The document provides information about arterial blood gas (ABG) testing including the procedure, common terms, normal values, indications, contraindications, and complications. It describes how to perform an arterial puncture to obtain a blood sample including gathering supplies, locating the radial artery, administering local anesthesia, inserting the needle, applying pressure after removal to stop bleeding, and proper handling and labeling of the sample. The goals are to assess acid-base status, oxygenation, levels of carbon dioxide and bicarbonate, and to determine if issues lie with ventilation, oxygenation or metabolism.
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Defines Lumbar Puncture, Discusses the Indications of Lumbar Puncture, Contraindication, and complications of Lumbar Puncture, Equipment used and preparation required for the procedure, positioning the infant and assessing the landmarks for the procedure and the procedure of Lumbar Puncture. Interpretation of CSF, and the Nursing Care Post Procedure and the important key points to remember.
A cardiac event monitor is a device that you control to record the electrical activity of your heart (ECG). This device is about the size of a pager. It records your heart rate and rhythm. Cardiac event monitors are used when you need long-term monitoring of symptoms that occur less than daily
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Defines Lumbar Puncture, Discusses the Indications of Lumbar Puncture, Contraindication, and complications of Lumbar Puncture, Equipment used and preparation required for the procedure, positioning the infant and assessing the landmarks for the procedure and the procedure of Lumbar Puncture. Interpretation of CSF, and the Nursing Care Post Procedure and the important key points to remember.
A cardiac event monitor is a device that you control to record the electrical activity of your heart (ECG). This device is about the size of a pager. It records your heart rate and rhythm. Cardiac event monitors are used when you need long-term monitoring of symptoms that occur less than daily
NABH : National Accreditation Board for Hospitals & Healthcare Providers - guidelines for sterlity protocols, care of poly-trauma cases and hospital waste management
Stepwise approach to adult male circumcision.Adeniji Victory
This slide is meant to advance knowledge . The author takes no responsibility for errors and no accountability for misrepresentation or misinterpretation
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient Prof. Mridul Panditrao
A case report of Emergency Peri-operative Mnagement of a Jehovah's Witness patient.
Because of their peculear religious belief, these patients do not accept Blood and It's products. This can pose serious problems to the Anesthesiologist.
Nebulizer Therapy in Spontaneous Breathing Patients PI
Leonor Ortiz, RRT
Ricardo Montoya, RRT, AE-C
Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013
NEW BLOGSITE ADDRESS:
"Nurses Information Site"
http://nursesinfosite.blogspot.com
To evaluate apical impulse. To assess dilatation and dynamics of RV, aorta and pulmonary artery.
To identify apex of the heart. To detect enlargement of RV, aorta and pulmonary artery.
NEW BLOGSITE ADDRESS:
"Nurses Information Site"
http://nursesinfosite.blogspot.com
Arterial Pulse: Radial
To assess cardiac function. To assess state of health.
NEW BLOGSITE ADDRESS:
"Nurses Information Site"
http://nursesinfosite.blogspot.com
Pathology of Pneumonia:
Broncho- pneumonia,
Lobar Pneumonia,
Lung Abscess,
Lung Fungal Absces,
Normal Lung
Please leave a comment after downloading.
THANK YOU ^^
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
2. Objectives:
1.Understand ABG and its terms
2.Know some of the indications and
contraindications for performing an
arterial puncture.
3.Be able to demonstrate the
technique for performing an arterial
puncture.
3. What is an ABGWhat is an ABG
• Arterial Blood Gas
• Drawn from artery- radial, brachial, femoral
• It is an invasive procedure
• Caution must be taken with patient
anticoagulants.
• Helps differentiate oxygen deficiencies
from primary ventilatory deficiencies from
primary metabolic acid-base abnormalities.
6. Information Obtained from an ABGInformation Obtained from an ABG
• Acid base status
• Oxygenation
• Dissolved O2 (pO2)
• Saturation of hemoglobin
• CO2 elimination
• Levels of carboxyhemoglobin and
methemoglobin
7. IndicationsIndications
• Assess the ventilatory status, oxygenation and
acid base status.
• Assess the response to an intervention.
• Regulate electrolyte therapy.
• Establish preoperative baseline parameters.
9. Complications:
Complications:
The most commonThe most common
complication from ancomplication from an
arterial puncture isarterial puncture is
hematomahematoma at the site.at the site.
Less common butLess common but
important complicationsimportant complications
areare thrombus in thethrombus in the
artery and infection atartery and infection at
the sitethe site..
11. WhichArteryto
WhichArterytoChoose?
Choose?
