17 Burst results for "royal alexandra hospital"

"royal alexandra hospital" Discussed on True Crime Brewery

True Crime Brewery

05:52 min | 3 weeks ago

"royal alexandra hospital" Discussed on True Crime Brewery

"On december fourth. She confided more of her feelings about motherhood in diary. I'm ready this time. She wrote but i have already decided. If i get any feelings of jealousy or anger too much i will leave craig in the baby rather than answer being as before silly but will be the only way i will cope. I think support and not being afraid to ask for it will be a major plus also i have and will change my attitude and try earnestly not to let anything stress me to the max i will do anything to pamper myself regularly and just deal with things if i have a clingy baby then so be it a cat napper so be it. That will be when. I will ask for help and sleep whenever i can to keep myself in a decent mood i know now that battling wills and sleep deprivation were the causes last time. So i feel like these excerpts are very incriminating heart. Think given what happened. Yeah you can be real suspicious. Absolutely she even mentions being jealous and angry changing her attitude trying to be in a better mood. Yeah i think that's very suggestive of her. Having something to do with those children being killed. She's talking about oh ask for help So it's absolutely like someone who's made mistakes before and this time is going to do things differently now at the same time. She doesn't say. I killed my other. Babies she doesn't but some of that word makes me think she's purposely trying to be vague to protect herself because some of the wording is just very straight it really is yeah so she went into labor just after midnight on august seventh nineteen ninety seven delivered a little girl that the laura as soon as she was delivered. Craig held a baby in his arms and he prayed that this time his baby would be all right. Kathleen stayed in the hospital with laura for five days and this was the first baby she breastfed but she didn't enjoy it when she got home. She started bottle-feeding. Laura when laura was just over week old. The family drove over to sydney and stayed overnight at the royal alexandra hospital for chiltern to get laura tested for any illness or abnormality and finally. They got their cpr lessons. The laura was fitted with an electronic koro metrics monitor and the nurse explained to them how the machine worked to record and measure laura's breathing and heartbeat and how it would alarm if there is a stoppage of breathing or any changes in the baby's heartbeat creggan kathleen was shown how to use the monitor and how to respond by touching laura gently to check weather. She response the machine could show whether it was a heart alarm breathing alarm or if also well every detail of every alarm had to be written in a daily diary and the data recorded on. The machine's memory had to be downloaded to the hospital. So the experts could interpret them..

Kathleen Laura sydney five days kathleen december fourth Craig first baby laura royal alexandra hospital chiltern august seventh nineteen ninety seven after
"royal alexandra hospital" Discussed on True Crime Brewery

True Crime Brewery

05:58 min | 3 weeks ago

"royal alexandra hospital" Discussed on True Crime Brewery

"Bud was sent to the adelaide children's hospital for testing to check for any chemical abnormalities and they checked his white cells and they found no genetic diseases. That could have caused neurological abnormalities. According to the pediatrician patrick's condition consistent with him suffering a catastrophic asphyxiating event from anon- causes. So what is a catastrophic a succeeding event. Well so they're saying that something caused his airway to be blocked smothered. That's one thing. He could have aspirated milk formula. I don't know it would seem that there was suspicious. Yeah i mean catastrophic says like it was really bad. Well it was. He had a lot of sequentially from this. Yes so he suffered oxygen deprivation to the brain and over time. He had changes in the brain matter of his brain that resulted in seizures so with oxygen deprivation. They're oftentimes of severe swelling of the brain. And this can lead to scarring of the brain. Because of this lack of oxygen this is called leos so can result in an irritation of the normal electric activity in the brain which can result in seizures. And this is what he had. So patrick was discharged from the hospital on october. Twenty nine is physician completed a five. Page discharge summary. He never believed that. Patrick had encephalitis a viral inflammation of the braid because no tests or lumbar puncture showed any evidence of that so he couldn't find a medical costs for petric's illness patrick's cat scan on admission to the hospital showed a normal brain but unfortunately as time passed the damage that had been done to his brain became more and more clear he did survive but was later diagnosed with epilepsy and blindness and he would die four months later february thirteenth nineteen ninety one and he was in the care of his mother while his father was at work so it was just after ten. Am when kathleen called. Craig's sister carol at her home. Kathleen told her sister-in-law that it had happened again so carol got into her car and drove over in the house she found kathleen sitting on the couch with elbows knees crying in waiting for the ambulance. She was also waiting for craig to arrive. She had called him. Carol walked into patrick's bedroom and found him lying in his crib just as he had looked on other occasions when she'd put him down for sleep she moved to pick him up but kathleen told her no. Don't do that. And that's when carol realized that. Patrick was dead. Craig been at work by frantic sounding kathleen and once home. He found the baby's still lying on his back in the crib. So they're not doing anything to try and save the baby besides calling the ambulance craig. Right away picked up. Patrick and he could feel that he was floppy but still warm but also his lips were blue so craig tried to resuscitate him until the paramedics arrived. Patrick's physician met the full biggs at the er. Patrick was on responsive and he had no spontaneous breathing and no pulse. So the doctor told craig and kathleen the terrible news. That patrick was dead and all efforts to resuscitate him were stopped at that point. Greg just couldn't believe it so slides with teachers. Sections from patrick's brain were sent to the royal alexandra hospital for children at camper down along with the autopsy report. Doctors concluded that patrick's brain damage was caused by a lack of oxygen to his brain during the episode..

Kathleen Carol carol kathleen Patrick Craig Greg october patrick Twenty nine craig five one thing four months later february thi Bud ten royal alexandra hospital adelaide
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

02:24 min | 2 months ago

"royal alexandra hospital" Discussed on Surgery 101

"Hello again and welcome back to surgery. one one. the podcast brought you with the help. The department surgery at the university of alberta my name is jonathan white coming to you live from the royal alexandra hospital here edmonton this week is the second in our series of podcast episodes all by hand injuries. Brought to us by sean dot and in this episode sean considering the topic of traumatic injuries to the nail bed. You'll be considering. What's the nail bed made off. What's in all of the structures you'll be looking at how you can determine. If a patient's how to nail bite injury basam history and physical examination you'll be looking at the initial management and then considering surgical and non surgical options and then looking at some of the possible complications of injuries to the nail band. So let's to consider injuries to the bad off the fingernail here on surgery one. Oh one oh.

