continuous or intermittent monitoring of heart activity, generally by electrocardiography, with assessment of the patient's condition relative to their cardiac rhythm.
continuous or intermittent monitoring of heart activity, generally by electrocardiography, with assessment of the patient's condition relative to their cardiac rhythm.
Cardiac catheterization (kath-uh-tur-ih-ZAY-shun) is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart.
Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization. Some heart disease treatments, such as coronary angioplasty, also are done using cardiac catheterization.
Usually, you'll be awake during cardiac catheterization, but given medications to help you relax. Recovery time for a cardiac catheterization is quick, and there's a low risk of complications.
Cardiac monitoring(presentation ) for medical studentsNehaNupur8
presentation on cardiac monitoring , different tools and mechanism used for monitoring one of the vital organ of our body that is heart. specially for medical students, made by basic bsc students of nursing
Pulse oximetry is a noninvasive method for monitoring a person's oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy (within 4% accuracy in the worst 5% of cases) of the more desirable (and invasive) reading of arterial oxygen saturation (SaO2) from arterial blood gas analysis.
Cardiac catheterization (kath-uh-tur-ih-ZAY-shun) is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart.
Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization. Some heart disease treatments, such as coronary angioplasty, also are done using cardiac catheterization.
Usually, you'll be awake during cardiac catheterization, but given medications to help you relax. Recovery time for a cardiac catheterization is quick, and there's a low risk of complications.
Cardiac monitoring(presentation ) for medical studentsNehaNupur8
presentation on cardiac monitoring , different tools and mechanism used for monitoring one of the vital organ of our body that is heart. specially for medical students, made by basic bsc students of nursing
Pulse oximetry is a noninvasive method for monitoring a person's oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy (within 4% accuracy in the worst 5% of cases) of the more desirable (and invasive) reading of arterial oxygen saturation (SaO2) from arterial blood gas analysis.
Examination of cardiovascular system in PediatricsBirhanu Melese
The paediatrics cardiovascular exam can be a logistical minefield, requiring a good understanding of cardiac anatomy and possible congenital anomalies. With babies especially, it’s important to be opportunistic with your examination – doing the three ‘quiet things’ first: auscultation of heart sounds, auscultation of breath sounds and palpation of femoral pulses.
Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
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)
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
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. INTRODUCTION:-
Assessment of the cardiovascular system is one of the
most important areas of the nurse’s daily patient assessment. Report
your findings as clearly as possible. Charting your results clearly is
essential for others to be able to assess the problem, and good
documentation is also essential for the treatment of the patient as
well as for the nursing care.
3.
4.
5. PHYSICAL EXAMINATION
General:-
Build (obesity or wasting); shortness of breath; difficulty in talking; note
whether they look ill.
Look for pallor, jaundice, sweatiness and clamminess, and for xanthelasma
around the eyes.
Cyanosis
This is seen below the fingernails and toenails but also in the lips, cheeks,
ears and nose.
It may increase in the cold and on exertion.
6. Face
Malar flush - redness around the cheeks (mitral stenosis).
Xanthomata - yellowish deposits of lipid around the eyes, palms, or tendons
(hyperlipidaemia).
Corneal arcus - a ring around the cornea (normal ageing or
hyperlipidaemia).
Proptosis - forward projection or displacement of the eyeball (Graves'
disease)
Hands
Finger clubbing.
Janeway lesions - macules on the back of the hands (infective endocarditis).
Osler's nodes - tender nodules in the fingertips (infective endocarditis).
7. Pulse
Rate: average 72/minute in adults, faster in children and may
slow in old age. Also slower in athletes. Compare with apex rate.
Rhythm:
Respiratory variations are common in healthy individuals (if
there is noticeable quickening in inspiration and slowing in
expiration, this is termed sinus arrhythmia).
8. •Peripheral pulses:
Femoral pulses (radial femoral delay in coarctation) and foot
and ankle pulses.
Listen over the renal and femoral artery for murmurs.
9. Check blood pressure
This should be measured in the brachial artery, using a cuff
around the upper arm.
A large cuff must be used in obese people, because a small cuff
will result in the blood pressure being overestimated.
Systolic pressure is at the level when first heard (Korotkoff I)
and the diastolic pressure is when silence begins (Korotkoff V).
In patients with chest pain, or if ever the radial pulses appear
asymmetrical, the pressure should be measured in both arms
because a difference between the two may indicate aortic dissection.
10. Chest examination
Check the level of the jugular venous pressure.
Chest examination:
Look to see if the chest wall is deformed (eg, funnel chest)
and moves equally (inequality of expansion is usually due to
respiratory disease).
Note the respiratory rate; it is related to the pulse rate in the
ratio of about 1:4 and remains constant in the same individual.
11. Ask the patient to breathe out and, using both hands resting lightly on
the side walls of the chest with thumbs meeting in the middle, ask them to
breathe in to assess the expansion of the chest on full inspiration by noting
how far the examiner's thumbs move apart.
Feel over the anterior chest wall for any thrills associated with cardiac
murmurs.
Auscultation of the heart -
12. Examination of other areas
Abdomen - see also separate Abdominal Examination
Palpate the abdomen for hepatomegaly and splenomegaly
(congestive cardiac failure), or spleen alone (infective
endocarditis).
Feel for enlargement of the aorta (aneurysm); feel with the
hands flat either side of the aorta - feel for pulsation and
tenderness.
15. Electrocardiography (ECG or EKG*) is the process of
recording the electrical activity of the heart over a period of
time using electrodes placed on the skin. These electrodes
detect the tiny electrical changes on the skin that arise from
the heart muscle's electro physiologic pattern
of depolarizing during each heart beat. It is a very
commonly performed cardiology test.
