The document provides guidelines for approaching critically ill patients, beginning with the primary survey of airway and cervical spine control, breathing and ventilation, circulation and hemorrhage control, disability, and exposure/environmental control. It then details assessments and interventions for each component. The secondary survey involves collecting subjective information from the patient, performing objective examinations, and creating a problem list and treatment plans. The approach emphasizes stabilizing life-threatening issues first before conducting full evaluations and treatments.
Structured Approach to Critically Ill and Injured Patientmetriccertain
CERTAIN (Checklist for Early Recognition and Treatment of Acute Illness and iNjury) is designed and developed to standardize the approach to the evaluation and treatment of acutely decompensating patients. The design and content was informed by the survey of clinicians from diverse international settings. Available in electronic (laptop/mobile) and paper formats, CERTAIN provides evidence based diagnostic checklists, clinical decision support, educational modules on performing critical procedures, and has the ability to time and document real-time interventions. CERTAIN prompting has been shown to improve performance of clinical providers faced with simulated emergencies.
د/ماجد الوراقي
Structured approach for critically ill patient
المحاضرة التي قدمت يوم الاربعاء 9 ابريل 2014 في دار الحكمة بالقاهرة
من فعاليات مشروع اعداد طبيب حكيم ناجح بالتعاون مع معتمد باتحاد الاطباء العرب
و ضمن موديول الطوارئ و التخدير و العناية المركزة
Structured Approach to Critically Ill and Injured Patientmetriccertain
CERTAIN (Checklist for Early Recognition and Treatment of Acute Illness and iNjury) is designed and developed to standardize the approach to the evaluation and treatment of acutely decompensating patients. The design and content was informed by the survey of clinicians from diverse international settings. Available in electronic (laptop/mobile) and paper formats, CERTAIN provides evidence based diagnostic checklists, clinical decision support, educational modules on performing critical procedures, and has the ability to time and document real-time interventions. CERTAIN prompting has been shown to improve performance of clinical providers faced with simulated emergencies.
د/ماجد الوراقي
Structured approach for critically ill patient
المحاضرة التي قدمت يوم الاربعاء 9 ابريل 2014 في دار الحكمة بالقاهرة
من فعاليات مشروع اعداد طبيب حكيم ناجح بالتعاون مع معتمد باتحاد الاطباء العرب
و ضمن موديول الطوارئ و التخدير و العناية المركزة
Mechanical Ventilation (MV) is almost always a challenging topic for ICU nurses and practitioners. In this presentation we are going to review and relearn basics of MV together.
approach to dyspnoea / shortness of breathjonahyounus26
subjective experience of breathing discomfort that consistes of qualitatively distinct sensations that vary in intensity. the experience derives from interactions among multiple physiological, psychological, social and environmental factors and may induce secondary physiological and behavioral responses
Mechanical Ventilation (MV) is almost always a challenging topic for ICU nurses and practitioners. In this presentation we are going to review and relearn basics of MV together.
approach to dyspnoea / shortness of breathjonahyounus26
subjective experience of breathing discomfort that consistes of qualitatively distinct sensations that vary in intensity. the experience derives from interactions among multiple physiological, psychological, social and environmental factors and may induce secondary physiological and behavioral responses
Pulmonology
Variations in nomenclature
Diagnosis
Procedures
Surgical procedures
Treatment and therapeutics
Education and training
Pediatric pulmonologist
Scientific research
History of pulmonology
What are the pulmonary function tests used?
What are the indications?
What are the contraindications?
How to perform each and prepare patients?
How to interpret and reach a diagnosis?
How to clean and calibrate devices?
At the end of the lecture, the student will be able to
Describe the patho-physiology of the disease.
Discuss the major risk factors and clinical manifestations of the disease.
Use the nursing process as a framework for patient care.
Discuss medical , surgical and nursing management of the disease.
Airway diseases presenting with behavior of Reaction to any trigger have been in increase. We intend to visit available resources for better understanding of RAD - in Children and adults
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
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
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.
