High level disinfection and sterilization protocols are essential for preventing infection in the operating theatre. Proper cleaning involves 3 stages - washing with soap, disinfecting with sodium hypochlorite, and drying. Instruments are soaked in glutaraldehyde or sent for ethylene oxide sterilization. Autoclaving uses steam under pressure to sterilize items. Regular inventory checking and documentation ensures accountability and patient safety. Thorough cleaning and fumigation weekly maintains sterility.
Sterilization and disinfection are the basic components of hospital infection control activities. Every day, a number of hospitals are performing various surgical procedures. Even more number of invasive procedures are being performed in different health care facilities. The medical device or the surgical instrument that comes in contact with the sterile tissue or the mucus membrane of the patient during the various processes is associated with increased risk of introduction of pathogens into the patient's body. Moreover, there is chance of transmission of infection from patient to patient; from patient or to health care personnel, and vice versa; or from the environment to the patient through the improper sterilized or disinfected devices. Hence, medical personnel, laboratory people and the health care providers should have better knowledge regarding these techniques to prevent the spread of these pathogens.
Sterilization and disinfection are the basic components of hospital infection control activities. Every day, a number of hospitals are performing various surgical procedures. Even more number of invasive procedures are being performed in different health care facilities. The medical device or the surgical instrument that comes in contact with the sterile tissue or the mucus membrane of the patient during the various processes is associated with increased risk of introduction of pathogens into the patient's body. Moreover, there is chance of transmission of infection from patient to patient; from patient or to health care personnel, and vice versa; or from the environment to the patient through the improper sterilized or disinfected devices. Hence, medical personnel, laboratory people and the health care providers should have better knowledge regarding these techniques to prevent the spread of these pathogens.
Sterilization and disinfection in prosthodonticsNishu Priya
Routinely dental care professionals are at an increased risk of crossinfection while treating patients. This occupational potential for disease transmission becomes evident initially when one realizes that most human microbial pathogens have been isolated from oral secretions. Because of repeated exposure to the microorganisms present in blood and saliva, the incidence of certain infectious diseases has been significantly higher among dental professionals than observed for the general population.
Sterilization and disinfection in prosthodonticsNishu Priya
Routinely dental care professionals are at an increased risk of crossinfection while treating patients. This occupational potential for disease transmission becomes evident initially when one realizes that most human microbial pathogens have been isolated from oral secretions. Because of repeated exposure to the microorganisms present in blood and saliva, the incidence of certain infectious diseases has been significantly higher among dental professionals than observed for the general population.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Sterilization
• Sterilization may be defined as the statistically complete destruction of all
microorganisms including the most resistant bacteria and spores.
3.
4. Zones in an operation theater
• Outer – till the changing area
• Clean zone- from the door of changing room till the entrance of operation
theatre
• Sterile zone- operation theatre
• disposal zone- waste segregation and disposal area
5. Entrance into OT complex
• All outside belongings have to be kept in the changing area
• Wash your feet before entering the clean area to negate any contamination
• Carry bare minimum items when you enter the clean and sterile area
• Ensure that your OT dress and footwear is clean
• Wash your hands before start your work in the clean area
6. Autoclave
• An autoclave is a machine that uses steam under pressure to kill harmful bacteria,
viruses, fungi, and spores on items that are placed inside a pressure vessel
• Cycles :- wet, dry and vacuum
7. • Works like a pressure cooker
• The high temperature and pressure create saturated steam which penetrates
the objects and destabilises the structure of microorganisms including spores
• One of the methods of absolute sterilization.
FLASH STERILIZATION/ LITTLE SISTER: rapid increase in
temperature upto 134 C /121 C with wet and moist mode, should be in
proximity to sterile area.
8. Cleaning protocol
• Before commencing and after finishing all cases:
10L Of water + 5L of Sodium Hypochlorite - 2% strength
9. In between the cases:-
• 1st mopping :- diluted soap solution – 200 ml soap sol. In 20L of plain water
• 2nd mopping :- plain water
• 3rd mopping:- 20L water+ 5L sod Hypo- 1%
10. Fumigation
• 4 L of water + 1 L of silvicide for minimum 30 minutes
• Fumigation has to be done after HLD and mopping the OT with 3 bucket
system. The screens of all the equipment should be covered but not tight ,
air entry should be there. The room must be airtight.
• Done every week and in case of every infected case
• We can use the OT 1-2 hour after fumigation in case of any emergency.
11. Soaking instruments after every case
• Wash the used instruments in running water for removing blood and tissue
• Soak the used instruments in :- 20L water+ 5L sod Hypo- 1% strength of
sodium hypochlorite for a minimum of 10-15 minutes.
• Instruments are then to be scrubbed and washed with soap solution
• Ensure that no blood stains or tissues are adhering to the instruments
• The instruments are then to be thoroughly dried before being sorted and
neatly packed
12. • All cleaning and instruments checking procedures have to be supervised by
the senior nursing officers
• Fumigation has to be recorded and reported to the next shift for the
continuity of care
14. ETHYLENE OXIDE
• ETO is used in healthcare facilities to sterilize critical items (and sometimes
semicritical items) that are moisture or heat sensitive and cannot be sterilized by
steam sterilization.
