How to do CPR – First Aid Training

How to do CPR – First Aid Training


Welcome to Flying Fish, this week we’re going to
show you how to do CPR on a dry land casualty. When approaching a casualty,
stop, and check for danger. Firstly, to yourself or to the person. Remove the danger, if needed. Next thing, check for response. Do they respond to your voice? Hello, I’m a first
aider, I’m here to help! Or a light squeeze of the shoulders? Or are they totally unresponsive? Next thing, open the
airway by placing one hand on the top of the head,
two fingers under the chin and carefully tilting the head back. Have a look in the mouth and see if there’s any
obstructions over the throat. Now that the airway is open, you need to look down the chest. Listen with your cheek and feel with your hand to
see if they are breathing. Look, listen and feel for
minimum of 10 seconds. You’re looking for two
to four normal breaths within that time. If there is no breaths,
that’s the time to do CPR. If you shouted for help
and no one has arrived at this point you need to
dial the ambulance yourself. Do this by calling 999 or 112 in European countries. To begin CPR place the heel of your hand on the center of their chest. Directly between the nipples. Interlock the fingers
of the other hand on top and with straight arms, compress the chest five
to six centimeters. Compress the chest 30 times at a rate of 100 beats per minute. At this point, if you
feel confident to do so, complete two rescue breaths. Do this by placing your
hand on the top of the head, two fingers under the chin and
tilting the head right back. Pinch the nose and place
your mouth over the casualty. Breathe in a normal breath, take a pause and then breathe
in a second normal breath. In between each breath,
look down the chest to see the rise and fall
of the breath going in. Continue CPR at a rate of 30 to 2 until one of the following
three things happens. One, a medical professional
tells you to stop. Two, the casualty shows signs of life. Or three, you swap with a
teammate due to exhaustion. To summarise, always
remember this easy formula. Doctor. ABC. Danger. Response. Airway. Breathing. CPR.

