1. The document outlines a 4 plan approach for managing difficult or failed tracheal intubation during anesthesia induction.
2. Plan A involves initial direct laryngoscopy and use of introducers or alternative laryngoscopes if poor view is obtained.
3. Plan B involves use of supraglottic airway devices like ILMA or LMA if Plan A fails, with fiberoptic intubation through the device.
4. Plan C maintains oxygenation and ventilation by reverting to a face mask if intubation fails via Plan B, postponing surgery and awakening the patient.
5. Plan D involves rescue techniques if ventilation and oxygenation cannot be maintained as
Acid base balance & ABG interpretation,Dept of anesthesiology,JJMMC,DavangereGopan Gopalakrisna Pillai
Acid base balance and ABG interpretation presented by Dr.Gopan.G,Post-Graduate student. Chairperson : Dr.Ravi.R,Professor, Department of Anaesthesiology & Critical care,JJMMC,Davangere.
Acid base balance & ABG interpretation,Dept of anesthesiology,JJMMC,DavangereGopan Gopalakrisna Pillai
Acid base balance and ABG interpretation presented by Dr.Gopan.G,Post-Graduate student. Chairperson : Dr.Ravi.R,Professor, Department of Anaesthesiology & Critical care,JJMMC,Davangere.
Successful management of massive intra-operative pulmonary embolism Apollo Hospitals
Acute Pulmonary Embolism has a high rate of mortality (26%) due to blockade of the pulmonary artery leading to acute increase in right ventricular pressure causing sudden cardiac decompensation. Lack of specific tests for early diagnosis is one of the causes for high rate of mortality but timely diagnosis and active intervention can save the life of the patient.
Mechanical Ventilation in Critical Care: Why driving pressure mattersSMACC Conference
Marcelo Amota makes the case for why driving pressures matter during mechanical ventilation in critical care.
Sao Paulo, Brazil, experiences flooding every year. This exposes locals to Leptospira bacteria. The severe form of disease this causes – leptospirosis - sees patients end up on mechanical ventilators. These machines were traditionally complicated, with a huge number of settings and buttons.
Marcelo Amato trained in this setting. He, alongside his colleagues, developed methods to halt bleeding in leptospirosis by manipulating ventilator settings. He calls it “protective ventilation”. It was not long before the same principles were being applied to patients suffering acute respiratory distress syndrome.
Through research, Marcelo and his team concluded that driving pressures, above all other ventilator settings, were most important for patient survival.
Driving pressure is the oscillation of alveolar pressure or variation of pressures inside the lungs. It is what your lungs are sensing. Although there is an obsession with tidal volume, which is displayed on ventilators, Marcello explains, driving pressures are easily calculated and more important.
Marcelo discusses the increasing mortality with mechanical ventilation. The medical community, especially physiologists, are traditionally wrapped up in the concept of volutrauma. However, it is the gradient of pressures oscillating inside the lung (the driving pressure) that is causing lung injuries.
So, the question became - would the lessons learnt the study on mechanical ventilation for leptospirosis be transferable to reducing risk in acute respiratory distress syndrome?
Marcelo presents over twelve years of research. In doing so he highlights the changing dogma of the protective role of small tidal volumes. Research shows that the size of the tidal volume does not matter in terms of mortality. What matters is the pressure that is generated. The force with which the lung is deformed is much more important than the size of the deformation.
The message: Do not look at absolute pressures, rather look at the swings in pressure. The only way a patient can survive is through a decrease in driving pressure, and not through a decrease in tidal volume.
BIPAP and CPAP are being used to support COVID patients for artificial respiratory support. This PPT Explains how the CPAP AND BIPAP Works and how to use and maintain these. equipment.
I created these slides to outline for our sales team some of the techniques and procedures that would be covered in the new Advanced Airway course. This was a challenge since I was given very little course information, so a lot of reading a research was required. In the course of creating this, I learned a lot! On this upload, deleted faculty biographies, seminar date/location, and pricing.
Successful management of massive intra-operative pulmonary embolism Apollo Hospitals
Acute Pulmonary Embolism has a high rate of mortality (26%) due to blockade of the pulmonary artery leading to acute increase in right ventricular pressure causing sudden cardiac decompensation. Lack of specific tests for early diagnosis is one of the causes for high rate of mortality but timely diagnosis and active intervention can save the life of the patient.
