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Chest tube
A
chest tube or chest drain is a flexible plastic tube that is inserted through the side of the chest into the pleural space. It is used to remove air (pneumothorax) or fluid (pleural effusion, blood, chyle), or pus (empyema) from the intrathoracic space. The procedure is called tube thoracostomy in the United Kingdom. It is also known as a Bülau drain or an intercostal catheter.
Technique
The free end of the tube is usually attached to an underwater seal, below the level of the chest. This allows the air or fluid to escape from the pleural space, and prevents anything returning to the chest. Alternatively, the tube can be attached to a flutter valve. This allows patients with pneumothorax to remain more mobile.
The British Thoracic Society recommends the tube is inserted in an area described as the "safe zone", a region bordered by: the lateral border of pectoralis major, a horizontal line inferior to the axilla, the anterior border of latissimus dorsi and a horizontal line superior to the nipple[citation needed].
Chest tubes are usually inserted under local anesthesia. The skin over the area of insertion is first cleansed with antiseptic solution, such as iodine, before sterile drapes are placed around the area. The local anesthetic is injected into the skin and down to the muscle, and after the area is numb a small incision is made in the skin and a passage made through the skin and muscle into the chest. The tube is placed through this passage. If necessary, patients may be given additional analgesics for the procedure. Once the tube is in place it is sutured to the skin to prevent it falling out and a dressing applied to the area. The tube stays in for as long as there is air or fluid to be removed, or risk of air gathering.
Once the drain is in place, a chest radiograph will be taken to check the location of the drain.
Chest tubes can also be placed using a trocar, which is a pointed metallic bar used to guide the tube through the chest wall. This method is less popular due to an increased risk of iatrogenic lung injury. Placement using the Seldinger technique, in which a blunt guidewire is passed through a needle (over which the chest tube is then inserted) has been described.
Indications
* Pneumothorax: accumulation of air in the pleural space
* Pleural effusion: accumulation of fluid in the pleural space
o Chylothorax: a collection of lymphatic fluid in the pleural space
o Empyema: a pyogenic infection of the pleural space
o Hemothorax: accumulation of blood in the pleural space
o Hydrothorax: accumulation of serous fluid in the pleural space
Contraindications
Contraindications to chest tube placement include refractory coagulopathy, lack of cooperation by the patient, and diaphragmatic hernia.
Complications
Major complications are hemorrhage, infection, and reexpansion pulmonary edema. Injury to the liver, spleen or diaphragm is possible if the tube is placed inferior to the pleural cavity. Injuries to the thoracic aorta and heart have also been described.
Minor complications include a subcutaneous hematoma or seroma, anxiety, shortness of breath (dyspnea), and cough (after removing large volume of fluid).
Pleurovac (Chest Drainage System)
A three chamber device is typically used to drain chest tube contents (air, blood, effusions). The first chamber is a collecting chamber. The second is the "water seal" chamber which acts as a one way valve. Air bubbling through the water seal chamber may indicate a pleural or system leak that should be evaluated critically. The third chamber is the suction control chamber. The height of the water in this chamber determines the negative pressure of the system. Bubbling should be kept a gentle bubble to limit evaporating the fluid. Increased wall suction does not increase the negative pressure of the system.
chest tube or chest drain is a flexible plastic tube that is inserted through the side of the chest into the pleural space. It is used to remove air (pneumothorax) or fluid (pleural effusion, blood, chyle), or pus (empyema) from the intrathoracic space. The procedure is called tube thoracostomy in the United Kingdom. It is also known as a Bülau drain or an intercostal catheter.
Technique
The free end of the tube is usually attached to an underwater seal, below the level of the chest. This allows the air or fluid to escape from the pleural space, and prevents anything returning to the chest. Alternatively, the tube can be attached to a flutter valve. This allows patients with pneumothorax to remain more mobile.
The British Thoracic Society recommends the tube is inserted in an area described as the "safe zone", a region bordered by: the lateral border of pectoralis major, a horizontal line inferior to the axilla, the anterior border of latissimus dorsi and a horizontal line superior to the nipple[citation needed].
Chest tubes are usually inserted under local anesthesia. The skin over the area of insertion is first cleansed with antiseptic solution, such as iodine, before sterile drapes are placed around the area. The local anesthetic is injected into the skin and down to the muscle, and after the area is numb a small incision is made in the skin and a passage made through the skin and muscle into the chest. The tube is placed through this passage. If necessary, patients may be given additional analgesics for the procedure. Once the tube is in place it is sutured to the skin to prevent it falling out and a dressing applied to the area. The tube stays in for as long as there is air or fluid to be removed, or risk of air gathering.
Once the drain is in place, a chest radiograph will be taken to check the location of the drain.
