Midterm Flashcards
(238 cards)
1
Q
what are the stages of a minimally invasive procedure?
A
Pre-procedure
Intra-procedure
Post-procedure
2
Q
pre procedure
A
- explain procedure
- make them physicslly comfortable
- play music
- ask questions
3
Q
intra-procedure (during)
A
- check in on them
- walk them thorugh it
- take their mind off whats happening
- take sterile field out of view
- ask to hold their hand
4
Q
post-procedure
A
- answer questions
- knowing when results will come in
- walk them out
5
Q
what in the advantage of minimaly invasive procedures
A
Procedures that reduce the time spent in the hospital have a two-fold benefit in that the patient can remain in their own home and also the cost of care for the service provider is reduced.
6
Q
what is an indication?
A
A symptom that suggests certain medical intervention is necessary
7
Q
what is a contraindication?
A
specific situation in which a drug, procedure or surgery should not be used because it may be harmful to the patient
8
Q
what are indications for an US guided biopsy?
A
- questioning the condition of an organ or gland
- new symtoms that cannot be diagnosed with other tests
- new focal lesion/lesions
9
Q
what are contraindications for an US guided biopsy?
A
- target is near a major blood vessel/bowel
- patient is very nervous/ill and unable to hold still
- unable to visualize the target of interest
- high risk of bleeding
- allergy to drugs used during procedure when needed
10
Q
what are indications for an US guided access and drainage?
A
- less invasive procedure to reduce complicatons/increase patient comfort
- increased pressure from fluid accumulation causing discomfort
- find out the composition of fluid/genetic diagnosis of fetus
11
Q
what are contraindications for an US guided access and drainage?
A
- poor visability of target of interest
- high risk of bleeding
- allergy to drugs used during procedure when needed
12
Q
what are indications for an US guided percutaneous therapy?
A
- less invasive procedure to reduce complications/increase patient comfort
- am more direct delivery method of treatment vs systemic delivery of treatment
13
Q
what are contraindications for an US guided percutaneous therapy?
A
- poor visability of target of interest
- high risk of bleeding
- allergy to frugs used during procedure when needed
14
Q
what are indications for a sonohysterography?
A
submucosal fibroid/polyp/endometrial mass
15
Q
what are contraindications for a sonohysterography and contrast?
A
- cervix is shut tight and does not have access to endometrial canal
- pregnancy
- poor visability of target of interst
- patient is very nervous and wont hold still
16
Q
what are indications of contrast?
A
- vascularity of lesion during arterial/portal venous phase
- identify the boarder of lesion
- focal delivery of medication
17
Q
what are the differen types of US guided procedures?
A
Biopsy
Access and Drainage
Percutaneous Therapy
Misc
18
Q
why do we do a liver or renal biopsy?
A
Any lesion identified within the liver or kidney that is suspicious and cannot be 100% diagnosed by imaging
To obtain liver tissue for systemic analysis
19
Q
why do we do a superficial abdominal/chest biopsy?
A
Suspicious superficial lesion or focal sectional abnormality of the abdominal or chest wall
20
Q
why do we do a thyroid biopsy?
A
suspicious nodule
21
Q
why do we do a lymph node biopsy?
A
enlarged abnormal appearing lymph node
22
Q
why do we do ovarian/endoetrial biopsy?
A
Suspicious ovarian lesions
Thickened endometrium
23
Q
why do we do a prostate biopsy?
A
Usually for patients with an abnormal DRE or elevated PSA
24
Q
what is a percuatneous drainage of fluid?
A
Drainage of fluid using needle through skin
25
why do we access vascularity?
- PICC line insertion
- Groin vessel for angiogram procedure
- clotting of PSA
26
paracentesis
Aspiration / Drainage of ascites fluid
27
Thoracentesis
Aspiration / Drainage of pleural effusion
28
what is Radiofrequency Ablation Therapy of Liver or Renal Lesion?
Therapy for primary or metastatic lesions
29
what is brachytherapy?
radioactive seed implants
30
what is Breast Needle Wire Localization?
Localizes the breast lesion for the surgeon
31
what is a common name for Acetaminophen?
tylenol
32
what is a common name for Acetylsalicylic Acid?
aspirin
33
what is a common name for Ibuprofen?
advil
34
what is a common name for Lidocaine?
