This is an artcile I wrote years ago, and is an updated artcile from an original one I wrote for EMSvillage.com (now defunct) in 2001.
Autonomic Dysreflexia 2007 by Robert S. Cole is licensed under a Creative Commons Attribution 4.0 International License.
Pain from acute vertebral fracture appears to be due in part to instability (non-union or slow union at the fracture site), while more than 1/3 of patients become chronically painful.
Traditional treatment for patients with painful VCFs includes bed rest, narcotic analgesics and bracing, resulting in increased pain because of acceleration bone loss and muscle weakness.
Pain from acute vertebral fracture appears to be due in part to instability (non-union or slow union at the fracture site), while more than 1/3 of patients become chronically painful.
Traditional treatment for patients with painful VCFs includes bed rest, narcotic analgesics and bracing, resulting in increased pain because of acceleration bone loss and muscle weakness.
Avascular necrosis (AVN) or Aseptic Necrosis of the hip is caused by a disruption to the hip’s blood supply which results in the deterioration and often collapse of the ball of the thigh bone (femoral head). Early identification and treatment of the condition increases the likelihood that a patient’s hip will recover. Surgery may be required in severe cases to repair or revascularize (restore circulation) the hip or to replace the hip in neglected/end stage cases.
http://www.davidsfeldmanmd.com/specialties/avascular-necrosis-hip
The professor David Lopez PT, DC from Chile, Director of the Chiropractic Program of the Universidad Central de Chile describes the Whiplash as a common injury that occurs to a person's neck following a sudden acceleration-deceleration force, most commonly from motor vehicle accidents. The term "whiplash injury" can means a occult microdamage to both the bone structures and soft tissues, and these injuries can explain those cases where the clinicians find more severe and chronic condition in the patients.
Avascular necrosis (AVN) or Aseptic Necrosis of the hip is caused by a disruption to the hip’s blood supply which results in the deterioration and often collapse of the ball of the thigh bone (femoral head). Early identification and treatment of the condition increases the likelihood that a patient’s hip will recover. Surgery may be required in severe cases to repair or revascularize (restore circulation) the hip or to replace the hip in neglected/end stage cases.
http://www.davidsfeldmanmd.com/specialties/avascular-necrosis-hip
The professor David Lopez PT, DC from Chile, Director of the Chiropractic Program of the Universidad Central de Chile describes the Whiplash as a common injury that occurs to a person's neck following a sudden acceleration-deceleration force, most commonly from motor vehicle accidents. The term "whiplash injury" can means a occult microdamage to both the bone structures and soft tissues, and these injuries can explain those cases where the clinicians find more severe and chronic condition in the patients.
This is a presentation made on stress and related problems related to physiological aspects of it. It also explains General Adaption Syndrome i.e our bodies response to stressor hormone like Oxytocin and cortisol in basic 3 stages, also some of the sympathetic and parasympathetic functions. It gives you general idea about the "Stress curve" .
Review of Nervous System, Unconsciousness, and CVA. The Nursing Core FunctionsAyinla Kazeem
This presentation was made at several sessions of Mandatory Continuing Professional Development Programme for Nigerian Nurses in Kwara State, and have undergone series of editing till date. While still working on the final editing to totally conform with global standard of practice, I deemed it necessary to share it in this forum.
2024 03 Monumental Mistakes in EMS BAD EMS v0.2.pdfRobert Cole
(note: This presentation contained videos not included in this slide deck)
Describe the elements of Negligence
Describe the concept of vicarious liability
Describe the role of anchor bias, fatigue, anger and fear in EMS decision making
Review the case of Kyle Vess
Review the case of Paul Tarashuk
Review the case of Crystal Galloway
Introductory/onboarding training for Video Laryngeoscopy, specifically for the MacGrath VL.
NOTE: This is meant to be part of a larger educational endeavor including online, hands on, and team based training.
2018 Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiop...Robert Cole
Bag-mask ventilation (BMV) is a less complex technique than endotracheal
intubation (ETI) for airway management during the advanced cardiac life support phase of
cardiopulmonary resuscitation of patients with out-of-hospital cardiorespiratory arrest.
It has been reported as superior in terms of survival.
1963 COWLEY Clinical Shock: A study of the Biochemical Response in Man.pdfRobert Cole
Accession Number: AD0427998
Title: CLINICAL SHOCK; A STUDY OF THE BIOCHEMICAL RESPONSE TO INJURY IN MAN
Descriptive Note: Annual progress rept. 1 Jan-31 Dec 1963
Corporate Author: MARYLAND UNIV BALTIMORE SCHOOL OF MEDICINE
Personal Author(s): Crowley, R. A.
Report Date: 1963-12-31
Pagination or Media Count: 226.0
Abstract: Traumatic shock is associated usually with severe injury and characterized principally by inability to maintain an adequate circulation. This study focuses on the total problem - the reaction of the body to injury, maintenance of life, and repair of injury. Studies currently in progress and those proposed are aimed primarily to understanding the biochemical response to injury in man. Provisions have been made for careful metabolic studies in the shocked patient without interfering with obvious life saving measures. Such extensive studies have required the assembly of a considerable staff - professional and technical - to support a C.S.U. on a 24-hour basis. Experimental problems relevant to establishment of such a unit evolved from two major factors 1 original nature of the study a scientific study of shock in man and 2 an unprecedented design of this study. Solutions to these problems are described. Since inception of the contract January, 1962, some 200 patients have been studied as they have undergone resuscitation measures. Final organization of the unit now permits more complex studies into the physio-biochemical response to injury in man.
