Indications of chest tube insertion Pneumothorax: In any ventilated patient (positive airway pressure will force air into the pleural cavity and produce tension pneumothorax) Tension pneumothorax after initial needle thoracocentesis Persistent or Recurrent pneumothorax after simple aspiration Large secondary spontaneous pneumothorax in patients >50 years Pleural effusion: Malignant pleural effusion…
PGMEE, MRCS, USMLE, MBBS, MD/MS
NG tube insertion
Indications Gastric decompression Gavage (feeding) Gastric lavage (irrigation or dilution of gastric contents) Sampling of the gastric contents for analysis Sometimes used to instil air into the stomach to detect a gastric perforation on erect CXR Contraindications Basilar skull fractures (Risk of NG reaching brain) Facial fractures (risk of cribiform…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Aspirin and Clopidegrol : Perioperative Guidelines
The average lifespan of platelets is 7 to 10 days. Aspirin and Clopidegrol inhibits platelets for around 21 days. Hence, when these agents are stopped 7 days before the surgery, it allows 33% regeneration of platelets. Stents and coronary lesions act as unstable plaque until they are completely covered by…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Pediatric Lateral Condyle Humerus Fracture : Review
A) Epidemiology: B) Mechanism of Injury: C) Classifications: a. Milch: Fracture line based – b. Jakob and Weiss: Displacement and articular congruency based – Modified Weiss classification: No need for arthrogram1. Type I: <2 mm displacement2. Type II: 2-4 mm displacement 3. Type III: >4 mm displacement (displacement of >4…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Superficial Cervical Plexus Block : Mnemonic
This is a visual mnemonic for the nerve arrangement of superficial cervical cutaneous branches of cervical plexus. This mnemonic was created only for the ease to remember and may not resemble exact anatomy. The site of injection for superior cervical plexus nerve block is the midpoint of posterior border of…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Forearm muscles : Tricks to remember
Anterior Forearm (Compartment) Muscles Total muscles: 8 (4 superficial + 1 intermediate + 3 deep) Mnemonic: Do it yourself as shown in the figure below! Place your thenar/hypothenar eminence over medial epicondyle and fan out 5 fingers with thumb resting below the 4 fingers. The 4 fingers represent superficial flexors…
Case Reports
Acute Pancreatitis – Case Discussion
Cases of Acute Pancreatitis Case 1 32 years old male came to emergency department with complaint of: Upper abdominal pain X 3 days Vomiting X 2 episode (3 days back) Yellowish discoloration of urine and decreased urine output X 2 days Vitals: Pulse rate BP RR TPR SpO2 Triage Level…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Febrile Seizure : Clinical approach
A) General consideration: Febrile seizures are seizures during fever occuring between 6 months and 5 years of age in absence of: CNS infections Abnormal neurologic findings Types of febrile seizure: Simple febrile seizure: Solitary Brief (< 15 minutes) Within 24 hours of onset of fever Generalized Tonic Clonic Seizure (GTCS)…