Xylocaine and Lignocaine
35
look at medication activity
Saved on Laptop
36
what do many procedures preformed in the diagnostic imaging departments require?
special consent forms to be signed by the patient or parent/guardian
37
what is a consent?
a contract wherein the patient voluntarily gives permission to perform a service
38
what must the patient be informed before consent?
all aspects of the procedure prior to signing a consent. At this time the patient may choose to continue with the exam or refuse all together
39
what must you make sure before you preform the exam?
double check and make sure they have signed it
40
informed consent
A competent patient voluntarily accepts a plan for medical care after physician adequately discloses propsed PLAN, RISK AND BENEFITS
41
voluntary informed consent
the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family.
42
infromed-informed consent
the person must be given all of the information, by the person who will perform the procedure, in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment does not go ahead
43
capacity informed consent
the person must be capable of giving consent, which means they understand the information given to them, and they can use it to make an informed decision.
44
how may a patient express their consent?
written
| oral
45
written consent
Mandatory in every invasive diagnostic/therapeutic procedures. Should be in patient’s own language/ have translator if English is not their first language
46
oral consent
Needed in tests such as putting in stitches or radiological examination (especially involving female patients).
47
what is simple consent?
Obtaining a patient’s permission to perform a procedure, without knowledge of that procedure.
48
expressed consent
occurs when the patient does not stop the procedure from taking place
49
implied consent
occurs in emergency situations when it is not possible to obtain consent.
50
Inadequate consent – aka- Ignorant consent
This occurs when the patient has not been informed adequately to make a responsible decision.
51
what are cathedars?
simply tubes of varying lengths and inside diameters with holes in each end that allow the flow of fluids.
52
what are cathedars manufactured out of?
teflon
polyurethane
polyetylene
53
all cathedars are ____
disposable
54
who makes the choice of cathedar?
physicial preforming the procedure
55
who is responsible for the ordering and the maintenance of the materials used during procedures including the catheters?
the sonographer
56
what are the advantages of teflon cathedar?
- good memory-retains shape
- high material strength
- stiffer than other material
- larger inner diameter
- higher potential to kink
57
what are tha advantages to a polyurethane cathedar?
- high tissue compatibility
- increased lumen diamters
- increased flow rate
- low thrombogencity
- ease of insertion and placement
- gas sterilized only
- low incidence of tissue trauma
58
what are the advantages to a polyethylene cathedar?
- high tissue compatibility
- contains no additives soft and flexible
- better torque than polyerethane
59
how are cathedar sizes expressed?
inches or millimeters by THE FRENCH NUMBER
60
what is the french guage system defined as?
diamter times 3" relationship
61
what is the french number used to measure?
diamter of the cathedar
62
1 Fr=
0.3 mm
63
(mm) =Fr/______
3
64
Fr= D (mm) x _________
3
65
where do some companies imprint information on the cathedars?
on the hub
66
what is the hub of a cathedar?
proximal portion of the catheter that provides an attachment for the syringe
67
what does the distal end of the cathedar look like?
can either be straight or shaped
68
what does the shape of the cathedar depend on?
the type of procedure being done and the anatomic part being imaged
69
what do small balloons do on a cathedar?
mechanically occlude vessels and allow hemodynamic studies to be performed as well as providing hemorrhage control, segmental isolation, etc
70
how are needles measured?
Stubs needle gauge system
71
what does the guage number describe about the needle?
outer diamter of the needle
72
the smaller the gauge number ________
the larger the outer diameter
73
guage needle size for adults
21-23
74
guage needle size for children
25-27
75
what medication uses a 30 or 31 guage?
Byetta for diabettes
76
what is the universal protocol created to prevent?
wrong person
wrong procedure
wrong procedral site
77
what does verification include?
- patient identification double identifier (name, record #, DOB)
- history and physical in the medical record
- sign consent with correct procedure verified
78
what is the sonographers role in the pre procedure set up?
Evaluation of:
- medical records
- Lab values
- Allergies
- Other imaging studies
- Informed consent
- Set up sterile biopsy tray
79
what might site marking be delegated to?
