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| Unknown | 1994-03-02 | 2.0 KB |
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|00000000| 08 00 12 00 fc 00 0a 02 | 13 03 2f 04 61 05 e4 05 |........|../.a...|
|00000010| e9 06 50 72 65 6c 69 6d | 69 6e 61 72 79 20 64 69 |..Prelim|inary di|
|00000020| 61 67 6e 6f 73 69 73 20 | 69 6e 64 69 63 61 74 65 |agnosis |indicate|
|00000030| 64 2c 20 61 6e 64 20 74 | 68 65 20 58 2d 72 61 79 |d, and t|he X-ray|
|00000040| 20 63 6f 6e 66 69 72 6d | 65 64 20 61 20 73 75 62 | confirm|ed a sub|
|00000050| 64 75 72 61 6c 20 68 65 | 6d 61 74 6f 6d 61 2e 20 |dural he|matoma. |
|00000060| 59 6f 75 20 68 61 76 65 | 20 73 75 63 63 65 73 73 |You have| success|
|00000070| 66 75 6c 6c 79 20 72 65 | 74 72 61 63 74 65 64 20 |fully re|tracted |
|00000080| 74 68 65 20 73 63 61 6c | 70 20 28 73 65 65 20 49 |the scal|p (see I|
|00000090| 6e 63 69 73 69 6e 67 20 | 61 6e 64 20 4f 70 65 6e |ncising |and Open|
|000000a0| 69 6e 67 20 74 68 65 20 | 53 63 61 6c 70 29 2c 20 |ing the |Scalp), |
|000000b0| 61 6e 64 20 74 68 65 72 | 65 20 73 68 6f 75 6c 64 |and ther|e should|
|000000c0| 20 62 65 20 61 20 76 69 | 73 69 62 6c 65 20 66 72 | be a vi|sible fr|
|000000d0| 61 63 74 75 72 65 20 75 | 6e 64 65 72 6e 65 61 74 |acture u|nderneat|
|000000e0| 68 20 77 68 69 63 68 20 | 6c 69 65 73 20 74 68 65 |h which |lies the|
|000000f0| 20 68 65 6d 61 74 6f 6d | 61 2e 20 00 49 66 20 74 | hematom|a. .If t|
|00000100| 68 65 72 65 20 69 73 20 | 6e 6f 20 66 72 61 63 74 |here is |no fract|
|00000110| 75 72 65 2c 20 67 75 65 | 73 73 20 77 68 61 74 20 |ure, gue|ss what |
|00000120| 2d 20 79 6f 75 20 65 69 | 74 68 65 72 20 6d 69 73 |- you ei|ther mis|
|00000130| 64 69 61 67 6e 6f 73 65 | 64 20 6f 72 20 74 75 72 |diagnose|d or tur|
|00000140| 6e 65 64 20 74 68 65 20 | 70 61 74 69 65 6e 74 27 |ned the |patient'|
|00000150| 73 20 68 65 61 64 20 74 | 68 65 20 77 72 6f 6e 67 |s head t|he wrong|
|00000160| 20 77 61 79 2e 20 45 69 | 74 68 65 72 20 77 61 79 | way. Ei|ther way|
|00000170| 2c 20 74 68 65 20 63 68 | 69 65 66 20 6e 65 75 72 |, the ch|ief neur|
|00000180| 6f 73 75 72 67 65 6f 6e | 20 77 69 6c 6c 20 68 61 |osurgeon| will ha|
|00000190| 76 65 20 79 6f 75 72 20 | 68 65 61 64 2e 20 49 66 |ve your |head. If|
|000001a0| 20 79 6f 75 20 73 65 65 | 20 74 68 65 20 66 72 61 | you see| the fra|
|000001b0| 63 74 75 72 65 2c 20 79 | 6f 75 20 63 61 6e 20 62 |cture, y|ou can b|
|000001c0| 72 69 65 66 6c 79 20 62 | 72 65 61 74 68 65 20 61 |riefly b|reathe a|
|000001d0| 20 73 69 67 68 20 6f 66 | 20 72 65 6c 69 65 66 2e | sigh of| relief.|