Choking Dog: What to Do | First Aid for Pets


– My name is Emma Hammett. I’m the founder and CEO
of firstaidforpets.net, and we do first aid training
to teach you how to help your pet in an emergency
before you can get to the vet, in those first vital seconds or minutes. Today, I’m going to talk about choking. If your dog is choking, it’s really important that
you’re able to help them quickly, and dogs can choke on
pretty much anything. They can wolf down their food. They can scavenge and
find all sorts of things that aren’t suitable for
them to eat like socks, and they can choke on the
ball, and they can choke on, as I said, pretty much anything. Rawhide is particularly nasty for them, so please avoid giving your dog rawhide, and also bones, cooked bones
can end up being very brittle and they can do damage if they get stuck. Okay, so if you suspect
your dog is choking, they may be pouring, they may be drooling. They will look distressed, pacing. Have a look very carefully. Your safety is the most important. So have a look in their
mouth, but make very sure that you are not in
danger of getting bitten. What you will need to
do, and if you’ve got someone else to help, that’s even better, is have a look in their
mouth and see if there is anything obvious that you can just remove. Obviously, protect your fingers, and don’t risk getting bitten. If there’s anything that you
can remove quickly and easy with your finger and thumb or with a pair of forceps or tweezers,
then get it out quickly. Don’t finger sweep or
poke your fingers down, because you’ll make things worse. So if there’s nothing obvious down there, then your next thing to do
is to try repositioning them to see if gravity can help
you get the obstruction out. If you have a smaller dog, then holding them upside down and shaking them slightly can end up getting the obstruction out, so that is a good thing to start doing. If you’ve got a large dog, then you would need to do
a wheelbarrow position. I don’t know if you can see. So you would hold them in a
sort of wheelbarrow position in order to try and get
the obstruction out. It’s harder with a big
dog, and they’re heavy, but you’re doing what you
can to save their lives. If holding them like that hasn’t worked, your second line of treatment is the Heimlich manoeuvre for dogs. So, the Heimlich manoeuvre
is the same as with humans where what you are doing with
a human is going under your ribcage, between your tummy
button and your rib cage and making a fist like that, with the thumb towards you. You’re putting that into that dip, and dogs have the same dip. You’re talking about
this sort of dip here, so this dip, just at this point, and you’re going to put
your fist in at that point, and you’re going to be
doing an upward thrust. So you’d be holding them downwards. You’d be putting your fist like that, and you would be doing an upward thrust to try and get the obstruction out. If I demonstrate with this larger dog here that has got a choking vest on, what I will hopefully
be able to demonstrate is that in doing the Heimlich manoeuvre, I will force the obstruction out, and hopefully, if this works, you should be able to see the
obstruction coming through. So what you would do is put
one hand around like that. The other hand goes on top,
and it’s a hard and fast upward movement, a J-shaped movement. In and up, like that. Up, like that. And the obstruction was out. So you would hold them upside down first, so actually, first of all,
you’re checking in the mouth. Then you’re holding them
upside down to reposition and see if you can get
the obstruction out, and failing that, you are then going to do five abdominal thrust or
Heimlich manoeuvres for them, and then back like that. Don’t waste any more time. If it’s not coming out, get
them to the vet quickly. So pop them in and get
them as fast as you can to your local vet, your closest vet, which may not be your usual vet. It’s whatever is closest. This is a medical emergency for your pet. Okay, if the pet loses consciousness, you might need to do CPR on them. We’ll cover CPR in a
separate Facebook Live video, but what you would be doing
is breathing into their nose. You would be giving them two breaths, 30 compressions, two breaths again. 120 beats per minute when
you’re pushing on their chest, but again, get to the vet
as quickly as you can. Do not delay anything in
getting them to the vet fast. So, hopefully that is helpful. If you have managed to
dislodge the obstruction but they are showing signs
of difficulty swallowing or anything, they should
always be checked out by a vet, particularly if you’ve done
a Heimlich manoeuvre on them, because you can end up
damaging their ribs a bit. So get them checked
out, and it may be that whatever was stuck in
the back of their throat, that it’s actually scratched
or damaged the back of their throat and that you might need
to give them some soft food for a couple of days,
and the vet might be able to prescribe some
painkillers for them as well. It can take a few days
for the back of the throat to heal up and feel that much better. I hope that’s been useful to you. So we are firstaidforpets.net,
with practical first aid training, and
we have online courses. We have short courses and
longer courses for you to learn immediate and important first aid elements for your pet, and we also
have First Aid for Dogs available on Amazon and
in all good bookstores. So, please contact us,
[email protected], or just visit our website. Many thanks, and look
forward to seeing you on another Facebook Live.

Don’t block the ambulance!

Don’t block the ambulance!


