Post craniotomy

Post-Craniotomy Pain Management: Beyond Opioid

  1. Pain management following craniotomy is a balancing act of achieving adequate analgesia but avoiding sedation, respiratory depression, hypercapnia, nausea and vomiting, and hypertension
  2. Immediate visual loss following craniotomy in the supine position is a disastrous complication in neurosurgical patients. The incidence is unknown and little is known on the definite pathogenesis. Also, preventive or restorative interventions are unclear. We describe the rare case of post-craniotomy
  3. If craniotomy was because of a brain tumor or mass, radiation oncology and neuro-oncology consults and appointments will be needed; Make sure you have your post-operative clinic appointment scheduled (typically 2 weeks post-operative). Call clinic to verify date and time
  4. •Craniotomy defines a procedure where the cranial cavity is accessed through removal of bone to perform a variety of brain surgeries. Once the surgery is completed, the bone flap is returned to its previous position

Purpose of review: This review reports an update of the evidence on practices applied for the prevention and management of the most common complications after craniotomy surgery. Recent findings: Latest guidelines support the combined thromboprophylaxis with the use of both mechanical and chemical modalities, preferably applied within 24 h after craniotomy POST-OPERATIVE INSTRUCTIONS AFTER A CRANIOTOMY . Please call (303)724-2305 for: • A temperature of 101 degrees or higher. • Chills with shivering • Worsening headaches or neck stiffness • Confusion or changes in behavior • Persistent vomiting. Inability to keep down food or fluids Post-Operative Instructions Craniotomy Surgery Use these guidelines to help speed your recovery time after craniotomy surgery Activity: Start with light activity at home and gradually increase your activity No heavy lifting (>10lbs) Use your knees when bending (try to avoid straining that may increase head pressure Craniotomy Rehabilitation & Post Surgery Nursing Care Program in BLR & HYD What is Craniotomy ? Craniotomy is a surgical removal of part of the skull (bone flap) to expose the brain. (done under general anesthesia). The bone flap is removed temporarily and replaced at the end of the surgery

Supra-orbital craniotomy (often called eyebrow craniotomy) is a procedure used to remove brain tumors. In this procedure, neurosurgeons make a small incision within the eyebrow to access tumors in the front of the brain or around the pituitary gland, which is deeper in the brain behind the nose and eyes Background: Post-craniotomy headache is a frequent complication of neurosurgical procedures and is often a challenge for neurosurgeons, neurologists, and headache specialists. Method: This was a narrative review. Results: Surgical trauma, adherence of the musculature to the dura mater, peripheral nerve injury, development of neurinomas in the surgical scar, and central sensitization may be.

Craniotomy adalah Operasi untuk membuka tengkorak (tempurung kepala) dengan maksuduntuk mengetahui dan memperbaiki kerusakan otak A craniotomy is type of brain surgery. It involves removing part of the skull, or cranium, to access the brain. The bone is replaced when the surgery is done. In general, a craniotomy is done to.. Craniotomy incisions are usually closed with sutures or surgical staples. Follow the physician's instructions regarding incision care. Some physicians want patients to keep the incision dry, while others allow patients to gently wash their hair (and the incision) soon after surgery

A craniotomy is a surgical operation in which a bone flap is temporarily removed from the skull to access the brain.Craniotomies are often critical operations, performed on patients who are suffering from brain lesions, such as tumors, blood clots, removal of foreign bodies such as bullets, or traumatic brain injury (TBI), and can also allow doctors to surgically implant devices, such as, deep. Background: Post-craniotomy CSF collection is a problem that may cause severe complications as meningitis, wound disruption, prolonged hospitalization, and additional surgeries. Objective: To evaluate our cases with resistant post-operative subgaleal CSF collection, trying to identify causes and optimal management. Methods: Retrospective review of elective skull base cases during the period of. Post-craniotomy headaches (PCH) are one of the most frequently encountered adverse events after craniotomy, presenting in over two-thirds of patients who have undergone the procedure. PCH falls under the category of secondary headaches and can present unique challenges in diagnosis and management Postcraniotomy pain management is an unorganised sphere owing to the dearth of standard analgesic protocols. Besides the intraoperative anaesthetic techniques or opioid usage may be variable in different patients or surgical settings which have a bearing on the postoperative pain A craniotomy is the removal of a part of the skull or the cranium bone. Specialized tools are utilized to take out the part of the bone. After the brain surgery is performed, the bone flap is removed and then replaced

