Critical care involves close monitoring and treatment of seriously ill patients in an intensive care unit (ICU). It aims to support failing organ systems and prevent further damage through evidence-based interventions and a multidisciplinary team approach. Key aspects of ICU care include recognizing severity of illness, initiating early goal-directed therapy to stabilize physiological parameters, and implementing bundles of best practices for issues like ventilation, central lines, and sepsis to improve outcomes. Bundles comprise proven practices that must be reliably performed together to achieve benefits greater than their individual elements alone.
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
Post anesthesia care unit or , High Dependency unit is part of hospital for Post surgery/procedures recovery.Nursing, anesthesiologist, surgeons, hospital administration need to know about ideal conditions.
Nursing tool used in a medsurg environment to detect early changes in patient conditions monitoring temperature, respirations level of consciousness and oxygen level
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
Post anesthesia care unit or , High Dependency unit is part of hospital for Post surgery/procedures recovery.Nursing, anesthesiologist, surgeons, hospital administration need to know about ideal conditions.
Nursing tool used in a medsurg environment to detect early changes in patient conditions monitoring temperature, respirations level of consciousness and oxygen level
Advanced Cardiovascular Life Support (ACLS) is the pre-eminent resuscitation course for the recognition and intervention of cardiopulmonary arrest or other cardiovascular emergencies.
I picked that presentation from the internet and edited it, all rights reserved to the original owner. Anyhow this presentation might be helpful for med students doing their emergency rotation/elective and especially those who don't have an instructor or any kind of mentor in their emergency elective, like me.
FAST HUGS BID principle followed for care of critically ill patients, as checklist is a simple strategy which is used for identifying and checking the significant aspects in the general care of ICU patients.
This is a very simple presentation prepared for nurses. It will help nurses to understand the need of monitoring and the available methods. The presentation has been constructed on a clinical case base scenario and gradually different methods of monitoring has been introduced.
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.
A brief yet comprehensive coverage of ICU role in ECMO cases. Presentation has been prepared in order to help ICU fellows and registrars to understand the importance of their role and to know necessary actions they have to take in case of need.
Advanced Cardiovascular Life Support (ACLS) is the pre-eminent resuscitation course for the recognition and intervention of cardiopulmonary arrest or other cardiovascular emergencies.
I picked that presentation from the internet and edited it, all rights reserved to the original owner. Anyhow this presentation might be helpful for med students doing their emergency rotation/elective and especially those who don't have an instructor or any kind of mentor in their emergency elective, like me.
FAST HUGS BID principle followed for care of critically ill patients, as checklist is a simple strategy which is used for identifying and checking the significant aspects in the general care of ICU patients.
This is a very simple presentation prepared for nurses. It will help nurses to understand the need of monitoring and the available methods. The presentation has been constructed on a clinical case base scenario and gradually different methods of monitoring has been introduced.
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.
A brief yet comprehensive coverage of ICU role in ECMO cases. Presentation has been prepared in order to help ICU fellows and registrars to understand the importance of their role and to know necessary actions they have to take in case of need.
Planning and specification of Intensive Care UnitsAchi Kushnir PMP
This presentation has been designed to give the reader an overview in relation to the different aspects that are to be considered when planning and designing a new intensive care unit within a hospital
Location and layout of hospital, need of hospital to community,planning,factors and data required in planning,fundamentals and objectives,principles,different stages,equipment planning,icu design and layout,quality quantity and temperature and noise control in hospital,conclusion
Consolidating, Improving, and Novel Palliative Care: Order SetsMike Aref
A selection of slides, taken from a series of presentations, showing the evolution of consolidating and developing order sets for delivery of primary palliative care in our healthcare system.
Enhanced Recovery After Surgery (ERAS®) is the Enhanced Recovery After Surgery (ERAS®) is the implementation of patient-focused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidence-based, interdisciplinary perioperative guidelines.
Learn more about Enhanced Recovery Canada:
http://ow.ly/hR3j30jsnjR
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
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.
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
2. What is critical care?
•Critical care is medical care for patients
whose illness requires close, constant
watch by a team of specially trained
caregivers.
•Most critical care takes place in an
intensive care unit (ICU) or a trauma
centre.
3. How does it differ from other branches of
medicine? (Wikipedia)
• Intensive care usually takes a system by system approach to treatment,
rather than the SOAP (subjective, objective, analysis, plan) approach of
high dependency care.
• The nine key systems are each considered on an observation-intervention-impression
basis to produce a daily plan.
• Intensive care treatment raises other issues including psychological health,
pressure points, mobilisation and physiotherapy, and secondary infections.
• The nine key IC systems are (alphabetically): cardiovascular system, central
nervous system, endocrine system, gastro-intestinal tract (and nutritional
condition), hematology, microbiology (including sepsis status), peripheries
(and skin), renal (and metabolic), respiratory system.
