Acute respiratory failure is a life-threatening condition where the lungs fail to provide adequate oxygenation or ventilation to the blood. It can be hypoxemic (low oxygen) or hypercapnic (high carbon dioxide). Causes include conditions affecting the respiratory center of the brain, spinal cord, nerves, muscles, airways, lungs, or blood vessels. Treatment focuses on identifying and treating the underlying cause, restoring adequate gas exchange through intubation and mechanical ventilation if needed, and monitoring the patient closely in a critical care setting. Nursing management includes airway care and ventilation support, repeated assessments, implementing comfort measures, education, and communication support.
Pediatrics notes about "Acute Respiratory Failure". These notes were published in 2018.
You can download them from
- Telegram: https://t.me/pediatric_notes_2018
- Mediafire: http://www.mediafire.com/folder/u5u60m184t9z7/Pediatric_Notes_2018
Pediatrics notes about "Acute Respiratory Failure". These notes were published in 2018.
You can download them from
- Telegram: https://t.me/pediatric_notes_2018
- Mediafire: http://www.mediafire.com/folder/u5u60m184t9z7/Pediatric_Notes_2018
Acute respiratory failure happens quickly and without much warning. It is often caused by a disease or injury that affects your breathing, such as pneumonia, opioid overdose, stroke, or a lung or spinal cord injury. Respiratory failure can also develop slowly
Acute respiratory failure happens quickly and without much warning. It is often caused by a disease or injury that affects your breathing, such as pneumonia, opioid overdose, stroke, or a lung or spinal cord injury. Respiratory failure can also develop slowly
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
3. Respiratory Failure
It is a sudden and life-threatening
deterioration of the gas
exchange function of the lungs.
Indicates failure of the lungs to
provide adequate oxygenation
or ventilation for the blood.
4. Acute Respiratory Failure
Conditions:
1. Hypoxemia
- decrease in arterial oxygen tension
(PaO2) to less than 50 mmHg
2. Hypercapnia
- increase in arterial carbon dioxide
tension (PaCO2) to greater than 50
mmHg
3. Arterial pH of less than 7.35.
5. Causes of Respiratory Failure
Site Examples
Respiratory centre (CNS) Depressant drugs, opiates; traumatic and
ischemic lesions
Loss of respiratory sensitivity to CO2
Spinal cord and peripheral
nerves
Spinal injury, Guillain Barre, poliomyelitis
Neuromuscular junction Myasthenia, neuromuscular blocking drugs
Muscle Myopathies, respiratory muscle fatigue in
COPD
Pleura and thoracic cage Flail chest, pneumothorax, hemothorax
Deformities, trauma (e.g. rib fractures), loss of
optimal shape due to chronic lung
hyperinflation
Airways Extrathoracic: foreign bodies, croup
Intrathoracic: asthma, bronchiolitis, bronchitis
Gaseous exchange Emphysema, pulmonary edema, ARDS,
pneumonia
Lung vasculature Pulmonary embolus, ARDS
6.
7.
8. Classification:
A. Hypoxemic respiratory failure (type I) a PaO2 of
less than 60 mm Hg with a normal or low
PaCO2.
-Generally involves fluid filling or collapse of
alveolar units.
