Archive for November, 2013

Learning through experience

As you progress through the ranks of residency, you come to a point where you realize that you’ve learned so much through experience and repetition, often without consciously making an effort to do so. Ironic, because as a medical student and early resident, it was always frustrating when I would ask someone higher up how s/he would know the correct actions to take in a certain non-textbook type situation and the answer I would receive was “experience”.

Cardiothoracic chief

When the chief of cardiothoracic surgery calls you to ask for a favor, you ask how high.

Heads up display

A heads up display (HUD) in a car is one of the neatest features to be offered and widely available as an option on cars today. Interestingly, while they have been used in military aviation since WWII, the first automobile HUD units were offered in 1988 on the Oldsmobile Cutlass Supreme and Pontiac Grand Prix.

Elephant trunk technique

For combined lesions of the aortic arch and descending aorta, Borst introduced the elephant trunk technique in 1983. It is a two-staged procedure in which the arch is fixed first, with a segment of graft left protruding in the downstream aorta which is used in the second stage to repair the distal diseased area.

Elephant Trunk Procedure

Elephant Trunk Procedure

Vein stripping

Vein stripping is one of the most gruesome operations performed. A minor outpatient procedure where the patient goes home the same day, it consists of accessing a vein proximally and distally through two separate, small incisions, passing a wire through the vein, and essentially pulling the vein out through the other incision. Pressure is held to stop bleeding from all the venous branches.

Cryo-amputation

A cryo-amputation–where a limb threatened by acute ischemia is essentially frozen dead–can be performed when a patient is too sick to go to the operating room. Materials include a trash bag to wrap around the limb; a tourniquet to cut off blood supply below the amputation level; a pile of towels or other material for insulation; and about 10 kilograms of dry ice. Article here.

Catastrophic antiphospholipid syndrome

Catastrophic antiphospholipid syndrome (CAPS) is a rare form of antiphospholipid syndrome which leads to rapid organ failure and is associated with 50% mortality. Any medical term with the word “catastrophic” is definitely not something you want to be on the patient side of.

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