16.
17.
18.
19. MAIN PATTERN
The 12 lead ECG is used to classify MI patients into one of three groups:
those with ST segment elevation or new bundle branch block (suspicious
for acute injury and a possible candidate for acute reperfusion therapy
with thrombolytics or primary PCI),
those with ST segment depression or T wave inversion (suspicious for
ischemia), and
those with a so-called non-diagnostic or normal ECG. However, a normal
ECG does not rule out acute myocardial infarction.
20.
21.
22. CARDIAC ASSESSMENT
GUIDE BY: PRESENTED BY:
MRS. SHEFALI CHARAN LECTURER MR. JEEVAN LAL
M.Sc. NURSING M. Sc. NURSING FINAL YEAR
(MEDICAL SURGICAL NURSING)
23.
24. Health History:-
1. Current Health Status
-chest pain
- shortness of breath
- swelling of ankles or feet
- heart palpitations
- fatigue
25. 2. Past Health History
-Congenital heart disease
- Rheumatic fever
- Heart murmur
- High blood pressure, high cholesterol, diabetes mellitus
- Confusion
- Fatigue
28. Techniques of Examination
The patient should be supine with upper body elevated
at a 15-30E angle.
The room must be quiet, warm, and have good lighting.
You should stand to the right of the patient being
examined. Inspection and Palpation of the Heart
The finger pads are more sensitive in detecting pulsations.
29.
30. Inspect and Palpate for:
Pulsations- these are more visible when patients are thin. A
thick chest wall or increased AP diameter can obscure them.
Pulsations may indicate increased blood volume or
pressure.
Lift or heaves- these are forceful cardiac contractions that
cause a slight to vigorous movement of sternum and ribs.
Thrills- these are the vibrations of loud cardiac murmurs.
They feel like the throat of a purring cat. Thrills occur with
turbulent blood flow.
31.
32. AREA FINDINGS
Aortic (2nd inter
coastal space to
the right of the
sternum)
A pulsation could indicate an aortic aneurysm
A thrill could indicate aortic stenosis
You should inspect and palpate at the following areas:
33. Pulmonary
(2nd inter
coastal space
to the left of
the sternum)
A pulsation could indicate pulmonary
hypertension
A thrill could indicate pulmonic stenosis
34. Tricuspid (4-
5th inter
coastal
space,
lower half
of the
sternum)
A sustained systolic lift could indicate right ventricular enlargement.
A systolic thrill could indicate a ventricular septal defect.
38. 1. Aortic Area
2nd right interspace close to the
sternum.
2. Pulmonic Area 2nd left interspace.
3. ERB's Point 3rd left interspace.
4. Tricuspid Area
5th left interspace close to the
sternum.
5. Mitral Area
(Apical)
5th left interspace medial to the MCL
Auscultation of the Heart
39.
40. 1. With your stethoscope, identify the first and second heart
sounds (S1 and S2) at the aortic and pulmonic areas (base).
S2 is normally louder than S1. S2 is considered the dub of
'lub-DUB.' S2 is caused by the closure of the aortic and
pulmonic valves.
AUSCULATION OF HEART WITH STETHOSCOPE
41. 2. Identify the heart rate.
tachycardia
bradycardia
3. Identify the rhythm.
if it is irregular, try to identify the pattern.
Do early beats appear on a regular rhythm?
Does the irregularity vary consistently with respiration?
Is rhythm totally irregular?
Contd…….
42.
43. 4. Listen to S1 first, then S2 at the previously mentioned
areas using the diaphragm and then the bell.
note its intensity.
are there any splitting sounds check during inspiration
where S2 usually splits at pulmonic and ERB's point.
A thick chest wall or increased AP diameter may make S2
inaudible.
Contd……
45. S.N
O
ALTERATION
IN S1
ALTERATION
IN S2
LISTEN FOR
S3
LISTEN FOR
S4
LISTEN FOR MURMUR
1. S1 is
accentuated in
exercise,
anemia,
hyperthyroidis
m and mitral
stenosis
Normal
physiological
splitting of S2 is
best heard at
pulmonic area.
It occurs on
inspiration.
A physiologic
S3 is
frequently
heard in
children and
in pregnant
women.
It occurs
before S1
It is low
pitched and
best heard
with the bell
Heart murmur are heart sound
produced when blood flows across
one of the heart valves that is loud
enough to be heard with a
stethoscope.
46. 2. S1 is diminished in
first degree heart
block
Splitting of S2 can
indicate pulmonic
stenosis, atrial
septal defect,
right ventricular
failure.
It occurs early in
diastole during
rapid ventricular
filling. It is heard
best at the apex
in the left lateral
decubitus
position.
It may be
caused by
coronary
artery disease,
hypertension,
myocardiopat
hy, or aortic
stenosis.
3. S1 split is most
audible in
tricuspid area
A pathologic S3
occurs in people
over the age of
40. Cause is
usually
myocardial
failure
Sounds like
dee-lub-dub(or
Tennessee)
47. S.NO ASSESSMENT OF EXTRA
HEART SOUND
FEATURES OF SOUNDS
1. Ejection click High pitched sounds that occur at the
moment of maximal opening of the
aortic or pulmonary valves.
2. Opening snap High pitched additional sound may be
herd after the A2 (aortic) component of
the second heart sound (S2), which
correlates to the forceful opening of the
mitral valve.
3. Mid systolic click High frequency sound in mid systole.
Assessment of Extra Heart Sounds: