Case Study Of An Eighteen Month Old Toddler In Respiratory...

Case Study of an Eighteen Month Old Toddler In Respiratory...
As a respiratory therapist at a local hospital, I was called to the Emergency Department to await the
arrival by ambulance of a 32 lb. (14.54 kg.), eighteen–month old male toddler with a history of
coughing, congestion, fever, and runny nose for the previous five days. He is currently taking
prescribed medication, by his pediatrician, consisting of acetaminophen to control fever as well as
cough syrup to lessen his cough, congestion and runny nose. He has been on this medication for the
past two days but suddenly, within the past hour, has developed an audible wheeze and cyanosis
around his lips. This change in condition alarmed his mother and she called 911 to have an
ambulance come to her home. While in route to the hospital, the EMS ... Show more content on
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I would choose pressure controlled – continuous mandatory ventilation (PC–CMV) for this patient. I
would set up the ventilator with the following settings: initial PIP of 20 cm H2O and once patient is
attached, I would adjust the PIP to 10 cm H2O above the determined plateau pressure, tidal volume
at 90 ml (patient's IBW is 14.5 kg and the recommended VT is 5 – 8 ml/kg), frequency at 30
(recommended is 20 – 35 for a toddler), FiO2 at 100%, PEEP at the recommended pressure of +5
cm H2O, and inspiratory time of 0.6 seconds (recommended is 0.6 – 0.7) (Walsh 335). I would also
add heated humidity to the circuit via a heated pass–over humidifier set at 37 degrees Celsius. The
alarm settings would be the following: humidifier high temperature alarm at 38 degrees C. and low
temperature alarm at 30 degrees C., high pressure alarm set to 10 cm H2O above PIP and low
pressure alarm set to 5 – 10 cm H2O below PIP, low exhaled tidal volume alarm set to 80 ml (10 –
15% below set tidal volume), high PEEP set to 7 cm H20 and low PEEP alarm set to 3 cm H2O (2 –
3 cm H2O above and below set PEEP), high respiratory rate alarm set to 42 and low respiratory rate
set to 18 (40% above and below the set rate) (Cairo 106–109). To assess the appropriateness of the
ventilator settings, I would first assess the patient by listening to breath sounds, monitoring heart
rate, respiratory
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The Causes Of Premature Neonates
Introduction
Premature neonates or preterm babies refer to the neonates that are born before 37 weeks of
gestation are over. Given that most of the body organs are not completely developed at this stage,
the neonates have a high risk of developing many complications at birth. A good example of these
organs is the lungs, which completely mature by week 36 of gestation. The surfactant production
does not begin until 20 weeks of gestation age; at this stage of gestation surfactant only present in
small amount and in immature form. The mature surfactant production begins approximately after
35 weeks of gestation age. Even though the lung has mature surfactant at this stage it is not
completely capable of respiratory function. Therefore, ... Show more content on Helpwriting.net ...
However, even if these methods have managed to reduce mortality in preterm infants, they are
associated with serious adverse effects that may be fatal or contribute to chronic conditions later in
life of the patient.
According to DiBlasi, even in animal models, the conventional methods cause inflammation of the
lungs and sometimes cause injure to the lungs.1 These techniques also cause redundancy in alveolar
growth and also affect the efficacy of surfactant produced in the animal lung.1 This is a good signal
that these techniques may have serious consequences in the neonate. One of the adverse effects of
invasive and mechanical ventilation is ventilator–induced lung injury.1 This complication is defined
by the presence of polytrauma (excessive tidal volume) and shear injury to the airways, a condition
known as atelectrauma.1 Insertion of the endotracheal tube into the lungs through the airways also
causes injury to the lungs and the airways, a condition known as endotrauma.1
Insertion of the endotracheal tube through the airways is also a painful procedure that may need the
neonate to be sedated first. According to DiBlasi, insertion of the tube may also cause acute airway
injury, emergencies, an infestation of the airway with bacteria,

Airway Pressure Release Ventilation ( Aprv )
WHAT IS APRV? Airway pressure release ventilation (APRV) is a fairly new mode of ventilation,
just becoming available in the U.S. in the mid–1990's. APRV is "inverse ratio, pressure controlled,
intermittent mandatory ventilation with unrestricted spontaneous breathing and it is based on the
principle of open lung approach". (Daoud, Farag, & Chatburn, 2012) The open lung approach is
"concept of maximizing and maintaining alveolar recruitment throughout the ventilatory cycle by
potentially ventilating the lung on the steep portion of the pressure–volume curve, thus avoiding
over–distention on inspiration and alveolar collapse on exhalation". (2012) APRV "was first used
and described in 1987 as CPAP with an intermittent pressure release phase. Continuous airway
pressure is applied to maintain adequate lung volume and improve alveolar recruitment. It is a
pressure–limited, time–cycled, volume–variable mode of ventilation." (2012) This time–cycled
release phase allow for CO2 removal and keep the alveoli inflated at the "inspiratory pressure for
most of the respiratory cycle", allowing for "a higher mean airway pressure at lower peak airway
pressures. APRV produces similar or improved oxygenation with lower peak airway pressures with
no significant hemodynamic effects compared with alternative modes of ventilation in neonatal,
pediatric, and adult populations." (Kenny, et al., 2011) The Respiratory Care Journal (2012) stated
that "the primary goals of this mode were to

Critical Care Experience Report ( Micu )
Critical Care Experience Report (MICU) Patient is a 58 year old female admitted and brought in by
ambulance on February 16, 2017 due to PEA (pulseless electrical activity) arrest at home. This
patient has a history of hypertension, diabetes type 2, chronic obstructive pulmonary disease
(COPD) and found to have a mild pulmonary hypertension with possible interstitial lung disease,
mixed connective tissue disease, peripheral neuropathy and bipolar disorder. According to patient's
spouse, the night before the incident, the patient was acting like her usual self and went to sleep
around 2330 with her oxygen in place. She was found unresponsive and had foaming at the mouth
and was gasping for air. Her code status did not require resuscitation ... Show more content on
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Additionally, her medications included chlorhexidine liquid for mouth care, Colace for bowel care,
famotidine for prevention of gastric acid, folic acid, thiamine and multiple vitamins due to patient
being on enteral feeding and nothing by mouth, gabapentin for peripheral neuropathy, heparin for
prevention of thrombus formation, hydralazine for management of hypertension, Furosemide/Lasix
for diuresis to remove extra fluid from tissues and bloodstream thereby reducing swelling and
promote breathing for management of pulmonary hypertension. Moreover, her medications also
included regular insulin for blood glucose management, albuterol for respiratory management,
melatonin for promotion of rest and sleep, methylprednisolone sodium for interstitial lung disease
management, quetiapine/Seroquel for agitation's role in tachypnea and Clindamycin/Cleocin as
prophylactic for infection prevention. She also completed a course of Cefepime antibiotic from
2/17–2/21 and Vancomycin from 2/17–2/19. Furthermore, the patient also had an
electroencephalogram in 2/21 and her result showed consistency with her clinical diagnosis of a
moderate–severe encephalopathy. Chest x–ray on 2/21 showed increasing mild pulmonary edema
but with continued diuresis with Lasix 20 mg every 6 hours with a target of –2L over a 24 hour
period, her chest x–ray on 2/22 showed improving atelectasis changes on left retro–cardiac area and
resolution of previous pulmonary

