Cardiac arrest is the abrupt cessation of cardiac pump function that requires prompt intervention to prevent death. The four rhythms that can cause pulseless cardiac arrest are ventricular fibrillation, pulseless ventricular tachycardia, asystole, and pulseless electrical activity. Immediate CPR and defibrillation are critical, along with identifying and treating reversible causes such as hypoxia, acidosis, hypothermia, tamponade, pulmonary embolism, or drug overdose. Management involves high-quality CPR, defibrillation for shockable rhythms, intravenous epinephrine and amiodarone, and treating underlying causes.
Sudden cardiac arrest (SCA)&Sudden cardiac death (SCD)Abdullah Ansari
INTRODUCTION
SCD : Definition
Epidemiology
Etiology
THE INITIAL ASSESSMENT
BASIC LIFE SUPPORT
CPR Steps
SELF-ASSESSMENT FOR BLS
ADVANCED CARDIAC LIFE SUPPORT
PRINCIPLES OF EARLY DEFIBRILLATION
AUTOMATED EXTERNAL DEFIBRILLATOR
SELF-ASSESSMENT FOR ACLS
Sudden cardiac arrest (SCA)&Sudden cardiac death (SCD)Abdullah Ansari
INTRODUCTION
SCD : Definition
Epidemiology
Etiology
THE INITIAL ASSESSMENT
BASIC LIFE SUPPORT
CPR Steps
SELF-ASSESSMENT FOR BLS
ADVANCED CARDIAC LIFE SUPPORT
PRINCIPLES OF EARLY DEFIBRILLATION
AUTOMATED EXTERNAL DEFIBRILLATOR
SELF-ASSESSMENT FOR ACLS
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
Sudden cardiac arrest (SCA) is an event caused by a problem with the heart's "electrical" system. SCA occurs when the heart suddenly stops beating. The heart’s electrical system sends signals to the heart to beat much too fast. The heart cannot beat that fast, so the heart muscle just quivers. Blood and oxygen do not reach vital organs like the brain. Then it stops altogether. The heart needs immediate treatment from an electrical shock (defibrillation) to restart the electrical system. If SCA is not treated within 7-10 minutes, it leads to sudden cardiac death.
This is a presentation I made while I was going through my college days. A presentation which included 5 people all my peers and and a lot of research. You will find all types of Information on Rape with Real Case studies ranging from Man Raped by a woman to the Infamous Hannah Foster Rape Case. Read and Share so that everyone can know more about this heinous crime.
Cardiovascular emergencies are life-threatening disorders that must be recognized immediately to avoid delay in treatment and to minimize morbidity and mortality. Patients may present with severe hypertension, chest pain, arrhythmia, or cardiopulmonary arrest
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.
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
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.
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.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
2. • Cardiac arrest :
is an abrupt cessation of cardiac pump function that may be reversible
but will progress to death without prompt intervention.
• The four rhythms that produce pulseless cardiac arrest are :
• ventricular fibrillation,
• pulseless ventricular tachycardia
• Asystole
• Pulseless electrical activity
by : A.taskin ( a_taskeen91@hotmail.com )
3. Clinical features :
A patient who is :
1. unconscious,
2. apneic, and
3. pulseless
fulfills the cardiac arrest diagnosis criteria
by : A.taskin ( a_taskeen91@hotmail.com )
4. Clinical features :
• In ventricular fibrillation :
• loss of consciousness occurs within 15 seconds,
• but agonal gasping may persist for around 60 seconds following
collapse.
• Brief seizure may occur, caused by cessation of cerebral blood
flow
• Cardiac arrest secondary to respiratory arrest causes :
• loss of consciousness, bradycardia, and absent pulse within 5
minutes
by : A.taskin ( a_taskeen91@hotmail.com )
5. Clinical features :
Symptoms : ( may be present )
New or changing angina
Fatigue
Palpitations
Dyspnea
Chest pain
by : A.taskin ( a_taskeen91@hotmail.com )
6. often results from reversible causes that
must be rapidly identified and treated.
5 Ts':
'5 Hs :
• Hypovolemia
• Hypothermia
• Hypoxia
• Hypo- or hyperkalemia
• Hydrogen ion (acidosis)
• Tamponade, cardiac
• Toxins
• Tension pneumothorax
• Thrombosis, pulmonary
• Thrombosis, coronary
by : A.taskin ( a_taskeen91@hotmail.com )
7. Coronary artery disease with myocardial infarction is the most
common structural heart disease predisposing
to cardiac arrest.
by : A.taskin ( a_taskeen91@hotmail.com )
8. physical examination factors :
• immediate CPR and rapid defibrillation take precedent over
examination in the cardiac arrest victim.
