This document discusses the management of common emergencies including insect bites, anaphylaxis, heat stroke, snake bites, and scorpion stings. It provides guidance on treating animal bites, administering antibiotics, tetanus vaccines, and rabies prophylaxis when needed. For snake bites, recommendations include reassuring the patient, checking coagulation, giving antivenom, and immobilizing the area. Anaphylaxis requires epinephrine, IV fluids, oxygen, and monitoring for biphasic reactions. Heat stroke and exhaustion are also outlined, with cooling methods like cold water immersion and lavage to rapidly lower core body temperature.
Rabies is a severe, viral disease that can affect all mammals, including humans. Infection results in damage to the nervous system. The disease almost always ends in death. Rabies occurs worldwide.
Notes for MBBS students on epidemiologlogy, prevention and control of typhoid for subject of public health/community medicine/preventive and social medicine
Rabies is a severe, viral disease that can affect all mammals, including humans. Infection results in damage to the nervous system. The disease almost always ends in death. Rabies occurs worldwide.
Notes for MBBS students on epidemiologlogy, prevention and control of typhoid for subject of public health/community medicine/preventive and social medicine
Epidemiology and control measures for Yellow fever AB Rajar
It is an acute infectious disease of short duration, with sudden
onset,fever,headache,prostration,nausea,epistaxis,buccal bleeding,hematemesis,malena and jaundice
This ppt is About Rabies epidemiology and treatment .
This is done by using Park book 24th edition of PSM .
This presentation is presented in academics of Master of public health in Christian medical college .
One more Important thing is that that zareb regime (intramuscular ) is not practiced . We try to make this ppt lucid. and the statistics is used in the presentation is upto 27 june 2018
Rabies is a zoonotic disease (a disease that is transmitted from animals(Mammals) to humans).
Caused by the rabies virus (The Lyssavirus genus, within the family Rhabdoviridae).
Domestic dogs are the most common reservoir of the virus, with more than 95% of human deaths caused by dog-mediated rabies. Let's know the Sign symptoms, Treatment and Prevention of rabies which is 100% fatal and 100% preventable.
اختبار قصير: ماذا تعلم عن التغطية الصحية الشاملة؟
أَجِب على أسئلة هذا الاختبار القصير لتتأكد من صحة إجاباتك.
1 تحتفل منظمة الصحة العالمية (المنظمة) في يوم 7 نيسان/ أبريل من كل عام بذكرى إنشائها، باليوم الذي دخل فيه دستورها حيز النفاذ. فكم ستبلغ المنظمة من العمر هذا العام (2018)؟
30 عاماً
50 عاماً
70 عاماً
90 عاماً
2 ما المقصود بالتغطية الصحية الشاملة؟
يُقصد بالتغطية الصحية الشاملة حصول جميع الأفراد والمجتمعات المحلية على الخدمات الصحية اللازمة لهم متى وحيثما لزمتهم.
التغطية الصحية الشاملة تحمي الناس من الوقوع في دائرة الفقر حينما يُسددون تكاليف الخدمات الصحية اللازمة لهم من أموالهم الخاصة.
التغطية الصحية الشاملة تُمكّن جميع الأشخاص من الحصول على الخدمات التي تعالج أهم أسباب الإصابة بالمرض والوفاة.
التغطية الصحية الشاملة تعني تقديم خدمات صحية للأفراد ومختلف فئات السكان كالقضاء على مواقع تكاثر البعوض.
جميع ما سبق.
3 ما نسبة سكان العالم غير القادرين على الحصول على الخدمات الصحية اللازمة لهم؟
ما لا يقل عن 30% من سكان العالم
ما لا يقل عن 50% من سكان العالم
ما لا يقل عن 70% من سكان العالم
ما لا يقل عن 90% من سكان العالم
4 يُدفع نحو 100 مليون شخص في العالم إلى دائرة ’الفقر المدقع‘ (أي يعيشون بدخل لا يتجاوز 1.90 دولاراً أمريكياً في اليوم) بسبب اضطرارهم إلى سداد تكاليف خدمات الرعاية الصحية اللازمة لهم.
صحيح
خطأ
5 من له دور يؤديه في الدعوة إلى تحقيق التغطية الصحية الشاملة؟
أنت
الجماعات غير الهادفة إلى الربح
العاملون في مجال الصحة
وسائط الإعلام
جميع ما سبق
Session 6 se and complications [repaired]
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
3. Case 1
• 3 years old child brought by his mother after ho scratch by un
provoked domestic cat in his hand
• Vitals
• Weight 14
• Temp:36.8
• Superficial cat scratch marks seen on his hand
• Next step ??