|000001e0| 20 41 74 20 6c 65 61 73 | 74 20 79 6f 75 27 76 65 | At leas|t you've|
|000001f0| 20 66 61 6b 65 64 20 79 | 6f 75 72 20 77 61 79 20 | faked y|our way |
|00000200| 74 68 69 73 20 66 61 72 | 2e 00 43 68 65 63 6b 20 |this far|..Check |
|00000210| 72 65 73 70 69 72 61 74 | 69 6f 6e 2c 20 45 4b 47 |respirat|ion, EKG|
|00000220| 20 61 6e 64 20 62 6c 6f | 6f 64 20 70 72 65 73 73 | and blo|od press|
|00000230| 75 72 65 20 69 6d 6d 65 | 64 69 61 74 65 6c 79 20 |ure imme|diately |
|00000240| 74 6f 20 6d 61 6b 65 20 | 73 75 72 65 20 65 76 65 |to make |sure eve|
|00000250| 72 79 74 68 69 6e 67 20 | 69 73 20 77 69 74 68 69 |rything |is withi|
|00000260| 6e 20 73 61 66 65 20 6c | 69 6d 69 74 73 2e 20 53 |n safe l|imits. S|
|00000270| 65 6c 65 63 74 20 69 72 | 72 69 67 61 74 69 6f 6e |elect ir|rigation|
|00000280| 20 28 74 68 65 20 74 75 | 62 65 20 77 69 74 68 20 | (the tu|be with |
|00000290| 61 20 62 75 6c 62 20 6f | 6e 20 74 68 65 20 65 6e |a bulb o|n the en|
|000002a0| 64 29 20 61 6e 64 20 70 | 6f 73 69 74 69 6f 6e 20 |d) and p|osition |
|000002b0| 6f 76 65 72 20 74 68 65 | 20 63 65 6e 74 65 72 20 |over the| center |
|000002c0| 6f 66 20 74 68 65 20 66 | 72 61 63 74 75 72 65 20 |of the f|racture |
|000002d0| 61 6e 64 20 63 6c 69 63 | 6b 2e 20 4d 61 6b 65 20 |and clic|k. Make |
|000002e0| 73 75 72 65 20 74 68 65 | 20 69 72 72 69 67 61 74 |sure the| irrigat|
|000002f0| 69 6f 6e 20 74 6f 6f 6c | 20 62 65 67 69 6e 73 20 |ion tool| begins |
|00000300| 74 6f 20 64 72 69 70 20 | 70 72 6f 70 65 72 6c 79 |to drip |properly|
|00000310| 2e 20 00 4e 6f 77 20 67 | 72 61 62 20 74 68 65 20 |. .Now g|rab the |
|00000320| 64 72 69 6c 6c 2c 20 6d | 6f 76 65 20 6f 76 65 72 |drill, m|ove over|
|00000330| 20 74 6f 20 74 68 65 20 | 66 72 61 63 74 75 72 65 | to the |fracture|
|00000340| 20 61 6e 64 20 63 6c 69 | 63 6b 2d 68 6f 6c 64 20 | and cli|ck-hold |
|00000350| 6f 6e 20 74 68 65 20 63 | 65 6e 74 65 72 2e 20 4c |on the c|enter. L|
|00000360| 69 73 74 65 6e 20 74 6f | 20 74 68 65 20 73 6f 75 |isten to| the sou|
|00000370| 6e 64 2e 20 49 4d 4d 45 | 44 49 41 54 45 4c 59 20 |nd. IMME|DIATELY |
|00000380| 72 65 6c 65 61 73 65 20 | 74 68 65 20 62 75 74 74 |release |the butt|
|00000390| 6f 6e 20 77 68 65 6e 20 | 73 6f 75 6e 64 20 67 6f |on when |sound go|
|000003a0| 65 73 20 75 70 20 69 6e | 20 70 69 74 63 68 2e 20 |es up in| pitch. |
|000003b0| 59 6f 75 20 73 68 6f 75 | 6c 64 20 68 61 76 65 20 |You shou|ld have |
|000003c0| 61 20 63 79 6c 69 6e 64 | 72 69 63 61 6c 20 68 6f |a cylind|rical ho|
|000003d0| 6c 65 2c 20 6e 6f 74 20 | 61 20 72 6f 75 6e 64 65 |le, not |a rounde|
