This document describes the concept of a "Spa Hospital" where patients receive a more relaxing and comforting experience compared to a traditional hospital. Some key aspects of the Spa Hospital model include using aromatherapy, music, touch therapies, environmental controls like lighting and plants, and focusing on customer service and patient satisfaction. The goal is to reduce patient anxiety and pain while enhancing staff satisfaction through a more holistic approach to care.
Diverticulitis: Popular Misconceptions and New ManagementPatricia Raymond
Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
Hospitals have become unfriendly places for patients to be in…rushed, harried staff simply doesn’t have the time to provide the personal touch anymore…or can we? Delighted patients refer their friends and return for repeat procedures.
The ‘Spa Hospital’ addresses our patients’ needs with low or no cost techniques adapted from those used at spas. Attention will also be given to reception and departure from unit, patient privacy concerns, and their lasting impression with reviews of medical literature supporting these techniques.
This document discusses strategies for maintaining sanity and reducing compassion fatigue in healthcare professionals. It recommends triaging one's professional life by seeking clinical satisfaction, developing a healthy work environment, and finding ways to contribute beyond usual duties. It also stresses the importance of loving one's family by prioritizing time with them, getting finances in order, and seeking help for substance abuse issues. Maintaining personal health and laughter is covered, emphasizing exercise, nutrition, sleep, meditation and using humor. Implementing these self-care strategies can help prevent burnout.
Opiates are narcotics derived from the poppy plant that are used to relieve pain and suppress coughing. They work by binding to opioid receptors in the brain and body. This can activate the brain's reward pathway and reduce the perception of pain. However, repeated opiate use often leads to tolerance, physical dependence, and addiction through changes in the brain. Effective treatment for opiate addiction uses both behavioral therapies and pharmacological options like methadone, buprenorphine, and naltrexone to manage withdrawal symptoms and cravings while helping people regain control of their lives.
The document provides guidance on caring for dying patients. It discusses recognizing hope at end-of-life, assessing patients, and managing common symptoms in the last months, weeks, days, and hours of life such as pain, breathing issues, nausea, secretions, and psychological concerns. Effective care involves addressing the patient's symptoms, needs, and goals through both medical management and comforting the patient and family.
Long Island Periodontist presents "The Art and Science of the Painless Dental...Edward Brant DDS, MS
Periodontist who does his best when he provides Long Island with treatment for tooth and gum disease. Dentist, dental implants, laser gum treatment for periodontal disease, bone graft, gum surgery.
Explanation of how to give dental injections without causing the patient pain.
This document contains information about a newsletter called "Rx for Sanity" that provides medical humor, stories, and tips for healthcare workers. It aims to help people love their career in healthcare. The newsletter is free and delivered by email twice monthly. It also contains information about workshops and presentations on improving relationships and civility in healthcare settings.
This document provides information on bipolar disorder including:
- The prevalence of bipolar disorder is estimated to be around 2% of the population.
- Common comorbid disorders include substance abuse, narcissistic personality disorder, and borderline personality disorder.
- Treatment options include mood stabilizers, antipsychotics, antidepressants, psychotherapy, and lifestyle changes. Lithium, carbamazepine, and valproate are commonly used mood stabilizers.
Diverticulitis: Popular Misconceptions and New ManagementPatricia Raymond
Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
Hospitals have become unfriendly places for patients to be in…rushed, harried staff simply doesn’t have the time to provide the personal touch anymore…or can we? Delighted patients refer their friends and return for repeat procedures.
The ‘Spa Hospital’ addresses our patients’ needs with low or no cost techniques adapted from those used at spas. Attention will also be given to reception and departure from unit, patient privacy concerns, and their lasting impression with reviews of medical literature supporting these techniques.
This document discusses strategies for maintaining sanity and reducing compassion fatigue in healthcare professionals. It recommends triaging one's professional life by seeking clinical satisfaction, developing a healthy work environment, and finding ways to contribute beyond usual duties. It also stresses the importance of loving one's family by prioritizing time with them, getting finances in order, and seeking help for substance abuse issues. Maintaining personal health and laughter is covered, emphasizing exercise, nutrition, sleep, meditation and using humor. Implementing these self-care strategies can help prevent burnout.
Opiates are narcotics derived from the poppy plant that are used to relieve pain and suppress coughing. They work by binding to opioid receptors in the brain and body. This can activate the brain's reward pathway and reduce the perception of pain. However, repeated opiate use often leads to tolerance, physical dependence, and addiction through changes in the brain. Effective treatment for opiate addiction uses both behavioral therapies and pharmacological options like methadone, buprenorphine, and naltrexone to manage withdrawal symptoms and cravings while helping people regain control of their lives.
The document provides guidance on caring for dying patients. It discusses recognizing hope at end-of-life, assessing patients, and managing common symptoms in the last months, weeks, days, and hours of life such as pain, breathing issues, nausea, secretions, and psychological concerns. Effective care involves addressing the patient's symptoms, needs, and goals through both medical management and comforting the patient and family.
Long Island Periodontist presents "The Art and Science of the Painless Dental...Edward Brant DDS, MS
Periodontist who does his best when he provides Long Island with treatment for tooth and gum disease. Dentist, dental implants, laser gum treatment for periodontal disease, bone graft, gum surgery.
Explanation of how to give dental injections without causing the patient pain.
This document contains information about a newsletter called "Rx for Sanity" that provides medical humor, stories, and tips for healthcare workers. It aims to help people love their career in healthcare. The newsletter is free and delivered by email twice monthly. It also contains information about workshops and presentations on improving relationships and civility in healthcare settings.
This document provides information on bipolar disorder including:
- The prevalence of bipolar disorder is estimated to be around 2% of the population.
- Common comorbid disorders include substance abuse, narcissistic personality disorder, and borderline personality disorder.
- Treatment options include mood stabilizers, antipsychotics, antidepressants, psychotherapy, and lifestyle changes. Lithium, carbamazepine, and valproate are commonly used mood stabilizers.
2014 0503-2 sound and silence national council of acoustical consultantscamainc
The document summarizes research on noise levels in hospitals and their effects. It finds that hospital background noise often exceeds recommended levels, with common sources being staff voices, alarms, equipment. This noise disrupts patient sleep, increases stress, hinders communication and lowers satisfaction. High noise levels can also cause nurse burnout and medical errors. Design interventions discussed include creating a quiet culture, eliminating noise sources, using private patient rooms, and adding sound absorbing materials.
This document discusses restful sleep and sleep disorders. It notes that over 50 million Americans suffer from sleep or circadian disorders. Common disorders include obstructive sleep apnea, restless leg syndrome, insomnia, and circadian rhythm disorders related to shift work. Treatments discussed include sleep medications, herbal remedies, light therapy, behavioral changes, and addressing any underlying medical or psychological conditions. The document emphasizes creating a restful pre-bedtime routine and environment to promote better sleep.
Street drugs-down-and-dirty-1210047566000870-9latoyag06
This document provides information about street drugs and drug use culture. It begins with objectives to introduce drug culture and review heroin, oxycontin, MDMA, PMA, DXM, and GHB. It then discusses elements of rave culture like music, lights, and sensory enhancement techniques. Descriptions of drug paraphernalia and effects are included. Harm reduction resources are mentioned. Medical concerns at raves and with drug overdoses are outlined. Methods of use and effects of opioids and MDMA/PMA are summarized.
Street drugs-down-and-dirty-1210047566000870-9latoyag06
This document provides a summary of street drugs including heroin, oxycontin, MDMA, PMA, DXM, and GHB. It discusses how each drug is used, common signs and symptoms of intoxication and overdose, and recommendations for treatment. The goal is to provide first responders with essential information about the drug culture and how to assess and manage patients under the influence of these substances.
Jan English-Lueck at Consumer Centric Health, Models for Change '11HealthInnoventions
Small Experiments: Tinkering with Well-being
Jan English Lueck, San Jose State University.
Understanding People in Their Contexts. Ethnographic studies of people managing their own health.
This document contains information from a lecture on pain and pain control in endodontics given by Dr. Ashraf Refai. It defines pain, discusses the neurophysiology and process of pain, and notes that endodontic procedures can cause pain at different stages. It provides tips for atraumatic local anesthesia and discusses various local anesthesia techniques. It also addresses analgesic drugs for post-operative pain control, including non-narcotic drugs like NSAIDs and acetaminophen, as well as the potential use of hypnosis in endodontics.
This document summarizes a study on Biotouch, an energy therapy involving light touch. The study aimed to clinically integrate Biotouch and evaluate its effects. Women received weekly Biotouch sessions for 8 weeks and completed quality of life surveys before, during and after treatment. Results found that Biotouch significantly improved scores on domains measuring bodily pain, social functioning, vitality, general health and mental health. Biotouch was replicated in a clinical setting without adverse effects and showed sustained benefits for over 4 weeks after treatment. The study provides preliminary evidence that Biotouch may enhance quality of life.
The document discusses the importance of patient experience and satisfaction in healthcare. It emphasizes that soft skills are as important as clinical skills for doctors and staff. Treating patients with empathy, respect and going the extra mile can help build loyalty and referrals. Complaints from unhappy patients can negatively impact a practice. The document provides many tips for clinics such as minimizing wait times, greeting patients with a smile, addressing complaints effectively and gathering feedback to improve.
The document discusses the importance of patient experience and satisfaction in healthcare. It provides tips for medical clinics to improve patient engagement, such as treating patients with respect, improving soft skills, managing patient expectations, soliciting feedback, handling complaints effectively, and focusing on patient-centered care. The overall message is that prioritizing patient experience leads to better clinical outcomes, fewer errors, higher compliance rates, and a more profitable practice.
Management of Progressive Ataxia - Dr John EalingAtaxia UK
This presentation was given by Dr John Ealing, Consultant neurologist at Salford Royal NHS Foundation Trust, at the Care of Ataxia Patients (COAP) Study Day in Manchester on 18 November 2011. It summarises the symptoms and management of the progressive ataxias and briefly outlines specific therapies.
A 74-year-old female presented with a chief complaint of fractured teeth, tongue, and cheek from biting during sleep. She has a history of medical issues including arrhythmias and sinus issues. A home sleep study found severe obstructive sleep apnea in REM sleep and mild apnea in NREM sleep. CBCT imaging showed airway limitation in the retro-glossal region. The patient wishes to try oral appliance therapy along with weight loss and improved sleep hygiene, with follow up sleep study in 6 weeks, and is open to CPAP if needed. The dentist reviewed management options and bite registration models.
Direct Nerve Stimulation Slides from Webinar June 2015Jennifer French
Splashed on the media headlines are case studies of people benefiting from epidural stimulation after paralysis or using vagus nerve stimulation as a rehabilitation tool after a paralyzing stroke. How do you make sense of it all? This webinar will introduce the latest technology applications and the published research supporting or negating them. Take away what you need to know to make an informed decision.
Australian civilian hospital nurses' lived experience of the out-of-hospital ...Jamie Ranse
Ranse J, Arbon P, Cusack L, Shaban R. (2017) Australian civilian hospital nurses' lived experience of the out-of-hospital environment following a disaster: A lived-space perspective; paper presented at the 17th WADEM Congress on Disaster and Emergency Medicine. Toronto, Canada 25th April.
The document provides extensive guidance for planning a spay/neuter clinic in a community, including:
1) Outlining steps before the clinic such as notifying agencies, obtaining permits, assessing animal populations, recruiting volunteers, and conducting community outreach and fundraising.
2) Discussing logistical considerations like ensuring access for low-income groups, managing stray/feral animals, collecting data, and euthanasia protocols.
3) Detailing clinic requirements like necessary facilities, equipment, supplies, paperwork and having separate areas for intake, prep, surgery, recovery and exams.
In this talk about integrative medicine, I outline the need to teach clinicians - doctors, nurses, holistic healers, psychologists, naturopaths, etc. - about deep healing. We are taught to deconstruct the human into anatomic parts, cells, physiology in order to cure. But to heal, we need to help a person reintegrate all those parts - and rediscover themselves - as a person with family, hopes, dreams, beliefs, culture, tradition, hobbies.
We seek healthcare not for the experience of healthcare, but because the process helps us live more fully, and enjoy the things we love. This reintegration can happen at any stage of life and illness. It is holism. It is deep healing.
The document describes a case study of a 6-year-old quarter horse gelding that was found with a large wound on its right hind leg, believed to be caused by an injury on a fence. The veterinarian evaluates the wound, determines it does not involve any joints, debrides and sutures it closed. The veterinarian then provides aftercare recommendations including bandaging, antibiotics, and exercise restrictions to promote healing of the serious wound.
This document outlines the nursing process for sedative-hypnotic therapy. It includes assessing sleep patterns, vital signs, and anxiety levels. Nursing diagnoses could include disturbed sleep pattern, readiness for enhanced sleep, or risk for injury. The planning process involves scheduling assessments, monitoring for side effects, and ensuring a safe environment. Implementation involves giving medications as prescribed and monitoring therapeutic and adverse effects. Patient education focuses on establishing routines, managing nutrition, exercise, stress, and environmental factors to promote healthy sleep. Common sedative-hypnotic medications are listed.
Session C - The use of self as a guide to sensitive and compassionate communi...JaspreetBhogal
This document discusses the importance of compassion in healthcare interactions. It defines compassion and explores how stress can negatively impact compassion for both patients and healthcare providers. The role of self-awareness and mindfulness are examined as ways to mitigate stress and practice compassion even during difficult interactions. Active listening is also discussed as a way to understand patients' experiences without judgment and show compassion.
1) The patient, a 40-year old, reported a slowly growing hard swelling on the posterior mandible where a wisdom tooth is missing.
2) To manage the patient, the doctor will take a history, examine clinically and radiographically, consider differential diagnoses, make a diagnosis, discuss treatment options including enucleation or marsupialization, and follow up after treatment.
3) Key considerations include the cystic nature suggested by slow growth, missing tooth suggestive of a dentigerous cyst, and treatments aimed at complete removal while minimizing morbidity.
Holistic Management as an Adjunct in IBD: Encourage your patient to own the...Patricia Raymond
The document discusses the potential for holistic management approaches as adjunct treatments for inflammatory bowel disease (IBD). It provides information on several ways patients can self-monitor their disease activity through indices like CDAI, UCDAI, and P-SCCAI. It also reviews evidence on the role of vitamin D supplementation, dietary changes, cannabis use, and lifestyle factors like exercise and meditation in managing IBD symptoms. While some studies found improvements in outcomes from these approaches, the evidence has limitations and their long-term impact requires more research.
2014 0503-2 sound and silence national council of acoustical consultantscamainc
The document summarizes research on noise levels in hospitals and their effects. It finds that hospital background noise often exceeds recommended levels, with common sources being staff voices, alarms, equipment. This noise disrupts patient sleep, increases stress, hinders communication and lowers satisfaction. High noise levels can also cause nurse burnout and medical errors. Design interventions discussed include creating a quiet culture, eliminating noise sources, using private patient rooms, and adding sound absorbing materials.
This document discusses restful sleep and sleep disorders. It notes that over 50 million Americans suffer from sleep or circadian disorders. Common disorders include obstructive sleep apnea, restless leg syndrome, insomnia, and circadian rhythm disorders related to shift work. Treatments discussed include sleep medications, herbal remedies, light therapy, behavioral changes, and addressing any underlying medical or psychological conditions. The document emphasizes creating a restful pre-bedtime routine and environment to promote better sleep.
Street drugs-down-and-dirty-1210047566000870-9latoyag06
This document provides information about street drugs and drug use culture. It begins with objectives to introduce drug culture and review heroin, oxycontin, MDMA, PMA, DXM, and GHB. It then discusses elements of rave culture like music, lights, and sensory enhancement techniques. Descriptions of drug paraphernalia and effects are included. Harm reduction resources are mentioned. Medical concerns at raves and with drug overdoses are outlined. Methods of use and effects of opioids and MDMA/PMA are summarized.
Street drugs-down-and-dirty-1210047566000870-9latoyag06
This document provides a summary of street drugs including heroin, oxycontin, MDMA, PMA, DXM, and GHB. It discusses how each drug is used, common signs and symptoms of intoxication and overdose, and recommendations for treatment. The goal is to provide first responders with essential information about the drug culture and how to assess and manage patients under the influence of these substances.
