Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
This is a journal article critique on a research which is entitled " INSPIRATORY MUSCLE TRAINING TO ENHANCE RECOVERY FROM MECHANICAL VENTILATION; A RANDOMIZED TRIAL"
Inspiratory Muscle Training or Respiratory Muscle Training or Ventilatory Muscle Training. IMT is the physiotherapy technique, with the help of different breathing exercises.
Application of PEP devices in Cardiorespiratory physiotherapy.
It includes types of PEP devices and their uses in physiotherapy..
It stands for positive expiratory pressure.
It includes spirometry, flutter, rc cornet, acapella, etc.
useful in various cardiorespiratory disorders like COPD, asthma , cystic fibrosis, respiratory failure etc.
This is a journal article critique on a research which is entitled " INSPIRATORY MUSCLE TRAINING TO ENHANCE RECOVERY FROM MECHANICAL VENTILATION; A RANDOMIZED TRIAL"
indication foe intubation ,routes of intubation , the role of nurse in intubation ,indication of mechanical ventilation ,ventilators ,ventalotory modes and its advantages and disadvantages , complication of mechanical ventilation , nursing Management for patients on ventilator ,suction technique and weaning process
\It is a condition of the lung characterized by permanent dilatation of the air spaces distal to the terminal bronchioles with destruction of the walls of these airways.
Chronic Bronchitis
It is a disease characterized by daily cough with sputum for at least 3 months of the year for at least 2 consecutive years and airway obstruction which is irreversible.
These are cardiac anomalies arising as a result of a defect in the structure or function of the heart and great vessels which is present at birth
These lesions either obstruct blood flow in the heart or vessels near it, or alter the pathway of blood circulating through the heart
Burn is coagulative necrosis of the skin’s tissues, usually caused by excessive heat
Excess heat causes rapid protein denaturation and cell damage
Wet heat (scald) travels more rapidly into tissue than dry heat (flame)
A surface temperature of over 60˚C produces immediate cell death as well as vessel thrombosis
The dead skin tissue is known as Eschar
Modified Sweat gland
Lies in the deep pectoral
fascia
Boundaries:
clavicle superiorly,
the lateral border of the latissimus muscle laterally,
the sternum medially
inframammary fold inferiorly
Pre- Operative Assessment
Detailed History (Obsteritic & Gynecological h/o)
Chest assessment
Lung function tests (PFT)
Stage of cancer, extent of the disease
Surgical plan should be documented -length & duration of surgery, type of incision & details of the flap used for reconstruction
Assess the involvement of lymph nodes, posture, mobility
Checking of the Exercise capacity considering the patient’s tolerance
AMPUTATION:
“Surgical removal of limb or part of the limb through a bone or multiple bones”
DISARTICULATION:
“Surgical removal of hole limb or part of the limb through a joint”
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
Pulmonary function testing is the process of having the patient perform specific inspiratory and expiratory maneuvers while breathing in and out of tubing attached to the equipment that measure a variety of variables
More from Dr. Vitthalrao Vikhe Patil Foundation's College of Physiotherapy, Ahmednagar (20)
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
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
1. ADVANCED AIRWAY CARE
Intensive Care Unit Perspective
Dr.Nidhi Ahya (Asst Prof)
Cardio-Vascular & Respiratory PT
DVVPF College of Physiotherapy,
Ahmednagar 414111
3. Oropharyngeal Airways
Oropharyngeal airways help restore airway
patency by separating the tongue from the
posterior pharyngeal wall and maintain adequate
ventilation
4. There are two basic designs:
Guedel
Bermen
Both types have a external flange, a
curved body that conforms to the
shape of the oral cavity and are
available in different sizes
Difference is between the number
of channels
Guedel has a single centre channel
Bermen has two parallel side
channels
5. To choose the correct size, the therapist has to
place the device on the side of the patient’s face
with the flange even with the patients mouth.
The correct size is measured from the corner of the
patients mouth to the angle of the jaw, following
the natural curve of the airway
6. Technique to place Oropharyngeal airways:
Slip Technique using a tongue depresser
Jaw lift technique with 180˚ rotation
7. Possible Complications:
Insertion of an oropharyngeal airway can provoke
a gag reflex, vomiting or laryngeal spasm
These devices are best suited for semi-conscious
or unconscious patients to maintain airway patency
as well as to assist in suctioning
8. Nasopharyngeal Airways
Nasopharyngeal airways are inserted through the
nose instead of the mouth
Provides passage from the external nares to the
base of the tongue
Restore airway patency
by separating the tongue from
the posterior pharyngeal
wall
9. Indications:
When oropharyngeal airway cannot be used as in
case of seizures, mandible fracture, space
occupying lesion in the oral cavity
Insertion:
Appropriate size can be estimated by measuring
the distance from the patients ear lobe to the tip of
the nose
10. Airway is lubricated with a water soluble jelly to
ease insertion and is positioned perpendicular to
the frontal plane of the patients face
It is slowly advanced in the same direction through
either of the nasal cavity
When properly placed, it gets stabilized by its own
flange
11. Bag valve Mask
Bag valve mask combines a self-inflating bag
with a non-rebreathing valve mechanism
These devices are capable of providing
ventilation with air or supplemental oxygen
12. Endotracheal Intubation
Endotracheal tube intubation is a preferred
method for securing the airway during emergency
It can-
Prevent aspiration of
gastric contents
Permit suctioning
Facilitate oxygenation and
ventilation
Route for drug administration
13. One way valve
Universal adaptor
Pilot balloon
Bevel lumen
Murphy’s eye
Cuff
Body
Filling
tube
Parts of Endotracheal Tube:
17. Possible Complications :
During Intubation
Bradycardia caused by vagal stimulation
Hypoxemia caused by delay in procedure
Cardiac Arrhythmias
Right-mainstem intubation
Oesophageal intubation
While tube is in situ
Tube Malposition
Pharyngeal edema
Loss of cuff integrity
Tube kinking or obstruction
Post Extubation- Glottic stenosis, Vocal Cord Paralysis
18. Tracheal Intubation
Tracheostomy tubes provide an airway access
directly at the level of the second or fourth tracheal
rings
Tracheostomy is indicated when-
Long-term secretion management is required
To reduce dead space ventilation and airway resistance
Protection of airway from aspiration
Prolonged mechanical Ventilation
20. Care of Tracheostomy Tube :
Cleaning around the stoma and external portion of
the tube
Changing the ties and dressing
Cannulated tracheostomy tubes require cleaning of
inner cannula
Suctioning the tube
Cuff care- Maintaining the cuff pressure
21. IMMEDIATE COMPLICATION ( FIRST 24 HOUR)
• Bleeding
• Pneumothorax
• Air embolism-due to tearing of pleural veins
• Subcutaneous emphysema
LATE COMPLICATIONS ( After 24 – 48 hours)