4. Cat bite
• Cat bites account for 5% to 10% of animal bite wounds.
• Cat bites occur most often in adult women, usually on the
extremities.
• Almost all of these bites are self-reported as provoked.
5. Dog bite
• Most dog bite victims are children, and these bites usually involve the
head and neck.
• Adolescents and adults tend to have more bite wounds to the
extremities.
• More than 70% of bites are from a dog that is known to the victim,
and about 50% are self-reported as unprovoked
6. • The wound should be carefully explored for tendon or bone
involvement and foreign bodies, such as teeth fragments.
• Older dogs and cats often have significant periodontal disease,
increasing the risk that a tooth will break off during a bite.
• Radiography is indicated if a foreign body or bone involvement is
suspected.
• Tendon ruptures should be evident on examination, but identifying a
partial tendon rupture requires careful exploration of the wound.
Observing the tendon throughout the joint's full extension and full
flexion can reveal small or partially torn tendons, which warrant
referral for repair.
7. • In a study of 145 bite wounds that were primarily closed, only 5.5%
became infected, including bites from dogs (61%), cats (31%), and
humans (8%).
• Both of these studies are small and have design limitations; therefore,
wounds may be primarily closed if desired for cosmetic reasons.
• However, allowing a wound to close by secondary intention should
be considered if there is a higher risk of infection , such as wounds to
the hand.
• The safety and effectiveness of skin adhesives have not been studied
in animal bite wounds.
8.
9. • Antibiotic prophylaxis should be used for high-risk bite wounds
• considered in average-risk wounds
• Meta analysis showed no difference except for hand wounds
• All cat bites are considered high risk for infection because they tend
to cause deep puncture wounds.
10. • Antibiotic prophylaxis should be considered in :
1-a high risk of infection, such as with cat bites,
2-puncture wounds,
3-wounds to the hand,
4-immunosuppressed.
• Amoxicillin/clavulanate is the first-line prophylactic antibiotic.
11.
12.
13. RABIES
• Rabies is a virus that can infect any mammal.
• cats are the most commonly infected domesticated animal, whereas
raccoons, bats, and skunks are the most commonly infected wild
animals.
14. • Post exposure rabies prophylaxis consists of :
• immune globulin at presentation
• vaccination on days 0, 3, 7, and 14.
• The need for rabies prophylaxis should be addressed with any
animal bite because even domestic animals are often unvaccinated.
15. • The immune globulin is infiltrated around the bite wound, and any
additional volume is administered at a site distant to the vaccination
site, usually the opposite arm as the rabies vaccine.
• If the patient had already received pre exposure prophylaxis before
the animal bite, no immune globulin is needed, and the rabies vaccine
is administered only on days 0 and 3.
16. • Counseling patients and families about animal safety may help
decrease animal bites.
• In most states, physicians are required by law to report animal bites.
17.
18. aafp
• Postexposure prophylaxis is generally not needed in patients with a
dog or cat bite as long as the animal is not showing signs of rabies,
such as inappetence, dysphagia, abnormal behavior, ataxia, paralysis,
altered vocalization, or seizures; however, the animal should be
monitored for at least 10 days.
• if the animal shows signs of rabies, becomes sick, or dies, immediate
post exposure prophylaxis is recommended.
19. • Pre exposure prophylaxis should be considered in persons with higher
risk of rabies exposure, such as certain laboratory workers,
veterinarians, spelunkers, and certain international travelers.
20. • Tetanus vaccination is recommended after an animal bite if it has
been more than five years since the patient has been immunized
21.
22.
23. Case 2
• 60 years old American tourist was brought to your local health center
with h/o snake bite while he was in camping tour at the desert in his
left shin
• On ex
• Snake bite marks noted in his left shin
• Vitals within normal range
• How to proceed ??