Mechanical Engineering Career Paper
| Mechanical EngineeringRobert MolinowskiVocollect703 Rodi Road, Pittsburgh, PA, 15235(412)
829–8145 | | | | |
Pd. 6/7
Career Paper
December 15, 2011
Mechanical Engineering According to projected job employment in the year, 2018, mechanical
engineering will have an estimated quarter of a million jobs nationwide. This is an increase of
roughly 6% between 2008 and 2018. As the need for better, more economical necessities, a need for
mechanical engineers will always be on the uplift. Many mechanical engineers "research, design,
develop, manufacture, and test tools, engines, machines, and other mechanical devices." (Bureau, 4).
This branch, within the engineering field, ... Show more content on Helpwriting.net ...
"A design course is usually the way to go but having a course study that included mathematics and
the physical and life sciences would further benefit the engineer since they'll be a more defined
engineer." (Bureau, 6). Many colleges offer two or four year degree programs in engineering. For
example, Penn State offers what they call a 2+2 program. The program lets the student do his
undergraduate studies at any of the branch campuses throughout Pennsylvania for the first two
years. After those two years, the student will then be admitted to the main campus in University
Park to complete their graduate studies. The main difference between the set of two years is that for
the first two years, you'll be doing your core courses as well as courses designed for your intended
major. When you get to the main campus, that's where you'll focus primarily on your specific field
of engineering with other students from across the state. "Businesses often look for college
graduates who studied through a four year program instead of a two year." (Bureau, 6). Graduate
training is essential if you were to want to earn promotions within a certain company. This training
isn't required for most entry–level jobs. All fifty states and the District of Columbia require that any
engineer who offers their services to the public to have a license or they can be fined heavily for it.
These licenses are good for up to four years and must be renewed much like a driver's

A Respiratory Therapist
The average day of a respiratory therapist can be very stressful. When Melissa goes into work she
never knows what "she maybe walking into," it can be a code in the er to a newborn being born in
nursery. This is what makes my job so interesting said melissa. Melissa attended college at the
University of Indiana where she was born and raised. She decided to go to this college with a couple
of her close high school friends. After she had graduated she moved to Illinois because her parents
had moved while she was in college to be closer to family. Melissa decided to find a job close to her
parents. She applied at the hospital and got a call back within a couple weeks to come in for an
interview. The interview went great she said and then a week later she accepted her first respiratory
therapist job.According to www.learn.org the job growth rate is expected to increase 19% between
2012 to 2022. Melissa says she has already seen this growth rate increase within her hospital and
around the area needing more therapist. The first day of her job was coming in to fill out all kinds of
paperwork and then learning how to use the computer system. So that she can chart all of the
treatments she has done along with vital sign, lung sounds and post assessment of the patient. Then
once you get this part down you then go on to the job training. "Some co workers are better than
others when they train you some can be very rude at times when you have questions or don't
remember how to chart

Role Of The Modern Day Engineer
1 Introduction
The need to optimise efficiency in energy consumption is one of the greatest challenges opposing
the modern day engineer. Not only does increasing energy efficiency have a positive effect on the
environment, but also yields high cost benefits for the consumer. With the increasing threat of
climate change, it is critical that given the building industry accounts for 40% of global carbon–
dioxide emissions (UNEP , 2009), all houses minimise their energy losses. This is particularly
important in sub–tropical locations such as South–East Queensland (SEQ) where high energy
demanding appliances including air–conditioners and heaters are a requirement for a comfortable
life.
Although relative to Australia, Queensland has the second cheapest electricity price, collectively
Australia has the highest average household electricity price in the developed world (Mountain,
2012). This combined with the fact that 40% of each houses utility bill is associated with heating
and cooling (Australian Bureau of Statistics, 2009), along with the projected increase in electricity
price for SEQ as shown in figure 1, raises the need to limit the dependency on artificial heating and
cooling. The primarily focus of this paper is therefore to conclude on the possibility and
effectiveness of energy efficient houses in SEQ. This will be achieved by reviewing and analysing;
lot orientation, windows and landscaping, internal design, and amount and type of insulation
.
Figure 1:

Marilyn Manson 's Music Video Based On A Song ' The Dope...
"The Dope Show" is Marilyn Manson's music video based on a song "The Dope Show" from the
album "Mechanical Animals". The video was directed by Paul Hunter. Marilyn Manson was the co–
director. The video was filmed in the beginning of August 1998 and has its premiere on 20th August
in the same year. In the music video can be seen the leader of the rock band, Marilyn Manson
himself, who appears in the area of Hollywood Hills as an androgynous, red–haired person. In the
further part of the video the singer is being kept in a mysterious laboratory and then transported to a
place where he performs a music concert as a leader of his rock band. He performs in front of
amazed fans who are being under control of the police.
The video starts with a flash of white light (key light), close–up on syringes and the main character
in the video. The singer may be seen in a vast mountainous area. The light represents the dominant
light source in the scene. (Jackson, 2010, p. 196) It seems to be a signifier of the importance of the
person who is in the middle of action. A big number of quick zooms indicates both him and
mentioned in the beginning of the paragraph objects. It leads to conclusion that they may be
considered as keynotes in the music video (Jackson, 2010). The syringes filled with a liquid that
may be considered as a kind of drug, which is present in the whole video. It leads to a conclusion,
which may suggest that drugs are synecdoche that represents a wide range of harmful

Personal Statement For Sop For Mechanical Engineering
This is a crucial time for me to reflect on the various roads my career could take, as I am about to
complete my undergraduate education in a few months. I am doing my B.Tech in Mechanical and
Manufacturing Engineering from Manipal Institute of Technology, Karnataka, India, which is
among the top engineering colleges in India. The time that I spent here, learning about the various
mechanisms that make the world go forward, has really helped me understand where my interests lie
and where I can make a subtle yet noticeable difference in this world. So I pen down my statement
of purpose in front of you.
I want to start off by stating my real objective, which is to enhance and strengthen my knowledge
base in the field of Mechanical Engineering. The ideal path towards this, I feel, would be by
pursuing graduate studies in Mechanical Engineering. I really want to take in every ounce of
knowledge that is possible in this field so that in the long run I can become a master of this field.
This would eventually require team spirit besides ... Show more content on Helpwriting.net ...
For me, the pursuit for knowledge has been my supreme goal forever, so higher education is
something that I want to take, just to further quench my thirst for this area. I want to contribute my
knowledge and skills to the world in such an era when there are no longer boundaries. Thus to
satiate my curiosity and to fulfil my dreams, I have decided to pursue a Masters Degree in
Mechanical Engineering. I strongly believe that getting an higher education in USA would really
help me make my transition to this era of globalization. It's a fact that research work has to be
undertaken to achieve what I actually want in life. But scope for research is very limited in India,
whereas it is best in the United States of America, and this will be a perfect place for me to acquire
the next level of

