Autonomic dysreflexia (AD) is an abnormal response to painful stimuli below the level of spinal cord injury that causes dangerous increases in blood pressure. It is mediated by the autonomic nervous system. The main causes are full bladders and bowels. Acute care involves locating and removing stimuli, lowering blood pressure, and administering medications. Prevention through regular bladder and bowel care is key to avoiding autonomic crises.
Cardiac Rehabilitation has been defined as:
Coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning so that they may, by their own efforts, resume and maintain as normal a place as possible in the community
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
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
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. It's used for people who have severe coronary heart disease (CHD), also called coronary artery disease.
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.
Cardiac Rehabilitation has been defined as:
Coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning so that they may, by their own efforts, resume and maintain as normal a place as possible in the community
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
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
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. It's used for people who have severe coronary heart disease (CHD), also called coronary artery disease.
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.
This PowerPoint was one very small part of my Ecology Interactions Unit from the website http://sciencepowerpoint.com/index.html .This unit includes a 3 part 2000+ Slide PowerPoint loaded with activities, project ideas, critical class notes (red slides), review opportunities, challenge questions with answers, 3 PowerPoint review games (125 slides each) and much more. A bundled homework package and detailed unit notes chronologically follow the PowerPoint slideshow.
Areas of Focus within The Ecology Interactions Unit: Levels of Biological Organization (Ecology), Parts of the Biosphere, Habitat, Ecological Niche, Types of Competition, Competitive Exclusion Theory, Animal Interactions, Food Webs, Predator Prey Relationships, Camouflage, Population Sampling, Abundance, Relative Abundance, Diversity, Mimicry, Batesian Mimicry, Mullerian Mimicry, Symbiosis, Parasitism, Mutualism, Commensalism, Plant and Animal Interactions, Coevolution, Animal Strategies to Eat Plants, Plant Defense Mechanisms, Exotic Species, Impacts of Invasive Exotic Species.
If you have any questions please feel free to contact me. Thank you again and best wishes.
Sincerely,
Ryan Murphy M.Ed
www.sciencepowerpoint@gmail.com
I just wanted to share some of my Clinical Instructors lecture materials. I don't own this document, I wish to help you guys with the summary of Nursing MS.
hypotension and hypertention emergencies in the dental officevahid199212
this presentation shows how to treat Hypo tension and Hypertension in medical emergencies in the dental office. includes Vasovagal syncope.postural hypo-tension.hypertension as a medical complex.
Daily practice in medicine in general need awareness of critical signs and symptoms that can be the presentation of life threatening and fatal conditions
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
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
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.
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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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
64. References Paralyzed Veterans of America/Consortium for Spinal Cord Medicine. Acute management of autonomic dysreflexia: individuals with spinal cord injury presenting to health-care facilities. Washington (DC): Paralyzed Veterans of America (PVA); 2001 Jul. 29 p. Autonomic Dysreflexia in Spinal Cord Injury: Treatment & Medication Author: Denise I Campagnolo, MD, MS, Director of Multiple Sclerosis Clinical Research and Staff Physiatrist, Barrow Neurology Clinics, St Joseph's Hospital and Medical Center; Investigator for Barrow Neurology Clinics; Director, NARCOMS Project for Consortium of MS Centers Glynis Collis Pellat, British Journal of Neuroscience Nursing, Aug/Sept 2010, Vol 6, Number 6, PP 271-275 Autonomic Dysreflexia: What You Should Know, Consortium for Spinal Cord Management. www.pva.org
Editor's Notes
Patients most at risk of AD are those with SCI above T6 who have passed through the acute stage of spinal cord injury (spinal shock). This is a medical emergency and must be treated with prompt action. High blood pressure can lead to heart arrythmias and stroke. Repeated episodes of AD can cause long term organ and vascular damage.
this will help to reduce the blood pressure to the head and upper body. Patient must remain sitting up with head of bed elevated to 90 degrees until crisis has passed
This will allow pooling of blood in lower extremities to reduce blood pressure. It may also be the source of the crisis. Remove shoes, loosen braces, remove elastic anti-embolism stockings, and inspect for any other sources of pain related to clothing or devices.
Attach intermittent BP device and check BP every 5 minutes or more as needed. This will allow you to identify whether or not you have identified the problem. Example, if you cath the patient and that results in an immediate drop in BP then the source has been identified, Otherwise continue to investigate the cause of the crisis. If you have a cardiac patient, apply 6 lead EKG at this time. Some protocols indicate that a systolic BP above 150Hgmm requires pharmaceutical intervention.
If the patient has a foley catheter, check for any kinks or obstructions in the tubing. If foley is not draining replace it. Call a doctor if there is any difficulty replacing the foley. If the patient does intermittent cathing, cath the patient to empty the bladder. Apply lidocaine jelly to the urethra 2 minutes prior to cathing to avoid further painful stimuli. If there is a doubt about the bladder being empty, use a bladder scanner. Observe patient's urine. An odor or discoloration may point to bladder infection or kidney problems. Collect sample for analysis.
Impacted bowels can often lead to a crisis. Apply lidocaine 2 minutes prior to digital deimpactation. While the patient is in the lateral position, check patient's sacral area and buttocks for pressure ulcers or other causes of pain. Inspect area under patient to make sure they were not lying on any object such as an IV cap. A digical rectal exam may exacerbate the crisis! If blood pressure rises during the examination, stop, instill more lidocaine, and call the doctor.
Check for any other sources of pain. Start at the feet and work up. Inspect for ingrown toenails, bites, scratches or other minor wounds. Check for pressure ulcers under the heels. Make sure socks and pants are not tight. Loosen leg braces and pants. Make sure the leg openings of underwear are not constricting the upper thighs. Check to see if female patient has vaginal bleeding or discharge. Check male patients to see if they are lying on the scrotum. Check for discharge or swelling. Make sure patient is not too hot or too cold. Check temperature to detect a possible infection
Several situations a patient faces during surgery or outpatient procedures puts them at risk for AD. - Hypothermia: Use warming blankets to prevent hypothermia Use warmed IV fluids. - Positioning: Even if the patient does not feel awkward positioning, their ANS may detect muscle stretching and awkward positions that restrict circulation. - Procedures that puncture and cause pain below the SCI such as an angiogram may cause ADS.
The spinal cord patient must be educated on how to stop an AD crisis, and how to guide family and caregivers. They should have an AD kit prepared that has a cath set, lidocaine, prescribed medications, and step by step instructions. If the person or caregivers are not able to perform a cath procedure, the patient should call 911.
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