Ultrasound for bone fractures

Ultrasound for bone fractures


Hi, Today we will talk about the use of ultrasonography in bone fractures I am Mehmet Ali Aslaner, Emergency Medicine Specialist. Love from Cappadocia. Since children and pregnant women are considered radiation sensitive groups, minimum exposure is important for these patients Ultrasonograhy easily can be used instead of X-ray for the diagnosis of fracture If an X-ray was taken and fracture diagnosis still is not clear, It can be used to confirm the diagnosis It is also a very convenient method to evaluate the success of the reduction and environmental aspects. Linear probe is the most commonly used probe in musculoskeletal system Convex probe can also be used according to the condition of the patient In recognition of bony structures, it is enought to recognize the cortex If you can not see anything behind the well-constructed hyperechoic line, you can call it “bone cortex” You need to follow the cortex line to detect fracture Any deterioration and stepping should lead us to a suspected fracture Nasal scans should be performed on top as well as both sides You are more likely to catch lateral fissure fractures that you can skip. Although the fracture diagnosis is sometimes obvious, it is important that the fracture damage which tissues For example, a clavicle fracture may cause artery or ven injury Although the hematoma area is seen around the fracture in this patient, the artery-vein structures appear stable at a certain distance from the fracture Especially protecting the pediatric patient group from radiation has been the subject of study for many physicians Wrist fractures can easily be recognized with the US Recognition of sono anatomy is necessary for accurate diagnosis In this image, radius fracture is seen In case of suspected broken wrist, both Radius and Ulna should be scanned in 3 directions Fractures are most commonly found on dorsal scans In this image, the fractured line is not clearly seen on the volar and lateral scans, whereas the dorsal scan shows cortex irregularity. Epiphysis can be confusing, especially in childhood An epiphyseal line is seen in the view after the broken line. If you can not distinguish between a fracture and an epiphyseal line, the easiest way to do it is to view the other limb of the patient. The age-specific graphs for the epiphysis line are shown here The epiphyseal line is not observed after 18 years of age. US can be used for elbow fractures with 98% sensitivity and 70% specificity , and reduced unnecessary graph request by %48 The use of US in radial fractures reduces recurrent reduction rates and decreases surgical rates. Ankle, more complex than wrist, is easily scanned by US in isolated trauma. To summarize; Ultrasound reduces unnecessary radiological imaging rates and reduces reduction rates in fractures. Contact me for your questions and contributions Thank you.

First Aid for Anaphylaxis : General Allergic Reactions

First Aid for Anaphylaxis : General Allergic Reactions


Allergic reaction is nothing more than your
bodies? response to a foreign substance, this called an allergen. Allergic reaction can
be caused by any number of things. Basically, anything can cause an allergic reaction. Some
examples that I have on screen here are the four different ways that you can be exposed
to allergic reaction. One of them over here is skin contact through a plant, through animal,
through pollen or through latex are all ways the common allergic reactions happen. Another
way is through injection either through a needle at a hospital setting or through a
bee sting or any type of insect bite can also trigger an allergic reaction. If you ingest
something such as food, medication, nuts and shells are very common. Several people have
shell allergies and also to peanuts. Another one is through inhalation through pollen,
dust, mold mildew and animals. I am sure everybody has someone that they know that has an allergic
reaction of some sort and this is just overview of some of the things that can cause it.