4. Many disciplines, one team.
• The concept of critical care is to ensure the survival of the patient and
prevent end organ damage by providing optimal support.
• It involves the institution of set interventions based on evidence
based medicine to improve the survival of critically ill patients with
minimal disability.
• Critical care givers comprise a team care givers with special training.
• Each member of the team has specific role in the care giving and
includes a check list to monitor at each level.
5. Who needs to be admitted to ICU
• Depending on the severity of illness patient care is devided in to three
levels.
• Level 1 – basic care with intermittent monitoring.
• Level 2 – continuous monitoring with ability to provide hemodynamic
support and invasive monitoring.
• Level 3 – invasive ventilator support along with level 2 care.
• Level 2 and level 3 care areas are combined in most hospitals with
lower resources and called as ICUs.
6. How to recognize the severity of illness?
• Back to basics
• assess:
1. Consciousness
2. Airway competency
3. Features of respiratory insufficiency
4. Hemodynamic stability
7. What to do?
• Early goal directed therapies to counter the deleterious effects of loss
of homeostasis.
• Try to bring back the physiological parameters as close to their normal
levels as possible.
8. Intensive care bundles
• A bundle is a structured way of improving the processes of care and
patient outcomes:
• Small, straightforward set of evidence-based practices.
• Generally three to five — that, when performed collectively and
reliably, have been proven to improve patient outcomes
9. Most commonly implemented bundles
1. Ventilator Bundle
2. Central Line Bundle
3. Sepsis Resuscitation Bundle
4. Sepsis Management Bundle
10. Importance of implementation of bundles :
all or none rule
• All the elements of the bundle are necessary and removing any one of
them will result in inferior result.
• All the elements in the bundle are based on randomized controlled trial
(Level 1 evidence) and the recommendations are beyond any controversy.
• A bundle rather focuses on how to deliver this evidence of care rather than
what the right care should be.
• All elements in the bundle involve an all or none phenomenon and the
Bundle itself also bears
Implementation of all Bundle elements should take place
simultaneously at a specific time and place with a minimum delay.
11. Ventilator care bundle
• Elevation of the Head of the Bed
• Daily interruption of sedation and assessment of readiness to wean
• Peptic Ulcer Disease Prophylaxis
• Deep Venous Thrombosis Prophylaxis
• Daily Oral Care with Chlorhexidine
12. What else to do for improving outcomes?
• Daily interruption of sedation protocol
• Coordinate interruption of sedation with weaning protocol
• Use of validated sedation scale
• Incorporate other ICU staff
• Use visual cues
• Standardized order sets
• Checklists / multidisciplinary rounds
13. Central line bundle
• Appropriate hand hygiene
• Chlorhexidine skin prep
• Maximal barriers for central line insertion
• Subclavian vein placement is preferred site
• Review lines daily and remove unnecessary catheters
14. How to implement these bundles?
• Rigorous staff education
• Central line checklist
• Keep all necessary equipment in an easily accessible cart
• Empower nursing to enforce use of a central line checklist
• Include daily review of line as part of multidisciplinary rounds and
daily goals sheet
• Easy to find record of date and time of placement
15. Sedation and analgesia bundle
• Protocol-directed sedation
• Use of validated sedation scale
• Bolus doses of benzodiazepines instead of a continuous infusion
• Sedatives with a short duration of action
• Daily interruption of sedation (DIS) also referred to as spontaneous
awakening trials
16. Sepsis resuscitation bundle
• Describes seven tasks that should begin immediately, but must be
accomplished within the first 6 hours of presentation for patients
with severe sepsis or septic shock.
• Some items may not be completed if the clinical conditions described
in the bundle do not prevail in a particular case, but clinicians should
assess for them.
• The goal is to perform all indicated tasks 100 percent of the time
within the first 6 hours of identification of severe sepsis.
17. Details of sepsis resuscitation bundle
1. Serum lactate measured
2. Blood cultures obtained prior to antibiotic administration
3. Improve time to broad-spectrum antibiotics
4. Treat hypotension and/or elevated lactate with fluids
5. Apply vasopressors for ongoing hypotension
6. Maintain adequate central venous pressure
7. Maintain adequate central venous oxygen saturation
18. Sepsis management bundle
• Lists four management goals.
• Efforts to accomplish these tasks should also begin immediately.
• These items may be completed within 24 hours of presentation for
patients with severe sepsis or septic shock
19. Details of sepsis management details
1. Administer Low-Dose Steroids by a Standard Policy
2. Administer Drotrecogin Alfa (Activated) by a Standard Policy
3. Maintain Adequate Glycemic Control
4. Prevent Excessive Inspiratory Plateau Pressures