There are things such as a Cell Saver (a machine that re-circulates any blood the body uses), blood expanders, Hetastarch, erithropoetin medication (ahead of surgery). There are many persons who are not Jehovah's Witnesses that prefer bloodless surgery. There is the danger of passing on AIDS, Hepatitis B, C & E, any blood-borne diseases, parasites, worms, etc.

Also, because, in Leviticus is says to abstain from blood, you must not consume blood.

Jehovah Witnesses believe that you are still consuming blood through your veins. It's like if you want to do not want to drink liquor would it be better to A. Put it in your mouth. B. Stick an IV with a needle attached and pump liquor through your blood stream. C. Not drinking liquor at any amount in the first place.

The obvious answer is C. Not drinking liquor / blood in the first place either by putting it in orally, or into your veins at any amount in the first place.

Consider a man who is told by his doctor that he must abstain from meat. Would he be obedient if he accepted a kidney transplant?

ACCEPTABLE ALTERNATIVESBlood-oxygen monitoring devices

• Transcutaneous pulse oximeter
• Pediatric ultra-microsampling equipment
• Multiple tests per blood draw (batching)

• IV Iron (InFed, Ferrlicet, Venofer)
• Folic Acid
• Vitamin B-12
• Vitamin C
• Granulocyte-colony stimulating factor (Neupogen)
• Interleukin-11 (Neumega)
• Recombinant stem-cell factor (Stemgen)

• Hypotensive anesthesia
• Induced hypothermia
• Mechanical occlusion of bleeding vessel

• Avitene
• Gelfoam
• Oxygel
• Surgicel

• Desmopressin (DDAVP)
• e-aminocaproic acid (Amicar)
• Tranexamic acid (Cyklokapron)
• Vasopressin (Pitressin)
• Aprotinin (Trasylol)
• Vincristine (Oncovin)
• Conjugated estrogens
• Vitamin K (Phylonadione)
• Recombinant Factor VIIa (NiaStase)
• Recombinant Factor IX (BeneFIX)

• Ringer's lactate
• Normal and hypertonic saline

• Dextran
• Gelatin
• Hetastarch (Hespan, Hextend)
• Pentastarch

• Hyperbaric oxygen therapy
• Perfluorocarbon solutions (Oxygent)

• Electrocautery
• Ligasure vessel sealing system
• Laser surgery
• Argon beam coagulator
• Gamma knife radiosurgery
• Microwave coagulating scalpel
• Endoscope
• Arterial emobolization
• Cryosurgery
• Ultrasonic scalpel

PERSONAL DECISIONSMedical products and therapy

• Albumin
• Any drug buffered with albumin (e.g., Epogen/Procrit, Kogenate)
• Immune globulins
• Natural clotting factors
• Cryoprecipitate
• Plasma protein fractions (Plasmanate)
• Tissue adhesives
• Natural interferons
• Hemoglobin-based blood substitutes
• Platelet derived wound healing factors

• Red or white blood cell tagging

• Dialysis and heart-lung equipment
• Intraoperative blood salvage (Cell Saver) without storage
• Hemodilution (if blood is not stored)
• Therapeutic apheresis

1. OTOSCOPIC

The otoscopic exam is performed by gently pulling the auricle upward and backward. In children, the auricle should be pulled downward and backward. This process will move the acoustic meatus in line with the canal. Hold the otoscope like a pen/pencil and use the little finger area as a fulcrum. This prevents injury should the patient turn suddenly.

• Inspect the external auditory canal.
• Evaluate tympanic membrane
• • Note the color (red, white, yellow) and translucency (transparent, opaque) and position (retracted, neutral or bulging) of the drum
  • Identify the pars tensa with its cone of light, the handle and short process of malleus, and the anterior and posterior folds of the pars flaccida and position of the malleus handle..

Air inflation otoscopy (pneumatic-otoscope) is very useful to evaluate middle ear disease. Assess the mobility of tympanic membrane by applying positive and negative pressures with the rubber squeeze bulb.

• Auditory canal: Some hair, often with yellow to brown cerumen.
• Ear drum:
• • Pinkish gray in color , translucent and in neutral position.
  • Malleus lies in oblique position behind the upper part of drum.
  • Mobile with air inflation.