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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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
Approach to the critically ill patient
1. Approach To The Critically
Ill Patient
Ahmed Mohamed Abdelazeem
Critical Care Medicine Department
Benha University
2019
2. PRIMARY SURVEY
1. Airway and cervical spine control
2. Breathing and ventilation
3. Circulation with hemorrhage control
4. Disability
5. Exposure/Environmental control
4. Assessment
1. Airway Patency
• Have the patient speak
If the patient talks to you normally, the airway is clear. If there is no response to speech,
perform a more detailed assessment of the airway
• Look, listen and feel
Look for secretions, blood, vomit, foreign bodies, facial, mandibular, or tracheolaryngeal
fractures
Listen for upper airway noises
Gurgling ” caused by fluids (secretions, blood or vomit) in the oropharynx”
Snoring “partial airway obstruction at the pharyngeal level”
Stridor ”high-pitched inspiratory sound, may be associated with partial airway obstruction
at the level of the larynx (inspiratory stridor) or the trachea (expiratory stridor)”
Hoarseness “caused by partial laryngeal obstruction associated with oedema”
Absent breath sounds indicates either complete airway obstruction or absence of
breathing
Feel air flow
5. 2. Airway Protection
• Testing the gag reflex or the ability to swallow
3. Assume Injury To The Cervical Spine In Any Patient With The
Following Findings:
• Multi-system or major trauma
• Altered level of consciousness
• Blunt injury above the clavicles
• Concerning mechanism of injury
• Neck pain, ecchymosis or deformity
• Neurologic deficits
“A normal neurologic exam does not exclude cervical spine injury”
6. Interventions
1. General Guidelines
• Protection of the cervical spine
All trauma victims should be placed in a protective cervical spine collar
• Prevention of aspiration
Suctioning of the lower pharynx and oropharynx
A vomiting patient should be rolled to the left lateral decubitus position and the entire
spine properly protected so that the airway can be cleared.
7. 2. Simple Maneuvers
• Head tilt/chin lift: contraindicated if neck injury is suspected
• Jaw thrust: the preferred method for patients with possible cervical spine injury
3. Airway Adjuncts
• Oropharyngeal airway (unconscious patient)
• Nasopharyngeal airway (semiconscious patient)
“Do not use a nasopharyngeal airway if you suspect a skull base fracture”
• Laryngeal mask airway
4. Tracheal Intubation
9. Assessment
1. Physical Examination
• Inspection: Observe the chest wall for symmetric rise as well as for
paradoxical movement suggestive of flail chest
• Palpation: position of the trachea in the suprasternal notch,
Subcutaneous Emphysema, for crepitus and rib tenderness
• Auscultation: provides clues to possible causes of respiratory arrest or
distress, including pneumothorax, congestive heart failure (CHF),
pulmonary edema, or pleural effusions
10. 2. Monitoring
• pulse oximeter, end-tidal CO2 monitor
3. Diagnostics
• arterial blood gas, portable chest radiograph (+ pelvic and cervical spine
views in multiply injured).
11. Interventions
1. Administration Of Supplemental Oxygen
• Nasal cannula: delivers oxygen at concentrations of 25%–45% at a flow rate of 1–6
L/min
• Simple face mask: delivers oxygen at concentrations of 40%–60% at a flow rate of 6–
10 L/min
• Venturi mask: delivers oxygen at concentrations of 65%–75% at a flow rate of 12–15
L/min
• Non rebreather mask: delivers oxygen at concentrations of 24%–60% at a flow rate
of 2–15 L/min
• Bag-mask: delivers oxygen at concentrations of 90%–97% at a flow rate of 12–15
L/min, while the previous methods require spontaneous respirations the BVM is used
for apneic patients
• Mechanical positive-pressure ventilation
12. 2. Treatment Of The Cause
• Needle thoracostomy
• Chest tube thoracostomy
• Thoracocentesis
• Furosemide
18. Assessment
1. Level Of Consciousness:
• AVPU/GCS
2. Pupillary Examination:
• Size, equality, reactivity to light
• In structural causes of coma the light reflex is usually absent, in metabolic
causes it is usually present
• A difference in pupil diameters >1 mm suggests A structural cause
3. Movement Of Extremities And Lateralization
4. Check The Blood Glucose
22. Interventions
1. Remove All Wet Or Contaminated Clothing
2. Keep The Patient Warm By
• Applying warm blankets
• Ventilating with warm humidified air
• Administering warmed IV fluids
25. 1. Chief Complaints
• Demographics
• Name
• Age
• Gender
• Admission date
• Source of referral
• Relevant comorbidities
• Complaining of
26. 2. History Of Present Illness
• Presenting scenario (A brief summary of significant data only
“subjective, objective, assessment, plan” in a chronological order, first
during Pre hospital course then during ED/floor hospital course and
finally during ICU course)
• Relevant Systems Review, Past History, Personal and Social
History, Family History, Allergies, Medications
28. 4. Past History
• Medical
• Surgical
• Ob/Gyn
5. Personal And Social History
• Occupation
• Marital status
• Living conditions
• Habits “Tobacco, Alcohol, Illicit drugs”
29. 6. Family History
7. Allergies
8. Medications
• Indication
• Dose
• Duration
• Side effects
34. 1. Summary Statement with Synthesized Problem List
• Demographics (Name, Age, Gender, Admission date, Source of referral),
Relevant comorbidities, Presented complaining of, Found to have “main
problems in descending order of importance”
2. System – Based/Problem - Based Assessment and
Plans (Diagnostic, Therapeutic)