Changes in Respiratory System with Various Physiological ConditionsAnand Bansal
Topics - High-Altitude Physiology, Deep Sea Diving And Effects Of Increased Barometric Pressure, Changes In Respiratory System During Pregnancy, Physiological Changes Of Repiratory System With Exercise, Physiological Changes Of Respiratory System With Aging
Changes in Respiratory System with Various Physiological ConditionsAnand Bansal
Topics - High-Altitude Physiology, Deep Sea Diving And Effects Of Increased Barometric Pressure, Changes In Respiratory System During Pregnancy, Physiological Changes Of Repiratory System With Exercise, Physiological Changes Of Respiratory System With Aging
Bronchial Thermoplasty (BT) Novel Treatment for Patients with Severe AsthmaBassel Ericsoussi, MD
Do our Asthma Patients Know What They Are Missing?Now, A Revolutionary Procedure Can Help Them Lead A Fuller Life.
Bronchial Thermoplasty (BT) Novel Treatment For Patients With Severe Asthma
Altitude physiology typically focuses on people above 2500 m; ∼8000 ft. Altitudes above that are sometimes subdivided into very high (3500–5500 m; ∼11,500–18,000 ft) and extreme (>5500 m; >18,000 ft). An estimated 40 million people travel each year to altitudes >2500 m (∼8000 ft),1 and as many or more travel to altitude for leisure and sports, and work in mines, military or border operations, and the like. Altitude medicine considers the clinical disorders associated with acclimatization by the travelers, workers and migrants, and with adaptation by people with lifetimes or populations with millennia of residence (an estimated 83 million people).
With a hurried ascent, many (∼80%) will report a transient headache (high-altitude headache or [HAH]), and some will develop one of three forms of acute high-altitude illness: acute mountain sickness (AMS) and HAH, high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS and HAH are annoying and interfere with activity and work, however, HACE and HAPE can be fatal with mortality rates approaching 30%. Among some residents, chronic mountain sickness (CMS) and right ventricular hypertrophy develop over months to years of residence at altitude. Birth weights are generally lower and the rate of small-for-gestational-age babies and congenital heart defects are higher than that in lowland populations.
Acute respiratory distress syndrome (ARDS) is a sudden and progressive form of acute respiratory failure in which the alveolar capillary membrane becomes damaged and more permeable to intravascular fluid resulting in severe dyspnoea, hypoxemia and diffuse pulmonary infiltrates.
It discusses various effects of high altitude on human body in detail, acute mountain sickness, chronic mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, acclimatization
Barometric pressure falls with increasing altitude, but composition of air remain same.
Study is important for:Mountaineering
Aviation & Space flight
Permanent human settlement at highlands
Spirometry is the measurement of the flow and volume of air entering and leaving the lungs Test of pulmonary function (PFT) • Indicator of health status or disease • Exercise fitnessRespiratory system is functions include gas exchange , pH regulation, vocalization , and protection from foreign substances.Respiration:Cellular is the cellular mechanism of energy conversionExternal is the exchange of gases between atmosphere and cells, Includes ventilation, gas exchange at lungs and cells, and transport of gases in the blood.
Bronchial Thermoplasty (BT) Novel Treatment for Patients with Severe AsthmaBassel Ericsoussi, MD
Do our Asthma Patients Know What They Are Missing?Now, A Revolutionary Procedure Can Help Them Lead A Fuller Life.
Bronchial Thermoplasty (BT) Novel Treatment For Patients With Severe Asthma
Altitude physiology typically focuses on people above 2500 m; ∼8000 ft. Altitudes above that are sometimes subdivided into very high (3500–5500 m; ∼11,500–18,000 ft) and extreme (>5500 m; >18,000 ft). An estimated 40 million people travel each year to altitudes >2500 m (∼8000 ft),1 and as many or more travel to altitude for leisure and sports, and work in mines, military or border operations, and the like. Altitude medicine considers the clinical disorders associated with acclimatization by the travelers, workers and migrants, and with adaptation by people with lifetimes or populations with millennia of residence (an estimated 83 million people).
With a hurried ascent, many (∼80%) will report a transient headache (high-altitude headache or [HAH]), and some will develop one of three forms of acute high-altitude illness: acute mountain sickness (AMS) and HAH, high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS and HAH are annoying and interfere with activity and work, however, HACE and HAPE can be fatal with mortality rates approaching 30%. Among some residents, chronic mountain sickness (CMS) and right ventricular hypertrophy develop over months to years of residence at altitude. Birth weights are generally lower and the rate of small-for-gestational-age babies and congenital heart defects are higher than that in lowland populations.
Acute respiratory distress syndrome (ARDS) is a sudden and progressive form of acute respiratory failure in which the alveolar capillary membrane becomes damaged and more permeable to intravascular fluid resulting in severe dyspnoea, hypoxemia and diffuse pulmonary infiltrates.
It discusses various effects of high altitude on human body in detail, acute mountain sickness, chronic mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, acclimatization
Barometric pressure falls with increasing altitude, but composition of air remain same.