Effect Of Innovation Within The Healthcare Industry
The effect of innovations within the healthcare industry leads to many scientific and technical
changes in healthcare delivery. To cope with these changes, there necessitate to prepare and train
healthcare workers to improve employees ' knowledge and the quality of care. Limited clinical
experience with new mode of mechanical ventilation, such as Airway Pressure Released Ventilation
mode, make its implementation difficult in real critical world. Adequate staff training time, offsite
support services, and backup from ventilator manufacturers are essential to improve employees '
knowledge and skills. My research topic seeks to investigate the effectiveness of scenario–based
learning in training healthcare practitioners in the use of APRV. Airway Pressure Released
Ventilation (APRV) was first introduced by Dr. Christine Stock and Dr. John Downs, in the late
1980s. The APRV application was originally used as a rescue therapy to manage ARDS patients who
have difficulty in oxygenation.{40} The Drager Evita was the first ventilator provide APRV. Other
ICU ventilator manufacturers incorporated APRV mode with different terminology. Such as, the
Maquet Servoi refers to APRV as Bi–vent; the Puritan Bennett 840 uses the term Bi–level; the
Cardinal AVEA uses Bi–phasic; and Hamilton G5 refers to APRV as DouPAP.{13} Airway Pressure
Released Ventilation is a form of nonconventional mode of ventilation that based on open–lung
principle.{13} It is a time triggered, pressure limited, and

Study of Tractor Vibration and Ergonomic Design of Tractor...
A Report on
STUDY OF TRACTOR VIBRATION AND ERGONOMIC DESIGN OF TRACTOR SEAT FOR
OPERATORS COMFORT
INDEX
|Sr. No. |Content |Page No. |
|1 |Objectives |1 |
|2 |Introduction |2–4 |
|3 |Reviews |5–10 |
|4 |Vibration Studies |11–29 ... Show more content on Helpwriting.net ...
Vibration transmission has been reported to cause back problems because of tissue failure or from
metabolic interference, or a combination of both.
Vibration occurs in all moving bodies and tractors are no exception. It results from the interaction of
the vehicle with the rough terrain and from the power source. The level of ride vibration on tractors
during normal operation frequently exceeds the internationally accepted levels. The analysis of the
ride vibration is a complex issue especially for off–road condition, as the vibration is in category of
multi–degree of system and cawed by many components, in the system. Operating speed, surface
conditions, wheel air pressure, tire cas stiffness, mounting mechanism of the seat, cab or body parts
cause infirnth variable outcome.
A considerable amount of time and energy has been spent in minimizing this vibration problem.
Suspended seats fitted to most tractors reduce the vertical component of vibration, but the levels are
still undesirably high and there is little potential for further improvement using this technique. A
further reduction in the vibration level may be obtained by introducing wheel suspension, but it
makes the system complicated and costly. Cab suspension is another method of

Premature Lungs Essay
Premature neonates or preterm babies refer to the neonates that are born before 37 weeks of
gestation are over. Given that most of the body organs are not completely developed at this stage,
the neonates have a high risk of developing many complications at birth. A good example of these
organs is the lungs, which completely mature by week 36 of gestation. Therefore, neonates born at
37th weeks are likely to have immature lungs that are associated with respiratory problems such as
respiratory distress syndrome, pneumonia, and apnea of prematurity. Respiratory distress syndrome
(RDS) develops as a consequence of the lung's inability to produce enough surfactant necessary for
maintaining the air spaces in the lungs in an open state. As a ... Show more content on
Helpwriting.net ...
According to DiBlasi, even in animal models, the conventional methods cause inflammation of the
lungs and sometimes cause injure to the lungs.1 These techniques also cause redundancy in alveolar
growth and also affect the efficacy of surfactant produced in the animal lung.1 This is a good signal
that these techniques may have serious consequences in the neonate. One of the adverse effects of
invasive and mechanical ventilation is ventilator–induced lung injury.1 This complication is defined
by the presence of polytrauma (excessive tidal volume) and shear injury to the airways, a condition
known as atelectrauma.1 Insertion of the endotracheal tube into the lungs through the airways also
causes injury to the lungs and the airways, a condition known as endotrauma.1
Insertion of the endotracheal tube through the airways is also a painful procedure that may need the
neonate to be sedated first. According to DiBlasi, insertion of the tube may also cause acute airway
injury, emergencies, an infestation of the airway with bacteria, reduced ciliary function and
increased resistance to airflow that may result to increased work of breathing (WOB) energy
required for breathing.1 Another common complication associated with a conventional method is
bronchopulmonary dysplasia.2 This is usually a serious condition, and may progress to a condition
that resembles chronic asthma later in the child's life.2 According

Module 5 Assignment ( A Presentation Sheet
Module 5 Assignment (a presentation sheet)
The observation of both animal and humans has revealed that mechanical ventilation can cause
severe lung injury if over–distention occurs (Roupie et al., 1995). To make the matter even worse,
the very patients that need mechanical ventilation the most, patients with the acute respiratory
distress syndrome for example, are especially susceptible to over–distention and therefore, lung
injury (Stewart et al., 1998). The main reason that patients with acute respiratory distress syndrome
or respiratory distress syndrome are in higher risk of lung injury is due to over–distention, caused by
reduced numbers of alveoli as result of fluid buildup, consolidation, and atelectasis (Roupie et al.,
1995).
Another group of patients which require challenging ventilation strategies are the preterm infants.
The lungs of preterm infants have undeveloped distal airway structures, with a thick air/blood
barrier and a small surface area for gas–exchange (Wallace et al., 2009). They are most likely to be
surfactant deficient due to under–developed epithelial cells which lack the type II alveolar cells
(Wallace et al., 2009). As a result, preterm infants often require respiratory support in the minutes
following birth (Roupie et al., 1995).
Although essential for survival, mechanical ventilation of preterm infants is closely associated with
a high risk of developing bronchopulmonary dysplasia (BPD) (Wallace et al., 2009).
Bronchopulmonary dysplasia is

Ventilator associated pneumonia
Prevention of Ventilator Associated Pneumonia Abstract Ventilator associated pneumonia (VAP) is a
hospital acquired infection occurs in the intensive care unit (ICU) for the patients who are on
mechanical ventilator. It further complicates the hospital course by extending the length of stay,
increase the cost of treatment, and increases the mortality rate. It is estimated that about 1% to 3%
patients on mechanical ventilator develops VAP per day. Compared to the previous years, the
Chlorhexidine mouth care and other ventilator bundle strategies decreased the VAP rate. Evidence
based research studies proved that almost 89.7% reduction in VAP occurs after the implementation
of ventilator bundle and other care related to it (Hutchins et al, ... Show more content on
Helpwriting.net ...
Review of Literature Arroliga, A. C., Pollard, C. L., Wilde, C. D., Pellizzari, S. J., Chebbo, A., Song,
J., Ordner, J., Cormier, S., & Meyer, T. (2012). Reduction in the Incidence of Ventilator Associated
Pneumonia: A Multidisciplinary Approach. Respiratory Care, 57(5). 688–696. DOI:
10.4187/respcare.01392 VAP is one of the common hospitals acquired infections, which got
significant importance in following evidence based practice to prevent it. The authors of this study
used a retrospective single center observational cohort study, done in the ICU at Scott and White
Hospital, Temple, Texas. The study took almost two years for its completion. The research team
implemented the ventilator bundle about 258 patients in mechanical ventilator. The limitations of the
study were its retrospective nature, single center study and the database does not have metrics for
severity, such as Acute Physiology and Chronic Health Evaluation (APACHE) score. The research
team identified there was a significant decrease in the number of VAP rate and the use of antibiotic
rate in the treatment of VAP was also decreased in patients who received evidence based oral care.
The team concluded by stating that the VAP rate is relatively low when the respiratory therapist is
giving mouth care at least twice a day with Chlorhexidine. Following the simple evidence based
practice like oral care can