Following Craniotomy . wounD/suture care: You will probably be discharged with our sutures/staples still in place. You may shower or bathe within 24 hours after surgery, however do not get your incision(s) wet until 4 days after surgery. We recommend that you shower with someone in the bathroom to assist you Inadequate pain control in children after major craniotomy may contribute to significant anxiety, hypertension, shivering, and emesis, which may in turn increase intracranial pressure and cause bleeding [ 8, 9 ]. Therefore, although frequently overlooked, postoperative analgesia in children after craniotomy is important Drainage-related infection rate and risk factors of meningitis after major craniotomy. Of the 616 cases without any drain after craniotomy, 16 cases developed meningitis, yielding an incidence of 2.60%. Any CSF drainage led to 20.4-fold (95% CI: 11.1-37.4) increase in the risk of meningitis

A craniotomy is an operation to open the skull (cranium) in order to access the brain for surgical repair. There are many different types of brain surgery, but the recovery process following craniotomy is much the same in most cases. Conditions requiring a craniotomy. Some of the conditions that require craniotomy and surgical repair include Have you ever wanted to know how neurosurgeons actually access the brain? Learn about some of the tools that we use and how we actually perform a craniotomy. Comprehensive studies have been published on the risk factors for post-craniotomy meningitis (PCM). 12,14,24,28 In this study we publish the prospective 3-year experience from the University of Crete on the risk factors associated with PCM. We also analyzed the infections in patients undergoing craniotomies in terms of the prevalence.

A significant portion of patients developed a fever during the first post-craniotomy week. Patients with a lower pre-craniotomy Glasgow coma scale score and a longer intubation length were at a greater risk for both infection-related fever and unexplained fever. Patients with fever had a bad outcome score. Relevance to clinical practic Post-craniotomy sudden visual loss is a shocking complication to any neurosurgeon. Most neurosurgeons are unaware of its existence and it is probably underestimated in the literature. The prognosis is dismal and it is mostly due to the prolonged intra-operative vascular insufficiency of the ophthalmic arteries

Post-craniotomy blindness in the supine position: Unlikely

BACKGROUND: Post-craniotomy intracranial haematoma is one of the most serious complications after neurosurgery. We examined whether post-craniotomy intracranial haematoma requiring surgery is associated with the non-steroidal anti-inflammatory drugs flurbiprofen, hypertension, or hydroxyethyl starch (HES) Post-operative Instruction After Craniotomy • Diet: § You may resume your normal diet. § You should drink plenty of fluids • Please notify our office if you experience the following symptoms: § A temperature of 101 degrees or higher § Chills with shivering § Worsening headaches unrelieved by pain medications § Neck stiffnes What is a Craniotomy? A craniotomy is often the first step in brain surgery procedures used to treat a variety of conditions. These include brain tumors, vascular conditions and neurological diseases. The goal of a craniotomy is to provide the neurosurgeon access to the area of interest

Page 1 of 2 | Activities of Daily Living After a Craniotomy UWMC Occupational Therapy | Box 356490 1959 N.E. Pacific St., Seattle, WA 98195 | 206.598.4830 DRAFT. Activities of Daily Living After a . Craniotomy • • This handout gives guidelines to follow to help your healing and keep you safe after your craniotomy (a type of brain surgery) Conclusions: Post craniotomy surgical site infection remains an important problem in neurosurgery. Identification of risk factors for SSI should help us to improve patient care, reduce mortality, morbidity and economic burden of health care cost. Post surgical surveillance is important as well to identify the reliable risk factors for SSI. KEY.