Jan English-Lueck at Consumer Centric Health, Models for Change '11HealthInnoventions
Small Experiments: Tinkering with Well-being
Jan English Lueck, San Jose State University.
Understanding People in Their Contexts. Ethnographic studies of people managing their own health.
This document contains information from a lecture on pain and pain control in endodontics given by Dr. Ashraf Refai. It defines pain, discusses the neurophysiology and process of pain, and notes that endodontic procedures can cause pain at different stages. It provides tips for atraumatic local anesthesia and discusses various local anesthesia techniques. It also addresses analgesic drugs for post-operative pain control, including non-narcotic drugs like NSAIDs and acetaminophen, as well as the potential use of hypnosis in endodontics.
This document summarizes a study on Biotouch, an energy therapy involving light touch. The study aimed to clinically integrate Biotouch and evaluate its effects. Women received weekly Biotouch sessions for 8 weeks and completed quality of life surveys before, during and after treatment. Results found that Biotouch significantly improved scores on domains measuring bodily pain, social functioning, vitality, general health and mental health. Biotouch was replicated in a clinical setting without adverse effects and showed sustained benefits for over 4 weeks after treatment. The study provides preliminary evidence that Biotouch may enhance quality of life.
The document discusses the importance of patient experience and satisfaction in healthcare. It emphasizes that soft skills are as important as clinical skills for doctors and staff. Treating patients with empathy, respect and going the extra mile can help build loyalty and referrals. Complaints from unhappy patients can negatively impact a practice. The document provides many tips for clinics such as minimizing wait times, greeting patients with a smile, addressing complaints effectively and gathering feedback to improve.
The document discusses the importance of patient experience and satisfaction in healthcare. It provides tips for medical clinics to improve patient engagement, such as treating patients with respect, improving soft skills, managing patient expectations, soliciting feedback, handling complaints effectively, and focusing on patient-centered care. The overall message is that prioritizing patient experience leads to better clinical outcomes, fewer errors, higher compliance rates, and a more profitable practice.
Management of Progressive Ataxia - Dr John EalingAtaxia UK
This presentation was given by Dr John Ealing, Consultant neurologist at Salford Royal NHS Foundation Trust, at the Care of Ataxia Patients (COAP) Study Day in Manchester on 18 November 2011. It summarises the symptoms and management of the progressive ataxias and briefly outlines specific therapies.
A 74-year-old female presented with a chief complaint of fractured teeth, tongue, and cheek from biting during sleep. She has a history of medical issues including arrhythmias and sinus issues. A home sleep study found severe obstructive sleep apnea in REM sleep and mild apnea in NREM sleep. CBCT imaging showed airway limitation in the retro-glossal region. The patient wishes to try oral appliance therapy along with weight loss and improved sleep hygiene, with follow up sleep study in 6 weeks, and is open to CPAP if needed. The dentist reviewed management options and bite registration models.
Direct Nerve Stimulation Slides from Webinar June 2015Jennifer French
Splashed on the media headlines are case studies of people benefiting from epidural stimulation after paralysis or using vagus nerve stimulation as a rehabilitation tool after a paralyzing stroke. How do you make sense of it all? This webinar will introduce the latest technology applications and the published research supporting or negating them. Take away what you need to know to make an informed decision.
Australian civilian hospital nurses' lived experience of the out-of-hospital ...Jamie Ranse
Ranse J, Arbon P, Cusack L, Shaban R. (2017) Australian civilian hospital nurses' lived experience of the out-of-hospital environment following a disaster: A lived-space perspective; paper presented at the 17th WADEM Congress on Disaster and Emergency Medicine. Toronto, Canada 25th April.
The document provides extensive guidance for planning a spay/neuter clinic in a community, including:
1) Outlining steps before the clinic such as notifying agencies, obtaining permits, assessing animal populations, recruiting volunteers, and conducting community outreach and fundraising.
2) Discussing logistical considerations like ensuring access for low-income groups, managing stray/feral animals, collecting data, and euthanasia protocols.
3) Detailing clinic requirements like necessary facilities, equipment, supplies, paperwork and having separate areas for intake, prep, surgery, recovery and exams.
In this talk about integrative medicine, I outline the need to teach clinicians - doctors, nurses, holistic healers, psychologists, naturopaths, etc. - about deep healing. We are taught to deconstruct the human into anatomic parts, cells, physiology in order to cure. But to heal, we need to help a person reintegrate all those parts - and rediscover themselves - as a person with family, hopes, dreams, beliefs, culture, tradition, hobbies.
We seek healthcare not for the experience of healthcare, but because the process helps us live more fully, and enjoy the things we love. This reintegration can happen at any stage of life and illness. It is holism. It is deep healing.
The document describes a case study of a 6-year-old quarter horse gelding that was found with a large wound on its right hind leg, believed to be caused by an injury on a fence. The veterinarian evaluates the wound, determines it does not involve any joints, debrides and sutures it closed. The veterinarian then provides aftercare recommendations including bandaging, antibiotics, and exercise restrictions to promote healing of the serious wound.
This document outlines the nursing process for sedative-hypnotic therapy. It includes assessing sleep patterns, vital signs, and anxiety levels. Nursing diagnoses could include disturbed sleep pattern, readiness for enhanced sleep, or risk for injury. The planning process involves scheduling assessments, monitoring for side effects, and ensuring a safe environment. Implementation involves giving medications as prescribed and monitoring therapeutic and adverse effects. Patient education focuses on establishing routines, managing nutrition, exercise, stress, and environmental factors to promote healthy sleep. Common sedative-hypnotic medications are listed.