- medical residents
- fellows
- physician assistants
- advanced practice registered nurses
80
who is accountable for the procedure?
licensed independant practitioner
81
the procedure marking site is _________
unambiguous
82
what is a time out?
deliberate pause in activity involving clear communication (that includes active listening and verbal confirmation of the patient, procedure, site and side) among all members of the surgical/procedural team.
83
what does the timeout include in verifying?
- correct patient ID
- correct procedure with consent
- correct site and side=markking
- allergies patient may have
- Availability of correct implants and any special equipment or requirements
84
what are the 3 steps to the universal protocol?
- pre procedure verification process
- marking the procedure site
- a time out (PAUSE)
85
needle activity
finnish
86
where are microorganisms
- microscopic
| - Naturally present on and in the human body and environment
87
when can non-pathogenic microorganisms become infectious?
if a patient is immunocomprimised
88
are microorganisms harmful?
Some microorganisms (pathogens) cause specific diseases or infections, but many are also harmless
89
what is a microorganism?
pathogen-virus, bacteria, fungus that can cause a disease
90
what are common nosocomial infections?
- surgical site/wound infections
- pneumonia
- cathedar induced infection
- bloodstream infections
- gastrointestinal infections
91
pneumonia nosocominal infection
Ventilator Associated Pneumonia (VAP)
92
cathedar induced infection
UTI
93
blood stream infection
central line insertion
94
gastrointestinal infection
C-Diff
MRSA
VRE
95
Clostridium Difficile (“C Diff”):
a bacterium that causes mild to severe diarrhea and intestinal conditions like pseudomembranous colitis (inflammation of the colon)
96
what is the most frequent cause of infectious diarrhea in hospitals and long term care?
C-DIff
97
Methicillin-Resistant Staphylococcus Aureus (“MRSA”):
a bacterium that is resistant to many antibiotics.
98
what problems can MRSA cause?
skin infections to pneumonia to bloodstream infections and sepsis
99
Vancomycin Resistant Enterococcus (“VRE”):
Enterococci are bacteria that are naturally present in your intestinal tract. Vancomycin is an antibiotic to which some strains of enterococci can become resistant to.
100
where is VRE commonly caught?
in hospitals
101
what are common comunity aquired infections?
```
common cold
influenza
norovirus
bacterial pneumonia
Hep C
```
102
medical asepsis
- inhibits growth and spread of pathogenic microorganisms
| - clean technique
103
surgical asepsis
- destroys all microorganisms and their spore
| - sterile technique
104
what are examples of medical asepsis
- handwashing
- PPE
- cleaning equipment
105
whats the best way to ensure medical asepsis?
handwashing
106
when do we wash our hands?
- before patient care
- After touching blood, body fluids, secretions, excretions, and contaminated items
- Immediately after gloves are removed
- Between patient contacts.
107
what does surgical asepsis do?
absence of all microorganisms, pathogens, and spores from an object
108
what requires surgical asepsis?
any medical procedure that involves penetration of the bodt tissues (invasive procedure)
- major and minor surgeries
- changing dressing
109
principles of sterile field on lect.3 slide 13
finnish
110
does traffic have an impact in contamination?
no
111
what helps to not contaminate something?
cover trays
112
when do we open a sterile tray?
just prior to procedure
113
what is the proper attire to wear?
- scrubs
- cap
- mask
- shoe covers
114
zone 1
unrestricted zone
| people may enter in street clothes. Area of front desk, locker rooms and waiting room for family members.
115
zone 2
semi-restricted zone
persons who are dressed in scrub clothing, cap, mask and shoe covers. Area is limited to authorized workers and patients. Storage area for sterile supplies and instruments. No food or drink allowed.
116
zone 3
restricted zone
persons wearing scrub suits, mask, cap, shoe covers and sterile applications. Those directly involved in the operation are dressed in sterile gowns and sterile gloves and are often referred to as “being scrubbed.” Area where sterile supplies are opened and where surgical procedure will be performed.
117
where are most common causes of contamination?