Chest tubes can also be placed using a trocar, which is a pointed metallic bar used to guide the tube through the chest wall. This method is less popular due to an increased risk of iatrogenic lung injury. Placement using the Seldinger technique, in which a blunt guidewire is passed through a needle (over which the chest tube is then inserted) has been described.
Indications
* Pneumothorax: accumulation of air in the pleural space
* Pleural effusion: accumulation of fluid in the pleural space
o Chylothorax: a collection of lymphatic fluid in the pleural space
o Empyema: a pyogenic infection of the pleural space
o Hemothorax: accumulation of blood in the pleural space
o Hydrothorax: accumulation of serous fluid in the pleural space
Contraindications
Contraindications to chest tube placement include refractory coagulopathy, lack of cooperation by the patient, and diaphragmatic hernia.
Complications
Major complications are hemorrhage, infection, and reexpansion pulmonary edema. Injury to the liver, spleen or diaphragm is possible if the tube is placed inferior to the pleural cavity. Injuries to the thoracic aorta and heart have also been described.
Minor complications include a subcutaneous hematoma or seroma, anxiety, shortness of breath (dyspnea), and cough (after removing large volume of fluid).
Pleurovac (Chest Drainage System)
A three chamber device is typically used to drain chest tube contents (air, blood, effusions). The first chamber is a collecting chamber. The second is the "water seal" chamber which acts as a one way valve. Air bubbling through the water seal chamber may indicate a pleural or system leak that should be evaluated critically. The third chamber is the suction control chamber. The height of the water in this chamber determines the negative pressure of the system. Bubbling should be kept a gentle bubble to limit evaporating the fluid. Increased wall suction does not increase the negative pressure of the system.
Naga Bonar
Naga Bonar adalah film komedi situasi yang mengambil latar peristiwa perjuangan rakyat Indonesia ketika sedang melawan penjajahan Belanda di daerah Sumatera Utara pada era kemerdekaan.
Sinopsis : Tokoh Naga Bonar (Deddy Mizwar), adalah seorang pencopet yang mendapatkan kesempatan menyebut dirinya seorang Jenderal di pasukan kemerdekaan Indonesia pada saat pasukan pendudukan Jepang mundur pada tahun 1945 dan Belanda berusaha kembali menguasai daerah yang ditinggalkan tersebut.
Pada awalnya Naga Bonar melakukan ini hanya sekedar untuk mendapatkan kemewahan hidup sebagai seorang Jenderal, akan tetapi pada akhirnya dia menjadi tentara yang sesungguhnya, dan memimpin kemenangan Indonesia dalam peperangan.
Sumber : wikipedia and youtube
Naga bonar jadi 2
Ini adalah cuplikan dari film Naga Bonar jadi dua
Pemain :
Deddy Mizwar
Tora Sudiro
Wulan Guritno. Lukman Sardi
Uli Herdiansyah
Sutradara :
Deddy Mizwar
Penulis :
Musfar Yasin
Sekuel dari film Naga Bonar (1987), berputar tentang hubungan Naga Bonar (Deddy Mizwar) dan putranya, Bonaga (Tora Sudiro) dalam suasana kehidupan anak muda metropolis. Untuk memulai bisnis, Bonaga berniat menjual tanah milik ayahnya yang disana terletak kuburan keluarga Naga Bonar. Akhirnya timbul konflik perbedaan nilai diantara mereka
Pemain :
Deddy Mizwar
Tora Sudiro
Wulan Guritno. Lukman Sardi
Uli Herdiansyah
Sutradara :
Deddy Mizwar
Penulis :
Musfar Yasin
Sekuel dari film Naga Bonar (1987), berputar tentang hubungan Naga Bonar (Deddy Mizwar) dan putranya, Bonaga (Tora Sudiro) dalam suasana kehidupan anak muda metropolis. Untuk memulai bisnis, Bonaga berniat menjual tanah milik ayahnya yang disana terletak kuburan keluarga Naga Bonar. Akhirnya timbul konflik perbedaan nilai diantara mereka
Fly me to the moon
F
ly me to the moon
And let me play among the stars
Let me see what spring is like
On Jupiter and Mars
In other words hold my hand
In other words darling kiss me
Fill my life with song
And let me sing forevermore
You are all I hope for
All I worship and adore
In other words please be true
In other words I love you
repeat 2nd verse, then repeat 1st verse
ly me to the moon
And let me play among the stars
Let me see what spring is like
On Jupiter and Mars
In other words hold my hand
In other words darling kiss me
Fill my life with song
And let me sing forevermore
You are all I hope for
All I worship and adore
In other words please be true
In other words I love you
repeat 2nd verse, then repeat 1st verse
Pemasangan catheter pada vena femoralis
Dalam video ini akan ditunjukkan langkah demi langkah dalam melakukan pemasangan kateter vena,pada vena femoralis.