• Based on a gas diffusion process,
• Sterility occurs when an EO gas molecule reacts with and destroys
the microbial DNA.
• All heat sensitive and delicate items are send for ETO sterilization
to CSSD after double packing
18. Seal it in double cover
Write the date, OT, full name of the Nursing officer and signature legibly. Ensure that there is no
damage to the item before sending and after receiving.
19. Check the sticker when your receive it from
CSSD
IT IS VALID FOR 6
MONTHS
20. TOXICITY
• The reaction with water or other material components to form toxic residual
compounds (ethylene oxide, ethylene glycol, and ethylene chlorhydrin).
• hazardous both to people and to the environment.
• Ethylene glycol is formed from ethylene oxide and water – CNS DEPRESSANT
• Rust will also form on the equipment.
21. High level disinfection
• High-level disinfection traditionally is defined as complete
elimination of all microorganisms in or on an instrument,
except for small numbers of bacterial spores.
• Eg : glutaraldehyde (cidex)
22.
23. Chemical sterilization (Contd)
• We use 2% glutaraldehyde solution which comes in with activator
• Effective against fungi, bacteria, virus, spores, including pseudomonas,
tubercle bacillus, HIV, HBV Antigens
• Soaking time – minimum of 30 minutes , average -45 minutes
24. WHAT ALL CAN BE SOAKED IN CIDEX
• monopolar points
• Endoscopic things, camera and lens should be covered with the available
sheaths
• Fibreoptic cables
• Heat and pressure sensitive items
• All cidex soaked items have to washed with saline and dried before using on
the patient.
25. • Basically used when the equipment cannot withstand high temperature of
sterilization via a mechanical method.
• Reduces wear and tear
• Less change of physical damage
• Please note that for complete sterilization the item should be cleaned and
immersed completely into the cidex solution and kept undisturbed for 45min
and above
26. SURFACE CLEANING
• 250ml of silvicide (hydrogen peroxide base) in 5L of plain water (5%).
• Not useful towards spores
• Should not be kept near combustible substances like ether
• Electronic devices should be switched off before application
• Exposure time is 5 minutes
27. WEEKLY THOUROUGH CLEANING
• The entire OT has to be cleaned thoroughly
• All portable items like ot table and other furnitures , cusa machine etc. has to
be pushed out of the ots and cleaned with 5% silvicide(surface cleaning)
• The floor, wall and ceiling have to be cleaned with high dusting
• Vacuuming to be done every week in the ideal setting
• After the satisfactory cleaning is done, the entire OT has to be fumigated
28. • Screens( monitors, tv screens, microscope screens, ventilaler screen) to be cleaned
with instaact solution (undiluted)( for IOMRI)
• Care has to be taken that the sockets and key boards don’t get soaked
• Areas that are prone for dust collection like corers and veranda should be cleaned
diligently
• Weekly culture samples to be taken – both air sampling and swab culture, records to
be maintained
• Autoclave biological indicator also to be send every week and the records are to be
maintained.
29. Importance of Documentation
• “ not documented i equal to not done”
• Documentation should be
1. Timely
2. Accurate
3. Complete
4. Concise
5. Legible
31. • Eg : the following things have to be mentioned while writing due slips for
implants used:-
• Date & OT
• Patients name, age, sex, unit, UHID/N.no
• Name of the surgery
• Name of the surgeon: consultant and resident
• Name of the scrub nurse
32. Few documents in operation theatre
• Related to patients or specimen:
surgical safety checklist
Pre operative checklist
Recovery register
Daily report book
Specimen book
Frozen book
Post op monitoring chart
33. • Related to OT and material management:-
daily inventory checking book
Cssd book
Eto book
Fumigation book
Bme register
Implants register
HIV/PPE book
Microbiology culture sample sending and reporting book
34. Inventory checking
• Inventory checking basically means to have an account of the stock in hand
• Daily checking helps us to know any missing items and helps to locate them
early
• Helps us to know our functioning capacity and intimate other HCP
35. • Types of inventory that we follow:
1. Daily or essential use items : patient trolley, IV stand, head rings , plaster
cutting scissors, trimmers, blankets etc
2. High cost items: 4K endoscope, Colorado monopolar point,
microvascular sets, doppler machines, cusa, aneurysm clips, ICG etc
3. Sterile things: sterile packs and ETO items
36. When there is no periodic inventory
• Loss/breakage/misuse of supply
• Lack of accountability
• Harm to the patient
• Delay in repair and replacement
37. OT CHECKING
• Check complete equipment, cleaning and the required items in the ot
• The cables must be neatly folded
• All extra items must be removed from the ot. Eg: syringes, urobags
• Plasters or labels stuck on the walls must be removed
• Look out for blood stains especially on ot table, ventilators, suction bottles
• Remove any extra equipment from the ot.
• Ensure clean scrub stations
38. Importance of OT checking
• Helps us to ensure patient safety
• Makes OT presentable
• Helps in decluttering
• Prevents over stocking
• Allows equal distribution of available resources
• Allows in identification of missing items and prompt rectification.
39. • The whole class can be summarized on the basic principles of nursing:
“Make the best possible use of time and
energy while providing the best possible
quality of care”