Submit Search
Upload
Evidence basedcritcare06
•
Download as PPT, PDF
•
2 likes
•
272 views
H
Hayk Antonyan
Follow
O.K.
Read less
Read more
Health & Medicine
Education
Report
Share
Report
Share
1 of 81
Download now
Recommended
Presentation by Dr Jason Wu - resident in Critical Care at TWH, for the critical care journal club report findings of a paper by Kaukonen KM, et al. N Engl J Med. 2015 & update from the recent SMACC conference in Chicago #FOAMed #SMACC (http://www.ncbi.nlm.nih.gov/m/pubmed/25776936/)
Defining sepsis - Journal Club (Jason Wu)
Defining sepsis - Journal Club (Jason Wu)
Bishan Rajapakse
Hot Topics - Portsmouth INtensive Care Exam Revision Course 23rd Sept 2016
Hot Topics in Critical Care
Hot Topics in Critical Care
Steve Mathieu
Hot topics lecture given by Rob Mac Sweeney at the FFICM Preparation Course in London on March 9th 2016
Rob Mac Sweeney's FFICM Hot Topics Talk March 2016
Rob Mac Sweeney's FFICM Hot Topics Talk March 2016
robmacsweeney
Hot Topics presentation from Portsmouth INtensive Care Exam Revision Course 23rd Sept 2016
PINCER - Hot Topics Sept 2016
PINCER - Hot Topics Sept 2016
Steve Mathieu
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations. Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation. Death is a complex topic. Due to advancements in medical technology and processes, the definition of death is a challenging one. Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event. The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient. There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care. There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide. The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available. The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done. Bill also discusses other treatment options at the time of death such as optimising endocrine function. Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life. To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services. Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family. Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation. For more like this, head to our podcast page. #CodaPodcast
Death by Neurological Criteria and Organ Donation: Bill Knight
Death by Neurological Criteria and Organ Donation: Bill Knight
SMACC Conference
Portsmouth INtensive Care Exam Revision (PINCER) Course
Hot Topics in Critical Care - March 2017
Hot Topics in Critical Care - March 2017
Steve Mathieu
Presentation contributed by Dr. Mayuri Trivedi, DM Resident in Nephrology, IPGMER, Kolkata
Approach to deceased donor transplantation
Approach to deceased donor transplantation
Vishal Golay
The CHEST trial - HES in the ICU
The CHEST trial - HES in the ICU
Andrew Ferguson
Recommended
Presentation by Dr Jason Wu - resident in Critical Care at TWH, for the critical care journal club report findings of a paper by Kaukonen KM, et al. N Engl J Med. 2015 & update from the recent SMACC conference in Chicago #FOAMed #SMACC (http://www.ncbi.nlm.nih.gov/m/pubmed/25776936/)
Defining sepsis - Journal Club (Jason Wu)
Defining sepsis - Journal Club (Jason Wu)
Bishan Rajapakse
Hot Topics - Portsmouth INtensive Care Exam Revision Course 23rd Sept 2016
Hot Topics in Critical Care
Hot Topics in Critical Care
Steve Mathieu
Hot topics lecture given by Rob Mac Sweeney at the FFICM Preparation Course in London on March 9th 2016
Rob Mac Sweeney's FFICM Hot Topics Talk March 2016
Rob Mac Sweeney's FFICM Hot Topics Talk March 2016
robmacsweeney
Hot Topics presentation from Portsmouth INtensive Care Exam Revision Course 23rd Sept 2016
PINCER - Hot Topics Sept 2016
PINCER - Hot Topics Sept 2016
Steve Mathieu
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations. Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation. Death is a complex topic. Due to advancements in medical technology and processes, the definition of death is a challenging one. Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event. The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient. There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care. There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide. The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available. The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done. Bill also discusses other treatment options at the time of death such as optimising endocrine function. Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life. To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services. Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family. Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation. For more like this, head to our podcast page. #CodaPodcast
Death by Neurological Criteria and Organ Donation: Bill Knight
Death by Neurological Criteria and Organ Donation: Bill Knight
SMACC Conference
Portsmouth INtensive Care Exam Revision (PINCER) Course
Hot Topics in Critical Care - March 2017
Hot Topics in Critical Care - March 2017
Steve Mathieu
Presentation contributed by Dr. Mayuri Trivedi, DM Resident in Nephrology, IPGMER, Kolkata
Approach to deceased donor transplantation
Approach to deceased donor transplantation
Vishal Golay
The CHEST trial - HES in the ICU
The CHEST trial - HES in the ICU
Andrew Ferguson
Hot Topics talk given by Rob Mac Sweeney at the National FFICM Exam Preparation Course, London, February 23rd 2015
Hot Topics - FFICM Preparation Course 230215
Hot Topics - FFICM Preparation Course 230215
robmacsweeney
These slides form part of a Hot Topics presentation from Feb 2015 for Portsmouth INtensive Care Exam Revision (PINCER) Course
PINCER - Hot Topics
PINCER - Hot Topics
Steve Mathieu
Critical Care Trials summary To download send me an email to sherif_badrawy@yahoo.com
ICU Trials summary
ICU Trials summary
Sherif Elbadrawy
ICU topics for Final FRCA
ICU topics for Final FRCA
Andrew Ferguson
Revisión de la evidencia vigente en nefropatía inducida por contraste
Nefropatia inducida por medio de contraste 2015
Nefropatia inducida por medio de contraste 2015
Cristhian Bueno Lara
1019
Hussein drug therapy in aki 3 osama alshahat 2 pptx
Hussein drug therapy in aki 3 osama alshahat 2 pptx