• Ensure adequacy of airway. Note the presence of any blood,
vomitus, or secretions
by : A.taskin ( a_taskeen91@hotmail.com )
9. • Absent respiratory effort
• presence of only agonal gasps are characteristic
of cardiac arrest.
• Unilateral breath sounds may indicate:
• tension pneumothorax or
• aspiration.
• Wheezing and rales
• underlying pulmonary edema or
• aspiration
by : A.taskin ( a_taskeen91@hotmail.com )
10. • Heart tones may be heard in patients with :
• pulmonary embolus, tension pneumothorax, or
hypovolemia
• Jugular venous distension may be noted in :
• tension pneumothorax, cardiac tamponade, or pulmonary
embolus
• A distended, dull abdomen may be noted in patients with a
• ruptured abdominal aortic aneurysm or ruptured ectopic
pregnancy
by : A.taskin ( a_taskeen91@hotmail.com )
12. Differential diagnosis :
• Supraventricular tachycardia with aberration
• Choking
by : A.taskin ( a_taskeen91@hotmail.com )
13. Choking
• a person choking on a piece of food may be mistakenly thought to be
suffering acardiac arrest
• Choking commonly occurs during a meal, often when the person is
talking or laughing
• Food lodges in the oropharynx, causing sudden cyanosis and collapse
• May cause primary respiratory arrest with absence of respiratory
efforts or severe stridor with persistence of a pulse
• The Heimlich maneuver usually dislodges the piece of food, allowing
immediate recovery
• Choking may progress to cardiac arrest if the piece of food or other
foreign body is not dislodged
by : A.taskin ( a_taskeen91@hotmail.com )
17. Causes :
• Respiratory causes :
• mechanical airway obstruction, submersion injury, and
respiratory failure originating from asthma, pulmonary
edema, or sedative overdose.
• Metabolic abnormalities :
commonly hyperkalemia, which is most frequently seen
in patients with renal failure.
• Less commonly, hypokalemia, hypermagnesemia,
hypomagnesemia and hypercalcemia .
•
by : A.taskin ( a_taskeen91@hotmail.com )
18. Causes :
• Toxins :
• overdose of prescription medications or
• illicit drugs e.g. digitalis, β-blockers, cocaine, and heroin .
• Electrical currents of 100 mA to 1 A usually cause ventricular fibrillation;
currents above 10 A can cause asystole
• Brugada syndrome:
which is an inherited disorder affecting cardiac membrane
channels that is associated with polymorphic ventricular
tachycardia and ventricular fibrillation.
• ECG showing a right bundle branch block with ST segment
elevation in leads V1 to V3
•
by : A.taskin ( a_taskeen91@hotmail.com )
19. Causes :
Long QT syndrome :
• characterized by prolonged QT interval (repolarization) on
resting ECG .
by : A.taskin ( a_taskeen91@hotmail.com )
23. CPR :
•Initiate CPR with 30 chest compressions.
•For all adults:
provide cycles of 30 chest compressions
followed by 2 breaths.
by : A.taskin ( a_taskeen91@hotmail.com )
24. CPR :
•In the pediatric :
30 compressions:2 breaths for 1 rescuer CPR
15 compressions: 2 breaths for 2 or more
rescuers.
by : A.taskin ( a_taskeen91@hotmail.com )
25. CPR :
• push hard, push fast (≥ 100 compressions/min) while allowing
full recoil of the chest between compressions.
• Compressions should be delivered over the lower half of the
sternum to a depth of 2 inches in adults and
• at least one-third of anterior-posterior diameter of the chest in
infants and children
by : A.taskin ( a_taskeen91@hotmail.com )
26. CPR :
• Immediately resume CPR after each defibrillation
attempt and continue for 2 minutes before rechecking
rhythm .
by : A.taskin ( a_taskeen91@hotmail.com )
27. Immediate action :
• 1- Begin high-quality CPR & defibrillation .
• Perform rapid rhythm assessment with quick-look paddles, electrode
pads, or limb leads
• Patients with ventricular tachycardia or ventricular fibrillation require
immediate defibrillation
• Patients with PEA or asystole should have continued CPR while attempts
are made to diagnose and treat the underlying cause
• 2- Administer supplemental oxygen as soon as it is available
• 3- Establish intravenous or intraosseous access as soon as possible
by : A.taskin ( a_taskeen91@hotmail.com )
28. Immediate action :
• After 2 minutes of CPR, reassess rhythm. If a shockable rhythm is
present, shock again
• Administer epinephrine 1 mg intravenously or intraosseously.
• Repeat every 3 to 5 minutes.
• Administer amiodarone 300 mg intravenously or
intraosseously. Repeat once at 150 mg in 3 to 5 minutes .
