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Chicago Hope: Reading Between The Lines
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liver: In humans, a large reddish-brown organ that weighs approximately
4.5 pounds and sits in the right upper abdomen. The liver is responsible for
many regulatory, detoxification and storage functions, including secreting bile
and metabolizing carbohydrates, fats and proteins. Because huge amounts of
blood pass through the liver, a simple cut or laceration to the organ can
easily result in death.
suction: The drainage of a cavity using a suction apparatus attached to
a drainage tube. Suction is especially important in traumatic and surgical
situations where profuse bleeding can impair a doctor's ability to view the
area of concern.
retractor: A blunt metal bar or hook used to hold back an organ or the
edges of an incision.
gel foam: A medical product resembling a thin piece of Styrofoam
impregnated with a chemical that, when placed on a bleeding wound, can enhance
clotting.
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clamps: An instrument used to compress or grasp a structure. In this
case, clamps are being used to pinch off blood vessels in an attempt to stop
bleeding.
sponge laps: A large gauze pad used to soak up blood during a
laparotomy (the surgical procedure that opens the abdomen).
sponge sticks: A large gauze pad attached to the end of a clamp that
is use to soak up blood.
hemo clips: A type of clamp with a very small tip used to pinch off
blood vessels.
pulmonary artery: The pulmonary artery is the main blood vessel leading
from the heart to the lungs. It is the only artery in the body that carries
de-oxygenated blood. Because the pulmonary artery carries a large volume of
blood, injury to the artery can easily result in a patient bleeding to death.
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pulse: The rhythmical throbbing of arteries produced by the regular
contractions of the heart—usually felt at the wrist, on the neck or in the
groin. The absence of a pulse rate does not automatically mean death. In this
particular case, the patient's heart is still beating but his overall blood
volume is so low that his pulse is not registering—a condition is known as
hypovolemia.
thready: Medical jargon meaning "very weak."
lung: One of two spongy, sac-like organs which perform respiration—that is, removing carbon dioxide from the blood and replenishing it with
oxygen.
Bovey: An electrical tool used to cut tissue or cauterize blood
vessels.
thoracic aorta: The aorta is the main blood vessel that leads from the
left ventricle of the heart to the rest of the body. The thoracic aorta is the
portion of the aorta that is located in the thorax, or chest.
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aorta: The large artery that is the main trunk of the circulatory
system. Bigger than the diameter of a thumb and running from the heart to the
abdomen, it carries blood to all bodily organs. If the aorta is ruptured, a
patient can bleed to death in minutes.
blood pressure: The pressure exerted by the blood against the walls of
the arteries. Healthy young people tend to maintain normal blood pressure even
if they have lost a significant amount of blood. To achieve this, the heart
beats more quickly and the blood vessels constrict to keep the pressure steady.
If blood pressure does fall in a traumatic situation, it suggests massive blood
loss.
V-tach: Ventricular tachycardia. Normally, heart rhythm is controlled
by a specialized piece of tissue called the sino atrial node or "s.a. node."
If the function of the s.a. node is lost, the ventricle can take over this
pacemaking function. The result is a very unstable heart rhythm called
ventricular tachycardia.
internal paddles: The conductors on a defibrillator, which is a
machine used to shock the heart in an attempt to restart a normal heart rhythm.
Most defibrillation occurs externally with paddles placed against the
chest. In cases where the heart is exposed, smaller and more delicate internal
paddles can be placed directly on the heart.
joule: A unit of electrical energy (equal to the work done when a
current of 1 ampere is passes through a resistance of 1 ohm for 1 second).
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sinus tach: Sinus refers to the normal heart rhythm dictated by the
sino atrial node. Tachycardia or "tach" means fast. A patient with sinus
tachycardia has a heart that is beating quickly, but in a normal rhythm.
V-fib: Ventricular fibrillation. A state in which the heart stops
pumping, but the ventricle quivers—a very ominous cardiac rhythm.
direct cardiac compressions: Manually squeezing the heart to keep a
patient alive.
IV: A catheter that is placed in the vein to allow medications or
fluids to be administered directly into the blood stream.
ventilation: In this case, ventilation refers to artificially breathing
for the patient. In a trauma setting, this is usually achieved with a bag that
is manually squeezed to pump air into the patient.
O-neg blood: Blood is classified into groups according to antigens
present in the red blood cells. The two main antigens are designated A and B,
which gives rise to 4 blood groups: having A only (A), having B only (B),
having both (AB), and having neither (O). Each of these groups may or may not
contain the rhesus factor. Correct typing of blood groups is vital in
transfusion, since incompatible blood will result in blood clotting and
possibly death. O-negative blood is universal donor blood; in trauma
situations when there is no time for blood typing, O-negative blood can be
given without negative consequences.
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lactated ringers: A type of intravenous fluid often used in trauma
situations which mimics the chemistry of human blood.
Lidocaine: A drug used, in this case, to stabilize the heart rhythm.
amp: An ampule is a glass vial containing a dose of medication. It is
not a unit of measurement. An amp of one drug is not necessarily equal to an
amp of another drug.
Epi: Epinephrine. A drug which acts as a powerful stimulant to the
nervous system, which results in increased heart rate and force of
contraction.
asystole: The absence of heart contractions.
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flatline: Medical jargon referring to the flat line that appears on an
EKG when a person's heart has stopped beating.
Atropine: A drug used to speed up a slow heart rate.
EKG: Electrocardiograph. An instrument that measures electrical
activity of the heart muscle and presents a graphic display of the heart
rhythm.
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