|000003e0| 64 20 64 65 70 72 65 73 | 73 69 6f 6e 2c 20 61 74 |d depres|sion, at|
|000003f0| 20 74 68 65 20 64 72 69 | 6c 6c 20 70 6f 69 6e 74 | the dri|ll point|
|00000400| 2e 20 4f 6e 65 20 68 6f | 6c 65 20 69 73 20 73 75 |. One ho|le is su|
|00000410| 66 66 69 63 69 65 6e 74 | 20 73 6f 20 72 65 70 6c |fficient| so repl|
|00000420| 61 63 65 20 74 68 65 20 | 64 72 69 6c 6c 2e 00 47 |ace the |drill..G|
|00000430| 72 61 73 70 20 74 68 65 | 20 62 6f 6e 65 20 77 61 |rasp the| bone wa|
|00000440| 78 20 61 6e 64 20 63 6c | 69 63 6b 20 6f 6e 20 74 |x and cl|ick on t|
|00000450| 68 65 20 68 6f 6c 65 20 | 79 6f 75 20 6a 75 73 74 |he hole |you just|
|00000460| 20 64 72 69 6c 6c 65 64 | 20 74 6f 20 73 74 6f 70 | drilled| to stop|
|00000470| 20 62 6c 65 65 64 65 72 | 73 2e 20 52 65 70 6c 61 | bleeder|s. Repla|
|00000480| 63 65 20 74 68 65 20 77 | 61 78 20 61 6e 64 20 74 |ce the w|ax and t|
|00000490| 68 65 20 64 72 69 6c 6c | 20 74 6f 20 74 68 65 20 |he drill| to the |
|000004a0| 74 72 61 79 20 69 66 20 | 79 6f 75 20 68 61 76 65 |tray if |you have|
|000004b0| 20 6e 6f 74 20 61 6c 72 | 65 61 64 79 20 64 6f 6e | not alr|eady don|
|000004c0| 65 20 73 6f 2e 20 55 73 | 65 20 74 68 65 20 73 63 |e so. Us|e the sc|
|000004d0| 61 6c 70 65 6c 20 74 6f | 20 6d 61 6b 65 20 61 6e |alpel to| make an|
|000004e0| 20 69 6e 63 69 73 69 6f | 6e 20 69 6e 20 74 68 65 | incisio|n in the|
|000004f0| 20 68 6f 6c 65 20 61 6e | 64 20 72 65 70 6c 61 63 | hole an|d replac|
|00000500| 65 20 69 74 20 6f 6e 20 | 74 68 65 20 74 72 61 79 |e it on |the tray|
|00000510| 2e 20 53 65 6c 65 63 74 | 20 74 68 65 20 73 75 63 |. Select| the suc|
|00000520| 74 69 6f 6e 20 69 6e 73 | 74 72 75 6d 65 6e 74 20 |tion ins|trument |
|00000530| 28 74 75 62 65 20 77 69 | 74 68 20 61 20 62 75 74 |(tube wi|th a but|
|00000540| 74 6f 6e 29 20 61 6e 64 | 20 63 6c 69 63 6b 2d 68 |ton) and| click-h|
|00000550| 6f 6c 64 20 69 6e 20 74 | 68 65 20 68 6f 6c 65 2e |old in t|he hole.|
|00000560| 00 59 6f 75 20 77 69 6c | 6c 20 6e 6f 74 69 63 65 |.You wil|l notice|
|00000570| 20 74 68 61 74 20 74 68 | 65 20 74 75 62 65 20 69 | that th|e tube i|
|00000580| 73 20 72 65 64 2e 20 20 | 57 68 65 6e 20 74 68 65 |s red. |When the|
|00000590| 20 74 75 62 65 20 74 75 | 72 6e 73 20 77 68 69 74 | tube tu|rns whit|
|000005a0| 65 20 49 4d 4d 45 44 49 | 41 54 45 4c 59 20 72 65 |e IMMEDI|ATELY re|
|000005b0| 6c 65 61 73 65 20 61 6e | 64 20 63 6c 69 63 6b 20 |lease an|d click |
|000005c0| 6f 6e 20 74 68 65 20 74 | 72 61 79 20 74 6f 20 72 |on the t|ray to r|
|000005d0| 65 70 6c 61 63 65 20 74 | 68 65 20 73 75 63 74 69 |eplace t|he sucti|
|000005e0| 6f 6e 2e 00 4e 6f 77 20 | 73 65 6c 65 63 74 20 74 |on..Now |select t|