There have been some rather
disturbing stories lately of people getting in the way
of the emergency services. I don’t know about you,
but I find this quite mind-boggling: people’s lives are being put at risk
for seemingly trivial reasons. In one recent case, a man
confronted some paramedics because their ambulance was blocking his driveway
and he was going to be late for work. They were trying to resuscitate
a child who had collapsed, and a couple of them had
gone back to the ambulance to fetch an important piece of equipment. They were stopped by an irate homeowner
who threatened them with violence and tore a wing-mirror off the ambulance. For the record, the emergency services
do try their best not to block roads or driveways wherever possible. But saving lives is their number one priority. Basically: Sorry, but if saving lives means
that you’re going to have to phone your supervisor to explain why you’re half an hour late for work, that’s just something
you’re going to have to live with. It’s not just Germany, by the way. There was a similar case recently in Britain, where an ambulance crew returned to their vehicle to find a passive-aggressive note
under the windscreen wiper. At least is was just a note,
but still: inexcusable. Just to be clear about this: it is an offence
to hinder the emergency services. In serious cases you could be looking at
a four-figure fine or even a prison sentence. So here are a few things
to watch out for in Germany. A very important concept here in Germany
is the “rescue lane”. Unfortunately, it’s a concept Germans themselves
often have difficulty remembering, but still, it is a rule and you must follow it. If you’re on any road with
two or more lanes in each direction and traffic has slowed to less then 10 km/h,
or has come to a complete stop, a rescue lane must be formed for
any emergency vehicles that might need it. Vehicles in the left-most lane must move to
the left, all other vehicles move to the right. And this must be done as soon as
the traffic slows down enough: don’t wait until you hear a siren. You might be thinking that’s what
the hard shoulder is for; but no. For various reasons, the shoulder
is completely unsuitable. In fact, if at all possible, you should try to keep the shoulder clear as well. The rescue lane is only for emergency vehicles
and not for anybody else. You may see cars being driven down it
by people who are just impatient and don’t care about little things like the law, or keeping the damn lane clear for ambulances. Even if you do see other people doing it,
don’t do it yourself. Oh, and you also need to ensure
that junctions are kept clear so that emergency vehicles joining the road
can get to the rescue lane. Another issue that has become a real problem
recently is rubbernecking. In particular, vehicles have been slowing
or even completely stopping so that people inside them can take photos
or even videos of accidents. This can hinder not only the emergency services,
but other road users as well, as it leads to longer tailbacks and more delays. And you can get into very serious trouble indeed if you post graphic images
of accident victims online. It’s not just the gore: it’s the fact that it shows a callous disregard
for the privacy of the victims and the feelings of their loved ones. In a recent case near here, firefighters actually resorted to
spraying offending cars with water, while the police stopped several vehicles and actually took down the details of people
they’d caught filming the scene. Oh, and a judge later ruled that while there are
better ways of dealing with rubberneckers, spraying their cars with water wasn’t dangerous
and therefore wasn’t illegal — and it was completely understandable
under the circumstances. Finally, when you’re looking for a parking spot, a sign like one of these indicates an access
point designed specially for emergency vehicles: parking there is illegal. Stick to these rules,
and the emergency services will thank you. Well, actually, they probably won’t, because
they’ll be far too busy doing other things, but you know what I mean. Thanks for watching. If you’d like to
send me a postcard, here’s the address. And don’t forget to visit my website
and follow me on Twitter and Facebook. Also, if you’d like access
to special bonus content and help with the costs of running this channel, please consider making a small
monthly donation on Patreon.