FarragBahbah
PINCER Course Hot Topics Presentation March 2014 Steve Mathieu
Hot Topics in ICM
Hot Topics in ICM
Steve Mathieu
The use of adrenaline in cardiac arrest resuscitation has been advocated since the 1960s. Laboratory studies and anecdotal experience showed improved rates of return of spontaneous circulation (ROSC) with the use of adrenaline at a dosage of approximately 0.01 mg/kg. This led to the widespread adoption of adrenaline administration during cardiac arrest into every resuscitation guideline for decades to come. Extensive laboratory studies characterized the beneficial physiological effects of adrenaline during cardiac arrest and closed-chest cardiopulmonary resuscitation (CC-CPR). Adrenaline administered during CC-CPR results in peripheral arterial vasoconstriction that raises the aortic pressure, particularly during the relaxation phase of CC-CPR. This increase in aortic pressure results in an increased aortic to right atrial pressure gradient that drives blood flow to the myocardium during CC-CPR. This pressure gradient is known as the coronary perfusion pressure (CPP) and has been shown to correlate with ROSC in both laboratory investigations and clinical studies. During the 1990s, the use of “high-dose” adrenaline showed increased rates of ROSC compared to “standard-dose” adrenaline. However, it was subsequently recognized that larger doses of adrenaline did not result in improved survival. Furthermore, questions have been raised as to whether or not “standard-dose” adrenaline improves survival from cardiac arrest. Recent meta-analyses have raised serious questions about the value of adrenaline, showing a benefit for achieving ROSC but no clear evidence of improved long-term survival. Controlled clinical trials to address this question are now underway. However, there is another important issue that needs to be addressed: the “route” of administration. With the growing interest in endovascular resuscitation, the use of intra-aortic adrenaline titration offers a means of rapidly and effectively delivering adrenaline to peripheral arterial effector sites while providing arterial pressure and CPP monitoring to guide titration of adrenaline doses to achieve an optimal hemodynamic effects while avoiding excessive adrenaline doses. To enable screen reader support, press shortcut Ctrl+Alt+Z. To learn about keyboard shortcuts, press shortcut Ctrl+slash.
Rethinking Adrenaline in Cardiac Arrest
Rethinking Adrenaline in Cardiac Arrest
SMACC Conference
Delaney shares insights into the mysterious world of statistics and trials. This 12 minute podcast is particularly useful for Registrars preparing for their exams and was recorded at BCC4. For similar podcasts and audio; head to www.intensivecarenetwork.com and to rego for BCC5 in Cairns, check out www.bedsidecriticalcare.com
BCC4: Delaney on Stats and Trials "Stuff"
BCC4: Delaney on Stats and Trials "Stuff"
SMACC Conference
Michael Parr, director of Liverpool ICU in Australia, speaks about "Surviving Trauma Guidelines". He does so through the use of an interesting case of a patient admitted to ICU following a MVA. This educational podcast was recorded at BCC4.
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
SMACC Conference
Hot Topics Presentation - PINCER Course
PINCER - Hot Topics March 2016
PINCER - Hot Topics March 2016
Steve Mathieu
Review of all studies published in relation to Early Goal Directed therapy starting with Rivers finding to the most recent trials .
Early Goal Directed Therapy in 2015
Early Goal Directed Therapy in 2015
Yazan Kherallah
Associate Professor Samuel Galvagno: My bloody head: Diagnosis and management of coagulopathy and traumatic brain injury. From CICM ASM PROGRAM 2019.
My bloody head: Diagnosis and management of coagulopathy and traumatic brain ...
My bloody head: Diagnosis and management of coagulopathy and traumatic brain ...
CICM 2019 Annual Scientific Meeting
2018 UF ED/Trauma Symposium
Guirgis-em trauma sepsis
Guirgis-em trauma sepsis
UFJaxEMS
Dr Jonathon Ball: Contemporary management of spinal injury. From CICM ASM PROGRAM 2019
Contemporary management of spinal injury by Dr Jonathon Ball
Contemporary management of spinal injury by Dr Jonathon Ball
CICM 2019 Annual Scientific Meeting
sepsis guidelines
Sepsis guidlines
Sepsis guidlines
Pramod Sarwa
ATN
ATN
ATN
Isabella Nga Lai
Stephen Bernard shares his thoughts and the current evidence for using oxygen for cardiac arrest patients. Oxygen is ubiquitous in society! You can buy it in bottles and there are even oxygen cafes. This is especially true in hospitals where oxygen is used frequently and often without much thought. Oxygen is a natural substance. So surely, a short time on 100% oxygen can’t be harmful, right? Stephen wants to challenge that idea. In this talk he presents the data on why oxygen might be harmful to your patients, particularly following a cardiac arrest. Out-of-hospital cardiac arrest (OHCA) is common and carries a high mortality rate. In Victoria, Australia, approximately 50% of patients with an initial cardiac rhythm of VF achieve a return of spontaneous circulation (ROSC) and 30% overall survive to hospital discharge. The outcome for patients is improving. This is due mainly to faster ambulance response times and increased rates of bystander CPR. What is done in the hospital has altered the patient’s outcomes in the same way. Currently, OHCA patients who have achieved ROSC but who remain unconscious routinely receive 100% oxygen for several hours in the ambulance, ED, cardiac catheterisation laboratory until admission to ICU. However, there is now evidence from laboratory studies and preliminary observational clinical studies that the administration of 100% oxygen during the first few hours following resuscitation may increase both cardiac and neurological injury. Clinical trials are underway to test whether titrated oxygen to a target oxygen saturation of 90-94% in the immediate hours after ROSC results in improved outcomes compared with 100% oxygen. Join Stephen as he makes you think twice about blindly using oxygen for patients following a cardiac arrest.