How to PACK a WOUND | Bitesize First Aid

How to PACK a WOUND | Bitesize First Aid


– Catastrophic bleeding
and how to pack a wound. So many of us have heard of tourniquets and how you can stop bleeding on limbs by actually occluding or
blocking the blood supply below the wound. Or what if it’s more of a blast and you
can’t get to the source of the bleeding? Maybe it’s on the side of you and it’s not suitable for a tourniquet. So another way to stop
bleeding in this sort of wound is to actually pack the wound. Now what you are doing
when you’re doing this is, please wear gloves, so with your gloved hand, you are putting your finger
into the source of the bleeding. So you’re actually stopping
where the blood is coming out. You are then getting something to pack that wound. Now the military and the
NHS use things like Cellux or trauma gauze, which has a clotting agent on it. And that will increase the clotting and allow the wound to clot far quicker than you packing a wound. However, packing a wound
with an improvised dressing is still incredibly powerful. You can save somebody’s life with a sock. How about that? And what you would do is find
the source of the bleeding with your finger, so a gloved finger, gloved hand, and you get something like this, so this is just a triangular
bandage or it could be a sock or it could be a bit of
cotton shirt or whatever, and what you are doing is
literally putting that in and then bit by bit, you are lifting up and pushing down on top of this packing so that you are packing that wound in all the different areas, so that as you are packing it, which you would do relatively quickly, you are then filling the
wound with this material so that when you are now pushing down, you are applying pressure
directly to the source of the wound, because you have filled it. So you would put it in like this. You would apply pressure on top, ideally with a dressing or, if you have access to one of
these great blast dressing type of things, you can do a really good
compression over the top where you will put this
in and you can use this with this natty, little gadget to get it on as tight as you possibly can. ‘Cause you will need the pressure to stop the bleeding coming through. So you would put this on, you twist it, this one, as you go round, but you would put this on tightly and you would get emergency
help as quickly as possible. Look for signs of shock. If they’ve got a catastrophic bleed, they will be showing signs of shock. Keep them warm, keep them dry. Elevate the legs if at all possible. And this is an emergency, get help fast. (gentle music)

Recovering from Traumatic Brain Injury: Ryan’s Story

Recovering from Traumatic Brain Injury: Ryan’s Story


I remember looking around and just there
was not another soul there I knew we need to get the hospital right
now and it was very, very serious, but I didn’t realize exactly how serious it
was That morning had rained just a little
bit. Jess was out running errands. Our daughter Morgan, it was her first season
of soccer so I’d been wanting to get her out to the soccer field, just to practice. Our son Cameron was playing goalie, and Ryan was out there just kind of walking around, playing a little bit and
then just picking grass, here and there. Morgan kicked the ball and it went wide right of the soccer goal. I went to go
retrieve it and as I picked it up and I was turning around, there was
the full-sized, adult sized soccer goal was in mid-fall. I looked over to my
right and there was Ryan laying there, his eyes wide open, and the
dramatic, super pronounced swelling across his forehead. I picked him up and
I carried him maybe three or four steps calling out his name
not getting any response at all. That’s when I realized that he’s not breathing. Luckily my phone was in my pocket. I made the phone call real quick, let them know where we’re at, “Sent help now!” I had gotten CPR training
a couple years before and I just I tried to do my best.
The first responders got there immediately they’re like “hey we need to
get a life flight in here”, that’s when I I gave Jess a call. I knew the situation was bad because before we hung up the phone, Andy said he didn’t know
if Ryan was going to make it. They took him to CT and quickly
determined he needed to go into emergency surgery. The impact had caused
a portion of his skull to bone to be pushed in, so it’s putting a lot of
pressure on his brain and we removed those bone fragments and took the pressure off of his brain, and were able to repair his skull that way. Ryan was
semi-comatose and he could maybe follow some very simple commands, but he really
couldn’t talk or walk or speak or do anything that a typical three-year-old
should do. When you have a brain injury such as Ryan did a portion of the brain
is injured and that portion of the brain that’s injured does not recover. Other
parts of the brain that are not injured take over the functions that were lost,
and this is where it’s really important for patients to have good, high-quality
rehab, which we do fortunately have here at Arkansas Children’s Hospital. We evaluated him to come to the rehab floor where he stayed with us for about a month and he
was able to eat and drink some by the time he left but he still had the g-tube
in, he was also able to talk some by the time he left, he was also starting to
walk and to do some playful activities (SINGING) “Jingle Bells, Jingle Bells” Singing songs and not completing the
ending phrase to see if Ryan would pipe in, you could almost see his wheels turning when Andrew would play those songs for him, and I do think it helped, not only with his speech, but just with his
general cognitive progress. I’ve had the privilege of following him since he’s
been discharged. He is back to normal, he is able to walk and talk and play and do
everything now that a five-year-old should be able to do and he’s done
incredibly well after having this tragic accident.

Mission First Aid – Choking Adult and Child – Dr Sivaranjani’s Easy Health


Today we are going to discuss about choking. What to do, What not to do when a person chokes. Be it an adult or a child the principles are the
same. When a person is choking what do you mean by that? If a foreign object gets lodged in our windpipe
and we are not able to cough it out it means we are choking, and we need help. This is called universal choking position. If at all when you are in an airport you are in a
public place you are in a hotel. You are choking on something and you are not able
to get it out and you know that you need help. Try to indicate to the people around you by
holding like this. You are coughing and at the same time you are
also indicating to others to come and help you. So if I am choking and I am coughing a lot. I am trying to expel the foreign body out. Do I
need help? Not really. If a person is able to cough out
effectively or call out for help that means he is
actually able to make an effort to cough it out. So all that we need to do is just stand by and
encourage the person to cough it out. At the most ask the person to lean a little
forward. Okay but now the person is not able to cough and
is turning limb. Pale. He is not able to speak
out and he is actually having a sound like this. With all his ribs going in. This is the time you need to help the person to
get the foreign body out. Go stand behind the person in such a way that
just in case he collapses or loses consciousness
because of lack of air you are able to support him and get him on to the
floor. So now stand behind the person. Slightly lean him
forward and give 5 back slaps. What we call as back slaps, between the shoulder
blades with the heel of your hand please give 5 back slaps. One. Two. Three. Four. Five. Don’t be too gentle, between the shoulder blades
with the heel of your hand please give five back
slaps. This will put the pressure on the windpipe in
such a way that the foreign body gets expelled
out. So if it falls out. Fine our job is done. If the foreign body doesn’t get expelled out even
after 5 back slaps now you will have to give
something called abdominal thrusts. What do you do when you have to give abdominal
thrusts? So you can look here. This is the tip of the
breast bone and this is the belly button. Place your hand between them at the centre. Put
your other hand above it. So you fist one hand and place the other hand
above it and give 5 abdominal thrusts in such a
way that the foreign body gets expelled out. So what do you need to do? Put pressure towards you and upwards. Back and
up. Back and up. Back and up. So 5 thrusts. One. Two. Three. Four. Five. If the foreign body falls out fine, otherwise we
do again 5 back slaps. One. Two. Three. Four. Five. So 5 back slaps. 5 abdominal thrusts. 5 back
slaps. 5 abdominal thrusts. After three cycles if the foreign body has still
not got dislodged please do call the ambulance
and continue doing what you are doing. So you do 5 back slaps, 5 abdominal thrusts and
you keep doing these cycles until when? Till the foreign body falls out or till the
person loses consciousness. So if a person loses consciousness you have to
ensure you get him very safely on to the floor and the subsequent steps will be as per how to
manage an unconscious person. I will be dealing with this in my subsequent
videos. Now let us have a demonstration. What to do when
a child or an adult chokes. So if its a small child or a person shorter than
you the principles remain the same. Allow him to cough out and if he is not able to
cough out. Then you will have to give the same 5 back slaps
and 5 abdominal thrusts till the foreign body
comes out or the person loses consciousness. My earnest request to each and every one. Please
do not laugh or talk when you are eating. You can choke. One can die. And my earnest
request to everyone please learn how to handle
choking. You can save a life. Please do share our first aid videos. Spread the message Save Lives

