فيديوهات لtechniques في الDRcABCDE Approach 👇 :

📌 Cervical stability:

     📍Neck collar:
https://youtu.be/hHHy1mc7sqY
---------------------------------------------------

📌 Airway:

     📍Head tilt- Chin lift, Jaw
       thrust maneuvers:
https://youtu.be/5iwogajl-n8

     📍Oropharyngeal airway:
https://youtu.be/Hzc_T4QBp4E

     📍Nasopharyngeal airway:
https://youtu.be/gVgAlWRCZBs
https://youtu.be/f_kUeNjRw28

     📍Endotracheal intubation:
https://youtu.be/pXjyeHMYqUI
---------------------------------------------------

📌 Breathing:

     📍Respiratory distress:
https://youtu.be/5OR-0zuw9v0

     📍Needle decompression of
         Tension Pneumothorax:
https://youtu.be/2eZnT3V6cT8
---------------------------------------------------

📌 Circulation:

     📍Capillary Refill Time:
https://youtu.be/EwaDSZRH1LE

     📍IV Cannula insertion:
https://youtu.be/xnzUdr3c6wE

     📍 Urinary Catheterization:
https://youtu.be/XcU6g_ppWRI
https://youtu.be/Stc5mzIFJBY

     📍Applying Torniquet:
https://youtu.be/BVij7f6Brgo
---------------------------------------------------

📌 Disability:
    
    📍How to measure GCS:
https://youtu.be/vxOpsig-ft0

    📍Pupil examination:
https://youtu.be/ROEiGc_j2u4

    📍Neurological examination:
https://youtu.be/vZBpNsFPJVQ

📌 Videos for Hand Skills👇

📍How to insert a cannula (in    
     Arabic):

https://youtu.be/_XhDMtTQruI?si=mnBNQ6SNjPgaFG98
---------------------------------------------------

📍How to insert a urinary
     catheter:

👉 Male (in Arabic):
https://youtu.be/YnjAXc7B2mA?si=3wHW1AdfAh1s-SMH

👉 Female (in Arabic):
https://youtu.be/VAwKWqJSXjw?si=oxb0H_Sx4K66TYtk
---------------------------------------------------

📍How to take ABG (in Arabic):
    
https://youtu.be/MhCrMhQFNIo?si=2SuU5ASrCMnLuIg3

https://youtu.be/narqCoAlSWk?si=Cn9x3fHA52Wl2OCI
---------------------------------------------------

📍How to insert a Ryle or NGT
    (in Arabic):

https://youtu.be/SfiuYrFySUA?si=KEFQB-lm2AV4E3md

https://youtu.be/CQjTE72rOxk?si=W3Jnv2tDkKSsQUjH
---------------------------------------------------

📍How to insert an
     Endotracheal tube:

https://youtu.be/pXjyeHMYqUI?si=5NqNl18agzkW9U33
----------------------------------------------------

📌 Twist Score For Testicular Torsion

✅ Interpretation :

< 0–2 points: Low risk – torsion unlikely.

3–4 points: Intermediate risk – consider ultrasound.

5–7 points: High risk – immediate surgical intervention recommended.

#clinical
@Surgery_Practice

✅ هدية لزملاءنا اللي بيدرسوا جراحة 🤩🔥

بعدما تكمل اي شابتر بالجراحة كن ادخل واتناقش مع مرجع بيلي اند لاف رأساً 😁😂🏃‍♂

https://chatgpt.com/g/g-67f993f6c17881918e5df1842404d791-bailey-and-love


✅ هدية لزملائنا اللي بيدرسوا باطنة  🤩🔥

بعدما تكمل اي شابتر بالباطنة كن ادخل واتناقش مع مرجع دافيدسون رأساً 😁😂🏃‍♂

https://chatgpt.com/g/g-68090185b8a08191bff1b1e03d9c87ed-davidson-s-of-medicine-24th


✅ هدية لزملائنا اللي بيدرسوا نسائية 🤩🔥

بعدما تكمل اي شابتر بالنسائية كن ادخل واتناقش مع مرجع تين تيتشر رأساً 😁😂🏃‍♂
Chat GPT Gyn

https://chatgpt.com/g/g-681f83694f80819183fed44e8e4d31b9-gynaecology-by-ten-teachers