2.XRAY

X-radiation (composed of X-rays) is a form of electromagnetic radiation. X-rays have a wavelengthin the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz (3×1016 Hz to 3×1019 Hz) and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma rays. In many languages, X-radiation is called Röntgen radiation, after Wilhelm Conrad Röntgen, who is usually credited as its discoverer, and who had named it X-radiation to signify an unknown type of radiation.[1] Correct spelling of X-ray(s) in the English language includes the variants x-ray(s) and X ray(s).[2] XRAY is used as the phonetic pronunciation for the letter x.

X-rays from about 0.12 to 12 keV (10 to 0.10 nm wavelength) are classified as "soft" X-rays, and from about 12 to 120 keV (0.10 to 0.01 nm wavelength) as "hard" X-rays, due to their penetrating abilities.[3]

Hard X-rays can penetrate solid objects, and their most common use is to take images of the inside of objects in diagnostic radiography and crystallography. As a result, the term X-rayismetonymically used to refer to a radiographic image produced using this method, in addition to the method itself. By contrast, soft X-rays hardly penetrate matter at all; the attenuation length of 600 eV (~2 nm) X-rays in water is less than 1 micrometer.

The distinction between X-rays and gamma rays has changed in recent decades. Originally, the electromagnetic radiation emitted by X-ray tubes had a longer wavelength than the radiation emitted by radioactive nuclei (gamma rays).[5] Older literature distinguished between X- and gamma radiation on the basis of wavelength, with radiation shorter than some arbitrary wavelength, such as 10−11 m, defined as gamma rays. However, as shorter wavelength continuous spectrum "X-ray" sources such as linear accelerators and longer wavelength "gamma ray" emitters were discovered, the wavelength bands largely overlapped. The two types of radiation are now usually distinguished by their origin: X-rays are emitted by electrons outside the nucleus, while gamma rays are emitted by the nucleus.

3.ULTRASOUND

Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound examinations do not use ionizing radiation (as used in x-rays). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.

Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

Conventional ultrasound displays the images in thin, flat sections of the body. Advancements in ultrasound technology include three-dimensional (3-D) ultrasound that formats the sound wave data into 3-D images. Four-dimensional (4-D) ultrasound is 3-D ultrasound in motion.

A Doppler ultrasound study may be part of an ultrasound examination.

Doppler ultrasound is a special ultrasound technique that evaluates blood flow through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs and neck.

There are three types of Doppler ultrasound:

· Color Doppler uses a computer to convert Doppler measurements into an array of colors to visualize the speed and direction of blood flow through a blood vessel.

· Power Doppler is a newer technique that is more sensitive than color Doppler and capable of providing greater detail of blood flow, especially when blood flow is little or minimal. Power Doppler, however, does not help the radiologist determine the direction of blood flow, which may be important in some situations.

· Instead of displaying Doppler measurements visually, Spectral Doppler displays blood flow measurements graphically, in terms of the distance traveled per unit of time.

4.RADIATION

Radiation sickness treatment is aimed at preventing further radioactive contamination, managing organ damage, reducing symptoms and managing pain.

Decontamination

This phase of radiation sickness treatment removes external radioactive particles to the greatest extent possible. Removing clothing and shoes eliminates about 90 percent of external contamination. Gently washing with water and soap removes additional radiation particles from the skin.

Decontamination at the start of radiation sickness treatment prevents further distribution of radioactive materials and lowers the risk of internal contamination from inhalation, ingestion or open wounds.

Treatment for damaged bone marrow

A protein called granulocyte colony-stimulating factor, which promotes the growth of white blood cells, is used in radiation sickness treatment to counter bone marrow damage. This protein-based medication, which includes filgrastim (Neupogen) and pegfilgrastim (Neulasta), may increase white blood cell production and help prevent subsequent infections.

If you have severe damage to bone marrow, radiation sickness treatment may also include transfusions of red blood cells or blood platelets.

Treatment for internal contamination

Some radiation sickness treatments may reduce organ damage caused by radioactive particles. Medical personnel would use these treatments only if you've been exposed to a specific type of radiation. These treatments include the following:

Potassium iodide. This is a nonradioactive form of iodine. Because iodine is essential for proper thyroid function, the thyroid becomes a "destination" for iodine in the body. If you have internal contamination with radioactive iodine (radioiodine), your thyroid will absorb radioiodine just as it would other forms of iodine. Treatment with potassium iodide may fill "vacancies" in the thyroid and prevent absorption of radioiodine. The radioiodine is eventually cleared from the body in urine.