- The use of contaminated instruments
- Contaminated gloves
- Wet or damp sterile field
- Microorganisms blown onto a surgical site
118
what are special precautions we take to prevent spead (air)
-Ventilation ducts must have special filters
-Airflow in the OR should be unidirectional
-Air pressure in the OR should be greater than the outside corridors (negative pressure)
-Humidity is to be controlled to prevent static electricity
OR doors should remain closed as much as possible
119
who is on the surgical team?
```
Surgeon
Surgical assistant
Anesthesiologist
Nurse anesthetist
Circulating nurse
Scrub nurse
Imaging Technologist
```
120
disinfection
To remove as many microorganisms as possible from a surface by physical or chemical means.
121
what has to be disinfected?
Articles or surfaces that cannot be sterilized in the OR / special procedure room must be disinfected.
122
what is high level disinfectant?
Kills vegetative microorganisms and inactivates viruses, but not necessarily high numbers of bacterial spores
123
when is high level capable of sterilization?
long contact time (6-10 hours)
124
what is high level disinfectant used on?
on medical devices, but not on surfaces such as laboratory benches or floors.
125
what are excamples of high level disinfectants?
Formaldehyde
Cidex
Hydrogen peroxide
Trifectant
126
intermediate level disinfectant
Kills vegetative microorganisms including Mycobacterium tuberculosis, all fungi and inactivates most viruses
127
what is intermediate level disinfectant used on?
Commonly used to disinfect laboratory benches and as part of detergent germicides used for housekeeping purposes
128
intermiediate level disinfectant examples
- 70% ethyl alcohol
- Isopropyl alcohol
- Sani-Cloth
- Bleach
- Purex
- ChloraPrep
- SoluPrep
129
low level disinfectant
Kills most vegetative bacteria, some fungi and inactivates some viruses
130
what does low level disinfectant NOT kill?
M. Tuberculosis
131
what are some low level disinfectants?
Hospital disinfectants or sanitizers
132
low level disinfectant examples?
- Pine-Sol
- Lysol
- Providon Iodine (Betadine)
- Parvosol
133
what are the two types of sterilization?
- physical (heat or radiation)
| - chemical
134
what is the most common meethod of physical sterilization?
heat becuase it is reliable, easy, econimcal
135
moist heat
heat under steam pressure (Autoclave)
136
dry heat
dry heat ovens
137
what are the 3 ways of physical sterilization?
- heat
- filtration
- radiation
138
what are the types of chemical sterilization?
- gas
| - chemical solutions
139
gas chemical sterilization
-Ethylene oxide
(Used for materials that cannot withstand steam sterilization)
-Other oxidants
-Plasma
(Ionized gas: electrically charged and non charged particles)
140
chemical solutions
- Alcohols (Ethanol 70%, isopropanol 70%, propanol 60%)
- Aldehydes (Formaldehyde)
- Halogens (Chlorine, Iodine)
141
what must you check for before opening a sterile pack?
-expiration date
-condition of pack
(cloth wrapped and commericial packs)
142
when must a sonographer open his own gown and towel pack?
before begining the surgical scrub
143
what is the purpose of skin prep?
the purpose of a skin prep is to remove as many microorganisms as possible by mechanical and chemical means to reduce the potential of infection
144
what should the area of penetration be cleaned with?
antiseptic solution
145
what must be done after the skin has been prepared?
place sterile drapes around the area of interest
146
what clothes are used as drapes?
-disposable sterile cloth towel mainly but a fenestrated drape may be used
147
what are the most common sonography guided biopsy for soft tissue?
- fine needle aspiration (FNA)
| - core biopsy
148
what is a FNA?
Thin needle (20-25 gauge) is inserted into an area of abnormal appearing tissue under ultrasound guidance
149
how is a FNA preformed?
- Radiologist uses a needle and insert it into the tissue, using a back and forth motion, the cells are collected within the cannula
- Radiologist can attach a syringe to create negative pressure and aspirate the cells
- Samples (cells) collected during FNA can help make diagnosis (e.g., Malignant vs benign cells)
150
Is FNA considered safe?
yes, generally a safe procedure, complications are rare
151
when is FNA usually done?
on lump found just under the skin
152
what areas might a doctor recommend a FNA?
- nodules or masses
- enlarged lymph nodes
- inflammed tissue
153
where are common sites for FNA?