"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

01:50 min | 2 months ago

"royal alexandra hospital" Discussed on Surgery 101

"Hello and welcome back once again to surgery. One podcast series brought to the health. The department of surgery at the university of berta. My name is jonathan white. I'm a here at the royal. Alexandra hospital an eminent. This week is the first in a series of six. Yes count them. I said six episodes all about injuries to the hand brought to us by medical students. Sean dawn so in this first episode. He'll be looking out traumatic digital amputations he'll be considering an initial approach to the patient who's had digit amputated. He'll be classifying these injuries and looking at some of that indications and contraindications to digital replant. He'll be looking at some of the operative stamps and actually putting a digit back on again and he'll be summarizing. Some key points related to post operative care so let's get ready to cover quite a bit of ground on traumatic digital amputation. Here on thirty one owner.

jonathan white Sean first six episodes This week first episode thirty one owner One podcast six university of berta Alexandra hospital royal
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

03:42 min | 4 months ago

"royal alexandra hospital" Discussed on Surgery 101

"At the university of alberta my name is jonathan white coming to you from the royal alexandra hospital in edmonton alberta. This week's episode is something of a sesame street episode because it's the one that's not like the others will be covering the topic of inclusive medicine. This is an episode brought to us by a friend of mine. Don't do denache pilot. Panna comes to from queensland australia. So he's going to be talking about the important topic off inclusion in medicine. And i think it's very important. I'm vitally interesting topic. Especially at the moment we included medicine. Who do we ask medicine. I can we work together to make it better show. I'm not gonna say anymore. I'm going to hand you over to nash by less credited. Look at inclusion in medicine here on surgery one one hello. I am paula upon and australian doctor lawyer and disability advocate. I am the first quadriplegic medical intern in queensland australia. Also feel fortunate to have been the second person with quadriplegia to graduate as a doctor in australia today. I'm going to share. My story discussed my perspective on the importance of inclusive medicine and what role everyone can play in creating an environment for old to thrive off to listen to this podcast. Listeners should be able to one discussed the impact of a significant medical event on. Someone's life to recognize that our actions can have an impact on a patient's life forever three identify what inclusive medicine is and why it is important for described the history of inclusive medicine and five. Identify what you can do to create an inclusive profession. The thirty first of january two thousand ten. I'll never forget that date. I was a third year medical student. I found medicine after a degree in law with a journey through depression. Anxiety and agoraphobia. Thrown in there. I loved medicine. Life was good. I just come back from a snowboarding trip with one of my closest friends. As i did often. I went to visit my parents who lived about an hour and a half away when i used to visit them. I eight mom's food and veg doubt on the couch. This day was no different. But on that sunday night i ended up leaving the house at a particular time and ended up in a particular stretch of highway. That was wet. Do you know those crisp evenings. After the rain the smell was shop and the lights will luminescent at one hundred kilometers per hour. I hit a puddle of something. My life changed within seconds. The car rolled and rolled. When it landed. I couldn't move..

queensland jonathan white paula Panna This week second person edmonton alberta first royal alexandra hospital today third year queensland australia five university of alberta one hundred kilometers per hou thirty an hour and a half sunday night australian australia
"royal alexandra hospital" Discussed on As It Happens from CBC Radio