Questions On The Importance Of Lifelong Learning
PROTFOLIO 1
ENG 5001 PROFESSIONAL SKILLS IN ENGINEERING
AUGUST 6 2014
BY 0061065213
Table of Contents
Chapter No. 1 Reflect on and self assess your current 3 achievements. 1.1 Engineers Australia
Competencies 3
1.2 Raising your Competencies during your MEngSci 4
1.3 Qualities of USQ graduate 4
1.4 Project Selection via study desk 4
Chapter No.2 Skills and Knowledge from your past project 6
Chapter No.3 Study plan in form of Gantt chart 7
Chapter No.4 Reflect on engineering and study in Australia 8
Chapter No.5 Reflect on EWB Project 10
Chapter No.6 Teamwork Skills 11
Chapter No.7 Problems and appropriate solution techniques 12
Chapter No.8 Post to the forum 14
Chapter No.9 Discuss the importance of lifelong learning and 15 continuous professional
development 9.1 Lifelong learning 15 9.2 Continuous Professional development 15
Chapter No.10 Research and discuss major engineering 16 project in Australia and compare it with
EWB project
Chapter No.11 Invitation to a tender 17
Chapter No.12 Response to a tender 19
Chapter No. 13 Reference
Chapter 1 Reflect on and self assess your current achievements of Engineers Australia's Stage 1
Professional Competencies
1.1 EA stage 1 Competencies
 In depth understanding of specialist bodies of knowledge within the engineering disciple
o Proficiently applies advanced technical knowledge and skills in at least one specialist practice

The Monitoring Of End Tidal Co2
INTRODUCTION
The monitoring of expired carbon dioxide (CO2) concentration is becoming increasingly common in
the operating room. As per American Society of Anesthesiologists (ASA) guidelines, continuous
monitoring of end tidal CO2 (PETCO2) is recommended as standard II basics of anaesthetic
monitoring especially to ensure adequate ventilation during all anaesthetics. In neurosurgical
patients, intraoperative hypercapnia and hypocapnia must be detected reliably as the perfusion to
brain and spinal cord varies with these values. Intermittent arterial blood gas (ABG) samples are
routinely analysed to determine the partial pressure of carbon dioxide in the arterial blood (PaCO2)
during neurosurgical procedures. PETCO2 can also be used as a guide to maintain PaCO2 to desired
level during the surgery.
The PETCO2 is even more useful if its relationship to PaCO2 can be established initially by blood
gas analysis. If the gradient between arterial and end tidal carbon dioxide partial pressures, P(a–
ET)CO2 is stable with time, changes in treatment and clinical conditions, then PETCO2 can be
reliably used to follow respiratory acid–base status and assist in the titration of hyperventilation
therapy, at the same time decreases the expense and time involved in frequent ABG sampling.
Several factors such as changes in body position, temperature and pulmonary blood flow, as well as
mechanical ventilation and cardiopulmonary bypass, can result in changes in the ventilation
perfusion (V/Q)

A Short Note On Preventing Ventilator Associated Pneumonia
Subglottic Suctioning: Preventing Ventilator Associated Pneumonia
Ventilator Associated Pneumonia (VAP) is a hospital acquired infection which happens to patients
who are intubated. It costs the hospital and the patient money. It is a deadly disease that can be
prevented through the right type of interventions. Current practice generally depends on the hospital;
most hospitals use a VAP bundle. According to the Institute for Healthcare Improvement (2012) the
VAP bundle consists of; head of the bed elevation of at least 30 degrees, daily sedation from
weaning, readiness to extubate, Deep Vein Thrombosis (DVT) prophylaxis, stress ulcer prophylaxis,
oral care with chlorohexidine (How to Guide, 2012). This currently is the protocol at Gerald
Champion Regional Medical Center. However, adding subglottic secretion suctioning to this bundle
has the ability to improve patient outcomes
According to Seckel (2007) The American Association of Critical Care Nurses (AACN), the
American Thoracic Society (ATC) and the Centers for Disease Control and Prevention (CDC)
recommend using continuous subglottic suctioning to further decrease VAP (Seckel 2007). This is
important because subglottic secretions pool around the cuff of the endotracheal tube; oropharyngeal
suctioning does not reach to the subglottic space. A specialized endotracheal tube is needed which
will allow suctioning of these secretions. This kind of suctioning will prevent the patient from
inhaling the secretions which can

What Is A Sop Statement Of Purpose
STATEMENT OF PURPOSE
It takes a village to raise a child. I was brought up in a village, where there is no basic supply of
amenities, and it always indicates the necessity for invention, innovation and improvisation that will
help to elevate their standard of living. This urge made me look beyond the conventional pattern of
living and have strengthened my ability to recognize the opportunity of improvisation through
education.
Education is not learning of facts, but the training of the mind to think. The word that best describes
me is 'curiosity'. I was fascinated by the things that are happening around and made me wonder what
made it possible, how it works and indeed why they work. Scientific subjects as physics and
mathematics gave me better explanations for the questions inside me and my attention to those
subjects then led to secure 100% mark in the senior secondary examination. Every time I ... Show
more content on Helpwriting.net ...
I was captivated in the world of automation and robotics during the industrial visit to Bosch,
Bangalore–global supplier of automotive parts and Tractors and Farm Equipment Limited (TAFE),
Bangalore–third largest tractor manufacturer in the world. I also underwent an industrial training
program at SAIL–SCL Kerala Limited at Calicut for one month.
Work until you no longer have to introduce you. More I come to know about machines, robots and
mechatronics around me, more is the enlightenment, enjoyment and encouragement within me. I
took a decision of doing masters in mechanical engineering with an emphasis in automation and
Mechatronics as my first step in order to sustain that drive inside me. The university–––––––––
provides–––––––, –––––– which I feel will nourish my dreams and skills to reach out the destination
of being a pioneer in the field of my interest.
We rise by lifting

Mechanical Valve Induced Lung Injury
During mechanical ventilation, patients are at risk of injuries to their lungs caused by improper
settings on ventilators. Mechanical ventilator induced lung injury (VILI) can affect the lung in
several ways. Some of the ways the lung become affected is by excessive pressure, excessive
volume, and not enough volume. When the lungs are affected by excessive pressure its termed
pulmonary barotrauma. On the other hand, if the lungs receive too much volume it's called
volutrauma. However, when the lungs don't receive enough volume its termed atelectrauma. This
paper describes how pulmonary barotrauma, pulmonary volutrauma, and pulmonary atelectrauma
affects the lungs during mechanical ventilation and ways to prevent them from happening. The first
ventilator induced lung injury that I want to discuss is pulmonary barotrauma. Pulmonary
barotrauma is a lung complication caused by too much positive pressure forced into the lungs by a
mechanical ventilator. Pulmonary barotrauma occurs when the alveolar begins to rupture due to
elevated transalveolar pressure. Transalveolar pressure is a function of both the tidal volume and the
overall compliance of the lungs. Researchers use plateau pressures to get an estimation of
transalveolar pressure. Plateau pressures can be used as a tool to help measure for the risk of
pulmonary barotrauma. Researchers have discovered that plateau pressures less than 30 cmH2O
have shown to reduce the cause of pulmonary barotrauma. Guy W. Soo wrote

