![]() Here, you can download all the files associated with your order. If you have an Etsy account, after your purchase you’ll see a View your files link which goes to the Downloads page. You can download these files right here on ETSY as soon as your payment is made. Sizing of images can be adjusted inside your software.Īll previews have a watermark, but original image will be supplied without watermark. But make sure that the formats of item is supported by program files of your PC/cutting machine before purchasing. These files are ready for cutting/printing and should work almost with any cutting machines (Cricut, Silhouette, Brother’s, ets). ◇ 1 JPG file - white background, high resolution 300 dpi ◇ 1 PNG file - transparent background, high resolution 300 dpi ◇ 1 EPS file - vector, version 10, you can edit it ◇ 1 DXF file - compatible with Silhouette Studio program You can resize without losing image quality ![]() ◇ 1 SVG file - compatible with cutting machines and vector software (Adobe Illustrator, Inkscape). These files are available for PERSONAL and COMMERCIAL USE. This item is an INSTANT DOWNLOAD files for cutting, printing and making any designs. By doing this you help me and my family a lot, including a 5 month old baby. Now my Country is going through the most difficult times. ![]() I'm a graphic designer from Kharkiv, Ukraine □□ Rachel Liu, MD, is an assistant professor of emergency medicine at Yale University School of Medicine, Connecticut.Hello! My name is Lena. Nibhanipudi, MD, is a professor of clinical emergency medicine at New York Medical College in Valhalla, New York. The child was given a cold compress to wrap around the finger and was discharged home without the need for wound repair, antibiotics, or a tetanus injection. No obvious cuts were noted, other than a small linear abrasion of the epidermis. There was a little swelling of the fingertip due to compression in the pencil sharpener ( Figure 3). Although the child initially cried, the pencil sharpener was removed quickly. The staff subsequently held the pencil sharpener steady and turned her finger counterclockwise. In contrast, a pencil (or finger) turned counterclockwise will roll against the unsharpened underside of the angled blade, so that the blade will not cut. When a pencil is turned clockwise, the blade will pare the wood. With a manual pencil sharpener, the pencil is inserted to the left of the blade and the blade is angled slightly downward. The child cried out during this process, and so this attempted method of removal was abandoned.Īfter thinking about the mechanics of a pencil sharpener, we reasoned that the child most likely felt pain when her finger was turned clockwise, or the pencil sharpener moved counterclockwise. The ED staff attempted to remove the other blade (the free blade) by loosening its screw, but that screw was too tight and could not be loosened. However, this attempt at removal had stripped the head off of the screw, and it now could not be loosened with a smaller screwdriver. The family had attempted to remove the blade by loosening the screw using the Phillips-head screwdriver included on the uncle’s Swiss Army knife. The administration of a digital nerve block was considered prior to removal however, it was felt that this would also be traumatic to the child and could possibly be avoided. The concern was that attempts to remove the blades would worsen any cuts she had received. Removal of the pencil sharpener from the girl’s finger initially posed a challenge because of the 2 entry ports and 2 blades evident on the underside (one on each side), without a clear indication of the direction of the blades’ rotation. The child was in no significant distress and appeared calm her vital signs were noncontributory. A slight amount of bleeding was present through the right-sided blade of the pencil sharpener, but the bleeding stopped soon after presentation. On physical examination of the girl, the pencil sharpener was found to have 2 entry ports, with the distal phalanx of her left index finger firmly wedged into the right-sided port. Her vaccinations were up to date, with a diphtheria-pertussis-tetanus booster having recently been administered. The child had a previous medical history significant for asthma, and she was taking albuterol as needed. ![]() She brought the child to the ED after her attempts to remove the pencil sharpener failed. The event was unwitnessed the toddler’s mother found the pencil sharpener stuck when she attended to her daughter’s crying. Prior to triage, the mother reported that the child had been playing with various toys including the pencil sharpener. A 2-year-old girl, accompanied by her mother and uncle, presented to the emergency department (ED) with the girl’s left index finger stuck in a medium-sized, square, manual pencil sharpener ( Figures 1 and 2).
0 Comments
Leave a Reply. |