Examples:
1. cardiogenic or noncardiogenic pulmonary
edema
2. Pneumonia
3. Pulmonary hemorrhage
9. Pathophysiology: Hypoxemic Respiratory Failure
V/Q mismatch intrapulmonary/ intracardiac
shunt
↓ ↓
low ventilation mixing of venous
(deoxygenated) blood
↓
bypassing of ventilated alveoli
↓ ↓
venous admixture
↓
Widening of the alveolar-arterial oxygen difference
↓
Hypoxemia
11. Pathophysiology
‰
B. Shunt:
Blood pathway which does not allow contact between
alveolar gas and red blood cells
‰
Abnormal shunting:
„ a. Congenital defects in the heart or vessels ASD,
VSD, Pulmonary AVM
„ b. Lung atelectasis or consolidation ,Pneumonia,
Cardiogenic or Non-cardiogenic
pulmonary edema
‰
Shunt (right-to-left shunt)
Resistant to O2 supplementation when shunt
fraction of CO > 30%
12. ‰
Etiologies of Shunt physiology
• „Diffuse alveolar filling
• „Collapse / Consolidation
• „Abnormal arteriovenous channels
• „Intracardiac shunts
Hallmark of shunt is poor or no response to O2 therapy
‰
Shunt can lead to hypercapnia when there is
more than 60% of the cardiac output and
‰
ventilatory compensation fails
• ‰
↑RR → Increased dead space
• ‰
↓ total alveolar ventilation
• ‰
Respiratory muscle fatigue
13. Classification:
B. Hypercapnic respiratory failure (type II)
- characterized by a PaCO2 of more than 50 mm Hg.
- Common in patients with hypercapnic respiratory failure
who are breathing room air.
- The pH depends on the level of bicarbonate, which, in
turn, is dependent on the duration of hypercapnia.
Common causes:
1. Drug overdose
2. Neuromuscular disease
3. Chest wall abnormalities
4. Severe airway disorders- COPD
14.
15. Pathophysiology
Decreased functional components of the respiratory system
and CNS
↓
Reduction in overall (minute) ventilation / increase in the
proportion of dead space ventilation
↓
Decrease in alveolar ventilation
↓
Increased work of breathing
18. 2. Increase dead space- Increased RR
† a. Airway obstruction
„ Upper airway obstruction
„ Asthma, COPD
„ Foreign body aspiration
† b. Chest wall disorder
„ Kyphoscliosis, thoracoplasty
19. 3. Increase CO2 production
† a. Fever, sepsis, seizure, obesity, anxiety
† b. Increase work of breathing (asthma,
COPD)
† c. High carbohydrate diet with underlying
lung disease
20. Diagnostic Tests:
• Arterial blood gases
• Complete blood count
• Chemistry panel – renal and hepatic function
• Creatine kinase with fractionation and
troponin I
• Chest radiograph
• Echocardiography
• ECG
23. Medical Management:
Objectives of treatment:
To correct the underlying cause.
To restore adequate gas exchanges in the lungs.
1. Intubation
2. Mechanical ventilation
24. Nursing Management:
1. Assist in airway management
a. The mode of ventilation should be suited to
the needs of the patient. Ventilator settings
should be adjusted based on the patient's lung
mechanics, underlying disease process, gas
exchange, and response to mechanical
ventilation.
b. Supplemental oxygen is administered via
nasal prongs or face mask. In patients with
severe hypoxemia, intubation and mechanical
ventilation are often required.
26. Nursing Management:
*The lowest FiO2 that produces an SaO2 greater
than 90% and a PaO2 greater than 60 mm Hg
generally is recommended.
Maintain a PaO2 sufficient to give an arterial Hb
saturation of at least 85%.
Hyperoxia should be avoided, particularly in the
bronchitic who is a CO2 retainer and dependent
on hypoxic ventilatory drive.
27. Nursing Management:
2. Repeated assessments should be done, which
may range from bedside observations to
monitorings (ABGs, Pulse oximetry, VS and
responsiveness)
3. Constant monitoring in a critical care setting is a
must.
4. After the patient's hypoxemia is corrected and
the ventilatory and hemodynamic status have
stabilized, every attempt should be made to
identify and correct the underlying
pathophysiologic process that led to respiratory
failure.
28. Nursing Management:
5. Implement strategies such as turning schedule,
mouth care, skin care and range of motion
activities.
6. Assess patient’s understanding of the
management strategies that are done.
7. Assess if patient is able to initiate some form of
communication to enable the patient to express
concerns and needs to the health care team.
8. Assess patient’s knowledge of the underlying
disorder and provide teaching appropriately.