Effectiveness Of Scenario Based Learning During Training...
The Effectiveness of Scenario–Based Learning in Training Healthcare Worker: Literature Review
The effect of innovations within the healthcare industry lead to many scientific and technical
changes in health care delivery. To cope with these changes, there necessitate to prepare and train
health care workers to improve employees ' knowledge and the quality of care and. Limited clinical
experience with new mode of mechanical ventilation such as Airway Pressure Released Ventilation
mode make its implementation difficult in real critical world. Adequate staff training time and
offsite support services and backup from ventilator manufactures are essential to improve employees
' knowledge and skills. My research topic seeks to investigate the effectiveness of scenario–based
learning in training healthcare practitioners for the use of APRV. Airway Pressure Released
Ventilation (APRV) was first introduced by Dr. Christine Stock and Dr. John Downs, in late 1980s.
The APRV application was originally used as a rescue therapy to manage ARDS patients who have
difficulty in oxygenation.{40} The Drager Evita was the first ventilator provide APRV. Other ICU
ventilator manufacturers incorporated APRV mode with different terminology. Such as, the Maquet
Servoi refers to APRV as Bi–vent; the Puritan Bennett 840 uses the term Bi–level; the Cardinal
AVEA uses Bi–phasic; and Hamilton G5 refers to APRV as DouPAP.{13} Airway Pressure Released
Ventilation is a form of nonconventional mode of

Statement For MS Industrial Engineering
Program: MS Industrial Engineering Applicant Name: Venkatesh Manohar
Demand of both technical background and management capabilities are keeping me enthralled with
the field of industrial engineering. After twenty one months of industrial experience as Junior
Manager at JSW Steel Coated Products Ltd, I strongly feel that bachelor degree in mechanical
engineering is not sufficient for survival in this competitive field and hence I decided to explore
more by pursing MS Industrial Engineering at X Y Z.
My passion for engineering drove me to choose Physics, Chemistry and Mathematics at my high
school. After passing my high school examination with flying colors, I decided to pursue
Mechanical Engineering as my undergraduate major. I chose Mechanical because of its perfect
blend with many engineering fields such as Aerospace, Manufacturing, Industrial, Electronics and
what not. My undergraduate study was a judicious mix of core courses from various fields. I got
interested in industrial engineering after taking subjects like Engineering Economics and Analysis,
Operations Research, Manufacturing Planning and Control and Computer Aided Design and
Manufacturing.
My inclination drove me to do a project in quality control titled," Improving the Dimensional
Accuracy of Pump ... Show more content on Helpwriting.net ...
In the intermittent period my enthusiasm introduced me to a new concept viz 'Failure Mode and
Effect Analysis (FMEA)'. I have studied the fundamental principles of FMEA by discussing along
with my fellow classmates and professors. We also did two case studies on punching process and
sparkplug using FMEA principles. We got overwhelmed when both of our works got selected and
published in international journals (see my

Who Is The Protagonist In A Midsummer Night's Dream
A Midsummer Night's Dream: Character Analysis of Nick Bottom Nick Bottom, or Bottom as he is
commonly referred to, is portrayed as the joke of A Midsummer Night's Dream by William
Shakespeare and is easily manipulated by the other characters due to his arrogance and his
foolishness. Several times throughout the play. Bottom's arrogance is highlighted so that the
audience can mock him. An example of Bottom's arrogance is when, Bottom believes that he is a
talented actor and director, even better than the others performing and directing the play. He tells the
director of the play, Quince, to let him play more characters in the play and says that the play has
"things that will never please [...but I] have a device to make all well" (III. i. 8–13). ... Show more
content on Helpwriting.net ...
i. 35–36). He uses the word exposition, which is a comprehensive description, when he means to use
the phrase 'disposed to'. Bottom's arrogance and conceit is what gets him involved in Puck and
Oberon's plans because of how foolish it makes him. It makes Bottom look like an "ass", so Puck
decides to turn him into a literal "ass". His need for attention and his foolishness also lets him be
accepting and go along with Titania and the faeries. Despite his arrogance and foolishness, Bottom
is quite friendly and is well–received by the mechanicals. When Bottom is missing, the mechanicals
worry that the play will no longer be good if he is not there and begin complimenting his appearance
and saying that he is "the best wit of any handicraft man in Athens" (IV. ii. 7) Bottom's openness to
the faeries shows how friendly and outgoing he is as well. But it is this openness that also makes
him easily manipulated. He easily accepts Titania and the faeries care, which is actually him falling
into Oberon's plan to humiliate Titania. As a result of Bottom's arrogance, foolishness and
friendliness, Bottom is an easy target for Shakespeare to turn into the joke of A Midsummer Night's
Dream through both his own

Short Story : ' Flight 3531 Of Charlotte '
"Flight 3531 to Charlotte", read the ticket in my hand. I placed it on my bed and gazed around my
room for any belongings that I would want to have along for the week. With all the traveling that I
experienced throughout my career, I generally knew what was required for a week–long trip. Shirts,
pants, socks, dress shoes, ties, a briefcase, toiletries, notepads, a camera, and my personal computer.
I began to grow anxious about my trip across the ocean as I packed my suitcase but knew that only
professionalism would be appropriate. After a long day of scheduling, overseeing, designing,
machining, and negotiating, I rolled onto my bed and slowly began to drift into deep sleep.
Realizing that I had slept for only three hours, I felt hesitant to even push the blanket off myself. I
slid my "Comp–Pro" shirt on which displayed a long, narrow and well–engineered object that
shined with a bright red glow following an eye–soothing purple shadow, representing the logo of the
company.
My company is well–known for being the top innovator, researcher, and producer of the highest
technological materials and composites. However, every successful business man and woman
started from somewhere, whether it was a garage or an existing company that was passed through
each generation of a family.
Approaching the end of my college studies, I was not offered or informed about any job
opportunities to practice my newly developed, Mechanical Engineering skills. I told myself that I
would not waste