Cardiac Arrest and Oxygen: Stephen Bernard
Cardiac Arrest and Oxygen: Stephen Bernard
SMACC Conference
Sepsis management: Has anything changed? - อ.นพ.กลวิชย์ ครองตระกูล
ACTEP2014: Sepsis management has anything change
ACTEP2014: Sepsis management has anything change
taem
CHORUS: LORD I am grateful, grateful,I’m grateful LORD for all you have done (2x)
LORD I AM GRATEFUL
LORD I AM GRATEFUL
Oradiegwu Chikezie
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
Скиту Омск
big data made simple!!!!!
Big data made simple ppp five experts talk
Big data made simple ppp five experts talk
kwpillich
More Related Content
What's hot
Hot Topics talk given by Rob Mac Sweeney at the National FFICM Exam Preparation Course, London, February 23rd 2015
Hot Topics - FFICM Preparation Course 230215
Hot Topics - FFICM Preparation Course 230215
robmacsweeney
These slides form part of a Hot Topics presentation from Feb 2015 for Portsmouth INtensive Care Exam Revision (PINCER) Course
PINCER - Hot Topics
PINCER - Hot Topics
Steve Mathieu
Critical Care Trials summary To download send me an email to sherif_badrawy@yahoo.com
ICU Trials summary
ICU Trials summary
Sherif Elbadrawy
ICU topics for Final FRCA
ICU topics for Final FRCA
Andrew Ferguson
Revisión de la evidencia vigente en nefropatía inducida por contraste
Nefropatia inducida por medio de contraste 2015
Nefropatia inducida por medio de contraste 2015
Cristhian Bueno Lara
1019
Hussein drug therapy in aki 3 osama alshahat 2 pptx
Hussein drug therapy in aki 3 osama alshahat 2 pptx
FarragBahbah
PINCER Course Hot Topics Presentation March 2014 Steve Mathieu
Hot Topics in ICM
Hot Topics in ICM
Steve Mathieu
The use of adrenaline in cardiac arrest resuscitation has been advocated since the 1960s. Laboratory studies and anecdotal experience showed improved rates of return of spontaneous circulation (ROSC) with the use of adrenaline at a dosage of approximately 0.01 mg/kg. This led to the widespread adoption of adrenaline administration during cardiac arrest into every resuscitation guideline for decades to come. Extensive laboratory studies characterized the beneficial physiological effects of adrenaline during cardiac arrest and closed-chest cardiopulmonary resuscitation (CC-CPR). Adrenaline administered during CC-CPR results in peripheral arterial vasoconstriction that raises the aortic pressure, particularly during the relaxation phase of CC-CPR. This increase in aortic pressure results in an increased aortic to right atrial pressure gradient that drives blood flow to the myocardium during CC-CPR. This pressure gradient is known as the coronary perfusion pressure (CPP) and has been shown to correlate with ROSC in both laboratory investigations and clinical studies. During the 1990s, the use of “high-dose” adrenaline showed increased rates of ROSC compared to “standard-dose” adrenaline. However, it was subsequently recognized that larger doses of adrenaline did not result in improved survival. Furthermore, questions have been raised as to whether or not “standard-dose” adrenaline improves survival from cardiac arrest. Recent meta-analyses have raised serious questions about the value of adrenaline, showing a benefit for achieving ROSC but no clear evidence of improved long-term survival. Controlled clinical trials to address this question are now underway. However, there is another important issue that needs to be addressed: the “route” of administration. With the growing interest in endovascular resuscitation, the use of intra-aortic adrenaline titration offers a means of rapidly and effectively delivering adrenaline to peripheral arterial effector sites while providing arterial pressure and CPP monitoring to guide titration of adrenaline doses to achieve an optimal hemodynamic effects while avoiding excessive adrenaline doses. To enable screen reader support, press shortcut Ctrl+Alt+Z. To learn about keyboard shortcuts, press shortcut Ctrl+slash.
Rethinking Adrenaline in Cardiac Arrest
Rethinking Adrenaline in Cardiac Arrest
SMACC Conference
Delaney shares insights into the mysterious world of statistics and trials. This 12 minute podcast is particularly useful for Registrars preparing for their exams and was recorded at BCC4. For similar podcasts and audio; head to www.intensivecarenetwork.com and to rego for BCC5 in Cairns, check out www.bedsidecriticalcare.com
BCC4: Delaney on Stats and Trials "Stuff"
BCC4: Delaney on Stats and Trials "Stuff"
SMACC Conference
Michael Parr, director of Liverpool ICU in Australia, speaks about "Surviving Trauma Guidelines". He does so through the use of an interesting case of a patient admitted to ICU following a MVA. This educational podcast was recorded at BCC4.
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
SMACC Conference
Hot Topics Presentation - PINCER Course
PINCER - Hot Topics March 2016
PINCER - Hot Topics March 2016
Steve Mathieu
Review of all studies published in relation to Early Goal Directed therapy starting with Rivers finding to the most recent trials .
Early Goal Directed Therapy in 2015
Early Goal Directed Therapy in 2015
Yazan Kherallah
Associate Professor Samuel Galvagno: My bloody head: Diagnosis and management of coagulopathy and traumatic brain injury. From CICM ASM PROGRAM 2019.
