Sunday, February 28, 2021
Essential tremor - a mnemonic.
Wednesday, February 24, 2021
Tuesday, February 23, 2021
NEXUS criteria for Cervical Spine imaging - Mnemonic
NEXUS criteria for Cervical Spine imaging
Any 1 of the following is an indication :
Mnemonic = “NSAID”
Monday, February 22, 2021
Thursday, February 18, 2021
Wednesday, February 17, 2021
Tuesday, February 16, 2021
Sunday, February 14, 2021
Tuesday, February 9, 2021
Ear Syringing
EAR IRRIGATION (SYRINGING)
REQUIREMENTS: Water (temperature being as close to body temperature as possible), kidney tray, Simpson’s aural syringe/ 50 ml syringe attached to 16-18 gauze needle or pulsating water device, towel (if available)
PROCEDURE:
Examine the ear.
(Do not irrigate if there is: severe pain, recent trauma or surgery or a dry perforation of tympanic membrane, inability of patient to sit upright, organic foreign body in the ear, opening into mastoid, severe otitis externa, history of middle ear disease, ear surgery, inner ear problems [vertigo] or radiation in the area)
Ask patient to sit upright.
Hold the pinna backwards and upwards in adults and backwards in children to straighten the ear canal.
Keep a towel on the shoulder.
Use a kidney dish to catch solution.
While irrigating direct the syringe towards the ear canal, postero-superiorly.
Apply firm and constant pressure to the syringe.
Dry mop the ear and check it again to see if everything is out.
Written by our guest author - Abhineet Desai
Illustration by Devi Bavishi
Monday, February 8, 2021
Contraception
CONTRACEPTION
Cu-T INSERTION
REQUIREMENTS:
Written Informed consent, IUD, Povidone Iodine, Spirit and drapes, Sims’s speculum, Allis forceps, Uterine Sound
PROCEDURE:
Begin with the history and clinical examination to rule out contraindications.
Before inserting the IUD, always do UPT to rule out pregnancy.
The patient is taken up in the OT (but can be done in OPD or labour ward immediately post-partum). An anaesthetist should be present if in case perforation occurs.
POSITION: Standard lithotomy position with legs in stirrups.
Scrubbing, painting, and draping should be done.
Bimanual examination to check for uterine size, position, version, and adnexal pathology.
Depress posterior vaginal wall with Sim’s speculum and hold the anterior lip of cervix using Allis forceps.
Using uterine sound, measure utero-cervix length and the accordingly adjust the bobbin.
The technique used is “No Touch/ Withdrawal technique”.
CuT is self-loaded. Remove the whole thing without touching CuT.
Plunger should not touch the vaginal wall. Reach upto the uterine fundus. Pull the ring behind on the plunger. CuT is unfolded.
Slowly remove the loader so as not to disturb the CuT.
Cut the tail (2.5-3 cm). The patient should be made to feel the tail.
Observe for about half an hour for uterine cramps (since foreign body inserted so uterus tries to expel it)
Managed by giving Drotaverine/Dicyclomine.
Record the date of insertion. Document it on CuT card and mention the date of expiry. Give it to the patient.
Counsel the patient regarding all the possible complications and also regarding the follow-ups.
ANTARA
Injectable Contraceptive DMPA (Under ANTARA programme) given as i.m. injection on outer upper quadrant of buttock.
Dose: 150 mg every 3 months
Written by our guest author - Ayushi Gupta
Illustration by Devi Bavishi