✅ هدية لزملاءنا اللي بيدرسوا توليد 🤩🔥

بعدما تكمل اي شابتر بالتوليد obs كن ادخل واتناقش مع مرجع تين تيتشر رأساً 😁😂🏃‍♂

Chat GPT Obstetrics

https://chatgpt.com/g/g-682f1ca961f481918e445642944a5672-obstetricspartner

https://t.me/M_Information11

🗯 Paralytic ileus :
failure of trans mission of peristaltic waves secondary to neuromuscular failure.  

♦️Causes:

🔹Postoperative : within 24 - 72 hours , if prolonged means there is hypo- proteinemia.  

🔹Infection: intra-abdominal sepsis  

🔹Reflex ileus: this may occur following fractures of the spine or ribs, retroperitoneal haemorrhage  

🔹Metabolic: uraemia and hypokalaemia  

♦️Clinical features  :
Paralytic ileus takes on a clinical signifcance if, 72 hours after laparotomy: 

● there has been no return of bowel sounds on auscultation.
● there has been no passage of fatus.

❗️Abdominal distension becomes more marked and tympanitic.  

❌ Colicky pain is not a feature. 

❗️Distension increases pain from the abdominal wound.  

♦️Management  :
❗️Nasogastric tubes are not required routinely after elective intra-abdominal surgery.  

🔹nasogastric suction

🔹 restriction of oral intake until bowel sounds and the passage of flatus return.  

🔹Electrolyte balance.  

❗️The need for a laparotomy becomes increasingly likely the longer the bowel inactivity persists, particularly if it lasts for more than 7 days or if bowel activity recommences following surgery and then ceases.

#Git #surgery   
https://t.me/M_Information11

✅ Thyroid Diseases Guidelines

#clinical  #surgery
@M_Information11

▪︎Radiating pain: (ينتشر)

•Starts in one area of the body and spreads along the path of the nerve to the other areas supplied by the same nerve

•Herniated or bulging disc Pain start in the back and then progress to the legs (same nerve supply)


▪︎Referred pain:

•Pain felt at area not involved in the injury (Pain felt away from the real source) Because the sensory nerve fibres of these different areas meet at the same level in the spinal cord

•Pain of MI felt in the left side of neck, left shoulder, and back rather than in chest (chest is the real site of the injury)


▪︎Migratory (Shifting) pain :

•Pain starts at site Generalized not specific due to stimulation of the Visceral afferent fibers then shifted to the injury site to become localized after stiumation of the Parietal (Somatic) Nerve Fibers and dissappear from the origin Site.

•During acute appendicitis the pain start at the para umbilical area then localized to the RLQ area

#clinical  #surgery
https://t.me/Surgery_Practice

❇️The 'safe triangle' for chest drain insertion

🔹bounded anteromedially by the lateral border of pectoralis major

🔹inferiorly by a horizontal line at the level of the nipples

🔹posteriorly by the anterior border of latissimus dorsi.

This area is 'safe' because it avoids damage to the chest wall muscles and breast.

#Drains
#Surgery_rotation
https://t.me/Surgery_Practice

❇️Truma Basics

💢History of trauma

1. Cognitive function: ask who they are, where they live and their occupation.

2. History of the accident: ask the patient what they remember of the accident, and useful if they can describe what happened.


•Type of the Accident

🔹Gunshot:

▪︎Type of machine: low velocity (pistol), high velocity (gun)

▪︎Number of bullets

▪︎Distance from shooter

▪︎Site of inlet and outlet


🔹Road traffic accident:

▪︎Was he the walker (on the street, sidewalk),

▪︎driver, passenger (front or back seats)

▪︎protection (seat belts, airbags)

▪︎Others in accident: injured, dead.

▪︎Type of car and its speed (low or high velocity)

▪︎Damage to the vehicle: collision, rolling


🔹Fall from a height:

▪︎Height of fall

▪︎Did the patient hit anything on his way?