My bloody head: Diagnosis and management of coagulopathy and traumatic brain ...
My bloody head: Diagnosis and management of coagulopathy and traumatic brain ...
CICM 2019 Annual Scientific Meeting
2018 UF ED/Trauma Symposium
Guirgis-em trauma sepsis
Guirgis-em trauma sepsis
UFJaxEMS
Dr Jonathon Ball: Contemporary management of spinal injury. From CICM ASM PROGRAM 2019
Contemporary management of spinal injury by Dr Jonathon Ball
Contemporary management of spinal injury by Dr Jonathon Ball
CICM 2019 Annual Scientific Meeting
sepsis guidelines
Sepsis guidlines
Sepsis guidlines
Pramod Sarwa
ATN
ATN
ATN
Isabella Nga Lai
Stephen Bernard shares his thoughts and the current evidence for using oxygen for cardiac arrest patients. Oxygen is ubiquitous in society! You can buy it in bottles and there are even oxygen cafes. This is especially true in hospitals where oxygen is used frequently and often without much thought. Oxygen is a natural substance. So surely, a short time on 100% oxygen can’t be harmful, right? Stephen wants to challenge that idea. In this talk he presents the data on why oxygen might be harmful to your patients, particularly following a cardiac arrest. Out-of-hospital cardiac arrest (OHCA) is common and carries a high mortality rate. In Victoria, Australia, approximately 50% of patients with an initial cardiac rhythm of VF achieve a return of spontaneous circulation (ROSC) and 30% overall survive to hospital discharge. The outcome for patients is improving. This is due mainly to faster ambulance response times and increased rates of bystander CPR. What is done in the hospital has altered the patient’s outcomes in the same way. Currently, OHCA patients who have achieved ROSC but who remain unconscious routinely receive 100% oxygen for several hours in the ambulance, ED, cardiac catheterisation laboratory until admission to ICU. However, there is now evidence from laboratory studies and preliminary observational clinical studies that the administration of 100% oxygen during the first few hours following resuscitation may increase both cardiac and neurological injury. Clinical trials are underway to test whether titrated oxygen to a target oxygen saturation of 90-94% in the immediate hours after ROSC results in improved outcomes compared with 100% oxygen. Join Stephen as he makes you think twice about blindly using oxygen for patients following a cardiac arrest.
Cardiac Arrest and Oxygen: Stephen Bernard
Cardiac Arrest and Oxygen: Stephen Bernard
SMACC Conference
Sepsis management: Has anything changed? - อ.นพ.กลวิชย์ ครองตระกูล
ACTEP2014: Sepsis management has anything change
ACTEP2014: Sepsis management has anything change
taem
What's hot
(19)
Hot Topics - FFICM Preparation Course 230215
Hot Topics - FFICM Preparation Course 230215
PINCER - Hot Topics
PINCER - Hot Topics
ICU Trials summary
ICU Trials summary
ICU topics for Final FRCA
ICU topics for Final FRCA
Nefropatia inducida por medio de contraste 2015
Nefropatia inducida por medio de contraste 2015
Hussein drug therapy in aki 3 osama alshahat 2 pptx
Hussein drug therapy in aki 3 osama alshahat 2 pptx
Hot Topics in ICM
Hot Topics in ICM
Rethinking Adrenaline in Cardiac Arrest
Rethinking Adrenaline in Cardiac Arrest
BCC4: Delaney on Stats and Trials "Stuff"
BCC4: Delaney on Stats and Trials "Stuff"
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
BCC4: Michael Parr on ICU - Surviving Trauma Guidelines
PINCER - Hot Topics March 2016
PINCER - Hot Topics March 2016
Early Goal Directed Therapy in 2015
Early Goal Directed Therapy in 2015
My bloody head: Diagnosis and management of coagulopathy and traumatic brain ...
My bloody head: Diagnosis and management of coagulopathy and traumatic brain ...
Guirgis-em trauma sepsis
Guirgis-em trauma sepsis
Contemporary management of spinal injury by Dr Jonathon Ball
Contemporary management of spinal injury by Dr Jonathon Ball
Sepsis guidlines
Sepsis guidlines
ATN
ATN
Cardiac Arrest and Oxygen: Stephen Bernard
Cardiac Arrest and Oxygen: Stephen Bernard
ACTEP2014: Sepsis management has anything change
ACTEP2014: Sepsis management has anything change
Viewers also liked
CHORUS: LORD I am grateful, grateful,I’m grateful LORD for all you have done (2x)
LORD I AM GRATEFUL
LORD I AM GRATEFUL
Oradiegwu Chikezie
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
Скиту Омск
big data made simple!!!!!
Big data made simple ppp five experts talk
Big data made simple ppp five experts talk
kwpillich
Music Publishing Project
Music Publishing Project
Moi Jhien Jack
Evidence basedcritcare06
Evidence basedcritcare06
Hayk Antonyan
peerapon_resume
peerapon_resume
Peerapon Tungsup
planos seriados
Composiciones en 3D
Composiciones en 3D
carolayngc
Supramodernismo mexico final
Supramodernismo mexico final
Irving Abad
Ejercicios Matetica.