Untuk lebih lengkapnya silahkan baca kutipan saya berikut ini :
Femoral venous catheterization is a rapid way to obtain intravenous access in hospitalized or emergency department patients. In this video, you will learn how to safely place a femoral line. Placement of a femoral line may be indicated in the following situations: to obtain vascular access when peripheral access cannot be accomplished, to administer hemodialysis when access at a preferable site is not an option, to perform cardiac catheterization, or to administer large or caustic infusions. The following situations are relative contraindications: an uncooporative patient; the presence of infection, trauma, or distorted anatomy at the insertion site.
Chapters from this video that's:
Overview
Indications
Contraindications
Consent and Checklist
Equipment
Anatomy
Preparation
Ultrasound Guidance
Placing the Catheter
Troubleshooting
Complications
Here the Video
Dead Center: Behind the Scenes at...
B
ook Description:
A city with eight million people has eight million ways to die
For fifteen years, Shiya Ribowsky worked as a medicolegal investigator in New York City's medical examiner's office—the largest, most sophisticated organization of its kind in the world. Utilizing his background in medicine, he led the investigations of more than eight thousand individual deaths, becoming a key figure in some of New York's most bizarre death cases and eventually taking charge of the largest forensic investigation ever attempted: identifying the dead in the aftermath of the September 11 tragedies.
Now, in this mesmerizing book, Ribowsky pulls back the curtain on the New York City's medical examiner's office, giving an enthralling, never-before-seen glimpse into death and the city. Born and raised in New York City's orthodox Jewish community, Ribowsky seems an unlikely candidate for this macabre profession. Nevertheless he has forsaken a promising career of medical work with the living, descending instead into the realm of the dead, enticed by the challenge of confronting death on a daily basis. Taking you through the vermin-infested Bowery flophouses and posh Upper East Side apartments of the city's dead, Ribowsky explores in gruesome detail the skeletons that hang in the Big Apple's closets. Combing through the autopsy room, he also exposes the grim secrets that only a scalpel and a dead body can tell and explains how forensic investigation does not merely solve crimes—it saves lives.
But it is in the aftermath of September 11 that the ME's office is handed its biggest challenge: to identify as many of the fallen as possible. With poignant descriptions, Ribowsky provides a dramatic account of the office's diligent and unflappable work with the families of the victims, helping them emerge from the ashes of this tragedy while displaying the strength, grit, intelligence, and compassion that Americans expect from true New Yorkers.
At once compelling and heartbreaking, Dead Center is a story of New York unlike any other, blending the haunting with the sublime, while painting a striking portrait of death (and life) in the city that never sleeps.
now u can look at here and
here
Video Cardiac Pulmunary Preassure
B agi kita orang Indonesia jarang ada pendidikan untuk masyarakat tentang melakukan pertolongan pertama untuk mengatasi henti jantung sederhana atau yang dalam bahasa medik Indonesia disebut dengan "Resusitasi jantung paru".
Padahal tindakan ini sangat penting dilakukan sebagai pertolongan pertama jika ada keluarga,teman,atau orang yang kita tidak kenal mendadak pingsan dan mengalami henti jantung.
Mengapa kita perlu melakukan tindakan ini adalah mencegah untuk kejadian fatal selanjutnya yaitu "Kematian" dan "Hilangnya aliran oksigen ke otak setelah 5 menit".
Nah karena itu saya mencoba memberi video manual melakukan tindakan ini,video ini merupakan gambaran untuk kita bila mendapat kejadian-kejadian diatas,walaupun untuk melakukan tindakan ini memerlukan pengalaman,dan syarat-syarat klinik yang lainnya.Tapi kalo tujuan nya hanya belajar dan mengetahui sepertinya tidak ada masalah,bagi yang ingin bertanya dan memberi masukan saya buka comment seluas-luasnya.
Mudah-mudahan bermanfaat video ini bagi kamu yang peduli akan tindakan pertolongan pertama
ini
Padahal tindakan ini sangat penting dilakukan sebagai pertolongan pertama jika ada keluarga,teman,atau orang yang kita tidak kenal mendadak pingsan dan mengalami henti jantung.
Mengapa kita perlu melakukan tindakan ini adalah mencegah untuk kejadian fatal selanjutnya yaitu "Kematian" dan "Hilangnya aliran oksigen ke otak setelah 5 menit".
Nah karena itu saya mencoba memberi video manual melakukan tindakan ini,video ini merupakan gambaran untuk kita bila mendapat kejadian-kejadian diatas,walaupun untuk melakukan tindakan ini memerlukan pengalaman,dan syarat-syarat klinik yang lainnya.Tapi kalo tujuan nya hanya belajar dan mengetahui sepertinya tidak ada masalah,bagi yang ingin bertanya dan memberi masukan saya buka comment seluas-luasnya.
Mudah-mudahan bermanfaat video ini bagi kamu yang peduli akan tindakan pertolongan pertama
ini
link nya