Session C - The use of self as a guide to sensitive and compassionate communi...JaspreetBhogal
This document discusses the importance of compassion in healthcare interactions. It defines compassion and explores how stress can negatively impact compassion for both patients and healthcare providers. The role of self-awareness and mindfulness are examined as ways to mitigate stress and practice compassion even during difficult interactions. Active listening is also discussed as a way to understand patients' experiences without judgment and show compassion.
1) The patient, a 40-year old, reported a slowly growing hard swelling on the posterior mandible where a wisdom tooth is missing.
2) To manage the patient, the doctor will take a history, examine clinically and radiographically, consider differential diagnoses, make a diagnosis, discuss treatment options including enucleation or marsupialization, and follow up after treatment.
3) Key considerations include the cystic nature suggested by slow growth, missing tooth suggestive of a dentigerous cyst, and treatments aimed at complete removal while minimizing morbidity.
Holistic Management as an Adjunct in IBD: Encourage your patient to own the...Patricia Raymond
The document discusses the potential for holistic management approaches as adjunct treatments for inflammatory bowel disease (IBD). It provides information on several ways patients can self-monitor their disease activity through indices like CDAI, UCDAI, and P-SCCAI. It also reviews evidence on the role of vitamin D supplementation, dietary changes, cannabis use, and lifestyle factors like exercise and meditation in managing IBD symptoms. While some studies found improvements in outcomes from these approaches, the evidence has limitations and their long-term impact requires more research.
Hash It Out: The Role of Medical Marijuana in GIPatricia Raymond
Marijuana's side effect of Cannabinoid Hyperemesis Syndrome is well known to us, as is use of Marinol to enhance appetite in the chronically ill, but are there other high points in the use of medical marijuana? What about the possible use of CBD oil for chronic pancreatitis or intractable abdominal pain?
Studies have shown cannabis' effect on GI motility, inflammation and immunity, intestinal and gastric acid secretion, nociception and emesis pathways, and appetite. Let's weed through the available data on the medical use and side effects of medicinal cannabis in gastroenterology.
Celiac Disease: Beyond Bowes, Bone, & Blood Rev 2019Patricia Raymond
Celiac disease can cause iron deficiency anemia, osteoporosis, and malabsorption…but is that all? Nope. There are a huge number of other disease associations with celiac disease beyond just bowels, bone, and blood. Join us for this classic presentation of celiac comorbidities that may alert you to the presence of this woefully under-diagnosed condition.
Diverticulitis: Popular Misconceptions & New Management rev 2019Patricia Raymond
As presented at RMSGNA 2019: Of course, it's not about just avoiding nuts and seeds. However, do you know how many attacks you can endure before suggesting a resection? How to manage young or immunosuppressed patients with diverticulitis? How Eastern (asian)diverticulitis differs? The role of mesalamine in treatment? It's time to re-explore a disease that you thought you knew!
Evolving diets in GI Disease 2019 Raymond/GallagherPatricia Raymond
As presented 09/2019 at RMSGNA: In the 50's , doctors recommended smoking for your health. More recently gastroenterologists told patients with ulcers to drink milk and eat bread to heal.
Are you using new science based dietary information for your patients? It's time to update your timeworn dietary strategies and handouts. Join us and review the science on recent advances in dietary management for gastrointestinal disorders: Fatty liver, IBS, IBD, Gastroparesis, Post gastric bypass, Diverticulosis, Cirrhosis, and more!
Examine historical misinformation in dietary management of gastrointestinal disorders
Describe the emerging evidence supporting the primary role of dietary therapies in digestive disease including Irritable Bowel Syndrome, Inflammatory Bowel Disease, Small Intestinal Bacterial Overgrowth, Non-Alcoholic Fatty Liver Disease, Gastroparesis, Pancreatitis, Post-Gastric Bypass, and Diverticulitis.
Identify the role of the Registered Dietitian and the importance of a multi-disciplinary approach to the management of digestives diseases
Know GI Inside & Out? Recognizing Skin Lesions of GI DisordersPatricia Raymond
Skin lesions seen with disorders of the digestive tract are not rare; would you recognize and correctly correlate erythema nodosum, dermatitis herpetiformis, pyoderma gangrenosum? Those were easy-- how about pyoderma vegetans, pyostomatitis vegetans, sweet’s syndrome, xanthomas, tripe palms, palmoplantar keratoderma, or trichilemmomas? Stumped?
Join us and learn the art of GI diagnosis without resorting to our endoscopes.
Fun Functional Gallbladder Disorders: Update on Hypo and Hyperkinetic Gallbla...Patricia Raymond
Functional gallbladder disorder is biliary pain from motility disturbance in the absence of gallstones, sludge, or microcrystal disease. In patients with biliary-type pain and a normal US, the prevalence is 8% men and 21% women. We will review the clinical manifestations, diagnosis, and management of patients with suspected functional gallbladder disorder, and also address current evaluation and management of sphincter of Oddi dysfunction.