9 Chronic Illness Misconceptions

9 Chronic Illness Misconceptions


Flare ups can be horribly timed and sometimes they can be greatly timed and you have no say in the matter Just stop judging people and questioning the legitimacy of their illnesses. Thanks Hey guys, I’m Izzy and today I’m talking about chronic illness misconceptions, so let us begin It’s the same day to day and if we could do something yesterday, that means we can do it today This is a huge misconception of chronic illness and it really really bothers me So, for example, I can walk the stairs some days and other days I really can’t and it’s because It’s dependent on how my joints are feeling if they’re hurting me, how much my heart is bothering me from my POTS, if am I going to feel like I’m gonna faint if I walk up this flight of stairs or am I gonna feel okay, you know, and every single day is different sometimes you know how you’re going to feel so you know to do an activity or not to do an activity and other times you don’t really know and sometimes you just give it a shot and other times you’re like it’s not worth it or I don’t want to take the risk and That’s okay but I just find it really offensive and it hurts my feelings a lot when somebody questions the legitimacy of my illness Because it’s not the same every single day and I certainly don’t want to have to be like well I could walk the stairs yesterday I don’t really feel like I can today but I’m gonna do it anyway because I did it yesterday and then feel horrible You know what I mean? Okay, that was like a main one I just had like put a lot of energy into because that one really pisses me off Next, a flare up is caused by something that you did. Of course Every chronic illness is different and I don’t mean to speak for every single chronic illness for this but for the most part And in a lot of chronic illnesses know you oftentimes did not do anything to cause your flare-up. Some days I have a high pain day and I have absolutely no reason as to why I’m having such a high pain day You know, it doesn’t make any sense, or why did my gastroparesis flare? I don’t know It doesn’t mean that I ate the wrong foods. It doesn’t mean that I ate too much. It’s just happening. If I’m having fun and I’m laughing, that means that I’m feeling okay and That’s really not true. It really sucks when like people assume that. I can still have fun and enjoy my life and do things that I like and I can be laughing with my friends That doesn’t mean that my pain is gone or my nausea is not there. It is, You just have to learn to get past it You know somebody without these chronic illnesses if they experience some of the symptoms I experience, they might not be able to function in that Circumstance in like any circumstance that I could really. Like they’d probably be home not feeling great and you have to learn to live with it That’s the way it is, and on particularly bad days You can’t live with it and that’s okay But on the days where you can or the days where like you just might be able to make make it through you can have fun and You know, that doesn’t mean that you’re feeling great. There’s always another treatment option that you have not tried. This is a really big Misconception and it honestly leads to you a lot of blame on the person who has the chronic illness like well Have you tried this or well, why didn’t you try that medication or have you tried this, you know? You don’t need to try every option first of all Like there are different reasons as to why people don’t try everything But also sometimes people try every freaking option and there is no option. The point is it’s a chronic illness Sometimes the symptoms can be managed. Sometimes they can’t because somebody’s feeling bad don’t think that they’re being lazy and not trying anything because they probably are and if they’re not there’s probably a reason for it and that reason could Be financial. It could be I don’t even know religious like whatever it is. It could be just scared or side effects or Allergies to all medications or something. I don’t even know but like I just hate how people assume that if you’re still having symptoms Like you just haven’t tried the right thing because that’s that’s not that’s not the case. That’s not what it is Sometimes there isn’t a thing Resting before doing something that you want to do will ensure that you’ll be able to do it – also false. Like I said chronic illnesses are really unpredictable and sometimes you really want to do something and You’re doing really well and then suddenly you’re doing horribly and they can have just horrible timing. Flare-ups can be Horribly timed and sometimes they can be greatly timed and you have no say in the matter And so if you are resting that mean you’ll be fine to do something and you know, that’s just the way it is It’s not always something that you do or don’t do that will change around your symptoms Sometimes it just happens and a lot of the times it just happens This is similar to something that I’ve said before, but if you have a chronic illness you can tell – no, again I look happy I look pretty I look I look well put together, you know And that doesn’t mean I feel good surely not at all. So, just because I put makeup on my face or Like I’m wearing clothing