Prussian blue. This type of dye binds to particles of radioactive elements known as cesium and thallium. The radioactive particles are then excreted in feces. This treatment speeds up the elimination of the radioactive particles and reduces the amount of radiation cells may absorb.

Diethylenetriamine pentaacetic acid (DTPA). This substance binds to metals. DTPA binds to particles of the radioactive elements plutonium, americium and curium. The radioactive particles pass out of the body in urine, thereby reducing the amount of radiation absorbed.

Supportive treatment

If you have radiation sickness, you may receive additional medications or interventions to treat:

Bacterial infections

Headache

Fever

Diarrhea

Nausea and vomiting

Dehydration

End-of-life care

A person who has absorbed large doses of radiation (6 Gy or greater) has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting and diarrhea. They may also benefit from psychological or pastoral care.

5. C.T. SCAN

A computerized axial tomography scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Computerized axial tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments.

A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the body.

Imagine the body as a loaf of bread and you are looking at one end of the loaf. As you remove each slice of bread, you can see the entire surface of that slice from the crust to the center. The body is seen on CT scan slices in a similar fashion from the skin to the central part of the body being examined. When these levels are further "added" together, a three-dimensional picture of an organ or abnormal body structure can be obtained.

6. Mammography

Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts. A mammography exam, called a mammogram, is used to aid in the early detection and diagnosis of breast diseases in women.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Two recent advances in mammography include digital mammography and computer-aided detection.

Digital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by solid-state detectors that convert x-rays into electrical signals. These detectors are similar to those found in digital cameras. The electrical signals are used to produce images of the breast that can be seen on a computer screen or printed on special film similar to conventional mammograms. From the patient's point of view, having a digital mammogram is essentially the same as having a conventional film mammogram.

Computer-aided detection (CAD) systems use a digitized mammographic image that can be obtained from either a conventional film mammogram or a digitally acquired mammogram. The computer software then searches for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the radiologist to the need for further analysis.

7. Magnetic resonance imaging

An MRI machine uses a powerful magnetic field to align the magnetization of some atomic nuclei in the body, and radio frequency fields to systematically alter the alignment of this magnetization. This causes the nuclei to produce a rotating magnetic field detectable by the scanner-and this information is recorded to construct an image of the scanned area of the body.[1]:36 Magnetic field gradients cause nuclei at different locations to rotate at different speeds. By using gradients in different directions 2D images or 3D volumes can be obtained in any arbitrary orientation.

MRI provides good contrast between the different soft tissues of the body, which makes it especially useful in imaging the brain, muscles, the heart, and cancers compared with othermedical imaging techniques such as computed tomography (CT) or X-rays. Unlike CT scans or traditional X-rays, MRI does not use ionizing radiation.

8. Nuclear medicine scanning

In nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical compounds, to formradiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs or cellular receptors. This property of radiopharmaceuticals allows nuclear medicine the ability to image the extent of a disease-process in the body, based on the cellular function and physiology, rather than relying on physical changes in the tissue anatomy. In some diseases nuclear medicine studies can identify medical problems at an earlier stage than other diagnostic tests. It would not be wrong to call Nuclear Medicine as "Radiology done inside out" or "Internal Radiology" because it records radiation emitting from within the body rather than radiation that is generated by external sources like Xrays.

Treatment of diseased tissue, based on metabolism or uptake or binding of a particular ligand, may also be accomplished, similar to other areas of pharmacology. However, the treatment effects of radiopharmaceuticals rely on the tissue-destructive power of short-range ionizing radiation.

In the future, nuclear medicine may provide added impetus to the field known as molecular medicine. As our understanding of biological processes in the cells of living organism expands, specific probes can be developed to allow visualization, characterization, and quantification of biologic processes at the cellular and subcellular levels.[1] Nuclear medicine is an ideal specialty to adapt to the new discipline of molecular medicine, because of its emphasis on function and its utilization of imaging agents that are specific for a particular disease process.

by:

BERNADETH TUDAYAN

II-I