- breast
- thyroid gland
- lymph nodes in neck, groin, or axilla
154
how do you contain the samples for a FNA solid lesions?
- cells are pushed out of cannula onto microscopic slides
- a cytology tech will collect samples
- syringe and needle will be rinsed out with a fluid and that fluid will also be sent to lab for testing
155
Cytopathology/cytology
Diagnoses malignant and premalignant cells and diseases on the microscopic level
156
what is a core biopsy?
14-19 gauge needle is inserted into an area of abnormal appearing tissue under ultrasound guidance
157
what is usually obtained with a core biopsy?
sample of abnormal soft tissue (tumor or lymph node) or random tissue sample in an organ
158
what is the most common core biopsy needle mechanism?
reusable spring loaaded needle biopsy gun
159
what is another method for biopsy needle?
disposable spring loaded biopsy needle (supercore/trucut needle)-controlled click
160
when preforming a core biopsy, where are the samples usually kept?
in a formaldehyde solution for preserving tissue samples (clear fluid) formalin
161
what is formalin?
- A solution of gas formaldehyde in water
- Widely used for preserving tissue samples. It links protein molecules together, increasing the rigidity of the sample and making it easier to prepare thin slices for microscopic examination. It also prevents decay.
162
where are core samples sent?
Surgical Pathology aka histology
163
what are the 2 biopsy techniques?
- free hand
| - needle guided
164
what are the needle angle and positionning considerations based on?
depth of the target from the skin surface
165
what is the position when sampling superficial structures?
the needle is entered at a shallow
angle relative to the skin surface with the needle hub oriented
away from the transducer
166
what is the postition when sampling deeper structures?
When sampling deeper structures, the needle is entered at a steep angle relative to the skin surface, and the needle hub is oriented close to the transducer.
167
what is sonix system?
ultrasound screen has the dotted lines where the needle will insert
168
pros and cons slide 27 biopsy 1
look in notes
169
look at 2nd biopsy presentation
indications/diagnois/etc
170
what are the contraindications for a liver biopsy?
- Uncooperative patient (sedation required)
- Extrahepatic biliary obstruction (risk of biliary peritonitis, septicaemic shock and death)
- Bacterial cholangitis
- Abnormal coagulation indices
- Ascites
- Cystic lesions (especially echinococcal -cyst)
- Amyloidosis
- Patient body habitus or poor penetration of sound through soft tissue
171
what is the normal INR for liver biopsy?
< 1.4-1.5
172
what is the normal PTT for liver biopsy?
< 45 - 50 sec
173
what is the normal PLT in liver biopsy?
> 50 000 - 70 000
174
what may be used to correct cloting abnormalities?
vitamin K or fresh frozen plasma
175
what is done pre biposy of liver?
- Check for requisition and previous medical history, along with recent blood work for INR, PTT, PLT.
- Determine easiest visibility of lesion
- Determine access (intercostal, subcostal, subxyphoid)
- Look for ascites
176
what do you do pre biopsy for random liver?
determine a region without larger intrahepatic vessels
177
what do you do pre biopsy for a target liver?
look for peripherally located lesions with normal parenchyma
178
what are the pre scan images for a random liver biopsy?
area of interest 2D and color images
179
what are the pre scan images for a targeted liver biopsy?
chosen lesion with measurments and color images
180
how does the patient lie for a liver biopsy?
supine or left lateral decubitus
181
what kind of biopsy is done on the liver?
```
core biposy
(biopsy gun or disposable biopsy needle mechanism)
```
182
how many samples does the radiologist contain with a core liver biopsy?
anywhere between 2-6 samples depending on quality and indication for procedure
183
what guage of needle is used in a liver biopsy?
14-18 guage
184
what will be used to clean the skin after a biopsy?
alcohol
185
what will we ask the patient to do after applying a bandaid?
lie in their right side to apply pressure and decrease the chance of bleeding if the insertion is on the right side
186
what images do we look for for liver post biopsy?
- check if their is bleeding from needle track
- hematoma
- 2D and color/power doppler images
- damage to area near biopsy site
187
what is post biopsy patient care?
- Usually monitored by a nurse in surgical day care unit or other designated nursing unit
- Patient can use Tylenol if there is pain after procedure
188
when do most complications appear with a liver biopsy?
first 3 hours
189
what type of tissue sample so you want to be obtained?