doesn’t help or mean I feel good, you know. Maybe it took a lot of effort to do those or maybe it didn’t and I still just feel horrible whatever like But you can’t assume that somebody feels good that way, you know. If you have a chronic illness and you’re exercising, you’re being stupid. No, no, no. No, you’re not being stupid If you can exercise and your doctor agrees with you that you should exercise, it’s a really good thing and Like what’s really difficult sometimes for me to convey to somebody is Yes on a good day when things line up meaning I’m you know, none of my symptoms are horrible I Can go to the gym and do elliptical, you know, for example, I can’t really lift weights I can do certain ones and for like two minutes, you know, things like that, but I can do the elliptical And sometimes the bicycle but I have a lot of pain when I stand for 10 minutes and people don’t understand how that how You can do both, you know, how like you can struggle so much to stand yet you can do the elliptical, you know, and yeah, well first of all sometimes It’s you’re going to the gym – know, it’s probably going to hurt or make your symptoms worse or whatever But it’s for the greater good and also Like you’re preparing for it and it’s for something that’s like really worth it Whereas like standing it’s not but also they are different activities and like for me standing is something that’s way more painful than walking and I wish I Exactly knew why I know like certain reasons why but not the full reason I know people who go to the gym and it doesn’t Mean that their endometriosis isn’t horrible like what like of course their endometriosis can be horrible But they can still go to the gym maybe depending on the person depending on the day and their symptom levels Just stop judging people and questioning the legitimacy of their illnesses, thanks. I have two more: if you had a different outlook or you know, like a more positive outlook Your chronic illness would be better. Oh, it’s one pisses me off a lot a lot of lot. I have such a positive attitude I really do and I’m not I believe that your your mind does have power to make you feel good or not good You know, and I think that there is something to be said about having a certain type of attitude And you know, like maybe positive thinking can be helpful But in no way it’s not gonna cure your chronic illness unless you solely have a psychosomatic chronic illness which you probably don’t like it’s it’s just it’s so Invalidating when somebody tells me that like it’s all about my attitude I’m just like you know what it’s also about my genetics and the way my body is So you can stop putting the blame on me and my, you know The way my attitude basically or my thoughts because like you don’t even know me I don’t know it just like it bothers me a lot and I Think that people should put emphasis on Like your attitude, I think that and like how you look at things I think that’s really important. But like in no way is that going to cure you at all. Like that’s it’s it’s really not, like it might help you manage a bit with your symptoms, you know Which is great. And the last one Because we’ve declined your invitations in the past a lot It’s okay to stop inviting us places. I Really want to say no to this. I think it’s really hurtful if you you know, so I remember like for me tenth I mean not tenth grade, sophomore year college was the time where it was very difficult for me to go do things Um, probably like that was like one of the most difficult times. My stomach was the worst, my fatigue was so bad, And I was just like in a lot of pain. I didn’t, I couldn’t really do anything like I couldn’t go to that party I couldn’t, I didn’t want to go to that that activity because I really didn’t feel well But sometimes I did feel well enough to go or you know I didn’t I I don’t want to be I don’t want to feel left out It’s already sucky enough that I need to stop going to things. But please just keep inviting me because Sometimes I might say yes and sometimes I might say no or I might always say no or I might always say yes but regardless, it feels so good to be invited. You feel included and Even though you’re gonna feel horrible that you’re not going, how much more horrible would it be to not ever even be invited and not be able to go? Keep inviting us. Even if we can’t go and even if we keep saying no, and please don’t take it personally For me now. I don’t usually say no. I’m like in such a better place health-wise than I was but when I did You know, I was just people would ask me and then I’d say I’m sorry I really can’t but maybe we could do something at my place I’m trying to like to see or they could do another day and come over something like that But then if they stopped inviting me like it really just really hurt my feelings and I couldn’t be crazy mad at them about it, but it’s just, it feels Good to be invited. So, I hope you enjoyed this chronic illness misconceptions video Let me know in the comments if you can think of any other misconceptions I know that there are a bunch more, I actually wrote way more than this down and I sort of just had to pick my favorites, so that’s what I did. Um, and thanks for watching this video and Subscribe if you want to see more videos, bye guys