Cyst Assist: Pancreatic Cyst Evaluation & ManagementPatricia Raymond
This document provides an overview of pancreatic cyst evaluation and management. It discusses the prevalence of incidentally detected pancreatic cysts on imaging and categorizes cysts as benign, pseudocysts, or one of four subtypes of pancreatic cystic neoplasms (PCNs): serous cystic tumors, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, and solid pseudopapillary neoplasms. For each PCN subtype, it describes characteristics such as patient demographics, location, risk of malignancy, and management guidelines. It also reviews guidelines for managing pseudocysts and outlines the endoscopic, percutaneous, and surgical drainage options with expected outcomes. In summary,
Kudos To You: Learning your Kudo Pit Patterns and Paris Polyp ClassificationsPatricia Raymond
We've told patients that we won't know about their polyps until after the pathology report is back; turns out that's not precisely true. Today's excellence in optics provides an accurate instantaneous assessment of the histology of colon polyps which may help in decision making during colonoscopy.
Did you know that if a polyp has a type 5 Kudo pit pattern, 50% were invasive cancers to the submucosal layer? What is it about that scary polyp that raises your hackles? Join us in this highly interactive session where we'll learn Kudo pit patterns as well as Paris polyp classifications to elevate your GI procedure reporting and your patient care.
Describe the emerging evidence supporting the primary role of Kudo Pit Patterns in visual inspection of in situ polyps, and demonstrate your ability to identify the patterns
Authentication of Kudo Pits
Pits and their risks
Images of Kudo pits
Quiz of Kudo Pits
Discuss the potential and shortcomings of the Paris Polyp Classification, and demonstrate an ability to classify the polyp shape
Polyp shapes and and their risks (pedunculated, elevated, depressed)
Images of polyps for Paris classification
Polyps and their risks
Quiz of polyp shapes
Concerns regarding interobserver variability
Familial Adenomatous Polyposis affects 1 in 10,000 to 30,000 Americans who experience 100% risk of colon cancer, and FAP doesn't end with a total colectomy for removal of their hundreds of polyps.
Follow this journey of two real FAP patients through pancreatitis from symptomatic ampulla polyps, surgical resection of giant small bowel polyps, bowel obstruction from abdominal desmoid tumors, and Wilm's tumor of the kidney. How do we diagnose, monitor and support our FAP patients? Can pharmacotherapy reduce risk of polyp growth in FAP? What are the extracolonic manifestations of the APC gene mutation? Our responsibility doesn't end when the colon does.
Bored with Barretts: Diagnosing Gastric Intestinal Metaplasia, Meckels, & Pa...Patricia Raymond
We all know what to do with the border disorder that is Barretts, but what about other mucosal heterotopia: intestinal mucosa in the stomach, stomach mucosa in the intestine, pancreas mucosa in the stomach...what's going on with all this meandering mucosa? Join us for a discussion about how to diagnose and manage various misplaced gastrointestinal mucosa.
Discuss the natural history of Gastric Intestinal Metaplasia and construct proper endoscopic surveillance and mapping guidelines
Epidemiology and risk factors
Complete and incomplete, types I-III based on mucin expression
Risk of progression to cancer
Proper surveillance and endoscopic mapping
Management
35 min
Meckels
Describe the presumed anatomical development of Meckel's Diverticulum, summarize the 'Rule Of Twos', formulate management of a Meckel's associated cryptic bleed
Who was Meckel
Epidemiology and risk factors
Rule of twos
Risk of bleed
Management
10 min
Pancreatic Rests
Discuss the natural history of Gastric Intestinal Metaplasia and construct proper endoscopic surveillance and mapping guidelines
Review the endoscopic appearance of the Pancreatic Rest, discuss rare symptoms attributable to the finding and current endoscopic evaluation and management
Endoscopic appearance
Anatomic development
Risks for pancreatitis, cancer, obstruction
Endoscopic and surgical management
10 min
The document discusses the visual examination of the belly and navel from anatomical, historical, social, and medical perspectives. Anatomically, the navel is located at the midpoint of the body and develops from the umbilical cord that nourishes the fetus. Historically, many religions and cultures have ascribed spiritual or theological significance to the navel. Medically, examination of the navel can provide clues to intra-abdominal diseases and conditions. Variations in navel appearance like outies can occur normally or indicate issues like hernias.
Do You Believe in Reflux: Idiopathic Pulmonary FibrosisPatricia Raymond
Recent studies suggest that if you have IPF (idiopathic pulmonary fibrosis), that you may not perceive the GERD (reflux) that you have, and that this acid reflux may cause the fibrosis to progress. Ask for proper testing and treatment to see if you are one of the almost 80% of IPF patients who have reflux, often silent reflux.
This document summarizes key points from a presentation on restoring hospitality to hospital care. It emphasizes treating the whole person, not just the disease, and using a patient-centered approach. This involves greeting patients with courtesy, making them feel comfortable, clearly explaining their treatment plan, and finding ways to bring joy to difficult situations. The goal is to win by treating the person, not just curing the disease.
This document contains information from a gastroenterologist on various gastrointestinal conditions including secretory diarrhea, Giardia infection, celiac disease, lactose intolerance, protein-losing enteropathy, small bowel bacterial overgrowth, irritable bowel syndrome, mesenteric ischemia, and Whipple's disease. It includes diagnostic criteria, clinical features, diagnostic tests, treatment recommendations, and prevalence statistics for each condition.
What Their Poo Can Tell You: How FIT (iFOBT) Fits Your Colorectal Cancer Algo...Patricia Raymond
Everyone needs a colonoscopy at 50 for colorectal cancer prevention, but what if…they simply refuse? They can’t afford it due to insurance issues? We seem to have forgotten that the updated ACG guidelines of 2009 for first time recommend use of annual stool FIT testing as “the preferred cancer detection test” if colonoscopy was not available or refused. How does FIT differ from our venerable stool guaiac testing? And is it finally time to discard gFOBT (AKA guaiac testing) as an insensitive and nonspecific diagnostic tool? Join our conversation and see how FIT testing fits our current screening guidelines, your patients’ financial limitations, and your excellent medical care.