TheThe radial arteryradial artery isis
superficial, hassuperficial, has
collaterals and is easilycollaterals and is easily
compressed. It shouldcompressed. It should
almost always be the firstalmost always be the first
choice.choice.
Other arteries (femoral,Other arteries (femoral,
dorsalis pedis, brachial)dorsalis pedis, brachial)
can be used incan be used in
emergencies.emergencies.
13. Wash your hands, introduce yourself to theWash your hands, introduce yourself to the
patient and clarify their identity. Explain whatpatient and clarify their identity. Explain what
you would like to do and obtain consent. Thisyou would like to do and obtain consent. This
is a slightly uncomfortable procedure so youis a slightly uncomfortable procedure so you
should let the patient know this.should let the patient know this.
14. Gatherthe
Gatherthe
necessaryfollowing
necessaryfollowingequipment:
equipment:
a blue (23 G) needle
a blue (23 G) needle
2ml syringe with heparin
2ml syringe with heparin
a cap for the syringe
a cap for the syringe
a plastic bung
a plastic bung local anaesthetic (plus needle
local anaesthetic (plus needle
and syringe for giving)
and syringe for giving)
alcohol gel
alcohol gel gauze
gauze
gloves
gloves
a sharps bin
a sharps bin Usually, the syringe, needle, cap
Usually, the syringe, needle, cap
and bung are all provided in
and bung are all provided in
one pack.
one pack.
15.
16.
17. Position the patient’s arm with the wristPosition the patient’s arm with the wrist
extended.extended.
Locate the radial artery with your index andLocate the radial artery with your index and
middle fingers.middle fingers.
18. Perform Allen’s test where you compress both thePerform Allen’s test where you compress both the
radial and ulnar arteries at the same time.Theradial and ulnar arteries at the same time.The
hand should become white, release the ulnarhand should become white, release the ulnar
artery and the colour should return to the hand.artery and the colour should return to the hand.
This ensures that there will still be a bloodThis ensures that there will still be a blood
supply to the hand should the ABG cause asupply to the hand should the ABG cause a
blockage in the radial artery.blockage in the radial artery.
19. Put on your gloves
Put on your gloves
and attach the needle
and attach the needle
to the heparinised
to the heparinised
syringe.
syringe.
Also prepare your
Also prepare your
local anaesthetic and
local anaesthetic and
give a small amount
give a small amount
over the palpable
over the palpable
radial artery.
radial artery.
20. Take the cap off theTake the cap off the
needle, flush the heparinneedle, flush the heparin
through the syringe andthrough the syringe and
again locate the radialagain locate the radial
artery using your non-artery using your non-
dominant hand.dominant hand.
21. Let the patient know you are about to proceed and toLet the patient know you are about to proceed and to
expect a sharp scratch.expect a sharp scratch.
Insert the needle at 30 degrees to the skin at theInsert the needle at 30 degrees to the skin at the
point of maximum pulsation of the point of maximum pulsation of the radial arteryradial artery..
Advance the needle until arterial blood flushes intoAdvance the needle until arterial blood flushes into
the syringe.The arterial pressure will cause thethe syringe.The arterial pressure will cause the
blood to fill the syringe.blood to fill the syringe.
22. Remove the needle/syringe placing theRemove the needle/syringe placing the
needle into the bung. Press firmly over theneedle into the bung. Press firmly over the
puncture site with the gauze to halt thepuncture site with the gauze to halt the
bleeding. Remain pressed for 5 minutes.bleeding. Remain pressed for 5 minutes.
23. Remove the needle and discard safely in theRemove the needle and discard safely in the
sharps bin.sharps bin.
24. Cap the syringe, push out any air within it, andCap the syringe, push out any air within it, and
send immediately for analysis ensuring that thesend immediately for analysis ensuring that the
sample is packed in ice. Remove your gloves andsample is packed in ice. Remove your gloves and
dispose them in the clinical waste bin. Washdispose them in the clinical waste bin. Wash
your hands and thank the patient.your hands and thank the patient.
25. An extension to this station
An extension to this station
could be
could be Blood gas interpretation
Blood gas interpretation..
Before attempting to
Before attempting to
interpret the results you
interpret the results you
should know whether the
should know whether the
patient was on room air or
patient was on room air or
on oxygen when the
on oxygen when the
sample was taken, and if
sample was taken, and if
on oxygen, what
on oxygen, what
concentration.
concentration. It is also useful to know
It is also useful to know
whether the patient has a
whether the patient has a
temperature or not, and
temperature or not, and
this should be clearly
this should be clearly
written on the sample.
written on the sample.