Help! James Corden Needs a Favor – Terry Crews Edition

Help! James Corden Needs a Favor – Terry Crews Edition


THANK YOU FOR BEING HERE
EVERYBODY. I HAVEN’T GOT MY MIC. I HAVEN’T GOT MY CARD. SORRY. I HAVE A, I NEED THE CARD FOR
THE THINGS. I LEFT MY CARDS IN THE GREEN
ROOM. SORRY, SORRY
REGGIE, WOULD YOU MIND POPPING OUT AND GRABBING THEM FOR ME?>>Reggie: NO, SORRY. MY LEGS ARE BROKEN.>>James: SORRY WHAT DID YOU
SAY?>>MY LEGS ARE BROKEN. James: BROKEN LEGS. I SAW YOU WALK DOWN THE HALL. WHEN DID YOU BREAK YOUR LEGS?>>A COUPLE OF SECONDS AGO.>>James: WELL IF YOU JUST
BROKE YOUR LEGS,YOU SHOULD PROBABLY GO TO THE HOSPITAL.>>Reggie: THAT’S A GOOD IDEA. James: I’M LITERALLY ASKING
YOU TO HELP ME OUT. WE CAN’T DO IT, WE CAN’T DO IT
WITHOUT THEM. WE CAN’T — MATE, WILL YOU GO
AND GRAB MY CARDS. COME HERE, COME HERE. LET ME PUT THIS MOTORCYCLE ROW
PHONE ON YOU. HANG ON. PUT THAT, YOU PUT THAT IN YOUR
POCKET. I WILL PIN THIS ON YOU HERE. WHAT’S YOUR NAME?>>JOHN. ames: WHERE ARE YOU FROM?>>TEXAS. James: YOU HAVE A KIND AND
WELCOMING FACE. DO ME A FAVOR. THE CARDS, I LEFT THEM IN THE
GREEN ROOM. I WAS CHATTING TO TERRY. THEY’RE IN THE GROAN ROOM. WE HAVE ABOUT TWO MINUTES OF
THIS PART TO GO, MAYBE THE 0 SECONDS. YOU HAVE TO BE QUICK.>>OKAY. James: GO DOWN AND LEFT. GO FOR IT THANK YOU, THANK YOU. [CHEERS AND APPLAUSE]
>>James: JUST RUN THERE. THAT’S IT, KEEP GOING, KEEP
GOING. UNSTOPPABLE. OH, NO. COME ON. THAT’S IT. OH, OH. YES THAT’S IT MAKE YOUR WAY
THROUGH THERE. WATCH OUT. COME BACK, COME BACK. DOWN THE ALLEYWAY. DOWN THE ALLEYWAY THERE. JUST GET THROUGH THE CROWD. THROUGH, GET THROUGH THEM. GO, GO, GO, GO. OKAY. NOW LISTEN — COME BACK. IN THE PURPLE ROOM. THE PURPLE ROOM. TERRY CRUISE IS A SLEEP. RIGHT IN FRONT OF YOU, HE’S A
SLEEP. HE LIKES TO HAVE A SLEEP BEFORE
COMING ON THE SHOW. DON’T WAKE HIM. HE GETS ANGRY. IAN THE CARDS BUT DON’T WAKE
HIM. HE GETS CROSSED. OKAY. HE GETS REALLY ANGRY. RUN, RUN, RUN!>>WHAT ARE YOU DOING! James: RUN, RUN!>>GET OUT OF HERE. James: QUICKLY. BACK, BACK TO THE STUDIO. THIS WAY, THIS WAY, THIS WAY. PAST THE REST ROOMS. THEY’RE ALWAYS THERE. MAKE YOUR WAY THROUGH. GO THROUGH THE DOOR. THROUGH THE DOOR. GO THROUGH THE DOOR. THIS WE GO. [CHEERS AND APPLAUSE]
>>James: THANK YOU SO MUCH FOR BRINGING THESE TO ME. YOU ARE A LIFESAVER. THANK YOU SO MUCH. YOU CAN STAY HERE FOR A MINUTE. THERE IS A LOT GOING ON THERE.>>THERE IS. James: IT’S ALWAYS LIKE THAT
BACK STAGE AT THE LATE LATE SHOW.>>VERY EXCITING. James: WE WOULDN’T BE ABLE TO
DO THAT WITHOUT THE CARDS. THANK YOU. OKAY. WE WILL BE RIGHT BACK WITH MORE
OF THE LATE LATE SHOW. GIVE UP.

Cat Unconscious: What to Do | First Aid for Pets


Cat CPR, cardio pulmonary resuscitation. If you suspect your cat is unconscious, you need to have a look at them and see if you can see them breathing. It’s sometimes easier to do this holding a mirror and you can see if there’s breath coming out, otherwise use the back of your hand, and see if you can feel the breathing. Have a good look at them. Have a look at their gums. If their gums are looking blue, they haven’t got enough
oxygen in their system. Okay, so if they are unconsious, and you can’t see them breathing, you then need to feel for a pulse. So two fingers under their lower leg to feel the femoral artery, and you need to feel and push down quite firmly and you should be able to feel a pulse there. If you can’t feel a pulse, then they’re unconscious and not breathing and their heart isn’t beating. If you can feel a pulse and they are unconscious and not breathing, you would then lift them up, you would pull their
tongue forward a little bit to open the airway and see if that starts them breathing again. If it doesn’t, you need
to hold their mouth shut, and breathe into their nose. And you’re going to do
a short sharp breath. Remember your lungs are
bigger than a cat’s lungs, so you need to do a short, sharp sort of puff of your cheeks in, and hold them so that you can feel if their chest is rising when you’re breathing into them. So you would breathe in. A few breaths in, to see if that makes a difference. If they are unconscious and not breathing, but they do still have a pulse, then keep breathing into them, and get them to a vet quickly because they will need veterinary help. If they are unconscious and not breathing and they haven’t got a
pulse that you can feel, then you will need to do CPR. And you will be doing this by pushing hard and fast over where their heart is. So their heart is about here. So for a small cat or a kitten, you would use your
thumbs and you push down 120 beats per minute. Okay, hard and fast. If it’s a bigger cat,
you can use two hands and you can push down like that. 120 beats per minute, and you would do 30
compressions to two breaths. So if they’re unconscious
and they’re not breathing, you would start by giving them five rescue breaths similar
to how you did previously when you found that they had a pulse, but five of those, and then you would do 30 compressions to two breaths. 30 to two, 30 to two. Do not let this first aid delay you getting to the vet. So if you’re able to do this as you’re on the way to the vet,
that is by far the best. The quicker they can get
veterinary help, the better. And unfortunately, please bear in mind that bringing your cat back by doing CPR and having a
successful outcome is rare. So they will need veterinary help quickly, and the other thing, important thing to tell you is if it is not your cat, please make sure you have got consent from the owner to be doing CPR on the cat because the cat belongs to them. So that’s CPR for a cat.

