What Are Priorities In A Trauma Patient In Prehospital Setting?

In a trauma victim, the order of priorities can be remembered as ABCDE. They are prioritized deending on the severity of the element and urgency to deal with it. Here is brief of what each letter signifies.

A—Airway
First priority is to confirm and establish a secure unobstructed airway. There are many maneuvers defined which can be employed. This involves basic and advanced airway maneuvers, surgical airway placement, administration of oxygen, use of sedative or paralytic medications to secure the airway. [Read more...]

Alcoholic Fatty Liver

Alcoholic fatty liver (AF) occurs in most heavy drinker but is reversible on cessation of alcohol consumption.

Pathology

The liver is enlarged, greasy, yellow and firm. Hepatocytes are distended with fatty vacuoles which pushes the nucleus to the periphery. This occurs because fatty acid oxidation is impaired and they are taken up by the cells and esterified to form triglycerides. [Read more...]

Molluscum Contagiosum

molluscum_contagiosuIt is caused by a DNA pox virus which is the largest virus affecting the human beings. This is a cytoplasmic virus which gets implanted on the skin by contact with other infected individuals.

The disease is common in children, though less commonly, it may also occur in adults. The incubation period is 2-8 weeks.

It manifests in the form of asymptomatic, pearly white or pink, smooth-surfaced 2-10 mm size papules which may be present on any part of the body in diffusely scattered clusters.

The larger lesions tend to become umbilicated in the centre. [Read more...]

Frostbite – Injury, Presentation and Treatment

Frostbite is injury of the tissues due to exposure to freezing temprature. It usually occurs in extreme cold, especially at high altitude, and is aggravated by hypothermia.

Distal extremities and exposed skin are affected most often.

Mechanism of Injury

Ice crystals form within or between tissue cells, essentially freezing the tissue and causing cell death.Local vasoconstriction and thrombosis can cause endothelial and ischemic damage. When reperfusion occurs during rewarming, inflammatory cytokines  are released,  resulting in exacerbation of injury. [Read more...]

Acute Viral Hepatitis

Acute viral hepatitis can be caused by any one of the Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis E and  Delta viru,Epstein-Barr virus, cytomegalovirus, herpes simplex virus, rubella virus and virus of yellow fever.

Hepatitis A Virus

This is a RNA virus transmitted by fecoral route. Incubation period is 2-6 weeks. It leads to acute hepatitis and  does not lead to chronic disease or carrier state. Jaundice does not occur in half of the patients.

Hepatitis B Virus

This is a DNA virus transmitted parenterally or sexual intercourse. Workers dealing with blood products are at a higher risk.. The incubation period is 2-25 weeks. About 10 percent patients develop chronic disease or a carrier state. [Read more...]

Verruca or Common Skin Wart

papilloma_virus_verrucaWarts are thought to occur when there is infection of the skin by the papilloma virus. Pappiloma virus is a  a DNA virus and is known to have more than 40 subtypes distinguished on the basis of viral genome. Different subtypes are associated with different types of warts.

The virus grows only on the human skin and thus, the only source of infection is other infected individuals.

Warts are commonly seen in children, while adults generally develop immunity against this virus.

The infectivity of this virus is very low and therefore, a casual contact with an individual having these lesions is unlikely to result in infection.

How Does Virus Gain Entry Into Skin?

The virus enters the skin through microscopic abrasions and remains limited to the epidermis. The incubation period is variable and autoinoculation is frequent. [Read more...]

What Is Star Of Life Logo?

The Star of Life is a blue, six-pointed star, outlined with a white border which features the Rod of Asclepius in the center. It was originally designed and governed by the U.S. National Highway Traffic Safety Administration .

The logo in US was used as a stamp of authentication or certification for ambulances, paramedics or other EMS personnel.

Internationally, it represents emergency medical services  units and personnel.

A similar orange star is used for search and rescue personnel.

Image Credit - Wikipedia

Image Credit - Wikipedia

The six branches of the star are symbols of the six main tasks which are undertaken by  rescuers all through the emergency chain-

Detection

The first rescuers on the scene, , observe the scene, understand the problem, identify the dangers, and take appropriate measures to ensure their safety on the scene . The person is usually untrained civilians or those involved in the incident.

Reporting

The call for professional help is made and dispatch is connected with the victims, providing emergency medical dispatch.

Response

The first rescuers provide first aid and immediate care to the extent of their capabilities.

On scene care

The Emergency medical services  personnel arrive and provide immediate care to the extent of their capabilities on-scene.

Care in Transit

The emergeny medical services proceed to transfer the patient to a hospital via an ambulance or helicopter for specialized care. Medical care during the transportation is is provided.

Transfer to Definitive care

Appropriate specialized care is provided at the hospital.

Generalised Cutaneous Candidiasis

Occasionally, the lesions of candidiasis may spread on to the entire body producing multiple ill defined erythematous and scaly macules, but even in these cases, there is always a tendency for greater involvement of the skin folds.

This type of candidiasis usually occurs in very severely ill patients, particularly those having uncontrolled diabetes or those who are on treatment with immuno-suppressive drugs.

The diagnosis in each case can be confirmed by demonstrating the candida from the scrapings or the discharge. The scrapings should be taken in the same manner as for dermatophytosis, and mounted in 10 percent KOH solution. [Read more...]

What Is An Ambulance?

ambulanceThe term ambulance comes from the Latin word ambulare, meaning to walk or move about  which is a reference to early medical care where patients were moved by lifting or wheeling.

The word originally meant a moving hospital which follows an army in its movements. During the American Civil War vehicles for conveying the wounded off the field of battle were called ambulance wagons..

An ambulance is a vehicle for transporting sick or injured people, to, from or between places of treatment for an illness or injury. [Read more...]

How To Examine An Abdominal Lump

General Physical Examination

Appearance: Anemic, jaundiced or emaciated, Lymph nodes, especially supraclavicular.

Local Examination

Inspection:

  • Overlying skin
  • Position, size, shape and surface of the swelling
  • Movement of swelling  on respiration
  • Check sites of hernia
  • Observe scrotum for any fullness

Palpation: [Read more...]