formoterol inhaler without any result. On clinical examination, we saw a patient in moderately respiratory distress (inability to speak whole sentences). Lung auscultation was normal, there were no cardiac murmurs or edema. He didn’t display fever, important cough or sputum production. Lab results were normal in exception of an elevated D-dimer (0,64mcg/mL), C-reactive protein 50,8 mg/L and Lactate dehydrogenase (2098U/L). Oxygen saturation on the emergency unit was 94%. An X ray of the chest didn’t show pneumonia, pleural effusion or congestion. The arterial puncture was unsuccessful and even resulted in an accidental needlestick injury to a medical trainee on the emergency unit. The emergency doctor thought of a viral bronchitis and prescribed an extra short acting bronchodilator. If the dyspnea worsened, the patient got the advice to come back to the emergency unit for a CT scan to rule out pulmonary embolism.