Mechanical Ventilation in Critical Care: Why driving pressure mattersSMACC Conference
Marcelo Amota makes the case for why driving pressures matter during mechanical ventilation in critical care.
Sao Paulo, Brazil, experiences flooding every year. This exposes locals to Leptospira bacteria. The severe form of disease this causes – leptospirosis - sees patients end up on mechanical ventilators. These machines were traditionally complicated, with a huge number of settings and buttons.
Marcelo Amato trained in this setting. He, alongside his colleagues, developed methods to halt bleeding in leptospirosis by manipulating ventilator settings. He calls it “protective ventilation”. It was not long before the same principles were being applied to patients suffering acute respiratory distress syndrome.
Through research, Marcelo and his team concluded that driving pressures, above all other ventilator settings, were most important for patient survival.
Driving pressure is the oscillation of alveolar pressure or variation of pressures inside the lungs. It is what your lungs are sensing. Although there is an obsession with tidal volume, which is displayed on ventilators, Marcello explains, driving pressures are easily calculated and more important.
Marcelo discusses the increasing mortality with mechanical ventilation. The medical community, especially physiologists, are traditionally wrapped up in the concept of volutrauma. However, it is the gradient of pressures oscillating inside the lung (the driving pressure) that is causing lung injuries.
So, the question became - would the lessons learnt the study on mechanical ventilation for leptospirosis be transferable to reducing risk in acute respiratory distress syndrome?
Marcelo presents over twelve years of research. In doing so he highlights the changing dogma of the protective role of small tidal volumes. Research shows that the size of the tidal volume does not matter in terms of mortality. What matters is the pressure that is generated. The force with which the lung is deformed is much more important than the size of the deformation.
The message: Do not look at absolute pressures, rather look at the swings in pressure. The only way a patient can survive is through a decrease in driving pressure, and not through a decrease in tidal volume.
BIPAP and CPAP are being used to support COVID patients for artificial respiratory support. This PPT Explains how the CPAP AND BIPAP Works and how to use and maintain these. equipment.
I created these slides to outline for our sales team some of the techniques and procedures that would be covered in the new Advanced Airway course. This was a challenge since I was given very little course information, so a lot of reading a research was required. In the course of creating this, I learned a lot! On this upload, deleted faculty biographies, seminar date/location, and pricing.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
1. Unanticipated difficult tracheal intubation-
during routine induction of anaesthesia in an adult patient
Direct Any Call
laryngoscopy problems for help
Plan A: Initial tracheal intubation plan
Direct laryngoscopy - check:
Neck flexion and head extension
Laryngoscope technique and vector Not more
External laryngeal manipulation - than 4 attempts,
succeed
maintaining: Tracheal intubation
by laryngoscopist (1) oxygenation
Vocal cords open and immobile with face mask and
If poor view: Introducer (bougie) - (2) anaesthesia
seek clicks or hold-up Verify tracheal intubation
and/or Alternative laryngoscope (1) Visual, if possible
(2) Capnograph
failed intubation (3) Oesophageal detector
"If in doubt, take it out"
Plan B: Secondary tracheal intubation plan
Confirm: ventilation, oxygenation,
ILMATM or LMATM anaesthesia, CVS stability and muscle
Not more than 2 insertions succeed relaxation - then fibreoptic tracheal intubation
Oxygenate and ventilate through IMLATM or LMATM - 1 attempt
If LMATM, consider long flexometallic,nasal
failed oxygenation RAE or microlaryngeal tube
(e.g. SpO2 < 90% with FiO2 1.0) Verify intubation and proceed with surgery
via ILMATM or LMATM
failed intubation via ILMATM or LMATM
Plan C: Maintenance of oxygenation, ventilation,
postponement of surgery and awakening
Revert to face mask
Oxygenate and ventilate
Reverse non-depolarising relaxant succeed Postpone surgery
1 or 2 person mask technique Awaken patient
(with oral ± nasal airway)
failed ventilation and oxygenation
Plan D: Rescue techniques for
"can't intubate, can't ventilate" situation
Difficult Airway Society Guidelines Flow-chart 2004 (use with DAS guidelines paper)