Imaging of the Post- operative Cranium1 LEARNING OBJECTIVES FOR TEST 4 After reading this article and taking the test, the reader will be able to: Describe the nor-mal postoperative appearances of burr holes, craniotomy, craniectomy, and cranioplasty. Discuss the com-plications associated with cranial surgery. Describe the CT and MR imagin

Craniotomy Post-Operative Instructions advanced neurosurger

  1. A craniotomy is a surgical procedure where a piece of calvarial bone is removed to allow intracranial exposure. The bone flap is replaced at the end of the procedure, usually secured with microplates and screws. If the bone flap is not replaced it is either a craniectomy (bone removed) or cranioplasty (non-osseous surgical repair).. Classificatio
  3. Treatment depends on the cause, and in many instances, no treatment is necessary with the gas being gradually resorbed. This is the case in the vast majority of post-operative pneumocephalus, an expected finding in essentially all post-craniotomy patients
  4. A literature review shows that post operative pneumocephalus and the risk of tension pneumocephalus is the major medical concern when transporting patients post craniotomy
  5. Post Craniotomy ojan. I had a craniotomy 2 1/2 months ago for clipping of an unruptured, but unstable, aneurysm. About 2 weeks ago, I started noticing an indentation starting in my skull right at the outside edge of my eyebrow into the temple area. In 4 days, it left a visible indentation which is now about 1/4 inch deep

Post-Operative Concerns, Transport, Disposition: to ICU post-op. Keep intubated if mental status questionable or to maintain hyperventilation. Can assess neuro exam post-op while intubated by titrating narcotics The craniotomy, therefore, is the first step in operations that target elements within the intracranial compartment. The following is a list of many basic indications for a craniotomy: Clipping of cerebral aneurysm (both ruptured and unruptured) Resection of arteriovenous malformation (AVM) Resection of brain tumor Post-craniotomy pain is known to be significant and pain assessment problematic. Thus the difficulties in treating post-craniotomy pain may only be heightened by the use of codeine and inappropriate assessment tools. There is a need for properly structured and methodologically robust studies to investigate the efficacy, safety and. The general post-surgery risks are also present here: bleeding, infection, blood clots, and reactions to anesthesia. In the case of craniotomy surgery, some other dangers are also added, depending on the type of the procedure: Strokes. Seizures. Swelling of the brain. Nerve damage Post craniotomy problems. I will do my best to keep this concise while giving as much information as possible. I had 2 craniotomies at UCSF ( Jan 18th, 2006 and May 5th, 2006) for a left giant trigeminal schwanoma. It was performed at UCSF cause local neurosurgeons were unable to do anything about it due to the size and location

Long Term Pain Post Craniotomy? r0xmyface0ff. Hey all! I had craniotomy to have a brain tumor (astrocytoma) removed from my right temporal lobe two years ago. Since my surgery in June of 2010, I have had consistent, but not completely constant pains and aches in my temporal muscle and have had nerve burning and pain near my incision site. The. Post Craniotomy. Close. Vote. Posted by 5 minutes ago. Post Craniotomy. I had my craniotomy a little over a week ago and overall I feel I am doing really well. What I have noticed though is that my back and hips are killing me, I assume from the different sleeping/laying positions. I am normally a stomach sleeper but have been side sleeping Introduction. Acute tongue enlargement (Macroglossia) is a rare but potentially catastrophic postoperative complication following neurosurgical operations in a sitting position. 1 Excessive cervical flexion along with local mechanical compression by any object in the pharynx such as endotracheal tube (ETT), throat pack, or transesophageal echocardiography probe (TEE) can impede or even. Nursing Diagnosis Ineffective . You can . . Typical patients include those with a diagnosis of stroke, post - op craniotomy . are generally removed at 7-8 days post - op. 571: Head Trauma: p. Craniotomy: p. . . for which you underwent a craniotomy, as well as your post . . . This is called a biopsy .

Digital evolution of cranial surgery

Find craniotomy stock images in HD and millions of other royalty-free stock photos, illustrations and vectors in the Shutterstock collection. Thousands of new, high-quality pictures added every day Patients were followed up in an active post-discharge surveillance programm e for up to one year after surgery. Multivariate analysis was carried out to identify independent risk factors for SSI-CRAN. Among the 595 patients who underwent craniotomy, 91 (15.3%) episodes of SSI-CRAN were recorded, 67 (73.6%) of which were organ/space You had a craniotomy, which is the surgical opening of the skull. Your healthcare provider needed to do this to perform brain surgery. Recovery after a craniotomy varies, depending on why the procedure was done. The guidelines provided here are for general care. Ask your healthcare provider to provide additional information based on your specific condition Craniotomy and craniectomy are widely performed emergent neurosurgical procedures and are the prescribed treatment for a variety of conditions from trauma to cancer. It is vital for the emergency radiologist to be aware of expected neuroimaging findings in post-craniotomy and craniectomy patients in order to avoid false positives. It is just as necessary to be familiar with postsurgical. The Craniotomy Procedure . A craniotomy is a surgery during which a piece of the skull—called a bone flap—is removed in order to allow a surgeon access to the brain.   The bone flap is typically round or oval. The exact size and placement are determined by the nature of the procedure and what is to be accomplished during the surgery