Obtain a tissue sample that is representative of the liver lesion or of the hepatic parenchyma and that is adequate enough to obtain a pathologic diagnosis.
190
where is a core liver biopsy sample sent?
placed in formalin bottles and sent to HISTOLOGY
191
What are the complications of a liver biopsy?
- Abdominal or shoulder pain
- Hematoma
- Hemobilia
- Hemo- or pneumothorax
- Vasovagal reaction
- Puncture to adjacent organs
- Peritonitis
- Mortality
192
lec 4 slide 21
renal biopsy indications
193
for a random renal biopsy, what kidney and where do we obtain a sample?
lower pole of the left kidney is the selected choice
194
what are the indications for a targeted renal biopsy?
```
Renal cell carcinoma (RCC)
Oncocytoma
Papillary adenoma
Renal lymphoma
Renal leiomyoma (capsuloma)
angiomyolipoma
```
195
what are the contraindications for a renal biopsy?
```
Bleeding diathesis
Severe hypertension
Seeding of RCC
Hydronephrosis
Infection
Patient unable to lie prone
obesity
```
196
what are complications of a renal biopsy?
```
Pain
Puncture to adjacent structures
Hematuria
Bleeding/hematoma
Tract seeding
Infection
mortality
```
197
renal biopsy complication 40-50% appear
< 4 hours
198
renal biopsy complication 67-80% appear
<8 hours
199
renal biopsy complication 80-100% appear
<12 hours
200
coagulopathathy INR threshold
<1.4 - 1.5
201
coagulopathathy PTT threshold
<45 - 50 sec
202
coagulopathathy PLT threshold
>50 000 - 70 000
203
blood pressure for a renal biopsy
<90 mmHg diastolic
204
when should result of blood work be from? (time)
24 hours
205
when do you take blood pressure of a patient?
just before procedure
206
what type of biopsy can be preformed for a lymph node biopsy?
FNA
| Core
207
where are FNA samples sent?
cytology
208
where are core samples sent?
histology
209
what are the indications for a lymph node biopsy?
- Cause of enlarged node
- Cause of symptoms, such as an ongoing fever, night sweats or weight loss
- Staging (plan cancer treatment)
210
what is a normal lymph node biopsy result?
- Normal number of lymph node cells
- Structure and appearance of lymph node cells within are normal
- No signs of infection are present
211
what is an abnormal lymph node biopsy result?
- Signs of infection may be present, such as mononucleosis (mono) or tuberculosis (TB)
- Cancer cells may be present. Cancer may begin in the lymph node, such as Hodgkin or non-Hodgkin lymphoma, or may have spread from other sites, such as metastatic breast cancer
- HIV
- Inflammatory diseases, such as sarcoidosis
212
what are contraindications for preforming a lymph node biopsy?
- Uncooperative patient
- Allergies
- Blood thinners
213
what are complications for a lymph node biopsy?
```
Pain
Bruising
Bleeding
Infection
Allergic reaction
Lymphedema
```
214
Adjuvant
Enhances the effectiveness of medical treatment and modifies the effects of other agents. Ex) Adjuvant may be added to a vaccine to boost the immune responce.
215
Aspiration
Aspiration means to draw in or out using a sucking motion. A medical procedure that removes something from an area of the body. These substances can be air, body fluids, or bone fragments. An example is removing ascites fluid from the belly area.
216
Cannula
It is a flexible tube that is inserted generally into the hand or arm. It can either be used to put substances (fluids, medications, ect.) directly into the blood stream, or used to withdraw blood. Ultrasound could be used to ensure the position of the cannula is correctly within the vessel.
217
Catheter
A catheter is a flexible tube inserted through a narrow opening into the body to permit injection or withdrawal of fluids. Ultrasound is useful in the guidance and placement of a catheter.
Example: A Foley catheter is placed in the urinary bladder to drain urine.
218
Coagulopathy
Coagulopathy is a condition in which the bloods ability to clot is impaired. This can cause prolonged or excessive bleeding. In regards to ultrasound guided biopsies, bleeding is one of the major complications and feared risks of biopsies.