Imaging of Bones: Fractures, Bony Anatomy and Bony Density – Radiology | Lecturio


So let’s talk a little bit about bony abnormalities and fractures. Of all of the different x-rays that you take a look at, fractures are probably one of the most commonly encountered findings. Let’s start off with this case. Take a look at the findings here and keep these in mind as we go through the lecture and then we’ll come back to it in the end. So when you’re imaging bones, the images are best evaluated in at least 2 different projections and again it’s because you’re taking a look at a 3D structure using a 2D image. If the radiograph isn’t telling you what you need to hear, then you further evaluate this with CT or MRI. MRI is also very useful in visualizing the sorrounding soft tissues. So let’s first review some bony anatomy. Here we have a diagram and an x-ray of the femur. You can see here that the bone has what’s called an epiphysis which is at the very tip of it. The next portion of the bone is called the metaphysis and then the longer portion of the bone is called the diaphysis. On the x-ray, you can see that the epiphysis will be the very top of the femoral head. This entire portion is then the metaphysis and then again the longer portion or the shaft is called the diaphysis. Within the shaft, you have the cortex and then you have the medullary cavity in the middle. So the cortical bone or the cortex appears more dense or more white than the grayish center which is the medullary cavity. Bone density refers to the whiteness of the bone as it’s seen on the radiograph. It can either be focally or diffusedly increased or decreased in density by a lot of different pathologic processes. Common causes of density changes include metastases which can either be focal or diffused. You can have Paget’s disease which can also be focal or diffused or you can have a avascular necrosis. Other causes of decreased density includes again metastases and it depends on whether the metastasis is lytic or blastic, so if it’s a blastic metastasis that usually results in increased density. If it’s a lytic metastasis, that will result in decreased density. Osteopenia can also be focal or diffused and that results in a decreased density of the bone. Multiple myeloma is another cause and osteomyelitis. So let’s take a look at this case. Again, we’re focusing on the bony structures here. So can you see the difference between the images that was obtained 4 years ago and then the same patient, the image that’s obtained currently? So these are the areas that look a little bit different. You have an increase in density here within the lower lumbar spine. You have an increase in density with in the lower iliac bone and then you have an increase in density in the inferior pubic ramus when compared with the prior. This patient ended up having a bone scan and if you remember, areas of increased bone turnover are the ones that light up on a bone scan. So taking a look at this image here, this is the frontal image. You can see that the areas that showed increased density on the radiograph now have increased uptake on this bone scan. So we have the lower lumbar spine, we have the iliac crest and then we have the inferior pubic ramus. Again, remember that this is normal activity within the bladder and then the images on the right are inverted images to help you visualize these findings a little bit better. So this patient actually has prostate cancer metastases. The areas of increased sclerosis that you see involving the left iliac bone, the lower lumbar spine and the inferior pubic ramus all represent areas of blastic metastasis and the bone scan shows uptake in each of these areas. So let’s discuss avascular necrosis. Avascular necrosis is bony ischemia that results in cellular death and necrosis. It causes collapse of the affected bone and radiograph demonstrates an area of sclerosis or increased density associated with it. This is actually a coronal MRI image and you can see the findings in the left femoral head. There’s an area of hypointensity which reflects avascular necrosis. So this is a radiograph. How can you describe these findings? This is again an example of the left femoral head and the arrow points to the abnormalities. So there’s increased sclerosis in the superior aspect of the femoral head. There’s also what we call the crescent sign which is a linear lucency indicating subchondral fracture. This is also a very common sign seen in avascular necrosis. Let’s now take a look at this lateral view of the skull. What do you see here? This is an example of multiple myeloma. So you have multiple low density well circumscribed lesions throughout the skull. This is a very typical appearance of multiple myeloma and is called the “punched out” appearance. Lytic metastases can actually look very similar but they’re usually fewer in number. And let me just point out some of these abnormalities, so you can see here multiple lucent lesions of all different sizes and kind of scattered all throughout. So multiple myeloma is primary bone malignancy. It can cause either a single lytic lesion called a “plasmacytoma” or it can cause what we just saw multiple lytic lesions and a punched out appearance. This is an example of a plasmacytoma or a single lucent lesion and this is within the right humeral head.