The Emergency Department Of A County Hospital
A sedated 72–year old male was admitted to the emergency department of a county hospital. The
patient was complaining of chest pain and shortness of breath. This patient has a history of COPD,
type–two diabetes and has quit smoking for nearly seven years. In the emergency department, the
patient had labored breathing and a SpO2 of 72% on room air. This patient was then placed on
BiPAP. His weight is 117kg and temperature of 99.1. Blood pressure was 61/41 on arrival to the
emergency department and the patient was tachycardic with a heart rate of 145bpm. An EKG
showed the patient was in atrial fibrillation with rapid ventricular response. IV fluids were given in
the right antecubital and norepinephrine was administered. While the patient was on BiPAP with
100% FiO2, he had a SpO2 reading of 80%. The doctor decided to intubate the patient with an oral
endotracheal tube size nine. Prior to the procedure the patient was sedated with fentanyl. The patient
was put on PRVC with 100% FiO2. A chest x–ray showed that the endotracheal tube was in the
correct placement and had a prominent ill–defined rounded opacity overlying the left mid lung with
additional patchy airspace disease involving the remainder of the left lung. On auscultation, there
were scattered crackles and rhonchi on the left side and the right side was diminished. A complete
blood count was ordered on this patient and the results showed increased white blood cells at 26.2
and an increased glucose 194, BUN 82, and

Why I Want To Be A Mechanical Engineer Essay
Mechanical engineer Mechanical engineer is something great to look into because they make good
money. There a good things about being a mechanical engineer because you go to school for two
year at RCC. There a change that you can work it a shop with AC in there and heat for the winter. If
you're great at mechanical engineer you can tell your people what they're doing wrong and right
thing. Mechanical engineer works on cars, trucks, dirt bikes and four wheelers they can work on all
them thing because they all got motors that what they learn about in school. Mechanical engineer
got the avers house they work 5 day and 40 hours a week that good if you got a good paying job.
Mechanical engineers get paid weekly and they make 20 dollars and up a hour they being home
about 1000 or a little over. Mechanical engineer make about 78,741 a year if they went to school and
got there high school diploma and went to college for two years. Mechanical engineer is great if you
get a little side job making about 11 dollars hour you work weekend and week nights. Side job are
good working at motorcycle shop and four wheeler shop you can have a part time or a full time too.
Mechanical engineer working environment there are shop with AC and there shop with no AC just a
big slow fan. There are people that work in ... Show more content on Helpwriting.net ...
Computer will find the problem when you hook the wires to the motor. Designing is big for
mechanical engineer because they can build a new product for the car and designing will help you
make that. Mechanical engineers are going to school to learn the new thing about the car and were
every thing at on the cars. Mechanical engineers are having a big problem with their time working
all day then going to school at night it's hard for them to stay awake for a 3 hour

The Physics Of Mechanical Engineering
In our daily life we face challenges that we can relate to mechanical engineering, one of the
common examples is the temperature in metal, which is the thermal expansion. Mechanical
engineers use combination of material, human and economic resources to develop mechanical
solutions that help satisfy the needs and wants of society. They must be confident and accurate when
making decisions. Engineers try to look at the problems in the society and come with innovative
ideas in order to solve the difficulties.
Engineering industry has a wide variety of jobs such as civil engineer where you over–watch
bridges, buildings, and the other important structures; it makes sure everything is up to code for
large building and structures. Mechanical engineering works on mechanical systems and other
complex mechanics, such as; cranes and airplane motors. Work experience as an engineer is very
important because when projects are being built, calculations should be accurate in all details,
otherwise the projects will fail and that may cause deaths. In addition, knowing how to react in
certain situations under certain circumstances is an essential part of being an engineer. If someone
who is inexperienced tries to take on a real engineer job, there could be extreme results and
repercussions. One of the problems we, as engineers, face in the engineering world be when there
are or could potentially be an irresponsible engineer or engineers, who are the lead project
manager(s) working on

A Profile Of Interdisciplinary Senior Design Project
A Profile of Interdisciplinary Senior Design Project
Abstract:
Interdisciplinary undergraduate engineering programs have increased in importance and significance
over past few years. Interdisciplinary research areas are strongly motivated to become disciplines
themselves. If they succeed, they can establish their own research funding programs and make their
own tenure and promotion decisions. Interdisciplinary studies can also give skills that help future
engineers to cope in a changing environment. To understand the strengths and weaknesses of these
interdisciplinary courses and programs, it is important to examine how students ' perceptions
develop through the duration of the course, specifically in regards to their approach to an ... Show
more content on Helpwriting.net ...
The approach towards this project shows interdisciplinary learning between various engineering
fields. First thing to start is designing of table which involves precise dimensions and this involves
mechanical engineering to implement material modeling. Secondly, the design also involves kient
sensor which needs to be embedded with the simulator and programmed through assembly
language, requires electrical engineering in it. Finally all the functionality and image processing
results are programmed using JAVA coding which are exclusively done by computer engineering.
This shows the importance of Interdisciplinary studies.
Various heat exchanger designs are proposed for cooling beer wort from boiling temperature to
fermentation temperature. In beer making cooling the wort quickly is very important for three main
reasons: it avoids oxidation, bacteria contamination, and chill haze formation. Fast cooling the wort
provides a thermal shock to these heat–sensitive proteins causing them to permanently precipitate.
Chillpipe heat exchanger is been designed and developed, that will cool 5 gallons of wort in less
than 4 minutes, and that is easy to clean and set up. This involves using specialized software called
"S&Thex", developed to demonstrate the chemical design & rating calculations of Shell & Tube
Heat Exchangers. Also testing

My Grandfather And The Airfather
For myself, family has always been the most important aspect to my life. I would do anything for
my family, for without them, I would not be the man I am today. Whether it be my grandfather, who
inspired me through the telling of his own life story how to take the hardships you face and learn
from them, and use them to become a superior person; Or my two older brothers, who helped to
guide me throughout my life and teach me to use every lesson and opportunity grow and become
better. It was also the family I created throughout my life, my friends, for it was them who taught me
how to work together as a team, and how making a mistake is the only way to develop and become
improved. Every part of my ever–expanding family helped in one way or another to shape and
manifest the person I am today and the mechanical engineer I hope to become one day.
My grandfather, Gordon Karl Newberg, was born in December 12th, 1923. He joined the Airforce
when he was only nineteen years old; the same age I am now, to fight in World War 2. He was a
gunner on top of the cockpit of a B–17 and flew on thirty missions throughout the war. I remember
all the vivid stories he would tell me about the buzz bombs and shrapnel throughout the air as they
flew in a sea of aircrafts. The one thing I remember most of my grandfather was how he loved to
rebuild planes in his backyard. I remember watching him for hours as he would tell me stories as he
worked on his tailor craft plane of his Cessena 170. My

Statement Of Sop For Mechanical Engineering
STATEMENT OF PURPOSE
"If you can dream it, you can do it"
.................................Walt Disney
I believe that the 21st century belongs to people with the ability to dream far beyond the existing
reality and having the potential to realize those dreams. Behind every great invention there is bold
dream equipped with curiosity and hard work.
Career plans & long–term goals...
My name is Koundinya Kompalli and I am a Graduate in Mechanical Engineering from P. Indra
Reddy Memorial Engineering College, affiliated to JNTUH, India. My long–term career plan is to
take up a challenging position either in the academia or the industry where I can do research and
development work. And in order to realize my career plan my immediate objective is to do my
masters degree in mechanical engineering with specialization in Robotics and later work towards a
PHD in the same field.
What I have... ... Show more content on Helpwriting.net ...
I have always performed my best in academics right from my school days through my graduation in
which I have graduated with distinction and topped in my college.
I always had a flair for mathematics and physics as they kindled curiosity in me and got me thinking
about the reason behind every phenomenon. I derived immense pleasure every time I solved a
complex mathematical problem. Ever since my childhood I was deeply fascinated by machines
which can think and reason like human beings. My curiosity to question everything and look for the
logic and principle behind every machine has led me to choose Mechanical Engineering during my
under