Prophylaxis of postoperative complications after craniotom

Craniotomy is performed for a variety of indications, including tumor resection, intracranial vascular procedures, evacuation of hematoma, and trauma. This topic will discuss overall anesthetic management for craniotomy. Anesthetic management for some specific types of craniotomy is discussed separately Two of these 23 patients had undergone Gliadel Wafer (MGI Pharma) placement at the time of the original surgery. Seven of 50 patients had undergone craniotomy for vascular lesions. Nine cases involved craniotomy for hemorrhage. There were 4 decompressive craniotomies, 1 seizure surgery, and 1 infratentorial craniotomy

Craniotomy Rehabilitation & Post Surgery Nursing Care

A craniotomy is a surgical procedure that exposes the brain by removing a portion of the skull's bone. The bone flap, which is a portion of bone, is removed with specialized equipment. After the brain surgery, the bone flap is temporarily removed and then reinstalled The need for a craniotomy should be upon the discretion of the neurosurgeon. The nurse on the other hand must do his or her best to take care of the post operative patient. One can read and search about this procedure in google online. The pages of facebook ads and blog are also available to share the free articles about craniotomy LAPORAN PENDAHULUAN. ASUHAN KEPERA W A T A N P A DA KLIEN DENGAN POST CRANIOTOMY A T A S. INDIKASI MENINGIOMA DI RSUD Dr. MOEW A RDI SURAKA RT A. A. KONSEP DASAR CRANIOTOMY. 1. Pengertian. Menurut Brown CV (2004), Craniotomy ada lah operasi untuk membuka. tengkorak (tempurung kepala) dengan m aksud untuk mengetahui dan mem perbaiki Hair restoration in a female patient post craniotomy and radiation treatment for Astrocytoma. (malignant brain tumor) This case shows the capacity under the right circumstances to have a successful transplant performed on a post-radiation region of the scalp, which is sometimes considered to be situation that many surgeons would not.

Craniotomy Johns Hopkins Medicin

Post-craniotomy headache: a clinical view with a focus on

Asuhan Keperawatan Post Craniotomy (Craniopharyngioma

Roger in ICU after his 6 hour awake craniotomy at MD Anderson Cancer Center in Houston, Texas. More info at www.mommaerts.or Craniotomy: What to Expect at Home. Your Recovery. A craniotomy is surgery to open your skull to fix a problem in your brain. It can be done for many reasons. For example, you may need a this surgery if your brain or blood vessels are damaged or if you have a tumour or an infection in your brain THE TERM CRANIOTOMY MEANS TO SURGICALLY CREATE AN OPENING INTO THE SKULL FOR VARIOUS TYPES OF SURGICAL PROCEDURES ON THE BRAIN. until I saw a post in a health forum about a Herbal Doctor(Dr Akhigbe) who prepares herbal medicine to cure all kind of diseases including Herpes, at first i doubted, if it was real but decided to give him a trial. The term craniotomy refers broadly to the surgical removal of a section of the skull in order to access the intracranial compartment. The portion of skull temporarily removed is called a bone flap, and it is replaced to its original position after the operation is completed, typically fastened into place with plates and screws Craniotomy: positioning injury. Definition. Pressure on the femoral nerve or lateral femoral cutaneous nerve may be experienced, especially with post-type positioning devices (eg, the Relton-Hall or Jackson frame). In addition, ulnar nerve damage may occur from pressure against hard OR table edges or leaning by the surgical team..