Young Hero: St John Ambulance Everyday Hero Awards

Young Hero: St John Ambulance Everyday Hero Awards


Grandad: It’s a bit of a blur. I got
up and saw my granddaughter off to uni and then went back upstairs, woke up
Logan, came down the stairs and – pow. That was it. Logan: I didn’t know he was having
a heart attack at the time. He wasn’t like himself so I knew something was definitely up. I’d done a lot of the training and it was kind of like these
situations, so I knew what I was doing, so I could relax and do what I can do. And
after I calmed nanny down it got a lot easier. Grandad: Logan’s my grandson. He’s been living with us for the last [together] 10 and a half years [laughs] He came to live with us when he lost his mum and dad couldn’t cope so we’ve been
together, we’ve grown together. Logan: I straightaway noticed that he was all
sweaty and hot and bothered, and he just wasn’t responding very well. I
loosened his collar at his neck so he could get more air, and I put him into a comfortable position. Luckily, the week before we had done the
W position, and the recovery position – all the positions that you needed. Once my Nana got on the phone and told them everything and then she passed the phone over to me
so I could answer some of the questions whilst she went round to next
door because luckily she’s a nurse. And then the ambulance turned up and it was
off to hospital. I was only on my own for like, 15 minutes?
Grandad: It was still a long time! Long long time.
Logan: I know. Grandad: When I came round and Brenda said to me, ‘Logan’s done this and done that,’ you know it was amazing, and I went, ‘Well he’s only just really begun to learn what to do,
and not to panic and to do what he’s supposed to do,’ – it was incredible really. It was my first time performing first aid other than training. I definitely recommend going through St John Ambulance to learn first aid because they’ve
helped me understand a lot and helped me get better. To know it was my granddad, I felt
more relaxed because I knew him. Grandad: We always were strong. Our relationship’s been really pretty good you know from when he was little and up to now. Logan: my Grandad means the world to me. Grandad: I think Logan saved my life. 100%.

How to Treat an Injured Bleeding Baby – First Aid Training – St John Ambulance

How to Treat an Injured Bleeding Baby – First Aid Training – St John Ambulance


As your baby crawls around your home or outside, they can very easily graze or cut themselves. Most of the time the injury will not be too bad, but sometimes there can be serious bleeding. If there is blood flowing from a wound and it doesn’t stop, your baby has severe bleeding. To treat a severe bleed, remove any clothing from the area your baby is bleeding from. If there’s something in the wound, leave it where it is and apply pressure around the wound to try to push the edges together. If there’s nothing in the wound, apply pressure directly to it with a sterile dressing or a clean, non-fluffy pad. Next you need to ask a helper to call 999 or 112 for emergency help. Or if there is no one around to help, use a mobile on speakerphone so you can keep treating your baby while you speak to the emergency services. Tell them where the bleeding is and the amount of bleeding. Apply a firm bandage around the dressing on top of the wound. It needs to maintain pressure, but not restrict the circulation. Check the circulation by pressing a fingernail on the skin around the bandage for five seconds, release the pressure and if the colour does not return within two seconds the bandage is too tight and you should loosen it. Severe bleeding can lead to shock, so make sure they are lying down on a blanket or rug to protect them from the cold and raise their legs, but don’t raise an injured leg. You could hold a small baby in the recovery position. If the blood soaks through the dressing, apply a second dressing on top of the first. If it soaks through both, remove both dressings and apply a new one. Keep checking circulation every 10 minutes. While you’re waiting for help to arrive, keep checking your baby’s breathing and level of response. So remember, if your baby has a severe bleed, apply pressure around the wound if there’s something stuck in it, or apply direct pressure to the wound if it’s clear. Call 999 or 112 for emergency help and tell them where the bleeding is and the amount. Secure the dressing and check circulation, if blood comes through apply a second dressing. But if blood comes through both, take them both off and start again. Check circulation every 10 minutes, keep checking your baby’s breathing and level of response while you wait for help. And that’s how you treat a baby who’s got a severe bleed. Thanks for watching. Help support St John Ambulance and donate today.