219
Diffuse
Not definitely limited or localized. To pass through or spread widely through a tissue.
220
Empathy
The ability to understand and share the feelings of another person.
221
Fenestrated Drape
A fenestrated drape is a sterile body sheet with a hole, window or opening that allows access to the incision site for operation.
222
Fresh frozen plasma (ffp)
Fresh frozen plasma (ffp) is plasma that has been configured, separated from whole blood and frozen solid at -18 degrees within 6 hours of collection. It contains all the coagulation factors, and can be used prior to invasive procedures to assist in coagulation (management of bleeding risks)
223
Gauge
A Gauge is a device or an instrument that is used in various procedures for the measuring of the contents, magnitude or amount of something.
224
Hematoma
Localized swelling that is filled with blood caused by a break in the wall of a blood vessel. Can occur spontaneously or by trauma. Blood is usually clotted or partially clotted.
225
Hub
The expanded portion of a hollow needle that serves as a handle for manipulation and as a site of attachment for a syringe, infusion tube, or some other appliance.
226
Hypodermic
Hypodermic refers to the region directly beneath the skin. It can also be used to refer to a syringe or needle that pierces beneath the skin.
Ex) A hypodermic syringe injects a substance into your veins.
227
International Normalized Ratio (INR)
INR is a standardized measure of blood and its ability to clot. The ratio is based on each individual personal prothrombin time to the normal mean of prothrombin time. It is used to help monitor the risk of bleeding in patients receiving anticoagulant therapy.
Normal range for INR is 0.8-1.2 The higher the number, the longer it takes for your blood to clot.
228
Justification
Justification is an action used to decide whether something is reasonable, or right. In ultrasound, this could relate to justifying whether or not an exam request is correct
229
Lidocaine with Epinephrine
Lidocaine is a local anesthetic. It works by blocking nerve signals in your body.
Lidocaine injection is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgeries, needle punctures, or insertion of a catheter or breathing tube.
Epinephrine, a vasopressor, is added to the anesthetic to increase its effectiveness and to keep the anesthetic effect from spreading to other areas of the body.
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mobidity
the amount of diseased
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Mortality
the amount dead
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Partial Thromboplastin Time (PTT)
PTT is a blood test that measures the time it takes for blood to clot. It is a useful test, as different factors may affect the body's ability for blood to clot. Examples of this may include medication (heparin), low levels of clotting factors, absence of clotting factors, inhibitors, and more.
This test is done to find a reason for unusual bleeding/bruising, check the liver function, precautionary measures prior to a surgical procedure, other clotting conditions, etc.
Normal range is 25-35 seconds
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Percutaneous
Percutaneous means by way of the skin, in medical terms, it is generally a medical procedure that involves a medical device entering the blood vessels, usually by way of a needle.
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Platelets (PLT)
Platelets, also called thrombocytes, are fragments of larger cells made in the bone marrow called megakaryocytes.
Platelets help the blood heal wounds and prevent excessive bleeding. They work by circulating within our blood and bind together when they recognize damaged blood vessels and cause a blood clot
A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood
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Vasovagal
is a reflex of the involuntary nervous system that causes the heart to slow down (bradycardia) and at the same time affects the nerves of the vessels in the legs permitting them to dilate and as a result the blood pressure drops and the blood is circulating tends to go into the legs rather than to the head and this leads to fainting episode as the brain deprived of oxygen
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Vitamin K
Vitamin K is a group of compounds that play a key role in helping the blood to clot which will prevent excessive bleeding. K1 for example can be obtained from leafy greens and other vegetables and K2 from meats, eggs and cheeses. Since vitamin K is important for the blood to clot, low levels raise the risk of uncontrolled bleeding. Deficiencies can be associated with Crohn’s disease of celiac disease.
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Warfarin
Warfarin is an anticoagulant drug (aka Coumarin, Panwarfin and Sofarin) which is used to prevent blood from clotting. It is commonly used to prevent blood clots and reducing the risk of strokes, heart attacks and pulmonary embolisms. It does so by inhibiting the production of prothrombin by vitamin K. It is usually taken in individuals over the age of 65
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how much lidocaine is used in a procedure?
1% lidocaine