Kiss Your Hemorrhoids Goodbye: Surgical and Non-Surgical Management OptionsPatricia Raymond
Kiss Your Hemorrhoids Goodbye: Surgical and Non-Surgical Management Options
Patricia L. Raymond MD FACG, Rx For Sanity
There seem to be many options to manage our patients' hemorrhoids: hemorrhoidectomy, banding, sclerotherapy, laser photocoagulation, topical medications. Which option is the best for your patient? The physiology and management of the bitter end of the gastrointestinal tract.
Objectives: The participant will…
Distinguish between internal and external hemorrhoids, review the anorectal anatomy and understand the grading system for internal hemorrhoids.
Categorize the differential diagnosis of hemorrhoids, including proctalgia fugax, anal fissure, perianal crohns disease, anal cancer, condyloma, skin tags and rectal prolapse
Examine specific medical, endoscopic, office, and surgical treatment options for hemorrhoids and their stated efficacy
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
8. Sometimes you have to take your
brain and stomp on it a little.
It just gets caked up.
Mark Twain
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9. Instead of just providing care,
create a customer experience.
Create experiences
so compelling to patients and their
families that their loyalty
is assured.
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16. Environmental Control
• Room Colors
– Blue, green, purple- calming, soothing
– Orange- stimulating
• Plants (artificial), water features, pictures of
nature, fresh flowers (florists donation or
from garden)
Spivey, SGNA 328
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17. Stripping of Possessions
• “the personal possessions of an individual
are an important part of the material out of
which he builds a self, but as an inmate the
ease with which he can be managed by staff
is likely to increase with the degree to
which he is dispossessed.”
~Goffman, Asylums, 1955
Dignapants, FFS
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19. Modesty
• Ownership of space
• Maintain patient modesty
• Secret weapon? Warm blanket
– Coverage and comfort
• Retain control of corner or edge of sheet
• Tuck in drape
– Security and Coverage
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21. Starting the IV
• Jacobson, May, Warner
– 160 patients
– Guided imagery, self-selected music,
kaleidoscope
– assigned vs self-selected intervention
Jacobsen, May, Warner, SGNA 333
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22. Dancing in the Endo
• San Francisco VAMC, 198 vets,
– 15 min self selected music prior to colon
– 15 min no music prior to colon
• Anxiety measured with STAI
• Pre for both groups = 36
• Post for music 31, no music 35 (p=0.007)
Buffum, Hayes, Lanier
SGNA abstract 2037, 2002
Session 323
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23. Odors Modulate Pain Perception:
A Gender-Specific Effect
• Massage oil, orange water, aftershave,
distilled water, baby oil, vanilla extract,
almond extract, vinegar, perm product,
zonalin (dental product)
• Pleasant, neutral, and unpleasant odors (as
rated by subjects)- mood effect
• Subjected to odors and painful stimuli
Marchand, Phys and Beh, 2002
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24. Odors Modulate Pain Perception:
A Gender-Specific Effect
Marchand, Phys and Beh, 2002
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25. Aromatherapy
• Florence Nightingale: Lavender
• EEG studies
– Lavender: Increase alpha waves at back of
brain, c/w relaxation
– Jasmine: Increase beta waves frontal lobes, c/
w alert state
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27. Aromatherapy for Pain
• Lavender reduces perception of pain in
critical care settings
• Chamomile reduced perception of pain in
randomized study of 51 cancer patients
• Lemongrass has analgesic effects alone and
potentiates morphine
• Rose highly effective for pain despite PCA
• Use in midwifery common
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28. Aromatherapy 101
• 36 essential oils
• Contraindications
– Many are skin irritants
– Pregnancy, lactation, seizure disorders
– Avoid chamomile in ragweed allergic
– Avoid peppermint in arrhythmia patients
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31. Aromatherapy
• Ask if they would like to try it
– Ask re ragweed, cardiac arrhythmias
– Ask re pregnancy and lactation, seizure disorder (not
with demonstrated aromas)
• Premix relaxation
– 1-2 oils only, one drop oil in tub of rice, sample placed
in ziplock snack bag
– No skin contact with oil (irritant)
• Post procedure
– Peppermint oil for increased mental stimulation
Aroma demo
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32. Additional Options
• Antiemetic: Peppermint, ginger, mandarin
oil
• Antispasmotics: Clary sage, lavendar,
chamomile, rosemary
• Rubefacient (5% solution in alcohol):
Clove, black pepper to ease IV starts in
difficult veins
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34. Room Lighting
• Cool white light led to more startle response
than full spectrum, even dim
– Startle: EMG of eyeblink,GSR of finger
• Start at medium level, not bright
• Ask if you can further reduce lights
• Patient contact essential as sedation takes
effect and room lights low
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35. General and Patient Contact
• Ownership of space
• Identify all who enter space, and seek
permission for activities
• Hand contact at all times by one party as
lights dim or patient becomes sedated
– Featherstroke or walk hands
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36. Positioning of Patient
• All subjects in side lying massage are
placed with extra pillow between knees
– Settles top hip in position
– Settles internal organs in position
– Spine remains in alignment
• Pillow between knees in all
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37. Can you hear me now?
