Kidney transplantation involves transplanting a kidney from a living or deceased donor to a patient with end-stage renal disease. It has become the preferred treatment for most patients with kidney failure as it allows patients to avoid dialysis and improve their quality of life. The success rate is highest for transplants from living donors who are closely matched. The procedure involves removing the patient's native kidneys and surgically placing the donor kidney in the patient's body. Post-operative care focuses on monitoring for rejection and infection while the patient receives immunosuppressive drugs to prevent rejection of the new organ.
Presentation on utility of ultrasound in the arena of prehospital and retrieval medicine.
I intentionally strayed away from e-FAST & focussed more on the ongoing resuscitation of a medically shocked patient.
The presentation deals with the basics of pre anesthetic checkups, its only for the educations purpose!
Any kind of replication, modifications and republication is strictly prohibited.
All Rights reserved to the Author. 2016
The Midwest Stroke Action Alliance recently hosted a panel of health experts on the risks of venous thromboembolism (VTE which is commonly referred to as blood clots).
The health experts on the panel were:
- Mark J. Alberts, MD (Clinical Vice-Chair for Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center)
- Laurie Paletz, BSN, PHN, RN-BC (Stroke Program Coordinator, Cedars-Sinai Medical Center)
- Michael W. Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)
Stroke is a leading cause of death and disability in the U.S., with 800,000 cases occurring each year. Each year in the United States, an estimated 300,000 cases of VTE occur. Mortality can be as high as 3.8 percent in patients with deep vein thrombosis (DVT) and 38.9 percent in those with pulmonary embolism (PE). VTE is associated with a high risk of death in the U.S. and Europe, with an estimated incidence rate of 1 in 1,000 patients. VTE is particularly common after a stroke. Approximately 20 percent of hospitalized immobile stroke patients will develop DVT, and 10 percent a PE.
Preanesthetic evaluation of patients in oral and maxillofacial surgeryPunam Nagargoje
The word is derived from the Greek words an, which means “without” and aithesia which means “feeling”
The use of medical anesthesia was first reported in 1846
The development of anesthesia has made today’s modern surgical techniques possible
• Basic Principles of Anesthesia
• “Triad of General Anesthesia”
need for unconsciousness
need for analgesia
need for muscle relaxation and loss of reflexes
• Preoperative Evaluation
• The preanesthetic evaluation has specific objectives including:
- Establishing a doctor-patient relationship,
- Becoming familiar with the surgical illness and
- coexisting medical conditions,
- Anticipating potential complication
Developing a management strategy for perioperative anesthetic care,
- Obtaining informed consent for the anesthetic plan.
The overall goals of the preoperative assessment are to reduce perioperative morbidity and mortality and to allay patient anxiety.
• Pre-operative
This applied both in evaluation & investigations
• General
This include the following:
1-General condition of the patient.
2-Psychological condition. ( Specially in major operations).
• Specific
This include the following:
1-Related to anaesthesia.
2-Related to the surgery.
• Medical History
1. Review the chart
2. Review previous records
3. Interview the patient
• Demographic Data
Height / weight
Vital signs
Diagnosis
History and Physical Exam
Note any abnormalities
Don’t assume that all problems are listed
• Steps of the preoperative visit :
• Preoperative testing should be performed on a selective basis for purposes of guiding or optimizing perioperative management.
• Pre-op Testing Schema Example
• Preoperative Laboratory Testing:
• only if indicated from the preoperative history and physical examination.
• "Routine or standing" pre operative tests should be discouraged
• -CBC anticipated significant blood loss, suspected hematological disorder (eg.anemia, thalassemia, SCD), or recent chemotherapy.
• -Electrolytes diuretics, chemotherapy, renal or adrenal disorders
• -ECG age >50 yrs ,history of cardiac disease, hypertension, peripheral vascular disease, DM, renal, thyroid or metabolic disease.
• -Chest X-rays prior cardiothoracic procedures ,COPD, asthma, a change in respiratory symptoms in the past six months.
• -Urine analysis DM, renal disease or recent UTI.
• -tests for different systems according to history and examination
• Disease-based indications
Alcohol abuse
CBC, ECG, lytes, LFTs, PT
Anemia
CBC
Bleeding disorder
CBC, LFTs, PT, PTT
Cardiovascular
CBC, creatinine, CXR, ECG, lytes
• Disease-based indications
Cerebrovascular disease
Creatinine, glucose, ECG
Diabetes
Creatinine, electrolytes, glucose, ECG
Hepatic disease
CBC, creatinine, lytes, LFTs, PT
• Disease-based indications
Pregnancy (controversial)
Serum B-hCG- 7 days, Upreg 3 days
Pulmonary disease
CBC, ECG, CXR
Renal disease
CBC, Cr, lytes, ECG
RA
CBC, ECG, CX
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
1. KIDNEY T
RANSPLANTATION
Presented by----
Mrs. Usha Rani Kandula,
MSc.Nursing, Assistant professor,
Department of Adult Health Nursing,
College of Health Sciences,
Arsi University, Asella, Ethiopia.