24. Snake venom
• Venom is a complex of mixture of poisonous toxins ,proteolytic
,enzymes ,and different proteins
• Amount and degree of poisoning differ from one snake to another
depending on several factors
• Type of snake
• Age ,sex
• Geographical , seasonal variation
25. • Severity depends on amount of venom injected in to the victim
• Varies from one person to another
• Usual appearance of a bite of a non-venomous species or by a
venomous snake without a venom injection is two or more fang
(tooth) marks ,mild local tenderness , some swelling ,but no bruising
26. Types of enovenomation
• Haemotoxic(vipers )—(Dhofar )local pain , swelling ,petachia and co
agulopathy ,,bleeding , acute renal failure ,cardiovascular collapse
27. • Myotoxin sea snake muscle damage ,rhabdomolisis ,weakness
of the limb ,respiratory muscle and swallowing muscles can be
affected ,
• No ASV available
28. • Neurotoxic cobras (Naja haja Arabica )
• Affect nervous system , ptosis can be early sign ,systemic effect can be
delayed up to 12 hours , nausea , vomiting ,confusion , dysarthia
,muscle fasciculations , respiratory arrest
29. • Re assure the pt
• Perform WBCT , send for urgent coagulation profile ,INR , cbc ,RFT,LFT
, DIC ,blood group ,save serum ,
• Give ASV
• Give tetanus toxoid injection intramascular or sc if severe
coagulopathy
• Immobilize the bitten area , clean it with saline
• Observe patient during ASV , infusion for 1-2 hours
30. 20 minutes WBCT
• Place few ml of freshly sampled venous blood in a small ,glass vessel.
• Leave undisturbed for 20 minutes at ambient temperature
• Tip the vessel once
• If the blood still liquid (un clotted )and runs out , the patient has
hypofibrinogenaemia(incoagulable blood) as a result of venom-
induced consumption coagulopathy
31. First aid in management of snake bite
• Avoid walking in darkness
• Don’t disturb snakes
• Don’t handle snakes , beware if a snake has recently died or been
killed its head can still bite even few hours after its death
• Remove the wounded person from dangerous place
• Do not mobilize the bitten area
• Apply a splint or a sling to immobilize the affected area
• Don’t apply hot or cold water over the bitten area
• Don’t try to suck out the venom
32. • Don’t apply a tight bandage or tourniquet
• Re assure the victim
• Transport victim to nearest HLC as soon as possible with the affected
site immobilized
• If transport of the patient is expected to be delayed , give the patein
AVS , can be given even im if iv acsses not available , but make sure
that epinephrine is there (in case of anaphylaxis )
33.
34. • Contraindication of ASV
• NO absolute contraindication , but in patient with ho anaphylaxis
should be given with caution and pre treatment should be given ,
epinephrine and other measures
35. Case 3
17 years old male , not kwon to have chronic medical problem
Presented to LHC with ho scorpion sting at his right big toe
Patient is screaming from pain
On ex:
BP :128/70
A febrile
Local erythema noted in right big toe
What is your next step??
36.
37.
38. Case 4
• 30 year old Indian house made bought by her madam with ho sob ,
swollen lips and flush over her face after bee sting
• On ex:
• Patient is tachypnea
• BP :90/50
• Pulse :110
• Chest :bl wheezes
39.
40. anaphylaxis
• Anaphylaxis is a severe, life-threatening, systemic allergic reaction
that is almost always unanticipated and may lead to death by
airway obstruction or vascular collapse.
• Anaphylaxis occurs as the result of an allergen response, usually
immunoglobulin E–mediated, which leads to mast cell and basophil
activation and a combination of dermatologic, respiratory,
cardiovascular, gastrointestinal, and neurologic symptoms.
41. • The incidence of anaphylaxis in the United States is 49.8 cases per
100,000 person-years
42. • Dermatologic and respiratory symptoms are most common, occurring
in 90 and 70 percent of episodes, respectively.
• The three most common triggers are food, insect stings, and
medications.
• Food-related reactions are most common in children up to four years
of age, and medication reactions are most common in patients older
than 55 years.
43.
44. • The diagnosis of anaphylaxis is typically made when symptoms
occur within one hour of exposure to a specific antigen.
45. • A biphasic reaction is a second acute anaphylactic reaction occurring
hours after the first response and without further exposure to the
allergen.
• One to 20 percent of patients with anaphylaxis experience biphasic
reactions, which usually occur within eight hours of the initial
reaction, but may occur as late as 24 to 72 hours after exposure
46. • Compared with that of the general population, the risk of anaphylaxis
is doubled in patients with mild asthma and tripled in those with
severe disease.
48. • The clinical history is the most important tool to determine whether a
patient has had an anaphylactic reaction and the cause of the
episode.
49.
50.
51. DDX
• Any condition that may result in the sudden, dramatic collapse of the
patient such as
• myocardial ischemia
• pulmonary embolism
• foreign body aspiration
• acute poisoning
• hypoglycemia,
• seizure, can be confused with severe anaphylaxis.
52. • . However, a vasovagal event is the most common condition confused
with anaphylaxis.
• Bradycardia helps differentiate vasovagal events from anaphylaxis,
because tachycardia is typical in the latter.
• However, tachycardia can transition into bradycardia during the end
stages of a severe anaphylactic reaction when vascular collapse
occurs.