Matematica 01
Matematica 01
Yolet Contreras
Иван Поддубный
человек огромной силы, казак иван поддубный
человек огромной силы, казак иван поддубный
Скиту Омск
SOLUCIÓN DE LA PRÁCTICA CALIFICADA 4
Pract4 valor absoluto, radicales , racionalización y exponentes solucion
Pract4 valor absoluto, radicales , racionalización y exponentes solucion
CESAR IBARBURU
pasos a seguir en el inicio de una obra
Construccion
Construccion
carolayngc
Supramodernidad en Arquitectura - Brianda Yadira Martínez Medrano
Supramodernidad en Arquitectura - Brianda Yadira Martínez Medrano
Fabiola Aranda
BEST OF ASH 2015 MULTIPLE MYELOMA AND PLASMA CELL DYSCRASIAS Yvonne Efebera, MD,MPH
Ohio State's 2016 ASH Review - BEST OF ASH 2015 MULTIPLE MYELOMA AND PLASMA C...
Ohio State's 2016 ASH Review - BEST OF ASH 2015 MULTIPLE MYELOMA AND PLASMA C...
OSUCCC - James
Fifth year teaching
Cardiology cases[1]
Cardiology cases[1]
bsuhmess
"Best Paper Presentation Award" Presented at 3rd Annual Critical Care Medicine Conference , Sir Gangaram Hospital, New Delhi "A Case of H1N1 ARDS - Journey from NIV to Invasive Ventilation to recruitment to proning to ECMO & Nitric Oxide" For PPT, Check following link http://www.medicalgeek.com/clinical-cases/36303-h1n1-ards-case-presentation.html
H1N1 ARDS Case Presentation
H1N1 ARDS Case Presentation
Vitrag Shah
Property of Department of General Surgery, Faculty of Medicine, University of Zagazig, Egypt
Abdominal examination (Physical Examination for OSCE)
Abdominal examination (Physical Examination for OSCE)
Muhammad Eimaduddin
Informe sobre el aparato urinario para la presentacion de la materia de anatomia.
APARATO URINARIO UCEBOL
APARATO URINARIO UCEBOL
yuriken
Durant aquesta sessió hem parlat de la importància del màrqueting digital - per diferenciar-nos de la competència, en un mercat sobresaturat - posicionar-nos a internet. Si no som a Google, no existim! Hem parlat d'estratègies internacionals, ja que hi ha algunes especificitats que cal tenir en compte I no, no es tracta de tenir molts diners o de ser empreses molt grans, ni tampoc de fer feina extra. Es tracta d'activar el "xip 2.0" en el nostre dia a dia empresarial. Sempre amb indicadors d'èxit Aquí podeu llegir el ressò que ha tingut a la premsa aquesta formació: http://bit.ly/1nmp93c Més presentacions, vídeos i continguts a http://www.txellcosta.com
Màrqueting digital
Màrqueting digital
Txell Costa
CHORUS: Knowing you, Jesus knowing you,There is no greater thing,You’re my all, you’re the best,You’re my joy, my righteousness, And I love you Lord.
MY HEART DESIRE
MY HEART DESIRE
Oradiegwu Chikezie
Viewers also liked
(20)
LORD I AM GRATEFUL
LORD I AM GRATEFUL
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
сергей есенин диалог с 21 веком. конкурс художественного слова фотоотчет
Big data made simple ppp five experts talk
Big data made simple ppp five experts talk
Music Publishing Project
Music Publishing Project
Evidence basedcritcare06
Evidence basedcritcare06
peerapon_resume
peerapon_resume
Composiciones en 3D
Composiciones en 3D
Supramodernismo mexico final
Supramodernismo mexico final
Matematica 01
Matematica 01
человек огромной силы, казак иван поддубный
человек огромной силы, казак иван поддубный
Pract4 valor absoluto, radicales , racionalización y exponentes solucion
Pract4 valor absoluto, radicales , racionalización y exponentes solucion
Construccion
Construccion
Supramodernidad en Arquitectura - Brianda Yadira Martínez Medrano
Supramodernidad en Arquitectura - Brianda Yadira Martínez Medrano
Ohio State's 2016 ASH Review - BEST OF ASH 2015 MULTIPLE MYELOMA AND PLASMA C...
Ohio State's 2016 ASH Review - BEST OF ASH 2015 MULTIPLE MYELOMA AND PLASMA C...
Cardiology cases[1]
Cardiology cases[1]
H1N1 ARDS Case Presentation
H1N1 ARDS Case Presentation
Abdominal examination (Physical Examination for OSCE)
Abdominal examination (Physical Examination for OSCE)
APARATO URINARIO UCEBOL
APARATO URINARIO UCEBOL
Màrqueting digital
Màrqueting digital
MY HEART DESIRE
MY HEART DESIRE
Similar to Evidence basedcritcare06
Management of Sepsis
Management of Sepsis
Dr.Mahmoud Abbas
Sepsis
Sepsis
軒名 林
Early Goal-Directed Therapy in Septic Shock
Early Goal-Directed Therapy in Septic Shock
shivabirdi
describes the evidence for goal directed fluid therapy perioperatively
Goal Directed Therapy2.pptx
Goal Directed Therapy2.pptx
WaleedHamimy
Sepsis PowerPoint presentation
Sepsis power point presentation
Sepsis power point presentation
dlecolst
Paediatrics for the general intensivist.