As It Happens from CBC Radio

07:55 min | 6 months ago

"royal alexandra hospital" Discussed on As It Happens from CBC Radio

"Days and alberta doctor says surging covert numbers have brought her hospital to the brink and she invites the province's premier to see the human toll of the pandemic for himself. Making sure we get the point. As brits roll up their sleeves per vaccine shots today a scientist gives us a reality. Check about what we should and shouldn't expect vaccination to accomplish clear takeoff takeoffs air canada says it's eliminating service to sydney nova scotia leaving the ceo of the province's second largest airport wondering what will stop his region from being grounded for good tunnel. Visionary albert a high school student wins a very lucrative science prize for a video that puts the complex concept of quantum tunneling in terms of the rest of us can understand almost flight club. We remember the first pilot to break the sound barrier with a trip to our archives where we find him bonding with former host. Mary lou finlay over their shared love of flying and giving us our martian orders. The former head of space security for israel says a group of aliens called the galactic federation are in constant contact with various world governments with. They're not quite ready to burst out of regular people's chests just yet as it happens. The tuesday edition radio spaced out there. For a second alberta's graph of new cova cases. Looks like the side of a steep mountain. The red line keeps going up and up and no one knows where the summit will be yesterday. The province reported over seventeen hundred new cases. With an alarmingly high positivity rate this evening the province announced shutdown of bars restaurants and casinos but many retail spaces are staying open knee back. She is a doctor. Working on the covid ward at royal alexandra hospital in edmonton. That's where we reached her active. Acsi what is the most difficult thing about arriving at work. Each day most difficult thing is not knowing what we're going to walk into every night we have countless medical admissions and now more and more over the last couple of weeks a predominantly they are. All college admissions so when we walk onto the colored ward. We don't know who the new patients are. And we don't know how sick they are along with. How sick the rest of the patients might be from overnight. You know we were doing a lot of interviews. In the spring from italy and new york city away there were describing what was going on to the near collapse of things. And does it feel like you're getting close to that level of crisis it does it. Does i mean we certainly may look different. We don't have the ice trucks that are sitting outside of our hospital right now but it certainly feels like that in the hospital that everyday. There's a new crisis on where we're gonna place patients or who's look after the patients you know. Do we have physicians. We have enough. Nurses we haven't Therapists it feels very chaotic but not chaotic because of the system but the chaotic of all the moving pieces that have to go into planning for a pandemic as not. I guess just the mechanics of doing this this the emotions ever because you're dealing with people was you described. They come in. You don't know how quickly they might collapse or even if they'll recover they can't have their families with them. They can't support it. Just how how you how you dealing with that. With the possibility and probability of death so often all physicians especially those at work in acute care are used to having to deliver bad news and used to have to Talk about palliation but not at the level that we're talking about with covid patients. I'm having palliative care conversations for five six times a day often with family members who i've obviously never met always speaking to them on the phone. They may be provinces or countries away. And i may have only gotten to know their family member for six to twelve hours Based on how fast may have deteriorated until it's very emotionally jarring for us as providers. And i think the last thing any physician wants to ever become is is somebody. That doesn't have empathy Do these conversations over and over and over again it becomes really hard on your psyche. And how do you do that. How do you how do you prepare yourself for. What what what can you possibly say you know. I just try to put myself when. I'm having this conversation myself in in the family shoes. What do i want to hear. What would i want to hear if i was on the other end I think the equalizer here is that anybody who's receiving his call about covid patient understands that there's not much more we can do and it's very sad to have to say that But typically when we get to that level having that conversation. I think the vast majority of the world knows that. There's not much more we can do. Now you've seen so many cases. Can you describe what must be like to have an acute case of covid. imagine and thankfully have not had cova gonna have to imagine that it's scary and that you're waiting for the other shoe to drop you know. Am i going to be the next person that can't read that needs to go is that needs a ventilator. That's not going to see my family. So i think there's a lot of fear and anxiety around it. I think there's a lot of fear of how long it's going to take for me to recover. Am i going to recover. I know you're able to give them hope you know i've always practised medicine Truthfully so i always provide truth to the patient. Try to provide hope if hope is something that can provide. But i'm always honest to a fault as well. So if i feel that things are going in a direction that is not one that can change or that will will come with a positive outcome. I also provide them with that truth. In the time it takes to process at the time it takes to reach out to family members given that they can't see their family members. What do they want from you. I think they want to know that we've done everything that we possibly can never fighting for them and majority of patients who don't do al who know that they're not going to do well. They often want us to talk to their families on their behalf and let them know that we have tried everything in that you know. We're we're doing the best that we can typically. How often did in a week do you do that. Do you have to have those conversations every single day multiple times a day. What effect is it having on. You know this is something that i've never experienced before I mentioned that this this last week is probably the hardest week of my life in terms of my clinical care and my clinical practice It's not just having the conversations with the families in the patients. It's the the volume the number of times of having to do it in the number of conversations. I'm having and as i mentioned not always having a relationship with that family because i made just met their loved one a few prior It's exhausting and i think most health co workers are working twenty four hours at a time in living twenty four hours at a time. Because it's all we can. If you could have five minutes with jason kenyan government what would you ask for. I would ask for them to come to the hospital. I'd asked him to come and see what is happening in the hospital and that i recognize that making decisions on restrictions in lockdowns have many many repercussions i. I don't clean for that to be an easy position to be in. But we are getting overwhelmed. We are doing our best. We're trying to provide patients with all the same level of quality of care but we are running out of steam and we need help you posted on twitter picture of your husband and said that without him. You couldn't be doing this..

Visionary albert Mary lou finlay royal alexandra hospital alberta air canada nova scotia sydney edmonton israel new york city italy jason kenyan al twitter
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

02:12 min | 6 months ago

"royal alexandra hospital" Discussed on Surgery 101

"Hello and welcome back the surgery one. Who won the podcast brought to you. With the health the department of surgery at the university of alberta my name is jonathan white coming to you from the royal alexandra hospital here in edmonton. This week is the third. In a series of four episodes all about obstetrics brought to us by russ nell. Who's a medical student. Pappy university of saskatchewan. This week's topic is all about the delivery of twins label be looking at different sorts of twinning looking at some of the risk factors for twin or multiple justice pregnancy reviewing highway. We develop a prenatal management plan when we know they're twins and looking at the different types of presentations which are possible. when it's a twin birth lastly shelby looking at the specific considerations. We need to think about when we're delivering twins and again this topic like last week is interestingly because not a lot of people knew this i myself. I'm a twin. So let's wait to consider what happens when you're delivering more than one baby here. Surgery one oh one hi everyone. My name is leah. Russell and i am a fourth year medical student at the university of cisco in in china. This is episode three of a four part series covering complications. At the time. vaginal delivery. Today we will be discussing twin delivery. Before i begin. I would like to thank dr darien rattray an obstetrician gynecologist and clinical instructor at the university of saskatchewan who helped me develop the content for this series as well as to the surgery went on one team for making this podcast possible. After listening to this episode you should be able to one. Identify the types of twinning based on korean and amnesty bill to list the predisposing factors for a twin or multiple justification pregnancy and associated risks for the mother and fetuses three outlined prenatal.

royal alexandra hospital russ nell Pappy university of saskatchew jonathan white department of surgery university of alberta edmonton university of cisco dr darien rattray leah Russell university of saskatchewan china
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

01:48 min | 6 months ago

"royal alexandra hospital" Discussed on Surgery 101

"Surgery at the university of alberta my name is jonathan white coming to you from the royal alexandra hospital here in edmonton this week is the first in a series of four episodes all by obstetrics brought to us by medical. Shoot leah russ nail from the university of scheduling in this first episode. We'll be looking at the concept of the operative delivery will be reviewing when you shoot and shoot and consider using this technique. We'll be looking at some of the risks associated with the technique when compared to his arianne section. I'm looking at some of the tools and the steps required to carry out an opera delivery. So let's look at the context of operative vaginal delivery here on surgery one. Oh one hi everyone. My name is leah. Russell and i am a fourth year medical student at the university of schedule. In in regina this is episode one of a four part series covering complications at the time of vaginal delivery. Today we will be discussing operative vaginal deliveries. Before i begin. I would like to thank dr darien rattray and obstetrician gynecologist and clinical instructor at the university of Who helped me develop the content for this series as well as to the surgery one. Oh one team for making this podcast possible. After listening to this episode you should be able to one classified. Ovae's also known as operative vaginal deliveries and discuss the instrument available to perform lovie d.

royal alexandra hospital leah russ jonathan white university of alberta university of schedule edmonton dr darien rattray leah university of Who regina Russell Ovae
"royal alexandra hospital" Discussed on The Current

