This document discusses emergency care related to cardiac arrest and CPR. It describes the heart's location and function, as well as the signs and types of cardiac arrest including ventricular fibrillation, pulseless electrical activity, and asystole. The importance of early intervention through the chain of survival is emphasized, including early access to emergency care, early CPR, early defibrillation if needed, and early advanced care. Proper CPR techniques are outlined including compression depth and rate varying based on the patient's age. Potential complications of CPR are also noted.
Exercise tolerance testing (also known as exercise testing or exercise stress testing) is used routinely in evaluating patients who present with chest pain, in patients who have chest pain on exertion, and in patients with known ischaemic heart disease.
coronary artery bypass graft surgery CABGSunil kumar
coronary artery bypass graft surgery, explanation of CABG on-pump and off-pump procedures, physiotherapy management after surgery. indications of CABG. description of the procedure, investigations before surgery, per operative and post operative management
Overview of phases of cardiac rehabilitationnihal Ashraf
Cardiac Rehabilitation
Cardiac rehabilitation programs aim to limit the psychological and physiological stresses of CVD, reduce the risk of mortality secondary to CVD, and Improve cardiovascular function to help patients achieve their highest quality of life possible.
Emergency care-in-athletic-training
Emergency Care in Athletic Training
Organization and Administration
of Emergency Care
Physical Examination of the Critically
Injured Athlete
Airway Management
Sudden Cardiac Death
Head Injuries
Exercise testing is a non invasive procedure that provides diagnostic and prognostic information and evaluates an individual’s capacity for dynamic exercises
Exercise tolerance testing (also known as exercise testing or exercise stress testing) is used routinely in evaluating patients who present with chest pain, in patients who have chest pain on exertion, and in patients with known ischaemic heart disease.
coronary artery bypass graft surgery CABGSunil kumar
coronary artery bypass graft surgery, explanation of CABG on-pump and off-pump procedures, physiotherapy management after surgery. indications of CABG. description of the procedure, investigations before surgery, per operative and post operative management
Overview of phases of cardiac rehabilitationnihal Ashraf
Cardiac Rehabilitation
Cardiac rehabilitation programs aim to limit the psychological and physiological stresses of CVD, reduce the risk of mortality secondary to CVD, and Improve cardiovascular function to help patients achieve their highest quality of life possible.
Emergency care-in-athletic-training
Emergency Care in Athletic Training
Organization and Administration
of Emergency Care
Physical Examination of the Critically
Injured Athlete
Airway Management
Sudden Cardiac Death
Head Injuries
Exercise testing is a non invasive procedure that provides diagnostic and prognostic information and evaluates an individual’s capacity for dynamic exercises
First aid: Medical care steps to do for any person suffering a sudden
illness or injury until ambulance arrives or seeking for professional medical
care to:
1. Preserve Life
2. Prevent Deterioration
3. Promote Recovery
Basic life support is a part of the first aid.
Includes: ABC management (Airway, Breathing, Circulation), CPR
(Cardiopulmonary resuscitation) and AED (Automated external
defibrillation).
88% of cardiac arrest incidents occur at home.
Effective bystander CPR that is administered immediately can double or
triple the victim's chances of survival.
Only 32% of victims receive assistance from a bystander.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. Emergency Care in Athletic Training
Chapter 4
Keith Gorse, Robert Blanc, Francis Feld and Mathew Radelet
Presentation Prepared by:
Asma Lashari
University of Health Sciences
2. The heart is approximately the size of a fist.
located in the Thoracic cavity behind the sternum
and between the lungs.
The coronary arteries supply blood to the heart
muscles
The function of the heart is to pump blood
The Left Side Receives Oxygenated Blood from the
lungs and pumps it to the body through the
arteries.
The Right Side Receives, through the veins, the
blood that has circulated through the body and
pumps it to the lungs for re-oxygenation.
3. When Respiratory Arrest occurs, the heart can
continue to pump for several minutes.
Without early intervention, respiratory arrest may
lead to cardiac arrest.
Once cardiac arrest occurs, circulation ceases and
vital organs are deprived of oxygen.
4. Clinical death: Occurs when a patient is in
respiratory arrest (not breathing) or in cardiac arrest
(heart not beating) or when respiratory and cardiac
arrest occur together.
The brain is the first organ to suffer the effects of a
lack of oxygen.
The patient has a period of4 to 6 minutes to be
resuscitated without brain damage. Clinical death
can be reversed.
After 8 to 10 minutes the damage is irreversible.
5. Biological death:
The moment the brain cells begin to die biological
death occurs. Biological death cannot be reversed.
Signs of Certain Death
◦ Livormortis/ Lividity:
Serum/blood
◦ Rigormortis:
Stiffening of the body
◦ Decomposition
Odor will come
Only a Medical Doctor can Pronounce a Person
Officially Dead.