▪︎What position was the body at time of impact?


3. Walking after accident: to exclude pelvic and lower limb injuries.

4. Associated symptoms: Loss of consciousness, bleeding, vomiting, urination, cough, dyspnea .

5. Transportation: car, ambulance

6. The distance of the hospital

7. What resuscitation and procedures done? What organs was damaged.

#clinical  #surgery
https://t.me/Surgery_Practice

💢A Airway

🔹airway may be compromised due to:

▪︎Blood or swelling in the airway

▪︎Vomit or secretions

▪︎Reduced consciousness


🔹Clinical assessment

▪︎Can the patient talk? 

•Yes ➡️ Patent Airway
•No ➡️ Check Airway 👇

1) Look for signs of airway compromise:
•cyanosis
•see-saw breathing
•use of accessory muscles
•diminished breath sounds
•added sounds (Stridor)

2) Open the mouth and inspect: look for anything obstructing the airway such as secretions or a foreign object

3) Interventions

▪︎Head-tilt chin-lift manoeuvre
•If No Spine Injury
•Push head to the back
•Pull chin Downward

▪︎Jaw thrust Maneuver
•If there is Spine Injury

▪︎Oropharyngeal Tube
▪︎Nasopharyngeal Tube

#clinical  #surgery
https://t.me/Surgery_Practice

💢B Breathing

▪︎Check the patient’s respiratory rate
▪︎Check the patient’s oxygen saturations

▪︎Look for signs of 
•cyanosis
•respiratory distress
•use of accessory muscles
•abnormal breathing patterns

▪︎Assess for equal chest expansion with respiration and for any obvious chest wall trauma.

▪︎Palpate the position of the patient’s trachea

▪︎Assess for any chest wall tenderness

▪︎Auscultate both lungs for
•good air entry throughout the chest
•added sounds such as crackles and wheeze

#clinical  #surgery
https://t.me/Surgery_Practice

💢C Circulation

▪︎Check the patient’s heart rate & blood pressure

▪︎Assess temperature:
•the hands should be symmetrically warm, indicating adequate perfusion.

•Cool hands indicate poor peripheral perfusion (e.g. hypovolaemic shock).

•Pallor or mottled skin: commonly associated with hypovolaemic shock (e.g. haemorrhage)

▪︎Measure capillary refill time (CRT):
•should return to its normal colour in less than two seconds

▪︎Assess the patient’s radial and brachial pulse to assess rate, rhythm, volume and character

▪︎Auscultate the patient’s precordium to assess heart sounds, listening for evidence of murmurs.

#clinical  #surgery
https://t.me/Surgery_Practice

💢D Disability

▪︎Assess the patient’s level of consciousness by using the Glasgow Coma Scale (GCS).


▪︎Assess if the patient is orientated to person, place and time.


▪︎Assess the patient’s pupils:

•Assess the size and shape of the patient’s pupils.

•A normal pupil diameter ranges from two to five millimetres.

•Assess the pupils for both direct and consensual response to light using a pen torch.

•An oval-shaped pupil, sluggish reaction to light, “blown pupil” or deviated pupil suggests raised ICP or herniation.

•Bilaterally small or “pinpoint” pupils may be due to opioid toxicity.


▪︎Perform a neurological examination in patients who are able to follow commands, assessing:

•Cranial nerves

•Power in each limb

•Sensation in each limb

•Cerebellar function

#clinical  #surgery
https://t.me/Surgery_Practice

❇️Clinical features of raised ICP

▪︎Headache

▪︎Nausea and vomiting

▪︎Restlessness, agitation or drowsiness

▪︎Slow slurred speech

▪︎Papilloedema

▪︎Ipsilateral sluggish dilated pupil which then becomes fixed (“blown pupil”)

▪︎Cranial nerve palsy (e.g. CN III palsy with ‘down and out’ pupil)

▪︎Seizures

▪︎Reduced GCS

▪︎Abnormal respiratory pattern

▪︎Abnormal posturing, initially decorticate and then decerebrate

▪︎hypertension

▪︎bradycardia

#clinical  #surgery
https://t.me/Surgery_Practice