The Current

05:54 min | 7 months ago

"royal alexandra hospital" Discussed on The Current

"Kids in case. You didn't catch that. Jason lawn said that the government was waiting to see where hospitals would be pushed to their limit before gradually reducing more activities afterwards. He said that he was in his words. Incorrect suggesting that anyone is waiting until we're pushed to the limit but dr. How does that make you feel as a front line worker to hear that from a government representative. It seems at the very least like a bit of a mixed message. But perhaps more than that. It just tells me that Our governments will really informed about healthcare. Works this is like bailing a boat when the water is coming over the bough. It's too late already sunk These cases take two weeks to show up in the icu. Even if we institute measures now we're still going to see an incredible surge in the next two weeks coming through. Our hospitals and our resources are thin in our staffing thinner this We'll take and toll on healthcare workers. What does that mean in terms of the surge. We talked a bit about this last week. But with fifteen hundred forty nine cases recorded yesterday alone in a couple of weeks time what do you. What do you think you're going to be up against. We have projections And by the end of december the ice you system that we know we'll be overwhelmed. We'll have to convert to a more. Distributed protocol is modeled. And that's not regular icu. At all what does that mean. Well that means instead of when when you come into an intensive care unit you get one one nursing and you get a doctor with a one to ten patient ratio who figures everything owed and tailor your care. When you're overwhelmed in surging will instead be doing is having non intensive care. Physicians look after people and non-intensive trained nurses. And then i will go around and make sure that things are being done correctly but i use all about the details. Things changed rapidly and people who aren't as familiar with these things won't be able to deliver the same level of care. You said that just finally. This is put a heavier toll in a burden on people like yourself. I can hear it in your voice. I know it's early in the morning. And you've been working hard. But i can hear the the strain How are you and your colleagues holding up. Well we feel like we're held hostage. Everybody does this cause they love it. unit is a special place. We built trust and a culture of care. And we're willing to take a lot out of the bank knowing that It's for a good cause but we don't feel like we're being listened to and our please are going unanswered and so when we're done with this we will. We will finish doing the work. But i'm sure. I'm going to lose a lot of my colleagues to other careers once. This is take care of yourself. And i really appreciate speaking with you again. Dr thank you the pleasure. Dr darren markland and i see you doctor and frolic at royal alexandra hospital in edmonton. I am speaking to you at a moment of grave crisis. I'm jeff turner and this is recall. It's a series about history not the ancient past history. That still hot to the touch. In this first season i explore a revolutionary political movement that brought a modern democracy to the brink. You can find recall how to start a revolution on the cbc. Listen app or wherever you get your podcasts. I'm.

Jason lawn representative Dr darren markland royal alexandra hospital jeff turner edmonton
"royal alexandra hospital" Discussed on The Current

The Current

03:00 min | 7 months ago

"royal alexandra hospital" Discussed on The Current

"Fires burning in so many different areas and right now is the time to get those under control a warning candidates chief public health officer. Dr teresa tam. Those fires are cases of covid rising across the country and manitoba on saturday. A new single day record with fifteen deaths alberta and scotch win both reported record high number of cases as well on saturday so did ontario with almost sixteen hundred new cases. That number dropped to just over twelve hundred. Yesterday and severe cases across the country are increasing over the past week there were on average every day more than fourteen hundred people being treated in hospitals. Some areas of canada have seen that they now had to scale back on routine medical procedures because the hospital beds getting four. Much concern about icu. Capacity you have specialized medical resources personnel. And they're getting exhausted as well. Dr darren markland knows exactly what dr tamas is talking about. He's an intensive care. Physician and enough at royal alexandra hospital in edmonton dr good morning. Good morning you're about to head into a shift at the icu this morning. What do you think you'll be walking into well after the weekend. I think we're going to have and very important meetings about what. We're going to resource and staffer unit today and for this week. That's a big sigh as you start to answer that question. Well i think like Most canadians Were all a little tired of this But we also see what's coming and there are cells in the air already. I mean the first one hit because of thanksgiving. And we're waiting for the next one to hit because of halloween and so when you see exponential growth without a plan brings a lot of anxiety in the frontline healthcare workers. So when you say that you're going to need to have meetings around resource allocation tell me. What does that mean. What sort of decisions are you to have to make in the next few hours. So we have had a surge plan set up from the beginning of the pandemic. But it's one of these plans that It looks good on paper but is dependent on staffing and resources and hard decisions and so up until this point we've been running a full icu. But able to turn the patients over so that everyone gets the care they need but within this week next week. We're going to have to expand the icu in start drawing resources away from the laws We've already cut down elective surgeries to bring in more resources and prevent admissions. But we're going to have to do more. We'll have to reduce more surgeries. I take on take on more staff from other units and that process will have to continue as it does You start to get stretched a little thin and.

icu Dr teresa tam Dr darren markland royal alexandra hospital manitoba officer canada edmonton alberta ontario
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

02:46 min | 7 months ago

"royal alexandra hospital" Discussed on Surgery 101

"My name is jonathan white. And i'm coming to you. Live from the royal alexandra hospital in lovely evanston this week's episode. We'll be covering a topic close to my heart which is an update on the modern management of acute colas. His titus brought to us by vivian. Leong who's a medical student from mcgill university. This is a topic was really interesting for me because it's something that we have changed how we think about over the years. We i think about the management of acute colour status quite differently from the way we did whenever i was training. So vivian is going to look up high. We decide whether a patient has complicated versus uncomplicated. Acute coolest itis. She's going to consider the indications for therapy and she'll be covering the content of risk stratification we try and figure out patient as low risk or high risk and the highly should be managed. So let's look at the topic of the heart. Gallbladder surgery one. Oh one hello. My name is vivian. Lung and i may third year. Medical student from mcgill university today will be discussing a case titled khloe has coli and together. We'll review the management of acute coley. Cystitis i would. I like to thank dr white and the surgery one on one team for the opportunity to be here as well. I would like to thank. Dr feldman a general surgeon who specializes in minimally invasive surgery at mcgill for her volleyball expertise and contribution to this podcast. In this episode. I will briefly touch upon the guidelines for antibiotic therapy indications for urgent cooley suspect system and the concept of risk stratification which will serve as key information in determining whether your patient will benefit most from a surgical versus non surgical management of acute coley status. After listening to this podcast students should be able to recall endless classification factors uncomplicated versus complicated acute coleus status. Quo recognize the importance. And considerations of initiating antibiotic therapy described the concept of restaurant find patients into low risk versus high research for patients and their subsequent clinical management. So if you would like to brief review on the pathophysiology clinical presentation and workup of acute coli. Status feel free to pas this podcast and listened to a previously recorded episode titled bilious colic.