7. REASONS OF KIDNEY TRANSPLANT
-the desire to avoid dialysis or
- to improve their sense of well-being and
- the wish to lead a more normal life.
8. -Additionally,
-the cost of maintaining a successful
transplantation is one-third the cost of
treating a dialysis patient.
9. definition of kidney transplantation
-Kidney transplantation
-transplanting a kidney from a living donor or
human cadaver
-to a recipient who has ESRD
(End stage renal disease/ CRF).
10. Compatible ABO and HLA
antigens
-Kidney transplants from well-matched living
donors who are related to the patient are
slightly more successful than those from
cadaver donors.
(those with compatible ABO and HLA
antigens)
ABO- Blood grouping
HLA- Human leukocyte antigen
11. PROCEDURE
-The success rate increases if kidney
transplantation from a living donor is
performed before dialysis is initiated.
12. Nephrectomy of the patient’s
-A nephrectomy of the patient’s own native
kidneys may be performed before
transplantation.
13. Placement of new kidney
The transplanted kidney is placed in the
patient’s iliac fossa anterior to the iliac
crest.
14. - The ureter of the newly transplanted kidney
is transplanted into the bladder or
anastomosed to the ureter of the recipient.
18. Conducting investigations
- Tissue typing,
- Blood typing,
- Antibody screening
- to determine compatibility of the tissues
and cells of the donor and recipient.
19. -Completion of other diagnostic tests.
-Assessment of lower urinary tract.
- psychosocial evaluation of the patient.
22. Immunosuppressant agents
-immunosuppressant agents such as
• Azathioprine (imuran),
• Corticosteroids (prednisone),
• Cyclosporine, and OKT-3
• (a monoclonal antibody).
Note:Minimising the doses of
immunosuppressant agents.
23. POSTOPERATIVE NURSING MANAGEMENT
-ASSESSING THE PATIENT FOR TRANSPLANT
REJECTION
-oliguria,
-edema,
-fever,
-increasing blood pressure,
-weight gain,
-swelling or tenderness over the transplanted kidney or graft.
24. Monitoring of blood reports
-blood chemistry tests (BUN and
creatinine)
- leukocyte and platelet counts
Note: Immunosuppression depresses the
formation of leukocytes and platelets.
25. Clinical manifestations of
infection
-Clinical manifestations of infection include
• shaking chills,
• fever,
• rapid heartbeat and respirations
(tachycardia and tachypnea),
• and either an increase or a decrease in
WBCs (leukocytosis or leukopenia).
26. Nursing care
-Monitoring for infection.
-Following aseptic measures while caring
patient.
-Performance of Urine c/s frequently
-Observing wound drainage.
-providing catheter care.
-Minimize hospital/ patient visitors
- Monitoring urinary functioning
27. -Care of patient under haemodialysis.
-Monitoring patient fluid and electrolyte status.
-Assessment of urinary drainage.
-Monitoring intake and output of the patient.
-Checking vital signs.
-Administration of intravenous medications.
-Identifying psychological status of the patient.
-Monitoring and managing potential
complications.
28. -Educating regarding physical exercises.
-Education regarding home and continuous
care.
-Understanding anxiety level of the patient.
37. Left to right:
A, 2 jeweler’s forceps, and tip;
B, 2 Adson tissue forceps with teeth (1 ×
2), and tip;
C, 2 Gerald-DeBakey tissue forceps, 7
inch, and tip;
D, 2 microdiamond dust ring forceps, 7
inch, and tip.
38.
39.
40. Left to right:
A, 2 Autraugrip tissue forceps, titanium,
and tips;
B, 1 Kay aortic clamp, and tip;
C, 2 Cushing vein retractors, and tips;
D, 1 nerve hook, dull, and tip;
E, 1 bulldog clamp applier, and tip;
F, 1 Lahey gall duct forceps, and tip.
41.
42.
43.
44. Left center and clockwise:
-A, 1 Backhaus towel clip;
-B, 4 Hartmann mosquito forceps, curved,
and tip;
-C, 2 microdiamond dust needle holders, 6 1/4
inch, and tip;
-D, 2 Fell carbon inlay needle holders,
6 inch, and tip.