• N=160, GA, headphones with different words pre and
intraop. At 5 and 25 hours later, good intra-op word
recognition. Information processing during general anesthesia:
evidence for unconscious memory. Bonebakker, Mem Cognit 1996
Nov;24(6):766-76
• N=43, GA, headphones with common facts or fictitious
nonfamous people. CF group remembered more facts
(p<.0005), NFP group more false fame (p < 0.001).
Information-processing during anaesthesia can also take
place as unconscious learning. Unconscious learning during
anaesthesia. Jelicic, Anaesthesia 1992 Oct;47(10):835-7
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38. Can you hear me now (2)?
• N=30 for CABG interview for recollections, both
aware and unaware, of intra-operative events.
Audio tape when <37 degrees suggested they
touch their chin during the postoperative interview
(p=.015). Seven patients (23%) recalled
intraoperative events, five with the aid of
hypnosis. Memory of cardiac anaesthesia. Psychological sequelae
in cardiac patients of intra-operative suggestion and operating room
conversation.Goldmann, Anaesthesia 1987 Jun;42(6):596-603
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39. Can you hear me now (3)?
• Several null studies
• Meta analysis
– “…some evidence of implicit memory for intra-
operative events, even with clinically adequate
anaesthesia.”
– “neither the anaesthetic techniques nor the paradigms
used to assess memory have been standardized.”
• Subliminal speech (learning during anesthesia) is
real…watch what you say, and how you say it.
• Overt recall operative events about 1%
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40. Touch Therapies
• Therapeutic Touch: Focus thought energy
through the hands while focusing good
intent for the well-being of the recipient
• Healing Touch: Adds to TT by redirecting
energy to the area of imbalance
• Reiki: Ancient Oriental TT
• Reflexology: Stimulate nerve ending to
activate brain receptors.
Donna wanda stroke
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41. Touch
• Heidt 1980
– Casual touch (pulse monitor), no touch, therapeutic
touch (massage, stroking) proved decreased anxiety
• Meehan 1993
– TT decreased post op pain and analgesia needs
• Daley 1996
– HT accelerated post op wound healing
• Samarel 1998
– TT reduced pre op anxiety of breast cancer patients, no
effect on pain
Additional scientifically rigorous
studies are needed.
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42. Touch Techniques in Endoscopy
• Abdominal Massage
• Sacrocranial Techniques
• Reflexology
– Never massage or manipulate anything with
• edema
• acute inflammation
• recent surgery
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43. Abdominal Massage
• Best left to experts, and jostles the view
• Techniques to relax spasm
– Jostling
– “Deep” Longitudinal
• Advance pressure up the rectus from symphysis
pubis
– Cresting
• Knuckles and palm
• With direction of colon
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44. Sacrocranial stimulation
• Anywhere you do/did have hair
• Calming/soothing
• Tugging, brushing, moving facia
– Don’t push or stroke
• Keep out of vision, on scalp
– Startle with hand in and out of vision
demo
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45. Reflexology
• Either hand, not hand with IV (in arm is ok)
• Feet (not in diabetics)
• Right organs, right hand etc
• Use finger pads, no nail contact
• Follow direction of colon
• Specific movements for effect
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48. Reflexology
• Movements
– Clockwise circular motion
• Stimulating but calming
– Vibration
• Stimulation
– Gentle pressure
• Sedating
– Featherstroke at end toward heart
Demo
Mrs.C and the music
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49. Dancing in the Endo II
• 37 patients for flex sig
• No intervention, audio only, or audiovisual
• Lower abdominal discomfort
– AV 7.1, A 9.5, None 10.8 (p< 0.05)
• Lower Anxiety ratings
– AV 2.5, None 4.4
• Attributed to distraction of patient
Am J Gastro 1998 Jul; 93(7):1113-6
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50. Dancing in the Endo III
• 64 patients for flex sig, midwest
– Music, or none
• Music group with less anxiety and
discomfort, but same satisfaction and
compliance.
Gastroenterol Nurs 2000 Jul; 23 (4):148-56
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51. Dancing in the Endo IV
• 165 patients for colonoscopy, Hong Kong
– Music + PCA, PCA alone, Music and
anesthetic if requested
• Propofol .84 mg/kg with music and PCA
– Propofol 1.15 mg/kg with PCA alone (p=.02)
Gastrointest Endocop 2002 Jan;55(1):33-6
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53. Parting Gifts:
Restore Control to Your Patient
• Teach Reflexology or Aromatherapy
• Education (diets, exercise, educational
pamphlets)
• Gift (CCUU, exercise bands)
• Congratulations and thank you
• Make them an agent for change
Deep fried and d
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54. Make it hard(er) to choose!
• Only differences are
HPT
• New attitude,
automony
• Restore caring and
service to patient care
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55. Almost time for a break!
• Evaluation with name and legible email
address for subscription to Rx For Sanity
eNews, a complimentary monthly eZine
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San Fran, 198 vets, 15 min self selected music prior to colon 15 min no music prior to colon Anxiety a and p music with STAI 40 item State Trait Anxiety Inventory Pre for both 36 Post for each music 31, no music 35 (p=0.007
20 fem, 20 m..odors and rated mood. Then same odors with right hand immersed in hot water bath to wrist, perception of pain q 15 minutes
Florence Nightengale use lavender oil on the soldiers that she nursed.
165 patients Music + PCA PCA alone Music, anesthetic if requested Music by headphones, CD
165 patients Music + PCA PCA alone Music, anesthetic if requested Music by headphones, CD
165 patients Music + PCA PCA alone Music, anesthetic if requested Music by headphones, CD