Paediatrics for the general intensivist
Paediatrics for the general intensivist
SMACC Conference
Sepsis
sepsis 2019.pdf
sepsis 2019.pdf
zahid aziz
2009artandscienceofhemodynamicmonitoringfewphotos
2009artandscienceofhemodynamicmonitoringfewphotos
cjani
2009artandscienceofhemodynamicmonitoringfewphotos (1)
2009artandscienceofhemodynamicmonitoringfewphotos (1)
cjani
Delivering new models of care through large-scale digital solutions Day One, Pop-up University 7, 15.00
Itamar Medical
Itamar Medical
Health and Care Innovation Expo
Pediatrics osce
PICU OSCE.pdf
PICU OSCE.pdf
Pushpa Latha
Introduction and Statistics of PD
PD in AKI
PD in AKI
drsanjaymaitra
Septic shock, updated presentation, including latest guidelines from Intensive care societies and how to approach to the diagnosis with few notes about Early Goal Directed Therapy and role of steroids
Septic shock; latest update
Septic shock; latest update
Ramadan Arafa
Geriatric Anaesthesia - considerations
Geriatric Anaesthesia
Geriatric Anaesthesia
Anuradha
A 2 part presentation. Part 1 reviews a paper on the long-term clinical outcomes of STEMI patients undergoing remote ischaemic perconditioning prior to primary percutaneous coronary intervention. The 2nd part looks at how this technique can be used in Paramedic practice.
Remote Ischaemic Conditioning: A Paper Review & Uses in Paramedic Practice
Remote Ischaemic Conditioning: A Paper Review & Uses in Paramedic Practice
bgander23
Comparison of two fluid management strategies in acute lung injury
Comparison of two fluid management strategies in acute lung injury
Dang Thanh Tuan
Introduction, History and Indications - Teaching for Nursing Personnel
Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy
Shairil Rahayu
Some interesting papers from 2014 that might affect your practice
Hospital Medicine Update, VA ACP Meeting 2015
Hospital Medicine Update, VA ACP Meeting 2015
Jon Sweet
2012 anemo inghelmo - criteri trasfusionali in pediatria
2012 anemo inghelmo - criteri trasfusionali in pediatria
2012 anemo inghelmo - criteri trasfusionali in pediatria
anemo_site
Optimzing sepsis management
Optimzing sepsis management
EM OMSB
Similar to Evidence basedcritcare06
(20)
Management of Sepsis
Management of Sepsis
Sepsis
Sepsis
Early Goal-Directed Therapy in Septic Shock
Early Goal-Directed Therapy in Septic Shock
Goal Directed Therapy2.pptx
Goal Directed Therapy2.pptx
Sepsis power point presentation
Sepsis power point presentation
Paediatrics for the general intensivist
Paediatrics for the general intensivist
sepsis 2019.pdf
sepsis 2019.pdf
2009artandscienceofhemodynamicmonitoringfewphotos
2009artandscienceofhemodynamicmonitoringfewphotos
2009artandscienceofhemodynamicmonitoringfewphotos (1)
2009artandscienceofhemodynamicmonitoringfewphotos (1)
Itamar Medical
Itamar Medical
PICU OSCE.pdf
PICU OSCE.pdf
PD in AKI
PD in AKI
Septic shock; latest update
Septic shock; latest update
Geriatric Anaesthesia
Geriatric Anaesthesia
Remote Ischaemic Conditioning: A Paper Review & Uses in Paramedic Practice
Remote Ischaemic Conditioning: A Paper Review & Uses in Paramedic Practice
Comparison of two fluid management strategies in acute lung injury
Comparison of two fluid management strategies in acute lung injury
Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy
Hospital Medicine Update, VA ACP Meeting 2015
Hospital Medicine Update, VA ACP Meeting 2015
2012 anemo inghelmo - criteri trasfusionali in pediatria
2012 anemo inghelmo - criteri trasfusionali in pediatria
Optimzing sepsis management
Optimzing sepsis management
Recently uploaded
☑️░ 9630942363 ░ CALL GIRLS ░ VIP ░ ESCORT ░ SERVICES ░ AGENCY ░ 9630942363 THE GENUINE ESCORT AGENCY VIP LUXURY CALL GIRLS HIGH CLASS MODELS CALL GIRLS GENUINE ESCORT BOOK BOOK APPOINTMENT - 9630942363 THE GENUINE ESCORT AGENCY BEST VIP CALL GIRLS & ESCORTS SERVICE 9630942363 VIP CALL GIRLS ALL TYPE WOMEN AVAILABLE INCALL & OUTCALL BOTH AVAILABLE BOOK NOW 9630942363 VIP GENUINE INDEPENDENT ESCORT AGENCY VIP PRIVATE AUNTIES BEAUTIFUL LOOKING HOT AND SEXT GIRLS AND PARTY TYPE GIRLS YOU WANT SERVICE THEN CALL THIS NUMBER 9630942363 ROOM ALSO PROVIDE HOME & HOTELS SERVICE FULL SAFE AND SECURE WORK WITHOUT CONDOMS, ORAL, SUCKING, LIP TO LIP, ANAL, BACK SHOTS, SEX 69, WITHOUT BLOWJOB AND MUCH MORE FOR BOOKING 9630942363
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
GENUINE ESCORT AGENCY
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Girl UKHBET Escorts Service Available ✔ All Day And Night Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
parulsinha
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋 Call Mr Chirag Ji +91-7877925207 NORTH/SOUTH INDIANS HIGH CLASS MODELS/COLLEGE GIRLS/ HOUSEWIVES/BODY TO BODY MASSAGE, SANDWICH MASSAGE, SHOWER BATHING, BLOW JOB, LICKING, FRONT AND BACK SHOT, RUBBING, KISSING SMOOCHING ETC ETC... UNLIMITED FUN Call 24/7. Your assistance for your service... ☛ ✔✔ secure✔✔ 100% safe ✔✔ Vip Callgirl Service offers you the most beautiful High Profile sexy independent female Escorts in genuine ✔✔✔ To enjoy with hot and sexy girls ✔✔✔ A03524SW ★providing:- • Models • vip Models • Russian Models • Foreigner Models • TV Actress and Celebrities • Receptionist • Air Hostess • Call Center Working Girls/Women • Hi-Tech Co. Girls/Women • Housewife • Collage Going Girls. • Travelling Escorts. • Ramp-models • Foreigner And Many More.. ★OUR BEST SERVICES: - FOR BOOKING ★ A-Level (5 star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob)
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
TANUJA PANDEY
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Hyderabad Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Hyderabad Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Hyderabad Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Celebrity for 5* Hotels Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
parulsinha