mcgill university vivian royal alexandra hospital jonathan white evanston dr white Dr feldman Leong Lung cooley
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

02:48 min | 8 months ago

"royal alexandra hospital" Discussed on Surgery 101

"Surgery at the University of Alberta. My name is Jonathan White, and I'm a general surgeon here at the Royal Alexandra. Hospital in lovely. Edmonton. This week's episode we're hearing from Guard Tower, who's a medical student from McMaster and the topic will be covering is an update on recent advances in the management of inflammatory bowel disease. This episode links back to our earlier series of episodes bite inflammatory bowel disease. We'll be getting updates on both medical management on the surgical management on talking a bit about how important it is to have multidisciplinary management of patients with inflammatory bowel disease. So let's get ready to get an update on IBD here on surgery one. Oh One. Hey everyone. My name is Garfield War and I'm a second year medical student, from McMaster, university in Hamilton Ontario. I would like to start off by thanking Dr White and the surgery went to one podcast team for giving me the opportunity to join his exciting initiative, I would also like to give a huge shout to Dr Snell Grove a call rectal surgeon at the University of Alberta Hospital in Edmonton to dock Bresca Joe. Lou a call rectal surgeon at Saint Joseph's hospital in Hamilton and to Doctrine Henchi A. General surgeon with specialization in surgical oncology at Saint Joseph's hospital in Hamilton without their guidance and expertise. This podcast was not possible in today's podcast I. Hope to highlight some recent advances in the medical and surgical management of patients with inflammatory bowel disease. Recognizing that IBD's a huge topic I will be building on the concepts introduced white and Dr Districts Back in their twenty twenty, seven lecture series and I be. If you need a refresher, please be sure to listen to those podcasts as well. We will begin by discussing the advances in medical management, emphasizing the mechanisms and indications of new drugs, including biologics, biosimilars, and to visit in a novell small molecule drug. Next we will discuss advances in surgical management highlighting the impact of minimally invasive techniques and new procedures. And finally we'll briefly discuss the. Role of multidisciplinary care for patients with IB. So without further ado, let's get started. Medical Therapy for IBD continues to be the first line treatment for most patients. Traditional medications including five solid cyclic.

bowel disease IBD Hamilton Ontario Jonathan White Edmonton McMaster Saint Joseph's hospital University of Alberta University of Alberta Hospital Royal Alexandra Dr Snell Grove Guard Tower novell Bresca Joe Lou
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

12:47 min | 10 months ago

"royal alexandra hospital" Discussed on Surgery 101

"Either? My name is Yasmin and I'm a third year medical student from the University of Alberta. This video has been created with help from Dr Ziemba algae a thoracic surgeon at the Royal Alexandra Hospital..