Intracranial Epidural Plasmacytoma Presenting as a

Craniotomy Procedure: What It Treats, Precautions, and

Post-Craniotomy Care - Cure Toda

Posts about Post Craniotomy written by jennainabudhabi. After I found out about my aneurysm, life was categorized by lack of rest: there was fear, anxiety, restlessness, nervousness, worry, doubt, and a lingering unknown.I was able to cope with these daily feelings through prayer, reading cards and words of encouragement from friends and family, faith, allowing my husband to carry me during. Post-craniotomy pain is a recurrent complication of neurosurgical procedures and is difficult to manage. Pain management is of great importance to avoid complications such as hypertension and vomiting, which may lead to elevation in intracranial pressure, negative outcomes, and extended hospital stay S post craniotomy dengan cedera kepala berat. Kesimpulan dari karya tulis ilmiah ini adalah pada pasien Tn. S post craniotomi dengan diagnosa cedera kepala berat terjadi permasalahan bersihan jalan nafas tidak efektif yang memerlukan perhatian khusus perawat dalam penanganannya. Kata Kunci: cedera kepala berat, post craniotomy, jalan nafa I totally agree with ruger32. My wife had a craniotomy last year and was walking around the halls of the ICU the next day. She was discharged home that day with no activity restrictions other than don't overdo it. I had a craniotomy 12 days later. I was transferred to an inpatient rehab hospital two days post-op In such situations, craniotomy could aggravate the brain shift caused by LSD, and brain herniation would likely occur after the operation, 7 as has been reported especially after craniotomy for ruptured aneurysmal subarachnoid hemorrhage (SAH). 10,11,13,14 We often use intraoperative LSD during various types of neurosurgical procedures other.

Craniotomy - Wikipedi

Management of Post-Craniotomy Persistent CSF Subgaleal

3 1 Interventional Neurorehabilitation for Promoting Functional 2 Recovery Post-Craniotomy: A Proof-of-Concept 3 Introduction 4 The human brain is a highly plastic 'complex' network [1,2]: it self-organises without a 5 hard blueprint, it adapts to evolving circumstances, and can withstand external insults My wife was diagnosed with a brain tumor in May 2014. She had a craniotomy on July 23. They remove 80% of the tumor. The tumor is a grade 2 oligo with the 1q/19p deletions. They had to leave the last 20% because it was inter twined with her left arm and leg. Post surgery the left side went totally weak Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50 WBCs/mm 3 ), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen. Post-craniotomy headache is a complex phenomenon with many underutilized treatment options available, and many more under investigation. Nonetheless, further research is required to differentiate the efficacy of contemporary treatment strategies and to elucidate the applicability of novel therapies

Post-craniotomy pain was once thought to be less severe than for other types of surgery. It is now recognized that as many as 80 % of patients experience moderate to severe pain up to 48 h after surgery, and this pain is often inadequately treated. Morphine and other opioids provide consistent analgesia Chronic post-craniotomy pain is defined as symptoms directly caused by a surgical craniotomy and that last longer than 3 months. Like other headache syndromes, chronic post-craniotomy pain can. After my first craniotomy, the first words I said were, God is not done with me yet. If you've been following my story, you already know this. What you may not know is that it was a subconscious line that I had heard before they were the same words Bekah said upon waking from her medically induced coma after the bombing A craniotomy is a procedure in which a bone flap is temporarily removed from the skull to access the brain. Here, the surgeon i A highly realistic 16th-century scene of a craniotomy; this is the earliest depiction of a neurosurgical operation in progress I'm 4 years post clipping and am still struggling with daily headaches and a strange sensation of pressure near the clipping site. I've seen many, many doctors. Only one mentioned nerve damage and the next time I had an appointment with him, he'd changed hospitals and none of my new doctors believe in nerve damage caused by surgery

Is systematic post-operative CT scan indicated afterCureus | Endoscope-Assisted Combined Supracerebellar

Posts about Post Craniotomy written by stlgarden. I think the best advice I can give to anyone would be to trust your doctor's skill 100%..What i'm saying is.. you gut has to feel ok with your decision.. there is so much stress involved in this surgery, the main thing that gave me comfort was that I trusted my surgeon to do his job well Apa itu craniotomy? raniotomi adalah proses pembuatan lubang pada tulang tengkorak agar dokter dapat mengakses otak untuk melakukan pembedahan. Prosedur ini biasanya dilakukan untuk menangani tumor otak, pembengkakan pada otak, perdarahan dalam tulang tengkorak, hingga mengeluarkan darah yang menggumpal di otak I am posting because I have to have conditions of doing a bi-craniotomy or endovascular surgery with no post-op data. deleted_user 04/28/2009 I had one done two years ago The surgeon performed a right anterior temporal craniotomy, anterior subtemporal approach, microdissection with clipping of the aneurysm. I developed a staph infection, was on vancomyacin for several weeks. In your case you have three underlying causes: craniocerebral trauma due to surgery, ischemia and infarct and infection post surgery. The post-operative hemorrhage group was more likely to be male, to have a tumor or trauma as the reason for craniotomy, and to have received a greater volume of crystalloid and packed red blood cells compared with those who did not have a post-operative hemorrhage (Table 1)

Post-craniotomy Headaches After Surgery. Abstract & Commentary. By Dara G. Jamieson, MD, Associate Professor, Clinical Neurology Director, Weill Medical College, Cornell University.Dr. Jamieson is a consultant for Boehringer Ingelheim and Merck, and is on the speaker's bureau for Boehringer Ingelheim, Merck, Ortho-McNeil, and Pfizer post-craniotomy Fluid imbalance in the postcraniotomy patient usually results from a disturbance in production or secretion of antidiuretic hormone (ADH)- vasopressin and fluid retain. Unabated renal water loss even when blood volume is low and serum osmolality is high. This condition is known as diabetes insipidus (DI) Craniotomy. I had a large benign brain tumor wrapped in many nerves with an artery going through it. It was removed 4 weeks ago. It was located by my brain stem. All my post op problems seem to be on my left side, where the main part of the tumor was. Deviated tongue, problems with shoulder and arm.. Post-craniotomy pain is known to be significant and pain assessment is occasionally problematic. Thus, the difficulties in treating post-craniotomy pain will only be heightened by the use of codeine.Conflicting evidence regarding the efficacy of tramadol makes conclusions difficult The aim of this research was to assess the knowledge and practices among the caregivers of post craniotomy patients regarding home care of craniotomy patients. METHODS A descriptive exploratory study was undertaken on 36 purposively selected caregivers of patients undergoing craniotomy in Wardha district

Video: Post Craniotomy Headache Article - StatPearl

Pain following Craniotomy: Reassessment of the Available

If you find this post useful, please do consider sending me your own pictures/story post-craniotomy to be added to the library. You never know, your information could be incredibly useful to someone else in our situation in the future. So, without further ado, here are the brave contributors who have shared their scars so far. AND The objective of this study is to examine the current beliefs and practices of Canadian neurosurgeons when managing post-craniotomy pain. Methods: A survey was sent to all practicing Canadian neurosurgeons to examine the following aspects of analgesia in craniotomy patients: type of analgesics used, common side effects encountered, satisfaction. (2,3) Post craniotomy surgical pain usually decreases significantly after 24 hours whereas post craniotomy migraine headache, which may be a separate entity, continues for a longer period of time. (4) This migraine headache is in different location from the surgical incision and the conventional treatments of post surgical pain are ineffective. Post-craniotomy seizures were not associated with increased morbidity or mortality. Conclusion Early seizures were common after craniotomy for primary brain tumor resection, but were not.

Home Nursing For Pre & Post Operative Care for Craniotomy

Post-craniotomy intracranial air can be present in patients scheduled for air ambulance transport to their home hospital. We aimed to assess risk for in-flight intracranial pressure (ICP) increases related to observed intracranial air volumes, hypothetical sea level pre-transport ICP, and different potential flight levels and cabin pressures. A cohort of consecutive subdural hematoma. Orbitozygomatic craniotomy is the preferred exposure for all basilar apex aneurysms because it allows for the full range of approaches to the basilar apex, from an anterior supraorbital trajectory to lateral subtemporal trajectories.. In patients with large frontal sinuses likely to be entered with craniotomy or orbital osteotomy, pericranium is harvested after the scalp flap is reflected Footage of patient post op after a successful awake craniotomy. Courtesy of Farhad M. Limonadi, M.D. neurosurgeon of Palm Springs, Palm Desert and Rancho Mir..

Brain metastases from breast cancer during pregnancyDelayed diagnosis of post-traumatic aneurysm of distalBrain abscesses in a patient with a patent foramen ovaleDr Balaji Anvekar FRCR: 01/12/16 - 01/01/17Health careers