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available ★> Whatsapp Number-9521753030 <★ ★ CALL US High Class Luxury and Premium Escort Service We Provide Well Educated,Royal Class Female,High-Class Escort Service Offering a Top High Class Escort Service In The & Several Nearby All Places of . ★ To Enjoy With Hot and Sexy Girls . ★ We Are Providing :- • 3* 5* 7*Hotels Service in • Hygienic Full AC Neat and Clean Rooms Avail. • Daily New Escorts Staff Available • Minimum to Maximum Range Available. Our escort service •BJ (Blowjob) •FK (French kissing) •Kissing with tongue •O-Level (Oral sex) •Long Silky Brown Hair •69 (69 sex) •A-Level (5 start Escort) •Dating
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Janvi Singh
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 9004268417 Neha Thakur Booking Contact Details WhatsApp Chat: +91-9004268417 Mumbai Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant;$S2 making an impressionable. Independent Escorts Mumbai understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Anamika Rawat
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Miss This Chance Of Getting Into My Sexy Boobs?t Booking Contact Details WhatsApp Chat: +91-9332606886 Hyderabad Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant; making an impressionable Independent Escorts Hyderabad understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more. 01-May(Ast)
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
chandars293
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Rishikesh Escorts Call girls are available to provide the quality essentialness that will ease away life's tensions. Rishikesh Escorts are regular companions of elite gentlemen. It is possible to take them to places they would never have dreamed of visiting otherwise. Their portfolios can be found online through escort agencies; they maintain themselves to look attractive by visiting salons and spas regularly. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Rishikesh Escort Service are skilled at performing wild anal sex, deep throat sex and cum eating - ideal for satisfying all your sexual needs and playing any game possible. Professional assistants are readily available and ready to assist in any situation - romantic date or solo outing. They can accompany you to restaurants or bars where their presence will surely leave an impression with their beautiful appearances and striking personalities.
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
perfect solution
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Rajasthan Booking Details Are here 06-May-2024( Mj) Click On WhatsApp Chat +91-9521753030 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Sheetaleventcompany
☑️░ 9630942363 ░ CALL GIRLS ░ VIP ░ ESCORT ░ SERVICES ░ AGENCY ░ 9630942363 THE GENUINE ESCORT AGENCY VIP LUXURY CALL GIRLS HIGH CLASS MODELS CALL GIRLS GENUINE ESCORT BOOK BOOK APPOINTMENT - 9630942363 THE GENUINE ESCORT AGENCY BEST VIP CALL GIRLS & ESCORTS SERVICE 9630942363 VIP CALL GIRLS ALL TYPE WOMEN AVAILABLE INCALL & OUTCALL BOTH AVAILABLE BOOK NOW 9630942363 VIP GENUINE INDEPENDENT ESCORT AGENCY VIP PRIVATE AUNTIES BEAUTIFUL LOOKING HOT AND SEXT GIRLS AND PARTY TYPE GIRLS YOU WANT SERVICE THEN CALL THIS NUMBER 9630942363 ROOM ALSO PROVIDE HOME & HOTELS SERVICE FULL SAFE AND SECURE WORK WITHOUT CONDOMS, ORAL, SUCKING, LIP TO LIP, ANAL, BACK SHOTS, SEX 69, WITHOUT BLOWJOB AND MUCH MORE FOR BOOKING 9630942363
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy Bhabi Ready For Sex At Your Doorstep Booking Contact Details Whatsapp Chat :+91-6297143586 These professional and Call girls in Bangalore can satisfy your every desire - be it sensual massage or an erotic shower, they are always more than willing to meet them. Furthermore, they pay close attention to body language cues to ensure you enjoy every minute spent in their company - both in-call and outcall services are offered. Is an excellent choice for anyone seeking an exciting and thrilling night of fun and excitement The Oberoi, Bengaluru Taj West End The Leela Palace Bengaluru JW Marriott Hotel Bengaluru The Ritz-Carlton, Bangalore Sheraton Grand Bangalore Hotel at Brigade Gateway Conrad Bengaluru ITC Gardenia, Bengaluru Renaissance Bengaluru Race Course Hotel The Lalit Ashok Bangalore 1-may-24
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
vidya singh
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service Available 24/7 Hire Booking Contact Details WhatsApp Chat: +91-9004268417 Mumbai Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant;$S2 making an impressionable. Independent Escorts Mumbai understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Anamika Rawat
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Available Our agency presents a selection of young, charming call girls #J11 available for bookings at Oyo Hotels. Experience high-class escort services at pocket-friendly rates, with our female escorts exuding both beauty and a delightful personality, ready to meet your desires. Whether it's Housewives,#J11 College girls, Russian girls, Muslim girls, or any other preference, we offer a diverse range of options to cater to your tastes. We provide both in-call and out-call services for your convenience. Our in-call location in Lucknow ensures cleanliness, hygiene, and 100% safety, while our out-call services offer doorstep delivery for added ease. We value your time and money, hence we kindly request pic collectors, time-passers, and bargain hunters to refrain from contacting us. Our services feature various packages at competitive rates: One shot: ₹2000/in-call, ₹5000/out-call Two shots with one girl: ₹3500/in-call, ₹6000/out-call Body to body massage with sex: ₹3000/in-call Full night for one person: ₹7000/in-call, ₹10000/out-call Full night for more than 1 person: Contact us at 🔝 7877925207 🔝. for details Operating 24/7, we serve various locations in Lucknow, including Green Park, near metro stations. For premium call girl services in Lucknow 🔝 7877925207 🔝. Thank you for considering us!
