Chest X-Ray Interpretation

Chest X-ray interpretation is a common responsibility of any junior doctor. I think that having a structured approach to Chest X-ray interpretation will help you identify all the important diagnoses.

Surgical Hand Scrub

The way we wash our hands before entering the operating room is essential for preventing nosocomial infections. Even though it is a simple task it is important to do it right.
You need to proceed through the following steps:

1. Remove jewelry;
2. Apply antiseptic solution, from your fingertips to 4 cm below the elbow;
3. Scrub carefully between the fingers and subungual;
4. Scrub the forearm in a circular motion ;
5. Rinse hands with water;
6. Repeat the process one more time;
7. Dry your hands with a sterile towel from hand to forearm.

These are the simple steps but it is very important to pay attention at the following details:

• You should be proper dressed before hand scrubbing

• The time for hand scrubbing should be 5 min

• Don't use very hot water because it dries the skin

• Always place the hand higher than the elbow

• Rinse in one direction Hand -> Forearm

• After the scrub place your hands above the elbow

• Don't cross your hands

• Only touch things that are sterile

ALTERNATIVE:
According to Vergara Fernandez et al, who published the paper called Surgical team satisfaction levels between two preoperative hand-washing methods in "Revista de Investigacion Clinica" (2010 dec), 1% chlorhexidine gluconate and 61% ethyl alcohol (CGEA) is as effective as hand scrubbing and even prevents hand dryness, and reduces the cost of water.
I look at CGEA as a good alternative where acquiring water is a big problem.

 

 

 

 

 

 

http://www.queensburyschool.org/departments/health_safety/swineflu.htm

Perfect scar: how it's made?

Today I will talk about the best way to make an incision of the skin, so that the result will be the smallest cicatrice possible.
The most important component of the skin, that influences the way that a wound will heal is collagen, and in this case, type III collagen. Type I collagen is found in the skin, where it makes a network that draw invisible traction lines.[1]
According to Karl Langer, the first anatomist to search this subject in 1861, the human skin has a certain pattern. He observed this while doing research on cadavers with rigor mortis.

[2]
In 1999 Wilhelmi BJ and Co. published an article called "Langer's lines: to use or not to use" in which he claimed that the best incision lines are not Langer's, but ones made by Borges and Kraissl. The important detail observed in 1984 by Albert F. Borges was that in living humans traction lines differ a little bit. And so he formulated "Relaxed Skin Tension Lines", which are considered to be guideline for facial surgery.

 The best lines for body surgery is considered to be the one made by Cornelius J. Kraissl, because the healing process is faster and the scars post-incision are usually smaller.[3]
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1. http://www.ncbi.nlm.nih.gov/books/NBK21582/
2. http://www.med-ars.it/galleries/langer.htm
3. The Encyclopedia of Cosmetic and Plastic Surgery; Rinzler C.A.; Facts on File Inc; 2009