More information at http://www.vohrawoundcare.com/education Vohra Wound Physicians: Healing Wounds, Saving Lives Understand Wound Care: Wound Measurement Demonstration Summary- This is a demonstration of a wound care physician exhibiting the correct measurement of a wound. Japa Volchok, DO explains how to accurately and consistently measure wounds. Volchok discusses the importance of proper measurement and documentation in the wound healing process. This demonstration is performed by a trained wound care physician for educational purposes only and should not be tried at home. Understand Wound Care: Wound Measurement Demonstration Commentary: Japa Volchok, DO In this demonstration we will be exhibiting the correct measurement of a wound. For wound measurement you will want to have a disposable paper or similar measuring device as well as a cotton-tipped applicator. The measuring device is either a paper or plastic disposable measuring tape. It is generally marked in centimeter markings with sub-markings in millimeters. A cotton-tipped applicator is useful for measuring depth and checking for any undermining. This model demonstrates a wound. By convention, the superior aspect of the wound would also usually coincide with the head. The inferior aspect would be the foot. We measure length from a head to foot direction. Width is measured from left to right or right to left. Depth is measured at the maximum location of depth in the wound. The left to right or right to left convention does not matter in terms of the documentation. It is important however, that length and width are correctly measured and documented. As the convention from head to feet for length and left to right for width are important in being able to reproduce measurements between measurers. In this particular instance, we would start off by measuring the wound in the length dimension. Where there is the maximum length of this wound of approximately 5.7 centimeters. The width would then be measured at its maximum point of width which is 2.5 centimeters. The depth we then would determine by probing the wound with our cotton-tipped applicator using the cotton end. We would probe all areas of the wound to determine where the most depth was located. It appears to be approximately in the middle of the wound. We would then slide our finger down the cotton-tipped applicator to where it is flush with the intact skin. Pinch the applicator at that point and withdraw from the wound. This can then be laid over your measuring device and the depth determined. In this particular instance, it appears to be 1.8 or 1.9 centimeters. Once the length, width and depth of the wound have been measured, it is important to then record any evidence of undermining and what the dimensions of that undermining are. In determining undermining, gently probe the wound with your cotton-tipped applicator circumferentially around the wound. You can see that over on this side of the wound we are starting to see some undermining. It appears at this location, the cotton-tipped applicator slips deeper under the wound then it does at any other point. This would be the maximum area of undermining. As you can see, by convention, the superior aspect of the wound or the head aspect of the wound would be 12 o'clock. If we then progress clockwise around a clock face, the area of maximum undermining is approximately 10 o'clock. Similar to how we measured the depth of the wound, you would want to slide your finger down the cotton-tipped applicator. Pinch it with your nail. Then, bring it up to your measuring device. In this particular instance, it appears that the undermining is approximately 1.7 centimeters. As you will recall from the last image, the undermining is located at 10 o'clock. This will be recorded as 1.7 centimeters of undermining at 10 o'clock. For more information visit http://www.woundphysicians.com or http://www.understandwoundcare.com
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My advice is this: Settle! That's right. Don't worry about passion or intense connection. Don't nix a guy based on his annoying habit of yelling "Bravo!" in movie theaters. Overlook his halitosis or abysmal sense of aesthetics. Because if you want to have the infrastructure in place to have a family, settling is the way to go. Based on my observations, in fact, settling will probably make you happier in the long run, since many of those who marry with great expectations become more disillusioned with each passing year. (It's hard to maintain that level of zing when the conversation morphs into discussions about who's changing the diapers or balancing the checkbook.) Obviously, I wasn't always an advocate of settling. In fact, it took not settling to make me realize that settling is the better option, and even though settling is a rampant phenomenon, talking about it in a positive light makes people profoundly uncomfortable. Whenever I make the case for settling, people look at me with creased brows of disapproval or frowns of disappointment, the way a child might look at an older sibling who just informed her that Jerry's Kids aren't going to walk, even if you send them money. It's not only politically incorrect to get behind settling, it's downright un-American. Our culture tells us to keep our eyes on the prize (while our mothers, who know better, tell us not to be so picky), and the theme of holding out for true love (whatever that is—look at the divorce rate) permeates our collective mentality. Even situation comedies, starting in the 1970s with The Mary Tyler Moore Show and going all the way to Friends, feature endearing single women in the dating trenches, and there's supposed to be something romantic and even heroic about their search for true love. Of course, the crucial difference is that, whereas the earlier series begins after Mary has been jilted by her fiancé, the more modern-day Friends opens as Rachel Green leaves her nice-guy orthodontist fiancé at the altar simply because she isn't feeling it. But either way, in episode after episode, as both women continue to be unlucky in love, settling starts to look pretty darn appealing. Mary is supposed to be contentedly independent and fulfilled by her newsroom family, but in fact her life seems lonely. Are we to assume that at the end of the series, Mary, by then in her late 30s, found her soul mate after the lights in the newsroom went out and her work family was disbanded? If her experience was anything like mine or that of my single friends, it's unlikely. And while Rachel and her supposed soul mate, Ross, finally get together (for the umpteenth time) in the finale of Friends, do we feel confident that she'll be happier with Ross than she would have been had she settled down with Barry, the orthodontist, 10 years earlier? She and Ross have passion but have never had long-term stability, and the fireworks she experiences with him but not with Barry might actually turn out to be a liability, given how many times their relationship has already gone up in flames. It's equally questionable whether Sex and the City's Carrie Bradshaw, who cheated on her kindhearted and generous boyfriend, Aidan, only to end up with the more exciting but self-absorbed Mr. Big, will be better off in the framework of marriage and family. (Some time after the breakup, when Carrie ran into Aidan on the street, he was carrying his infant in a Baby Björn. Can anyone imagine Mr. Big walking around with a Björn?)
Views: 208417 Shari Wing
Awareness Day 2018: “Partnering for Health and Hope Following Trauma” took place on May 10. The event’s interactive town hall discussion focused on strategies for making child-serving systems more trauma-informed. The discussion featured senior federal officials and family and young adult leaders, as well as executives from the nation’s leading professional primary care and mental health organizations. Secretary of Health and Human Services, Alex M. Azar II, presented a SAMHSA Special Recognition Award to 18 governors’ spouses for their work in supporting trauma-informed care at the state level. The National Congress of American Indians (NCAI) accepted a Special Recognition Award on behalf of tribal nations across the country. The governors’ spouses and the executive director of NCAI served as Honorary Chairpersons of the event. Visit https://www.samhsa.gov/children/awareness-day/2018 for more information.
Views: 472 SAMHSA