Bottom In A Midsummer Night's Dream
Nick Bottom, or Bottom as he is commonly referred to, is a focal character of A Midsummer Night's
Dream by William Shakespeare that plays a part in all three storylines. Several times throughout the
play, Bottom's arrogance is highlighted. Bottom believes that he is a very good actor and director,
even better than the others performing and directing the play as can be seen when Bottom tells
Quince to let him play more characters in the play and when he says that the play has "things that
will never please [...and has] a device to make all well" (III. i. 5–8). Shakespeare also portrays
Bottom as being very foolish. He even makes it a point to have Puck turn Bottom into an "ass".
Bottom's foolishness can be seen when he is overconfident about

plato & aristotle Essay
In these sessions, I have gained a better understanding of Aristotle and Plato's ideas and theories.
Particularly, I have a specific interest in Aristotle and the notion of the two extremes and to aim
towards the "gray or middle of the road". I also have an interest in Plato's theory regarding the just
and unjust and the repercussions of their actions.
Aristotle is trying to achieve that single point in which life is the best of both worlds. He attempts to
define an obtainable median point in life. This idea sounds more like the resume of a public official.
I believe that is why Aristotle says that the ultimate virtue is that of political science. The public
officials' job is to represent the masses. It is ... Show more content on Helpwriting.net ...
The one question that I have is why do people choose to live that way ? Do they not see the benefits
of patience? How does Aristotle address these issues?
Secondly, we must alter our expectations according to the field of study. "[W]e must not expect the
same degree of accuracy in every department of study, but only so much precision as corresponds
with the nature of the particular subject..." (Sterba, 59–60). This statement fascinates me. The area
of study I am in is Mechanical Engineering Technology. That quote from the text could not be more
prevalent in Engineering today. When performing engineering equations, the degree of accuracy
cannot be carried out longer than that in which the data was recorded. If one does, the end result
would most likely be an error due to rounding. This, too, also applies to the initial data recorded. We
must be sure that this information is correct, as this will lead to failure or an error in the final point
or answer.
With regards to Plato, I find that in The Republic, when discussing the just and unjust, we find
ourselves between two evils. In the text, it asks what do we determine to be better, doing unjust
things with no repercussions or to just things. In some way or another, we find ourselves at a cross
road when faced with certain circumstances. Do we react unjust or just? What is it inside of us that
tells us not to do the wrong and do the right thing or

The Ventilation Strategies For Acute Respiratory Distress...
The purpose of this assessment is to critique a related pair of published papers surrounding the
ventilation strategies for Acute Respiratory Distress Syndrome (ARDS) within the Intensive Care
Unit (ICU).
My role as an Advanced Critical Care Practitioner (ACCP) involves me working with patients with
multi–organ failure and more often respiratory failure following prolonged periods of ventilation
and lung insult. ARDS has been studied in a variety of settings since it was first introduced by Dr
Ashbaugh (Ashbaugh et al, 1967), at which time mortality was between 60% and 70%, however, the
most effective way to ventilate patients with ARDS is still being researched. Despite this ongoing
research into the management of ARDS, mortality remains at 35–40%. It is thought this is linked to
lack of knowledge and evidence regarding the pathological process of ARDS.
ARDS can be defined as an acute decrease in the ratio of arterial oxygen partial pressure to
fractional inspired oxygen (P/F) 30% surface area burns or any other condition which had a >50%
6–month mortality. Although there are significant differences in each of these papers exclusion
criteria they are clearly identified, which is good practice and not always done (Van Spall et al,
2007). However, these extensive exclusion criteria can impair generalisability of the trial results in
the ICU.
Sample sizes required to show
Critique the sample sizes – look at sample size representivity.
INTERVENTIONS – drafted and critique

Mechanical Engineering And Their Knowledge Of...
Environmental engineers use their knowledge of biology and chemistry to create solutions to
environmental problems. They are associated with controlling water and air pollution, recycling and
ways of improving it, public health issues, and waste disposal. Environmental engineers evaluate
hazardous–waste, advise on how to treat and contain the hazard, and develop regulations on how to
prevent mishaps with the hazard in the future. They design water supply and industrial wastewater
treatment systems, research the impact on the environment a proposed construction project will
have, analyze scientific data, and do quality–control checks. Environmental engineers are concerned
with not just local environmental issues, but worldwide issues as well. They are also involved in the
protection of wildlife. Many environmental engineers work as consultants, help their clients to
comply with government regulations, prevent environmental damage, and clean up hazardous sites
and any waste on them.
Mechanical engineers design, manufacture, develop, research, and test machines, tools, engines, and
other mechanical devices. Mechanical engineering is considered one of the broadest engineering
disciplines out there. Internal combustion engines, steam and gas turbines, and electric generators
are some of the power–producing machines engineers in this line of work, will work on, while
machine tools, refrigeration and air–conditioning equipment, industrial production equipment, and
robots are some

Personal Statement For Purpose For Mechanical Engineering
Personal Statement
The prompt is write an essay describing your reasons to apply to graduate studies
Frankly, my family always encouraged me to become a doctor at the hospital, so I grew up having
the dream of joining the Medicine School to fulfill my family's ambition which I thought it was
mine too. In grade 10, I was studying at night and suddenly the electricity went off and that made
me think what if I am a doctor doing a life–and–death surgery for a patient and the power goes out. I
thought about energy recourses and other medical equipment the doctors use, who made them? I
started thinking that I can provide more services than doctors do. I can design and produce items
that all use and provide reliable and sustainable energy for us all. From that night, I decided to study
an engineering–related discipline, and upon completing high school and after consulting a
Mechanical Engineering graduate who explicitly explained to me what mechanical Engineering is
all about, I found that Mechanical Engineering is the best choice among the engineering fields.
During my undergraduate studies, I had the ambition of contributing to solve some of the major
problems in the world. Indubitably, the world we live in is facing so many challenges and problems
concerning energy crisis and climate change. Recently, Yemen is encountering a great power
shortage which doesn't meet its population and infrastructure power demands. One of the great
challenge and the sacristy of electricity in

Improving Healthcare Within The Realm Of Healthcare
Outcomes are used to evaluate care within the realm of healthcare. Advances in quality of care are
related to feedback, which is performed in quality improvement (QI). According to the Health
Resources and Services Administration (HRSA) of the U.S. Department of Health and Human
Services (2011), "quality improvement consists of systematic and continuous actions that lead to
measurable improvement in health care services and the health status of targeted patient groups" (p.
1). With the desire for excellence, QI is an essential component to the advances in quality
healthcare. QI is versatile, for it can be applied to various scenarios, such as a plan of care for
ventilator–associated pneumonia prevention. Ventilator–associated pneumonia (VAP) is a hospital–
acquired condition that is currently not on the Centers for Medicare and Medicaid Services' (CMS)
list of non–payment hospital–acquired infections (CMS, 2015). However, the thought of adding
VAP to the list occurred in past discussion by CMS (CMS, 2008). This may change when there is an
improved definition with clearer inclusion criteria that is currently being constructed by the CDC
(Klompas et al., 2014). Nonetheless, the goal is to prevent hospital–acquired illnesses, such as VAP.
After performing a review of care interventions for the prevention of VAP, a collaborative team
between the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of
America, the American Hospital Association, the