"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

11:31 min | 1 year ago

"royal alexandra hospital" Discussed on Surgery 101

"And Hello and welcome back once again to surgery one podcast brought to the help of the Department of Surgery at the University Alberta. I'm Jonathan White coming to you from Royal Alexandra Hospital in Edmonton Alberta. This week is the second in a series of two episodes all about trauma shock and bleeding last week. We left lift shock in some detail. This week will be considering bleeding. We'll be looking at the main types of hemorrhage on how you control it. We'll be talking about things like the fast exam exploratory laparoscopy on damage control techniques so let's get ready to get ourselves into some serious bleeding heroes surgery one. Oh one hello hello. My name is Tiffany Patsy. I am a fourth year medical student from McGill University. Today we are going to discuss our second episode in a surgery one podcast cast series on dealing with trauma I would I like to thank Dr White Surgery One on one podcast team for the opportunity to be here. I would also like to thank thank Dr Beckett and Dr Gorka Trauma Surgeons from McGill University for their valuable expertise on the subject in contribution to the podcast in the short series of podcasts. We're you're going to look at how to manage a patient who has undergone a trauma. We'll be following the same patient across two episodes last week we looked at the initial assessment mint and resuscitation of a trauma patient and this week will look at the management of hemorrhage after listening to this podcast students will be able to identify the two types of hemorrhage provide three methods to control external hemorrhage define the fast last exam why it is performed in the regions examined lists the six locations of life threatening bleeding and that define the difference between exploratory damage control lap. Rodney okay. Let's get an update on our patient who is brought by ambulance. After suffering blunt domino trauma following a motor vehicle collision upon arrival the patient was intimated for altered mental status and found to be hemodialysis unstable he was resuscitated with one leader. Ringer's lactate tate and three units of Pierre. BC's platelets and plasma the patients stabilized in no other injuries beside the seat belt sign across the abdomen where identified although the patient was human dynamic stable. Ongoing hemorrhage was highly suspected. Where is he bleeding from. How do you identify hemorrhage in a trauma patient. There are two main types of hemorrhage. One compatible also known as external hemorrhage and to not compress will or internal hemorrhage hemorrhage is typically visualized appears over a surface area of skin or the extremities for example a laceration to the scalp or Oren Open fracture to the Tibia depending on the type of external hemorrhage. There are different methods of management. Let's go over three types of management for external L. Hemorrhage one compression. This is typically done immediately. The open wound is packed with gauze pressures applied to try and compress the bleeding vessels else. It is important to mention that you must never remove packing. If the gods become soiled with blood you simply add more on top in continue to apply pressure removal of soil guys would also removed the newly forming blood clots to sutures or staples small aspirations can be suture immediately in in the trauma bay to prevent bleeding promote healing and prevent infection larger wounds may require the use of staples such as a bleeding scalp laceration tourniquet. Turn kids are commonly used for extremity bleeding. These are long belt like structures that are wrapped around the extremity proximal to the site the bleeding the tournament is then tightened to the extent in which bleeding cessation has occurred and distal pulses are no longer felt back to the case. What type of hemorrhage does arrogation have remember. When we did the exposure section of the primary survey. We did not identify any external bleeding in the context of our patients injuries. It is likely that he is suffering from internal bleeding. So what are you GonNa do now. How can you identify an intra abdominal bleed blunt abdominal injury causes compression of Intra abdominal organs in addition to Shear Shear Forces on vascular. Ns surrounding tissues which can result in internal bleeding the fast exam is an adjunct to the primary survey end. It's used as a method at the to rapidly identify intra abdominal or pericardial fluid fast dance for focussed assessment sophy in trauma. The examination consists consists of ultrasonography of the following regions won the right upper quadrant between the liver and the right kidney known as Morison's pouch to you the left upper quadrant between the spleen and the left kidney known as the spleen arenal space three the pelvis between the bladder and recommend males or the bladder and uterus in women known as the coach of Douglas and four the pericardial sac hyperbolic fluid identified on ultrasonography is highly Lee suspicious of bleeding and his record as a positive fast exam he mowed dynamically unstable patients with positive fast exam will likely be brought directly to the operating operating room whereas patients found to be stable. Maybe sent for a cat scan to better identify their injuries. What if you're fast exam is negative this. They should raise suspicion for bleeding in a different location. There are six main regions which can result in significant life threatening bleeding one the scout to intra cranial three the thoracic cavity four the abdomen the pelvis and six the thigh. The staff is very impressed with your ultrasound skills you you identified a significant amount of free fluid in the left upper quadrant of the abdomen indicating a positive fast exam before you can even turn off the machine. The patient's patient's blood pressure drops to ninety over fifty two. What now are you going to give him more fluids. At this point. The patient is likely bleeding internally an needs to be controlled in a patient with blunt abdominal injury hypertension and a positive fast exam. Treatment is a trauma lab. Harada me back to the case. It turns out that the surgeons have another patient on the table right now in he can't take your patient directly to the operating room. The trauma team leader asks you if you would consider using the Rebecca until the or is ready. What on Earth is that. Rebecca stands for resuscitate endovascular balloon inclusion of the Aorta which consists of a catheter device with a balloon located at the tip. The Catheter is inserted through the federal artery and threaded to the level of the abdominal aorta. The balloon is then inflated using normal ceiling proximal to the suspect a bleeding vessel there are three main zones in which ribaud can be deployed zone wine which is just above the silly at branch of the Aorta Zone to just below the silliest artery and above the renal branches although zone is commonly not used often zone three above the bifurcation of the order and this region and is commonly used for pelvic bleeding such as complex fractures or damage to the Elliott vessels the location of Ribaut device can be estimated based on the measurements movements of the Catheter external landmarks or imaging the Boa Balloon a clued Ziada reducing visceral blood flow and therefore bleeding as well it restores systolic blood pressure cardiac perfusion and cerebral blood flow. It is important to note that the Ribaud is a temporary method method of commonly used as a bridge to operative management back to the case amazing the or just called and they are now ready after all. We won't need to use the robot today. The patient is brought to the or amid line. Incision is made from the life process to the pubic synthesis upon entering the abdomen. The fossil form ligament is taken down and all four quadrant of the abdomen are packed uninspected for bleeding upon examination. The patient is found to have shattered spleen and a small liver laceration. The battle is run to identify a Mezin teric Eric Hematoma with no hollow viscous injury. Let's think about a different scenario what if the patient continued to remain stable in the or despite resuscitation with with blood products in this case it is likely that an exploratory lap Rodney would be abandoned and the surgeons would go on to perform a damage control at Ronnie in in the case of abdominal trauma patients who appear to be in extremists will go for a damage control apparatus which is different from your standard trauma laboratory at Damage Control Apparatus Rodney is performed as a temporary measure to obtain he most stasis this can be done through packing organs were section end clamping of bleeding vessels patients are then left with an open abdomen and brought to the Intensive Care Unit for additional resuscitation typically. These patients are then brought back to the war on the consecutive executive day for definitive management of their injuries. Luckily for our patient. He remains chemo dynamically stable. His spleen was removed without complication end. The abdomen was closed. The patient went on to make a full recovery and was discharged two days later some key points to remember for this podcast one the two main types of hemorrhage our internal and external to three humane methods to control external hemorrhage include packing and pressure sutures staples N. tourniquet three the fast exam. Zam is an abdominal ultrasound exam used to identify free fluid in the abdomen or the pericardial sac the region's examined include Morison's coach the spleen on renal space the pouch of Douglas and the pericardial sac for the six locations sins of life threatening bleeding include scalp inter cranial throughout the cavity abdomen pelvis and thigh and five exploratory. Tori laparoscopy is performed in a trauma patient where intra abdominal hemorrhage is suspected. The procedure includes definitive management whereas damage control apparatus includes only life life saving measures..

hemorrhage abdominal trauma Dr Gorka Trauma Surgeons abdominal aorta Rodney Morison McGill University Dr White Surgery One Department of Surgery Royal Alexandra Hospital Edmonton Jonathan White spleen arenal Alberta University Alberta Tiffany Patsy Zam BC
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

06:22 min | 2 years ago

"royal alexandra hospital" Discussed on Surgery 101

"Hello and welcome back again to surgery one one the podcast series. Brought you the health of the department of surgery at the university of Elbert this Jonathan white coming to you from the Royal Alexandra hospital in Edmonton is the third in a series of episodes kind of on the topic of Guinea on college. So for the last couple of weeks, we'd be looking at the topic of survival cancer this week were switching it up on looking at cantor over again, we're hearing from university of Ottawa medical student. Julia Boucher, and she'll be considering the pathophysiology and the different types of varying cancer. We looking what the risk factors are on high paces present what's in the history. What's in the visit emanation, and then should be considering what we do. When a patient has varying cancer was the workup high do make the diagnosis and what sort of treatments. So let's get ready to focus on the ovary here on surgery one. Oh one. Hi. My name is. Julia Boucher, and I'm a fourth year medical student from the university of Ottawa today with the help of Dr Hayek Otaki agai Nakada gist from the university of Albert we are going to be discussing an overview of an approach to ovarian cancer after listening to this episode learners should be able to understand the basic pathophysiology types of ovarian cancer. Recognize the risk factors in clinical presentation of ovarian cancer. And understand the workup and diagnosis of ovarian cancer. Every year approximately two thousand six hundred women in Canada will be diagnosed with ovarian cancer and more than half will die from the disease. It is the most lethal of all gonna collage cancers because it is often diagnosed at a later stage, not only are the symptoms of ovarian cancer nonspecific. But also, they don't often become apparent until the cancer has progressed. We will be discussing these symptoms later on in this podcast. First. Let's talk about the three types of varying cancer. Each type comes from a different component of the ovary. The most common is epithelial ovarian cancer which occurs in the epithelial cells that cover the outer surface of the ovary next are germ cell tumors. They start in the egg cells inside the ovary. Last are six chords struggle tumors that in the connective tissue of the ovary germ cell in sex courts, drill tumors can get pretty complicated. Just remember that germ cell tumors starting the egg and usually occur in girls or younger women. Sex cords struggle tumors, starting the connective tissue, which includes cells that secrete estrogen into stone. So patients can present with hyper estrogen symptoms like postmenopausal bleeding or hyper antigen symptoms like hers citizen now that we know about the three types of ovarian cancer. Let's talk a little bit more about the most common type, which is epithelial. There are many different sub types of epithelial ovarian cancer these include. Cirrus which can be low grade or high-grade and Dmitriev undifferentiated borderline clear cell and Mucis don't worry about memorizing, these it's more important to be aware that there are various subtypes of epithelial, ovarian cancer that you man counter on rotation. You may also want to remember that new research shows that Cirrus epithelial ovarian cancer likely originates in the Philippian tubes. Now that we have the basics down. Let's introduce our patient. You are on your family medicine rotation and your precept introduces you to MRs Bergeroo, she is a fifty six year old woman that has been your precepts patient for many years. She's opposed menopausal Gesia women, which means she has never been pregnant before for contraception. Her husband had of a sect to me many years ago when they decided they didn't want have children. She has never used any form of hormonal contraception herself, she suffers from hypertension that is well controlled otherwise, she is healthy has had no surgeries a review of her family. History reveals no history of breast uterine colon or ovarian cancer. She is coming in today. Complaining of fatigue now try to remember those details because we'll come back to them later in the podcast for now. You're precept our asks you to go see the patient to get a more detailed history. Upon questioning Mrs Berger says she has been feeling more tired than usual for the past three months. She denies any other constitutional symptoms when you inquire about her. Gal habits she says that she feels more bloated than usual has also noticed that she is only able to eat about half of what she would normally eat before she starts to feel full. She asks if these symptoms of bloating early society could be related to her fatigue before we answer that question. Let's review the clinical presentation of ovarian cancer as I alluded to earlier the clinical presentation can be somewhat vague women may present with fatigue, bloating, increased domino, girth, pelvic, or abdominal pain or pressure, dispatch Zia, and or early society, although these symptoms may seem nonspecific they occur because the cancerous cells being shed from the ovary into the peritoneal fluid are transported onto the lining of the pelvic domino peritoneum implantation on the peritoneum can lead to a site. He's and bowel obstruction, which explains the symptoms. We mentioned earlier cancer cells may also migrate to other organs and lead to urinary. Symptoms change in bowel habits, and even shortness of breath. It seems that MRs Bergeroo has some of these symptoms. She's complaining of fatigue, bloating and early society. So is she at risk of having ovarian cancer. Let's

ovarian cancer fatigue Julia Boucher MRs Bergeroo bloating Cirrus Royal Alexandra hospital university of Elbert university of Ottawa cantor change in bowel habits Canada Edmonton Mrs Berger Jonathan white Guinea on college postmenopausal bleeding Dr Hayek Otaki
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