The Beatles – Help! [Blackpool Night Out, ABC Theatre, Blackpool, United Kingdom]

The Beatles – Help! [Blackpool Night Out, ABC Theatre, Blackpool, United Kingdom]


Next song we would like to sing Is our latest record or our latest electronic noise Anyway we’d like to carry on with it its the last number and we’d like to thank you all for being so wonderful And it’s called “Help” 1 2 3 4 (help..) i need somebody not just anybody Help you know I need someone Help when I was younger, so much younger than today (i never need….) I never needed anybody’s help in any way (but….) But now those days are gone (those days are gone…) i’m not so self assured (I know I’ve found….) Now I find I’ve changed my mind and opened up the doors Help me if you can, I’m feeling down And I do appreciate you being round Help me get my feet back on the ground Won’t you please……, please help me (now…) And now my life has changed in oh so many ways (Life has changed…) (My independence….) My independence seems to vanish in the haze

The ‘burbs (9/10) Movie CLIP – Ambulance Encounter (1989) HD

The ‘burbs (9/10) Movie CLIP – Ambulance Encounter (1989) HD


Oh, Dr Klopek, I’m so sorry. You know, Dr Klopek,
when I get out of prison… I’m gonna help you
rebuild your house. I’ll even do some of the work myself.
I have the tools. Carol’s father just gave me
a brand new set of tools. Do I look like an idiot, Mr Peterson? No. Do you take me for an imbecile? No. You may have fooled the others,
Mr Peterson… but you don’t fool me. Uh, I fooled the others?– But you don’t fool me.
– I don’t? No, you don’t. Am I missing something, Doctor? Come now, Mr Peterson.
You were in my basement. Surely, you looked in the furnace. I saw your furnace, Doctor… but I figured a man’s furnace
is his own business. You saw one of my skulls, didn’t you? Oh, yes. I know you did. It belonged to a neighbour of yours. The name was Knapp. We took the house from them. I offered to buy it,
but you know how old people are. They grow so attached to things. Uh, you know, Dr Klopek,
I think I forgot my wallet. I let you keep the femur. Now, now, I want my skull. Or, perhaps, I might just take yours. Hans.Uh, hey!

How to Detect and Treat Stress Fractures Early | Ohio State Sports Medicine

How to Detect and Treat Stress Fractures Early | Ohio State Sports Medicine


A very common injury I see that’s oftentimes
preventable is stress fractures. Stress fractures are an overuse injury to the bone. It’s when
the bone breaks down with activity and doesn’t have enough time to build back up. If you’re
aware what to look for, you can catch this off early and prevent it from progressing.
I always tell my patients, your leg is a smarter doctor than I am. If you’re having more or
increasing pain with activity, and pain that is even now progressed to where it’s present
at rest, you have to listen to your leg. It’s trying to tell you to back off. Typically
for stress fractures the first line treatment is just rest. It’s okay to cross-train, so
if you have a leg injury, it’s okay to do core or upper-body work, but try to avoid
high impact to the area. Acetaminophen is okay for pain, but if you’re requiring doses
around the clock or increasing doses, please come into the office so you can have a further
evaluation. An initial period of rest, for maybe two weeks is adequate if your symptoms
have improved, gradually resume your activities. However, if pain persists beyond this rest
period, it is then important to make sure you get further evaluation, as some of these
progress and can be potentially dangerous.