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
adilkhan87451
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 100% verified Why you Choose Us- +91-7427069034 Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant; making an impressionable I Have Extremely Beautiful Broad Minded Cute Sexy & Hot Call Girls and Escorts, We Are Located in 3* 4* 5* Hotels. Safe & Secure High Class Services Affordable Rate 100% Satisfaction, Unlimited Enjoyment. Any Time for Model/Teens Escort in Delhi High class luxury and premium escorts agency. ★ CALL US High Class Luxury and Premium Escort Service We Provide Well Educated,Royal Class Female,High-Class Escort Service Offering a Top High Class Escort Service In The & Several Nearby All Places of . ★ To Enjoy With Hot and Sexy Girls . ★ We Are Providing :- • 3* 5* 7*Hotels Service • Hygienic Full AC Neat and Clean Rooms Avail. • Daily New Escorts Staff Available • Minimum to Maximum Range Available. Our escort service •BJ (Blowjob) •FK (French kissing) •Kissing with tongue •O-Level (Oral sex) •Long Silky Brown Hair •69 (69 sex) •A-Level (5 start Escort) •Dating 03-May(Ast)
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
chennailover
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Service Available Call Mrs Leela Ji +91-8005736733 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls,#J11 Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Kolkata Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In Kolkata C010524HD Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 8005736733 !! Thank you for Visiting.
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Namrata Singh
Top Rated Bangalore Call Girls Mg Road ⟟ ⟟ Call Me For Genuine Sex Service At Affordable Rate Booking Contact Details Whatsapp Chat :+91- These professional and Call girls in Bangalore can satisfy your every desire - be it sensual massage or an erotic shower, they are always more than willing to meet them. Furthermore, they pay close attention to body language cues to ensure you enjoy every minute spent in their company - both in-call and outcall services are offered. Is an excellent choice for anyone seeking an exciting and thrilling night of fun and excitement The Oberoi, Bengaluru Taj West End The Leela Palace Bengaluru JW Marriott Hotel Bengaluru The Ritz-Carlton, Bangalore Sheraton Grand Bangalore Hotel at Brigade Gateway Conrad Bengaluru ITC Gardenia, Bengaluru Renaissance Bengaluru Race Course Hotel The Lalit Ashok Bangalore
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Inaaya Sharma
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High profile Girls VIP Call Girl Pune As Enjoy Never Ending Pune VIP Call Girls is highly qualified professionals. #S10 They will offer only top quality services and never try to scam or drain you of money; in fact, they strive to give complete satisfaction so that each cent spent was worth its worth. Furthermore, these professionals pride themselves in keeping customer details confidential; any information gleaned will never be shared with any third party. Two shots with one girl: ₹4500/in-call, ₹7500/out-call Body to body massage with : ₹5500/in-call Full night for one person: ₹7000/in-call, ₹12000/out-call •𝐂𝐨𝐥𝐥𝐞𝐠𝐞 𝐆𝐢𝐫𝐥𝐬 •𝐇𝐨𝐮𝐬𝐞𝐰𝐢𝐯𝐞𝐬 •𝐇𝐢𝐠𝐡 𝐏𝐫𝐨𝐟𝐢𝐥𝐞 𝐆𝐢𝐫𝐥𝐬 •𝐑𝐚𝐦𝐩 𝐌𝐨𝐝𝐞𝐥𝐬 •𝐅𝐨𝐫𝐞𝐢𝐠𝐧𝐞𝐫 𝐆𝐢𝐫𝐥𝐬 𝐎𝐮𝐫 𝐞𝐬𝐜𝐨𝐫𝐭 𝐬𝐞𝐫𝐯𝐢𝐜𝐞𝐬 •𝐇𝐉 (𝐇𝐚𝐧𝐝 𝐉𝐨𝐛) •𝐁𝐉 (𝐁𝐥𝐨𝐰𝐣𝐨𝐛) # Completion # (Oral To Completion) # Special Massage # O-Level (Oral ) # Oral With A Noncondom) # COB (Come On Body) # Extraball (Have Many Times) # All Meetings 100%Safe Call Payal:-- 9352988975
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
chetankumar9855
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine Sex Service At Affordable Rate Booking Contact Details WhatsApp Chat: +91-9332606886 Hyderabad Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant; making an impressionable Independent Escorts Hyderabad understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more. 02-May(Ast)
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
chandars293
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time Call Mr Chirag Ji +91-6378878445 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls, Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In 03-May-2024 (chd) Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 6378878445 !! Thank you for Visiting.
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Call Girls Delhi
Recently uploaded
(20)
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Evidence basedcritcare06
1.
Evidence-based critical care
– Update 2006 Joel Peerless MD 3 January 2006
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
EBM in perspective
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
Download now