6. Sudden and unexpected cessation of the heart’s pumping
activity.
The resultant lack of blood flow to the brain leads to
unconsciousness in about 20 to 30 seconds.
When sudden cardiac arrest results in death, it is termed
sudden cardiac death.
Common in age group 50 to 75 years.
Overall survival rate is about 5% to 7%.
7. Sudden Cardiac Arrest occurring within 1 hour of
participation in sports or exercise.
Consistent with the low prevalence of
cardiovascular disease in people younger than 35
years of age.
The vast majority (85%) of sudden deaths in
athletes are a result of underlying cardiovascular
conditions.
8. 1. Ventricular Fibrillation (VF)
2. Pulseless Electrical activity
3. Asystole
Sudden Cardiac Arrest should be Differentiated
from a “Heart Attack.”
9. Most common rhythm abnormality, occurring in
about 60% of cases when assessed by an on-site
Automated External Defibrillator (AED).
Responds quickly to Defibrillation.
◦ A high energy shock delivered to the heart called with AED.
Survival rates are as high as 74% when defibrillation
occurs within 3 minutes from the time of collapse.
10. The term used for any other electrocardiographic
(ECG) rhythm, including normal sinus rhythm, when
there is no associated cardiac contraction.
Responds to Treatment when a reversible condition
is the cause, such as Hypovolemia or Hyperkalemia.
Mortality from this condition is higher than for VF.
11. Absence of any cardiac electrical activity and
therefore the absence of any mechanical cardiac
function.
Patients found in this rhythm have poor prognosis,
with most studies reporting survival of only 0% to
2%.
12. Screening :Every person who intends to participate
in vigorous physical activity, especially competitive
sports, should receive thorough screening for
cardiovascular and other disorders.
Recognition of Cardiac Warning Signs: Symptoms
include syncope, palpitations, episodic or
exertional dyspnea, exertional chest pain, and early
fatigue etc.
13. Heart Attack (Acute Myocardial Infarction)
occurs when a blood clot blocks one of the
arteries that supply blood to the heart muscle.
Most common cause; Coronary Heart Disease
(CHD).
Non-Modifiable Risk Factors
◦ Family history, Sex, Age, Ethnic background, Society
culture.
Modifiable Risk Factors
◦ Smoking, High Blood Pressure, High Cholesterol, Physical
Inactivity.
14. Pain, Pressure, Heaviness Or Tightness in:
◦ Jaw, Chest, Shoulder(s).
◦ Neck, Arm(s), Back.
Patients may also Feel:
◦ Nausea/ vomiting (unrelated to other illness)
◦ Dizziness or light-headedness, Syncope or near-syncope
◦ Cold Sweats.
◦ Shortness of breath.
◦ Palpitations (fluttering in chest)
◦ Fatigue/weakness
15. Successful Resuscitation of the victims of SCA/ Heart
Attack, requires the proper interventions to be
provided in a very short time.
The "Chain of Survival" has four links, and the
patient's chances for surviving are the greatest when
all the links come together.
1. Early Access
2. Early CPR
3. Early Defibrillation
4. Early Advanced care
16. Recognition of SCA/ Heart Attack and Preparing for CPR
Establish the need for Resuscitation.
Determine the level of responsiveness, if
unresponsive.
Activate Emergency Medical Service (EMS)
Check ABC's.
Open the Air Way (Head Tilt Chin Lift Maneuver)
For suspected Cervical injury (Jaw Thrust Maneuver)
Look Listen Feel
Rescue Breathing
17. CPR involves a combination of chest compressions
and artificial ventilations designed to revive a person
and prevent biological death by mechanically keeping
a person's heart and lungs working.
The goal of CPR is to prevent the death of cells and
organs for a few crucial minutes.
The patient's condition needs to be monitored
throughout CPR to determine if CPR is effective.
18. 1. Chest Compressions
◦ Consist of rhythmic, repeated pressure over the lower half of the
sternum.
◦ When combined with artificial ventilation, it provides enough
blood circulation to sustain life.
2. Position the patient.
◦ Must be supine on firm; flat surface, with arms on sides
3. Expose the patient's chest.
◦ Remove the patient's shirt (male only) providing for patient's
privacy as much as possible.
19. 4. Get in position.
◦ Kneel close to the patient's side, your body centered with
the patient's sternum and your knees about as wide apart
as your shoulders.
5. Locate the compression site.
◦ Place your hand in the centre of chest between the nipples.
6. Position your hands.
◦ For adult put your free hand on top of the first hand.
Extend or interlace your fingers (do not rest them on the
chest wall).
◦ For children when using 2 hands, heel of one hand with
second on top or with heel of one hand only.