Essay on Case Study on Pneumonia
Case Study: Pneumonia and Pressure Ulcer Prevention in an Elderly MICU Patient
June 6, 2012 Case Study: Pneumonia and Sepsis in an Elderly MICU Patient L.M. is a 75–year–old
female who suffers from severe dementia and lives in a SNF. She was diagnosed with lung cancer in
2005 and as a result had a right upper and middle lobectomy. She also has a history of severe
emphysema. L.M. has had several pneumonic infections and has an allergy to Pneumovax. She has a
recurrent aspiration risk and received a tracheostomy and a PEG tube in January 2012. On Aril 25,
2012, L.M. was found to be increasingly fatigued, somnolent, and had shortness of breath
accompanied with tachycardia as witnessed by the staff at the SNF. ... Show more content on
Helpwriting.net ...
Another important intervention was to maintain the head of the bed at 30–45 degrees and position
L.M.'s left lung into a dependent position to improve ventilation and perfusion. L.M.'s O2 was
decreased to 63 and her CO2 was increased to 50. According to the IHI, it is recommended to
elevate the bed to 30– 45 degrees to improve ventilation. Patients that lay in the supine position have
lower spontaneous tidal volumes on pressure support ventilation compared to those laying at more
of an angle (Institute for Healthcare Improvement, 2012). In regards to positioning, when the least
damaged portion of the lung is placed in a dependent position it receives preferential blood flow.
This redistribution of blood flow helps match ventilation and perfusion, therefore, improving gas
exchange (Lough, Stacy & Urden, 2010). Implementing these interventions combined with
respiratory therapy, significantly improved the blood gas values for oxygen and carbon dioxide
levels. "Pressure ulcers are key clinical indicators of the standard and effectiveness of care (Elliott,
Fox & McKinley, 2008)." L.M. was at high risk for pressure ulcers for multiple factors such as
immobility, poor nutrition, age, and health. Therefore, I used the Braden Scale as a quality indicator
in order to assess the risk of pressure ulcers and also to

Symptoms And Symptoms Of Neonatal Respiratory Distress...
Outline
I. Introduction
II. Continuous Positive Airway Pressure (CPAP)
a. History
b. Physiological Effects
c. Types of CPAP Delivery Devices
i. Nasal Masks ii. Nasal Prongs iii. Nasopharyngeal Prongs
III. Bubble CPAP System
a. Understanding How it Works
i. System Setup ii. Nebulization of Drugs iii. Cost iv. Difficulty of Use
IV. Indications for Bubble CPAP in Neonatal Patient
a. Neonatal Respiratory Distress Syndrome (RDS)
i. Definition of Neonatal RDS ii. Characteristics of RDS in Different Gestational Ages
1. Diagnosis
2. Causes
3. Risks
4. Clinical Management
5. Morbidity
b. Idiopathic Respiratory Distress Syndrome (IRDS)
i. Definition
1. Diagnosis
2. Causes
3. Risks
5. Morbidity
c. Meconium Aspiration
i. Definition
1. Diagnosis
2. Causes
3. Risks

5. Morbidity
d. Pulmonary Hypertension of the Newborn
i. Definition
1. Diagnosis
2. Causes
3. Risks
5. Morbidity
V. Complications
a. Failure of NCPAP
b. Pneumothorax
c. Nasal Trauma
d. Agitation
VI. Treatment with Bubble CPAP
a. NCPAP level
b. Monitoring
i. Cardiorespiratory Monitor ii. Pulse Oximetry iii. Blood Gas Analysis
c. Effect of Body Position
d. Length of Therapy
VII. Weaning from NCPAP
a. Titration of NCPAP Level
b. Monitoring
i. Cardiorespiratory Monitor ii. Pulse Oximetry iii. Blood Gas Analysis
VIII. Treatment followed by NCPAP
a. Oxygen via Low Flow Nasal Cannula
IX. Summary
Abstract
Continuous positive airway pressure (CPAP) is

Becoming A Licensed Master Mechanic
In the technologically advancing world country that we live in, everything has to be fast and
reliable. We want it right then and now, and if not we move on elsewhere. If the fast–food place has
a noticeable line in the drive thru most people just go to another more "convenient" place. The
growing inconvenience of commercial breaks has led to prosperity by the online media streaming
services such as Netflix and Hulu. If where we get our food and TV from has to be fast and reliable
then the demand for your car to be is an afterthought. Who is there to provide their services that
keep own country and daily lives moving? These men and women have many names and specialties.
Most would call them mechanics or automotive technicians. The most knowledgeable and
experienced of this necessary trade are master mechanics. In order to become a licensed Master
mechanic you have to be a lifelong student of the trade, have years of education and experience, and
love and respect for the trade itself.
Proposed Project It has been known for centuries that complex machines need regular maintenance
and repair when needed. From the first clocks ever created to the international space there were
someone who specialized in repairing and upkeep them. This is especially necessarily for our
everyday vehicles today that allow for us to have such a mobile life style. With the everyday wear
and tear that we put on vehicles today, it only makes sense that there's a demand for individuals who
can keep

Different Types Of The Mind : The Human, Animal, And...
Philosophy 3500
Final Paper
Seneca Cherry
12.2.14
Abstract
This essay
Introduction
The mind is made up of numerous classes of procedures that can be studied empirically; this paper
will limit this field to psychology. There are three different types of the mind: the human, animal,
and the mechanic. The human mind is the paradigm of the mind; the mechanical mind exists as a
challenge to materialism or mind–brain identity theory. This leads to the anti–materialist argument:
intelligence is made up of levels of mental processes in which the mind is the genus and intelligence
is a species of this genus. Intelligence is the ability to solve problems, and like the mind, human
intelligence is the paradigm of the intelligence. There ... Show more content on Helpwriting.net ...
It would belong to the domain of metaphysics, and if the mind were a substance it would individual.
Despite this, the mind is a collection of numerous classes of processes that can be studied
empirically. These processes are known as "mental processes," this is the way we can suggest the
vicious circle statement that the mind is the collection of the different mental processes.
There are ways to avoid the circularity of the previous statement by describing the various classes of
these "mental processes." The information boils down to four concepts that we can use to
distinguish the main types of mental processes. 1) Perceptions – the organized reception of
information, 2) the memories and storage of information, 3) our beliefs and judgments surrounding
the information we received, and finally 4) our plans – arrangements of information and how we
plan to act. From here we can give a more complete description of mental processes. Our own
bodies have sensations (internal such as pain), and then we have external sensations (from other
bodies). We have perceptions which help us construct a more or less definite object. We as humans
also retain memories that can come from different sources. We elaborate images with various
degrees of creativity. This helps us form beliefs about ourselves and other people (things or ideas).
From here we can develop conclusions that allow us to receive new information from previously
received data; this

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