|000005f0| 68 65 20 64 72 61 69 6e | 20 74 75 62 65 20 28 77 |he drain| tube (w|
|00000600| 69 74 68 20 22 75 22 20 | 68 6f 6f 6b 20 6f 6e 20 |ith "u" |hook on |
|00000610| 65 6e 64 29 20 61 6e 64 | 20 63 6c 69 63 6b 20 6f |end) and| click o|
|00000620| 6e 20 74 68 65 20 68 6f | 6c 65 2e 20 54 68 65 20 |n the ho|le. The |
|00000630| 44 72 61 69 6e 20 73 68 | 6f 75 6c 64 20 61 70 70 |Drain sh|ould app|
|00000640| 65 61 72 2e 20 4d 61 6b | 65 20 73 75 72 65 20 69 |ear. Mak|e sure i|
|00000650| 74 20 69 73 20 70 6c 61 | 63 65 64 20 70 72 6f 70 |t is pla|ced prop|
|00000660| 65 72 6c 79 2e 20 47 72 | 61 73 70 20 74 68 65 20 |erly. Gr|asp the |
|00000670| 73 75 74 75 72 65 20 28 | 63 75 72 76 65 64 20 6e |suture (|curved n|
|00000680| 65 65 64 6c 65 20 61 6e | 64 20 74 68 72 65 61 64 |eedle an|d thread|
|00000690| 29 20 61 6e 64 20 63 6c | 69 63 6b 20 6f 6e 20 74 |) and cl|ick on t|
|000006a0| 68 65 20 64 72 61 69 6e | 20 77 68 65 72 65 20 69 |he drain| where i|
|000006b0| 74 20 6c 69 65 73 20 6f | 6e 20 74 68 65 20 73 63 |t lies o|n the sc|
|000006c0| 61 6c 70 2e 20 44 6f 20 | 6e 6f 74 20 63 6c 69 63 |alp. Do |not clic|
|000006d0| 6b 20 6f 6e 20 74 68 65 | 20 62 6f 6e 65 20 6f 72 |k on the| bone or|
|000006e0| 20 64 72 61 70 65 2e 20 | 00 57 69 74 68 6f 75 74 | drape. |.Without|
|000006f0| 20 73 75 74 75 72 69 6e | 67 20 74 68 65 20 64 72 | suturin|g the dr|
|00000700| 61 69 6e 20 74 75 62 65 | 20 69 74 20 77 69 6c 6c |ain tube| it will|
|00000710| 20 70 75 6c 6c 20 6f 75 | 74 20 61 66 74 65 72 20 | pull ou|t after |
|00000720| 74 68 65 20 6f 70 65 72 | 61 74 69 6f 6e 20 61 6e |the oper|ation an|
|00000730| 64 20 62 65 20 76 65 72 | 79 20 6d 65 73 73 79 2e |d be ver|y messy.|
|00000740| 20 52 65 70 6c 61 63 65 | 20 73 75 74 75 72 65 20 | Replace| suture |
|00000750| 6f 6e 20 74 68 65 20 74 | 72 61 79 2e 20 49 66 20 |on the t|ray. If |
|00000760| 79 6f 75 20 68 61 76 65 | 20 67 6f 74 74 65 6e 20 |you have| gotten |
|00000770| 74 68 69 73 20 66 61 72 | 2c 20 79 6f 75 20 6d 69 |this far|, you mi|
|00000780| 67 68 74 20 68 61 76 65 | 20 77 68 61 74 20 69 74 |ght have| what it|
|00000790| 20 74 61 6b 65 73 20 74 | 6f 20 63 6c 6f 73 65 20 | takes t|o close |
|000007a0| 75 70 20 74 68 65 20 6f | 70 65 72 61 74 69 6f 6e |up the o|peration|
|000007b0| 20 73 75 63 63 65 73 73 | 66 75 6c 6c 79 20 28 73 | success|fully (s|
|000007c0| 65 65 20 47 65 6e 65 72 | 61 6c 20 43 6c 6f 73 69 |ee Gener|al Closi|
|000007d0| 6e 67 20 50 72 6f 63 65 | 64 75 72 65 73 29 2e 00 |ng Proce|dures)..|
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