South African Family Practice - Supplement 1, January 2015
Supplement 1, January 2015
Author A. AtiyaSource: South African Family Practice 57, pp 2 –5 (2015)More Less
The trauma epidemic sweeping the world continues to grow. Patients that are involved in a traumatic incident present to healthcare facilities on a daily basis, and may range from "bumps and bruises" to severely injured patients, requiring the co-ordinated care of several departments in the hospital. With the advent of several major military conflicts the world over, management of these severely injured patients, especially those with penetrating and blast injuries, has rapidly evolved, with concepts such as Damage Control Resuscitation, Damage Control Surgery, and high volume blood transfusions being better understood, and more widely practised. Furthermore, the pathophysiology of trauma is now also better understood, and interventions aimed at manipulating this physiology are now common. This focused review, will attempt to concisely explain the pathophysiology of trauma, as well as review the management of the modern trauma patient.
Author B.M. GardnerSource: South African Family Practice 57, pp 6 –9 (2015)More Less
The beach chair or barbershop position is used to facilitate several forms of surgery, by placing the patient in a semi-sitting position. A standard operating table or a special "beach chair" table can be used. Typically the patient is placed in 10° to 15° of Trendelenburg, the hips are flexed to 45° to 90° and the knees are flexed to 30°. The feet are supported with a foot bar to keep the ankles at 90°. The head, neck and torso are supported in a neutral position by straps and or special attachments.
Author C. QuanSource: South African Family Practice 57, pp 10 –15 (2015)More Less
Ultrasound is an oscillating sound pressure wave with a frequency greater than the upper limit of human hearing (20 kilohertz). Medical ultrasound utilizes sound waves with a frequency of 1-18 Megahertz. In the last decade or so, there has been an exponential increase in the use of ultrasound technology in the medical field, outside the realm of radiologists.
Author H.J. MoutlanaSource: South African Family Practice 57, pp 16 –19 (2015)More Less
Obstetric haemorrhage is one of the leading causes of maternal mortality worldwide. In South Africa, according to the National Committee for Confidential Enquiry into Maternal Deaths (NCCEMD), obstetric haemorrhage was the second most common cause of maternal deaths in the triennium 2008 - 2010. The report showed that obstetric haemorrhage contributed 14.1% of all maternal deaths in that period and it continues to be the most common cause of avoidable maternal mortality.
Author M.L. VariawaSource: South African Family Practice 57, pp 20 –24 (2015)More Less
Laparoscopic surgery is one of the key diagnostic and therapeutic tools in the current surgical era. It is a principle technique for minimally invasive surgery, and has been used in procedures ranging across various surgical subspecialities. Recent technological advances have enabled major progress and extension of the technique from gynaecologic surgery to major general surgical procedures. The greatest clinical advantages are probably in the area of abdominal general surgery, which is the main focus of this article. Since the first laparoscopic cholecystectomy performed in the late 1980's, the technique has developed as the treatment of choice for patients with gallstone disease. It has also been applied to various thoracic, upper and lower abdominal procedures including fundoplication, vagotomy, hemicolectomy, herniorrhaphy, nephrectomy, pelvic lymph node dissection, bariatric surgery, hysterectomy and oesophagectomy, to name a few.
Author A. BeetonSource: South African Family Practice 57, pp 26 –28 (2015)More Less
A child with morphological features at variance from societal perceptions of normality (too big, too small, too fat, too floppy, too stiff, too hairy, too distorted, funny face). The more "abnormal" features present, the more likely that the child has a syndrome. However, FLKs do not have to be syndromic. They may instead have malformations, disruptions, deformations, dysplasias, associations, complexes or sequences - all of which may be relevant to anaesthesia. The aetiology may be genetic or acquired. 3 -7 % of children are born with one or more congenital abnormality. 75% of these affect the cranio-facial area. Frequently, parents arrive at the pre-operative interview with literature related to the child's condition. Ignore this at your peril!