7. Position your shoulders.
◦ They should be directly over your hands.
20. 8. Perform Chest Compressions
◦ Keeping your arms straight and your elbows locked in
extension.
◦ Thrust straight downward from shoulders.
◦ Release pressure completely after each compression.
◦ Do not lift or move your hands, or you will lose proper
position. Count as you perform compressions.
21.
22. Compression depth: 4-5 cm.(1.5 to 2 inches)
Compression Rate: 100 per minute
Each Ventilation: 1 second
One-Rescuer Cycle: 30 Compressions, 2 breaths
Two-Rescuer Cycle: 15 compressions, 2 breaths
23. Compression depth: 3-4 cm. (1/3 to 1/2 of total
chest depth)
Compression Rate: 100 per minute
Each Ventilation: 1 second
One-Rescuer cycle: 30 compressions, 2 breaths
Two-Rescuer cycle: 15 compressions, 2 breaths
24. Cardiac arrest in infants is rarely caused by heart problems. Usually
the cause is Hypoxia due to;
◦ injuries, suffocation, smoke inhalation, etc.
Resuscitate an infant for two minute before activating the EMS
system (if only one rescuer).
1. Position the patient.
◦ Place him or her on your forearm, using your palm to support the head.
2. Expose the patient's chest.
3. Locate the compression site.
◦ Compression site is just below the nipple line.
4. Perform chest compressions.
◦ Use the flat part of your middle and ring fingers to compress the sternum.
◦ Release pressure completely after each compression.
◦ However, do not lift or move your hands, or you will lose proper position. Count
as you perform compressions.
25.
26. Compression Depth: 1.5-2.5 cm. (1/3-1/2 total
chest depth)
Compression Rate: 100 per minute or more
Each Ventilation: 1 second
One-Rescuer Cycle: 30 compressions, 2 breaths
Two-Rescuer Cycle: 15 compressions, 2 breaths
For Newborns: 3 compressions, 1 breath
27. "Successful" CPR does not mean that the patient
survives
It only means that you performed it correctly.
Very few patients will survive if they do not receive
advanced cardiac life support (ACLS).
1. Have someone feel for a pulse during compressions. A pulse
should be palpable with every compression.
2. The chest should rise and fall with each ventilation.
3. The pupils may begin to react normally.
4. Patient's skin color may improve.
5. Patient may attempt to move and try to swallow.
28. Obvious Mortal Wound
Livormortis and Rigormortis
Decomposition
Still Birth
29. Even properly performed CPR can cause injuries,
including:
◦ Fracture of the sternum and ribs
◦ Pneumothorax
◦ Haemothorax
◦ Cuts and bruises to the lungs
◦ Lacerations to the liver
Alternative to Complications is Death
30. Mistakes in Performing CPR
Problem Result
Patient is not on a hard surface Compressions are not effective
Patient is not in horizontal position Head is higher than the rest of the
body
Head-tilt chin-lift maneuver improperly
performed
Open airway not ensured
Incomplete seal around the patient's
mouth and/or nose
Ventilations are not effective
Nostrils not completely pinched and the
patient's mouth is not fully open during
mouth-to-mouth ventilation
Ventilations are not effective
Hands not in correct position or
compressions incorrectly placed
Fractured ribs; fractured sternum;
lacerated liver, spleen, lungs or
injured pleura as a result of fractured
ribs
Compressions too deep or frequent Insufficient amount of blood is
pumped
Improper compression/ventilation
ration
Inadequate oxygenation of blood
31. Defibrillators
Ventilation Aids
Telephone or other communications
equipment to call emergency centers or
hospitals.
32. ◦ Manual Defibrillators
◦ Automated Defibrillators
Manual Defibrillators
◦ Used by medical Personnel with specific training in
cardiac rhythm recognition and management and in
operation of the defibrillator.
◦ Requires the user to interpret the ECG rhythm and
determine if an electric counter shock should be
delivered
◦ The user must be able to set the energy level, activate
the charging process, and then push a button to deliver
the shock.
33. These devices can be used by virtually anyone, even
without prior training, although training is highly
advised
These portable, battery powered devices provide verbal
and visual prompts to the user once the device is turned
on.
The most important user action is to place the two ECG
sensing defibrillation pads onto the proper locations on
the patient’s chest .
Some models require the user to push an “analyze”
button and/or a “shock” button to deliver the electric
shock (semiautomatic).
Some perform analysis, charging, and shock delivery
without further user action (Fully Automatic).
35. Variety of Face shields and masks that cover the
victim’s mouth and nose.
Many of these have a one-way valve to prevent air
and fluid exchange from the victim to the rescuer.
36. Example of a pocket mask (left) and a face shield (right).