• Infection
• Hemorrhage
• Airway obstruction
• Dysfunction of the swallowing
• Tracheoesophageal fistula
23. WHAT IS SUCTIONING?
The patient with an artificial airway is not
capable of effective coughing, and hence the
mobilization of secretions from the trachea
must be facilitated by aspiration.
This application of negative pressure is
called as suctioning.
24. Indications :
Therapeutic
Presence of artificial airway
Coarse Crackles
Visible secretions in the airway
Decreased SpO2 by pulse oximeter reading
Deterioration of arterial blood gas values
Clinically increased work of breathing
Patient’s inability to generate an effective cough
Increased PIP; decreased Vt during MV
Diagnostic
The need to obtain a sputum specimen / ETA (Endo
Tracheal Aspiration) for Bacteriological or
microbiological or investigations
During bronchoscopy
25. Contra-indications :
Most contraindications are relative to the
patient's risk of developing adverse reactions
Suctioning is contraindicated only when there
is fresh bleeding
There is no absolute contraindication
suctioning
26. Hazards and Complications :
Hypoxia / hypoxemia
Tracheal and / or bronchial mucosal trauma
Cardiac or respiratory arrest
Pulmonary hemorrage / bleeding
Cardiac dysrhythmias
Pulmonary atelectasis
Bronchoconstriction / bronchospasm
Hypotension / hypertension
Elevated ICP
Interruption of mechanical ventilation
27. Necessary Equipment:
Vaccum source with suction jar and adjustable
regulator
Sterile gloves
Sterile catheter of appropriate size
Clear protective goggles, apron & mask
Sterile normal saline
Ambu bag to preoxygenate the patient
31. Patient Preparation:
Explain the procedure to the patient (If patient
is concious)
The patient should receive hyper oxygenation
by the delivery of 100% oxygen for >30 seconds
prior to the suctioning (Either with Bain’s circuit
or by increasing the FiO2 by mechanical
ventilator)
Position the patient in supine position
Auscultate the breath sounds
32. Procedure:
Perform hand hygiene, wash
hands. It reduces transmission of
microorganisms.
Turn on suction apparatus and
set vacuum regulator to
appropriate negative pressure.
•For adult a pressure of 100-120
mmHg
•For pediatric 80-100mmhg
•For neonates 60-80mmhg
33. Wear Personal Protective
Equipment
Open the end of the suction
catheter package & connect it to
suction tubing (If you are alone)
Disconnect ventilator
Kink the suction tube & insert
the catheter in to the ETtube
until resistance is felt
Resistance is felt when the
catheter impacts the carina or
bronchial mucosa, the suction
catheter should be withdrawn
1cm out before applying suction
34. Apply continuous suction while
rotating the suction catheter
during removal
The duration of each suctioning
should be less the 15sec
Instill 3 to 5ml of sterile normal
saline in to the artificial airway, if
required
Resumes the ventilator
Give four to five manual breaths
with bag or ventilator
Wash the suction catheter with
saline
Discard the used equipments
35. Assessment of Outcome:
Improvement in breath sounds
Decreased peak inspiratory pressure
Increased tidal volume delivery during
ventilation
Improvement in arterial blood gas values or
saturation as reflected by pulse oximetry
Removal of pulmonary secretions
36. Limitations of Suctioning:
Suctioning is potentially an harmful procedure if
carried out improperly
Can cause barotrauma
Suctioning should be done when clinically
necessary (not routinely)
The need for suctioning should be assessed at
least every 2hrs or more frequently as need
arises.
37. Manual Hyperinflation
This technique is used in patients with an artificial
airway who are mechanically ventilated or on a
tracheostomy. It can also be used on non-intubated
patients using a naso-oral seal mask
This method of airway clearance promotes
mobilization of secretions and reinflates collapsed
areas of the lung.
Two caregivers are necessary to provide this
treatment
A manual ventilation bag attached to an oxygen
source is needed for lung inflation
Dr.Nidhi Ahya(MPT Cardio-
Vascular& Respiratory PT)
37
38. One caregiver squeezes the bag slowly to
inflate the lungs
A pause is maintained momentarily at the peak
of inflation to allow collateral ventilation
Release of the bag should be rapid and result in
high expiratory flow rate
After 6 cycles of inspiration/expiration, patients
airway is suctioned using sterile technique.
It a potential to cause significant barotrauma
with inflation and this technique is therefore
contraindicated in patients with unstable
hemodynamics, pulmonary edema, severe
bronchospasm
39. Squeeze- 1,2
Release- 1
5-6 times
Can be combined
with vibrations
Dr.Nidhi Ahya(MPT Cardio-
Vascular& Respiratory PT)
39