• A single dose of vasopressin 40 units intravenously or
intraosseously may be substituted for the first or second dose of
epinephrine
by : A.taskin ( a_taskeen91@hotmail.com )
29. Immediate action :
• Magnesium sulfate
• 1 to 2 g intravenously or intraosseously may be considered for
suspected hypomagnesemia or torsade de pointes associated
with a long QT interval.
• It is not recommended for routine use in cardiac arrest
• sodium bicarbonate
• Routine use of for the treatment of cardiac arrest is not
recommended.
• May beneficial for tricyclic antidepressant overdose,
severe cocaine toxicity, hyperkalemia, and pre-existing
acidosis .
by : A.taskin ( a_taskeen91@hotmail.com )
30. Immediate action :
• Atropine is no longer recommended for routine use in the
management of asystole/PEA
• Electrical pacing is not recommended for the treatment of:
• PEA or asystole
• Norepinephrine can be used as adjunctive treatment for
patients with profound hypotension
by : A.taskin ( a_taskeen91@hotmail.com )
31. In a non-ventricular fibrillation/ventricular
tachycardia pulseless rhythm:
• Continue with CPR
• Add epeniphrine
• Continue CPR for 2 minutes, then recheck rhythm.
• If shockable rhythm is present, defibrillate
by : A.taskin ( a_taskeen91@hotmail.com )
32. Bradycardia
(heart rate < 50 beats/min):
• If perfusion is inadequate and thought to be due to
bradycardia:
• Administer a 0.5-mg intravenous bolus of atropine; repeat
every 3 to 5 minutes to a maximum of 3 mg
• If atropine is inadequate :
1. proceed to transcutaneous pacing or
administer dopamine 2 to 10 μg/kg/min or epinephrine
2 to 10 μg/min by intravenous infusion.
2. Intravenous infusion of chronotropic agents is an equally
effective alternative to external pacing in this setting
Consider transvenous pacing
by : A.taskin ( a_taskeen91@hotmail.com )
33. Tachycardia
(heart rate typically greater than or equal to 150 beats/min):
• If there is no evidence of inadequate perfusion,
• obtain a 12-lead ECG to assess whether rhythm is
• wide-complex tachycardia (QRS ≥ 0.12 s) or
• narrow-complex tachycardia (QRS < 0.12 s)
• If there is evidence of inadequate perfusion, perform immediate
synchronized cardioversion
by : A.taskin ( a_taskeen91@hotmail.com )
34. In wide-complex tachycardia:
( V-tach , (SVT) with aberrancy, pre-excitation
tachycardia, and ventricular paced rhythms )
If the rhythm is regular with a monomorphic QRS
waveform,
• adenosine can be used for diagnosis and
treatment.
• Administer a 6-mg rapid intravenous push
• followed by a flush to deliver the drug as a rapid bolus.
• If there is no conversion, give a 12-mg rapid intravenous
push of adenosine; the 12-mg dose may be given once more.
by : A.taskin ( a_taskeen91@hotmail.com )
35. Cont, complex tach :
Consider an antiarrythmic infusion of amiodarone.
• Administer 150 mg intravenously over 10 minutes.
• repeat as needed to a maximum dose of 1.1 g/24 h.
• Follow with a maintenance infusion of 1 mg/min for the first 6 hours.
Alternatives include procainamide and sotalol
• Prepare for synchronized cardioversion
by : A.taskin ( a_taskeen91@hotmail.com )
36. For irregular rhythm:
• Consider atrial fibrillation with aberrancy and treat as for atrial
fibrillation.
• If there is pre-excitation atrial fibrillation, such as Wolff-ParkinsonWhite syndrome, consider a consultation with a cardiologist.
• Avoid atrioventricular nodal blocking agents (adenosine, digoxin,
diltiazem, verapamil), which may paradoxically increase ventricular
rate. Consider amiodarone .
by : A.taskin ( a_taskeen91@hotmail.com )
37. In narrow-complex tachycardia
for regular rhythm:
• Attempt vagal maneuvers
• Administer a 6-mg rapid intravenous push of adenosine.
• If there is no conversion, give a 12-mg rapid intravenous
push of adenosine. The 12-mg dose may be given once more
• If the rhythm converts,
• it is likely to be re-entrant SVT;
• consider diltiazem or β-blockers to prevent recurrence
by : A.taskin ( a_taskeen91@hotmail.com )
38. If rhythm does not convert :
• consider possible atrial flutter, ectopic atrial tachycardia, or
junctional tachycardia.
• Consider expert consultation, and consider diltiazem or βblockers to control rate
Implantable cardioverter-defibrillators (ICDs) are:
indicated for patients surviving cardiac arrest resulting from
ventricular fibrillation or ventricular tachycardia
that is not due to a transient or reversible cause .
by : A.taskin ( a_taskeen91@hotmail.com )