07:11 min | 2 years ago

"royal alexandra hospital" Discussed on Surgery 101

"Hello on well again to surgery one one the podcast series. Brought you with health the department of surgery here at the university of Berta. My name is Dr Jonathan white on broadcasting from the Royal Alexandra hospital in Edmonton this week is part two of two part series on cancer of the cervix brought to us by medical student. Julia Bush from the university of Ottawa last week, we looked at risk factors pathophysiology this week looking at physical Titian so high to recognize the condition patient, how do we make the diagnosis? And then what do we do about? It. What we do in terms of staging what we do in terms of treatment. So lesku to look even further into the topic of cancer of the surveys, Iran surgery one. Oh one. Hi. My name is. Julia Boucher, and I'm a fourth year medical student from the university of Ottawa. This is the second in two part series on cervical cancer in this episode with the help of Dr Haya Kentucky agai Nakada just from the university. Alberda we will discuss an overview of the clinical presentation, differential diagnosis, staging and treatment options of cervical cancer. After listening to this episode learners should be able to. Recognize the common clinical presentation of cervical cancer. Understand the differential diagnosis of cervical cancer. Understand the basics of cervix cancer staging and treatment options. In last week's episode, we discussed the pathophysiology risk factors and prevention and screening methods for cervical dysplasia today. We will use two different case studies to discuss evaluation and workup for cervical cancer. Let's begin with our first patient. Juliet is a thirty year old. Jeez. Era woman that has recently become a new patient of yours. She and her family are recent immigrants to Canada from Uganda. She was not getting regular checkups in Uganda before moving to Canada. She is here today in your office for her first. Visit you get her complete medical history and on review of systems, she mentions that she sometimes has browned discharge after intercourse as part of her routine screening, you offer her Pap test today on examination you notice that the cervix appears very vascular and somewhat fry -able, which you note on the Pap test pathology requisition, you complete your examination and let her know that you will follow up with her in regards to the Pap test results. Juliet's mom is also here today as a new patient of yours. Mrs owner is a fifty year old g six p five women. That was also not getting routine care new. Enda before moving to Canada on review of systems. She mentioned that she sometimes has bleeding between her periods also known as intermittent Strobe leading an often has spotting after intercourse known as post-coital bleeding. Mrs owning is reluctant to have a Pap test today, you acknowledged that it can be uncomfortable. But emphasize the importance of the test after answering her questions, she is agreeable on examination you notice a focal area vascular sation on her cervix, which you note on the pathology requisition, you'll let her know that you will follow up with the results. But you also mentioned that you will refer her to gynecologist because of the Abner malady that you noticed on her cervix. Now that you've been introduced to our to patients. Let's talk a little bit more about cervical cancer. Most cervical cancers can be divided into two types squamous cell carcinoma accounts for proximity. Seventy to seventy five percent of cervix cancer in ad no carcinoma accounts for about twenty to twenty five percent. Other types include Adna, squamous, carcinoma undifferentiated and small cell carcinoma. Clinical presentation of cervical cancer can be divided into early or late symptoms early symptoms include abnormal bachelor, discharge that is thin watery or blood tinged. Patients may also present with abnormally bleeding, including inter menstrual, post coil or postmenopausal bleeding. The patient may also be symptomatic. Late symptoms include pelvic pain, leg. Pain or swelling bleeding from the rectum bladder flank pain or heavy vaginal bleeding. Do. Either of our case studies have any of these symptoms. Let's review both Juliet and MRs owning have symptoms that may be associated with cervical cancer Juliette complained of post-coital Brown discharge and MRs own acc- complained of inter menstrual and postpone bleeding does that mean that both women have served go cancer. Let's review our differential diagnosis a frequent cause of post-coital bleeding is an extra peon cervix in his very common. Amongst young women electro peon occurs. When the squamous NAR junction is present on the echo cervix are differential. Also includes cervical polyps. Nobody the insists Endo service Itis and other more rare vaginal legions, including malignancies to Burke, yellow and syphilis Schenker's metastasis of other cancers is also possible and generally occurs by direct. Extension of rectal, bladder uterine cancer. Let's return to the Pap test results are case studies Juliet's Pap test return normal negative for inter epithelial lesion. You are able to reassure her that she has an extra peon cervix that you saw on specula- MAGS eminating in that is likely the cause of her post Quito Brown discharge MRs own IX Pap test returned as high grade squamous epithelial lesion or h so as you had already referred her to a gynecologist who does capacity you forward the Pap test results to them as well. A couple of weeks later, you receive documentation from the consulting physician stating that biopsies retaken end reveal a moderately differentiated squamous cell carcinoma and MRs owning was therefore referred to gynecologic oncologists. Now,

cervical cancer Juliet cervical dysplasia uterine cancer Canada university of Ottawa postmenopausal bleeding Uganda Royal Alexandra hospital Julia Bush university of Berta Dr Jonathan white vaginal bleeding pelvic pain Julia Boucher Edmonton Dr Haya Kentucky Iran Enda
"royal alexandra hospital" Discussed on Surgery 101

Surgery 101

05:11 min | 2 years ago

"royal alexandra hospital" Discussed on Surgery 101

"Hello and welcome back to surgery one in one the podcast series. Brought to you with the help of the department of surgery at the university of Berta. My name is Dr Jonathan white. I'm coming to you from the Royal Alexandra hospital this week, we have the first two episodes focused on cancer of the cervix brought to us by university of of a medical student. Juliet Boucher in this first episode will be looking at the normal functions of the cervix at considering the risk factors unpack the physiology for cervical cancer hide as it arise next week. We'll be looking at the clinical presentation of the condition sue less karate to take a good look at cancer of the cervix here on surgery one. Oh one. Hi. My name is. Julia Boucher, and I'm a fourth year medical student from the university of Ottawa. This is the first of a two part series on cervical cancer in this episode with the help of Dr Hayek Kentucky gynecologist from the university of Alberta. We will discuss an overview of an approach to cervical dysplasia after listening to this episode learners should be able to one understand the basic pathophysiology of cervical, dysplasia and cervical cancer. To recognize the risk factors for cervical, dysplasia and cervical cancer. Three understand the screening tests and management of cervical dysplasia. Let's start with a brief introduction of the cervix the cervix acts as a mechanical barrier to infectious microorganisms, the part closest to the uterus is called the Endo cervix the part closest to the vagina is called the eco cervix and the Endo cervical canal lies between them the most important part of the cervix to understand today is the point where the calumnious epithelium of the Endo cervix meets the squamous epithelium of the echo cervix. This point where two different cell types. Meet is called the transformation zone or more. Specifically the square kilometer junction because it is continuously regenerating new cells. It is often where we find serve displeasure in cancer. Now, do we understand the cervix a bit more? Let's move onto Eddie meal g in developed countries where cervical cancer prevention and screening programs are available. Cancer of the cervix is the third most common gynecological cancer after uterus over because of these programs. There's been a seventy five percent decrease in the incidence and mortality of cervical cancer in the past fifty years. Unfortunately in developing countries with no screening programs in place. Cancer of the cervix is the second most common cancer diagnosis, and cause of death among women now that we have a basic understanding of the global inequity of this disease. Let's review the pathophysiology cervical displeasure or pre cancer is the development of abnormal cells on the surface lining, the cervix or under cervical canal. These normal changes are usually caused by an HP or human papillomavirus. Infection. There are over fifty types of HP all of which are sexually transmitted HP is the most common sexually transmitted infection in North America and most sexually active adults will be infected at some point in their lifetime. However progression to serve cancer only affects a small percentage of infected women with persistent infection and depends on which strain is present certain on Cajanek strains such as H P V types sixteen and eighteen account for seventy percent of all cervical cancer. Another twenty percent is caused by HP type thirty one thirty three forty five fifty two and fifty eight. There are many other strains that may cause genital warts also known as condo Lomas or have no long-term effect and regress back to normal basically cervical displeasure in cervical cancer lie on a continuum. Cervical dysplasia can regress. It can remain stable. Or it can progress to cervical cancer. It is the potential to progress to cancer that makes prevention in screening so important. Now,

cervical cancer cervical dysplasia Endo cervical canal HP Royal Alexandra hospital Dr Jonathan white university of Berta Juliet Boucher Julia Boucher university of Ottawa Dr Hayek Kentucky university of Alberta Eddie North America Lomas seventy five percent seventy percent twenty percent fifty years