53. Management
• Securing the airway and providing 100 percent oxygen
• Intravenous fluid administration is critical for all patients whose
hypotension does not respond to epinephrine.
• In adults and adolescents, 2 L of normal saline are usually
administered initially; more may be required in severe cases.
54. • Children should receive boluses of 10 to 20 mL per kg until
hypotension is controlled.
• Even in the presence of upper airway obstruction, placing a patient in
the recumbent position with the lower extremities raised is preferred
over elevating the head of the patient's bed, because the vascular
collapse during anaphylaxis can be devastating.
55. • Administration of intramuscular epinephrine at the onset of
anaphylaxis, before respiratory failure or cardiovascular
compromise, is essential.
• Histamine H1 receptor antagonists and corticosteroids may be useful
adjuncts.
56.
57.
58.
59. • All patients at risk of recurrent anaphylaxis should be educated
about the appropriate use of prescription epinephrine
autoinjectors.
60. • The preferred route of administration for epinephrine is
intramuscular injection because it provides more reliable and quicker
rise to effective plasma levels than the subcutaneous route.
65. • Heatstroke and heat exhaustion occur when the body’s
thermoregulatory responses are inadequate to preserve homeostasis.
This can result from extrinsic factors that make heat dissipation less
efficient, such as extremes of temperature, physical effort, and
environmental conditions.
66. • Classic heatstroke is caused by environmental exposure and results in
core hyperthermia above 40°C (104°F). This condition primarily occurs
in the elderly and those with chronic illness.
• These manifestations are thought to be an encephalopathic response
to a systemic inflammatory cascade
67. • Heat exhaustion is a more common and less extreme manifestation of
heat-related illness in which the core temperature is between 37°C
(98.6°F) and 40°C.
• Symptoms of heat exhaustion are milder than those of heatstroke,.
Patients with heat exhaustion lack the profound central nervous
system derangement found in those with heat stroke .
• Their symptoms typically resolve promptly with proper hydration and
cooling.
71. • External method
• A- evaporation
• In evaporative cooling, a mist of cool water (15°C [59°F]) is sprayed on
the patient’s skin, while warm air (45°C [113°F]) is fanned over the
body. Cooling rates with this technique have been measured at 0.31°C
(0.56°F) per minute.
72.
73. • B-immersion
• Immersion cooling can be achieved with an ice bath, or by using
cooling blankets in conjunction with ice packs placed on the axilla,
groin, neck, and head
• Although immersion methods are thought to be less effective than
evaporative cooling, direct comparison studies are lacking.
74. • Internal method :
• Internal cooling methods are more effective in rapidly decreasing
temperature
• Gastric, bladder, and rectal cold-water lavage
• Peritoneal and thoracic lavage are performed only in extreme cases.
• Cardiopulmonary bypass also is a rare but effective cooling method.
75.
76. Complications of Heatstroke
• Central nervous system injury is permanent in 20 percent of cases and
is associated with poor prognosis.
• Rhabdomyolysisincrease risk of renal injury
• Hepatocytes may be damaged, causing coagulopathy and hepatitis.
• Myocardial muscle may be damaged and result in arrhythmias or
even cardiac arrest.
77. Prevention
• Preparation for and understanding of heat-stroke can help prevent
much of its associated morbidity and mortality.
• Physicians should encourage their patients to protect themselves by
maintaining adequate hydration, avoiding heat exposure, wearing
loose, light clothing, and monitoring their exertion level.
78. • Athletes should be advised to acclimatize for at least three to four
days before exerting in the heat.
• Because a heat injury releases an inflammatory cascade that may
increase risk on subsequent days, patients should be protected from
exposure to heat for 24 to 48 hours following a mild injury.
There are 10 to 20 animal bite–related deaths, mostly from dogs, annually.
May be delayed 3-4 hours
WHOLE BLOOD CLOTTING TEST
Skin involvement, predominantly urticaria and angioedema, occurs in 90 percent of episodes.Respiratory manifestations are present in 70 percent of episodes, primarily with signs and symptoms of upper airway obstruction.1 Lower airway obstruction may occur, especially in patients with a history of asthma. Cardiovascular involvement, which could lead to life-threatening hypotension, occurs in 45 percent of patients.1,3,5,6 Gastrointestinal and neurologic involvement occur 45 and 15 percent of the
Presence of once out of three predicts anaphylaxis
Temprature should be measured with bladder or esophageal probe
Untreated heat exhaustion can lead to heat stroke
Cooling by evaporation is the most effective method in the field under normal conditions; patients with heatstroke should initially be treated with evaporative cooling.