Advanced cardiac life support (ACLS) refers to emergency treatment protocols for cardiac arrest and other life-threatening medical issues. The current ACLS guidelines include algorithms, or flowcharts, to standardize treatment for conditions like ventricular fibrillation, pulseless ventricular tachycardia, asystole, and respiratory or opioid emergencies. Key interventions discussed include defibrillation, synchronized cardioversion, and use of medications like epinephrine, amiodarone, atropine, and dopamine for various cardiac dysrhythmias and arrest rhythms. High-quality CPR is emphasized as crucial to ACLS.
Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.
Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.
Comprehensive presentation on intra arterial blood pressure with a good insight into the the basic physics and brief look into the risks and complications.
Mechanical ventilation ppt including airway, ventilator, tubings and connections, nursing management, trouble shooting common problems and issues, suctioning etc.
Comprehensive presentation on intra arterial blood pressure with a good insight into the the basic physics and brief look into the risks and complications.
Mechanical ventilation ppt including airway, ventilator, tubings and connections, nursing management, trouble shooting common problems and issues, suctioning etc.
Advanced cardiac life support, or advanced cardiovascular life support, often referred to by its acronym, "ACLS", refers to a set of clinical algorithms for the urgent treatment of cardiac arrest, stroke, myocardial infarction (also known as a heart attack), and other life-threatening cardiovascular emergencies.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Advanced Cardiac Life Support
Advanced cardiovascular life support (ACLS):
Refers to a set of clinical interventions for the urgent treatment
of cardiac arrest, stroke and other life-threatening medical
emergencies, as well as the knowledge and skills to deploy those
interventions.
3. Algorithms
• The current ACLS guidelines are set into several groups of
"algorithms" - a set of instructions that are followed to
standardize treatment, and increase its effectiveness.
• These algorithms usually come in the form of a flowchart,
making the algorithm easier to memorize.
5. Defibrillation
Defibrillation involves using electrode paddles to direct an electric current through
the patient's heart.
The current causes the myocardium to depolarize, which in turn encourages the
sinoatrial node to resume control of the heart's electrical activity.
The electrode paddles delivering the current may be placed on the patient's chest or,
during cardiac surgery, directly on the myocardium.
Because Ventricular Fibrillation leads to death if not corrected, the success of
defibrillation depends on early recognition and quick treatment of this arrhythmia.
Defibrillators can be internal, external, transvenous, or implanted, depending on the
type of device used or needed. For the purpose of this lecture, only external
defibrillator will be discussed.
6.
7. Synchronized Cardioversion
Cardioversion delivers an electric charge to the myocardium at the peak of the R wave.
This causes immediate depolarization allowing the sinoatrial node to resume control.
Synchronizing the electric charge with the R wave ensures that the current won't be delivered
on the vulnerable T wave and thus disrupt repolarization.
Uses:
a. Stable Paroxysmal Atrial tachycardia
b. Unstable Paroxysmal Supraventricular tachycardia
c. Atrial Fibrillation
d. Symptomatic Ventricular Tachycardia.
10. Ventricular Fibrillation (VF)
&
Pulseless Ventricular Tachycardia (VT)
• Perform CPR until defibrillator Arrives
• VF/VT present on defibrillator
Defibrillate up to 3 times if needed for persistent VF/VT
200 J, 200 - 300 J, 360 J
11. • Continue CPR
• Intubate / IV Access
VF & Pulseless VT
Defibrillate 360 J,
30 - 60 sec after Rx
Epinephrine
1 mg/IV
2 mg/ETT
q 3 - 5 min
Administer Rx
Amiodarone
Defibrillate 360 J
within 30 - 60 sec
12. A systole Treatment Algorithm
• Continue CPR
• Intubate at once
• Obtain IV Access
• Confirm a systole in more than 1 lead
• Atropine 1 mg IV push
repeat q 3 - 5 min up to a total
of 0.03 - 0.04 mg/kg
• Epinephrine 1mg IV push,
repeat q 3 - 5 min
Consider possible causes
Hypoxia Pre-existing acidosis
Hyperkalaemia Drug Overdose
Hypokalaemia Hypothermia
Consider termination of efforts
Consider immediate
transcutaneous pacing (TCP)
13. Skills Checklist for (VF, pulseless VT, A systole)
• On arrival, you do a quick initial assessment while assessing
responsiveness, Pulse, and vital signs and immediately begin
compressions (another nurse).