Descriptors: *ENDOTOXIC SHOCK BACTERIA ENZYMES METABOLISM AMMONIA THERAPY HYPOXIA PHYSIOLOGY WOUNDS AND INJURIES IMMUNOLOGY CARDIOVASCULAR SYSTEM HYPOTHERMIA TOXINS AND ANTITOXINS HEMORRHAGE BLOOD COAGULATION
Subject Categories: Stress Physiology
Distribution Statement: APPROVED FOR PUBLIC RELEASE
Proposal to establish a new training center for Multi Agency EMS Training v1....Robert Cole
Vision
The Joint Emergency Medical Services training Center (JEMSTC) is a multi-use campus
and facilities dedicated to the provision of EMS and public safety education in the Ada
County-City Emergency Medical Services System. It would serve as a locus of collaboration and
effort in EMS education, providing not simply classroom space, but a relevant, dynamic,
realistic, and effective learning capacity, ultimately affecting the provision of all EMS services in
a positive way.
The JEMSTC would provide facilities for 24 /7 EMS education, vehicle operation, skills
practice, and credentialing. The facilities would be able to accommodate both EMS and Fire
apparatus in all climates for a diverse array of educational activities. This JEMSTC would meet
all the EMS (and related operational) training for the ACCESS system.
This document from • The Centers for Medicare & Medicaid Services shows that refusing to accept reports or parking EMS patients on the wall may be an EMTALA violation.
Hospitals and administrators do not want line EMS providers to know this, but this is ammo against abuse of EMS systems by ER Staff.
Improving Drug Calculation Performance in Paramedics Practicing in an Emergen...Robert Cole
This literature review will examine the scope of the problem and challenges with mathematical proficiency in out-of-hospital care. It will also explore interventions targeted at improving performance in the out-of-hospital environment, and how they may be applied in initial and continuing education models. The author hopes that improvement in drug calculations will result in fewer medical errors and improved patient care.
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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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
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
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
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Autonomic dysreflexia 2007
1. Autonomic Dysreflexia : An Overview for EMS personnel
By Robert S. Cole, CCEMT-P
“It takes a lot of time to make things go right, but they can all go to hell in a heartbeat.”
-Walter Slovotsky
About the Author: Steve Cole has been involved in EMS and EMS education since 1990. He has worked
for a variety of EMS agencies including volunteer fire, military, hospital based, private, and third service.
He is currently employed by Ada County Paramedics (Boise, Idaho),a top-tier and often besieged Third
Service EMS.
He has no current conflicts of interest with any portion of this article, and has not received from any
commercial interest for its production. He would like to mention that he is open for some money, should a
sufficiently insane commercial enterprise wish to invest in his expansive, eclectic, and somewhat
haphazard quest for EMS excellence.
Comments are welcome. He can be reached by email at: colemedic@hotmail.com
Introduction:
Autonomic Dysreflexia (AD), sometimes known as Hyperreflexia, is a
potentially life threatening condition1
almost completely unique to patients with spinal
cord injuries (SCI). It is characterized by a severe sympathetic response, notably stroke-
level hypertension, and related symptoms. It can be triggered by the most benign and
subtle of events, and can be overlooked easily in its early stages. Fortunately, in many
cases treatment is fairly simple if AD is recognized.
The majority of this article assumes that EMS is called after the fact, and the symptoms
are severe. However, this information is also of use to those providers who transfer SCI
patients to prevent the development of AD caused by inadvertent stimulus.
Incidence and epidemiology:
AD typically occurs in approximately 85% of patient’s with spinal cord injuries above T-
5 (although some cases of T-10 injured patient’s with AD have been reported).2
While
more men than women sustain SCI, this is mainly due to lifestyle and risk-taking
behaviors. Once a cord injury occurs, there is no difference between the occurrence of
AD based on gender, age, or race.
Spinal Cord Injury itself was first discussed in a surgical papyrus dated over 5000 years
ago.3
It described two cases of high cord injury (AKA: Quadriplegia or Tetraplegia) as an
“ailment not to be treated”. Until the advent of modern medicine, however, these patients
seldom survived more than a few weeks. This has changed, with a typical patient
surviving his injury for many, many years. With this ever-increasing life span, more and
more conditions and complications of SCI are being discovered and managed. AD is one
of these conditions.
1
16. 1
Travers, Patricia L.. "Autonomic Dysreflexia: A Clinical Rehabilitation Problem."
www.rehabnurse.org (1999) 29 MAR 2007 <http://rehabnurse.org/ce/010299/auto.htm>.
2
"Other Complications Of Spinal Cord Injury: Autonomic Dysreflexia (Hyperreflexia)." RehabSite.
1998. Louis Calder Memorial Library of the University of Miami/Jackson Memorial Medical
Center. 29 Mar 2007 <http://calder.med.miami.edu/pointis/automatic.html>.
3
Consortium for Spinal Cord Medicine, "Acute Management of Autonomic Dysreflexia: Adults
with Spinal Cord Injury Presenting to Health-Care Facilities." Clinical Practice Guidelines 2nd
editionJul 2001 29 MAR 2007 <http://www.pva.org/site/DocServer/AD2.pdf?docID=565>.
4
Campagnolo, Denise I. "Autonomic Dysreflexia in Spinal Cord Injury." www.emedicine.com. 05
OCT 2006. 29 Mar 2007 <http://www.emedicine.com/pmr/topic217.htm>.
5
Bakewell, S.. "The Autonomic Nervous System ." Update in Anesthesia Issue 5, Article 6(1995)
1-2. 29 MAR 2007 <http://www.nda.ox.ac.uk/wfsa/html/u05/u05_010.htm>.