• While compressions are occurring , apply pads and electrodes to the
patient to analyze the rhythm.
• In addition, oxygen be applied to the patient
• Ask about any complaints the patient may have had and find that
minutes ago he was complaining of chest pain, palpitations, and
dizziness.
14. • As you pause during compressions you analyze the
rhythm… the patient is in Ventricular Fibrillation !!!
• The CPR team runs into the room, you notify
him/her of the patient’s rhythm and
• ANALYZE.. CLEAR…SHOCK DELIVERED
• Resume CPR! Wait to reanalyze the rhythm after the
next round of CPR
• Give patient a dose of Epinephrine in addition to
another shock.
• Evaluate!!
15. High quality CPR is key
• Rate approx 100/min
• Compression depth at least
(5cm) in adults
• Allow complete chest recoil
after each compression
• Minimize interruptions
• Rotate every 2 minutes
16.
17. Nursing Skills checklist:
•Follow algorithm
•Oxygen be applied to the patient
•Obtain Atropine from the crash cart and the
patient is bolused 0.5mg.
•Evaluate The patient’s HR and response (e.g still
remains somewhat confused and lethargic.
18. Tachycardia Algorithm
(Patient is not in Cardiac Arrest)
Assess ABC’s Assess vitals
Secure airway Review history
Administer O2 Perform physical exam
Start IV 12 lead ECG, chest x-ray
Attach monitor, pulse oximetry and B/P Cuff
If ventricular rate > 150 BPM
• Prepare for cardioversion
• May give Rx
• Immediate cardioversion is seldom
needed for heart rates < 150 BPM
19. Synchronized and unsynchronized cardioversion
Synchronized
Low energy shock
delivers shock w/ peak of QRS
Unsynchronized
High energy shock
delivers as soon as shock button
is pushed
Indications: pulseless VT/VF
20. Nursing Skills for stable tachycardia
• Provide oxygen per nasal cannula at 4 L/min.
• Continuously monitor ECG for rate, rhythm, and conduction.
• Assess vital signs and associated symptoms with changes in ECG.
• Report findings to physician.
• Explain the importance of rapidly reducing the heart rate.
• Explain the cardioversion procedure and encourage questions.
• Encourage verbalization of fears and concerns. Answer questions.
• Document pretreatment vital signs, level of consciousness, and
peripheral pulses.
• Assist with cardioversion as indicated.
• Assess LOC, cardiovascular, and respiratory status, and skin condition
following cardioversion. • Document procedure and
21. Dopamine Hydrochloride
(Intropin)
• Mechanism of action
− Increases myocardial
contractility and stroke
volume
• Indications
− Cardiogenic and
septic shock,
hypotension with low
cardiac output states
• Contraindications
− Hypovolemic shock,
Pheochromocytoma,
Tachydysrhythmias
• Adverse reactions
− Headache, anxiety,
dyspnea,
dysrhythmias
• Considerations
− Pregnancy safety:
Category C
− Effects are dose-
dependent
22. Amiodarone
(Cordarone, Pacerone)
• Mechanism of action
− Delays repolarization
and increases the
duration of action
potential
• Indications
− Ventricular fibrillation
• Contraindications
− Known
hypersensitivity to
amiodarone or iodine
− Cardiogenic shock
• Adverse reactions
− Dizziness, fatigue,
malaise
− Congestive heart
failure
• Considerations
− Pregnancy safety:
Category D
− Monitor patient
for hypotension.
23. Atropine Sulfate
• Mechanism of action
− Increases heart rate in
life-threatening
bradydysrhythmias
• Indications
− Hemodynamically
unstable bradycardia
• Contraindications
− Tachycardia,
hypersensitivity
• Adverse reactions
− Drowsiness,
confusion, headache,
tachycardia,
palpitations
• Considerations
− Pregnancy safety:
Category C
− Moderate doses may
cause pupillary
dilation.
24. Epinephrine
(Adrenalin)
• Mechanism of action
− Blocks histamine
receptors
• Indications
− Cardiac arrest,
symptomatic
bradycardia
• Contraindications
− Hypertension,
hypothermia,
pulmonary edema
• Adverse reactions
− Nervousness,
restlessness,
headache, tremor
• Considerations
− Pregnancy safety:
Category C
− May cause syncope in
asthmatic children