Study is important for:Mountaineering
Aviation & Space flight
Permanent human settlement at highlands
Spirometry is the measurement of the flow and volume of air entering and leaving the lungs Test of pulmonary function (PFT) • Indicator of health status or disease • Exercise fitnessRespiratory system is functions include gas exchange , pH regulation, vocalization , and protection from foreign substances.Respiration:Cellular is the cellular mechanism of energy conversionExternal is the exchange of gases between atmosphere and cells, Includes ventilation, gas exchange at lungs and cells, and transport of gases in the blood.
How is COPD and Nutrition Overlapped and Affecting Each Other
How to Solve the Problem as a Part of Pulmonary Rehabilitation
The Presentation is Discussing these items in the form of Problem Solving
What are the main sleeping disorders and what are the sleeping disorders related to respiratory system ? how to deal with it and how to diagnose and treat?
Early Enteral Nutrition in Critically Ill Patients is the best for helping early recovery, decreasing hospital stay and decreasing malnutrition in ICU
How? When? Formulas used? Access forms?
Deep sea diving and physiological response to high barometric pressure Ranadhi Das
Sea water is approximately 800 times more dense than air. Therefore, it exerts much greater pressure on the body of a diver.
The weight exerted by the atmosphere on an area of 1m2, is approximately 10,000kg at sea level. This value of pressure (10,000 kg m-2) is thus referred to as 1 atmospheric absolute (1 ATA), or 1 atmospheric pressure.
For every 10m(~32feet) below the surface a person dives, he is subjected to an additional pressure of 1ATA. Therefore, at 30m, a diver will experience a pressure of 4 ATA (1 ATA exerted by the atmosphere, & 3 ATA exerted by the 30m of water above him).
Meteorology:
The word meteorology is from the Ancient Greek and
meaning "the study of things high in the air."
Luke Howard has been called “the father of meteorology” because of his comprehensive
recordings of weather in the London area from 1801 to 1841 and his writings, which
transformed the science of meteorology.
Meatrology and its types by Muhammad Arslan Yasin, Sukhera Illustratorz
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
PowerPoint presentation on ECMO (Extracorporeal Membrane Oxygenation). Part 2 focuses on Monitoring ECMO patients
Ventilatory strategies, Sedation and pain control, Weaning, Complications and recent advances in ECMO. For better understanding please have a look at ECMO part 1 before going through part 2.
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
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.
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.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
- 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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
Follow us on: Pinterest
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
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.
3. What Does it Mean? History?
SCUBA – Self Contained Underwater
Breathing Aparatus
Long history dating back from 332
BC
Modern fins, mask and snorkel
tubes were developed by fishermen
from America, Russia, France and
England in the 1920s and 1930s
4. History continued
Recreational SCUBA Diving began
between 1942 - 1943, after Emile
Gagnan and Captain Hacques –Yves
Cousteau developed the self-
contained “Aqua-Lung” and new
regulator that was automatic.
Cousteau took many successful,
experimental dives with his friends,
wife and two sons, making this an
experimental family trip and
experience.
5. Introduction
SCUBA diving accidents are fairly
uncommon.
In experienced divers have a higher
incident rate of injury.
Emergencies can occur on the
surface, one meter of water, or at
any depth.
More serious emergencies usually
follow a dive.
6. Introduction
Behavior of gases and pressure
changes during descent and
ascent.
Clinical manifestations seen during
diving or up to 24 h after it.
7. Equipment
Mask- Device covering eyes
and nose, allowing you to
see underwater
Fins – Device put on the
feet to extend the kicking
motion underwater.
8. Equipment continued
BCD or BC – (Buoyancy
compensator device)
Device/jacket that controls
buoyancy up or down
Regulator – Device that
delivers air to you on
demand at reduced
pressure
9. Equipment continued
Pressure gauge – (SPG-
Submersible Pressure
Gauge) Device that tells
diver how much air they
have left
Weights – Lead weights
used to weigh down divers
for depth decent
10. Equipment continued
• Snorkel – Device used to
breath air close to or on the
surface of the water
Body suit – Warm
temperature suit that
protects the body against
abrasions and stings
11. Equipment continued
Wet suit – Insulated suit
used to keep the body
temperature in
Dry suit – Used to keep the
diver dry and warm in
colder temperatures
12.
13.
14. Underwater breathing
Regular breathing makes use of differences in air
pressure
The water above a diver increases the atmospheric
pressure. Therefore,
Air must be pressurized to be able to breathe at a
pressure of more than one Atmosphere (air pressure
at sea level).
(This is also why you have to pop your ears as you descend.)
15. Physical Principles of Pressure
Density of the water can be equated to
pressure, which is defined as the weight
or force acting upon a unit area.
Fresh water exerts a pressure of 62.4
pounds over an area of one square foot
(salt water is 64 pounds). Stated as
pounds per square inch (psi)
At sea level humans live in an
atmosphere of air, or a mixture of
gases, and they exert a pressure of 14.7
psi.
17. Gas Laws
Boyle’s Law
“For any gas at a constant
temperature, the volume of the
gas will vary inversely with the
pressure, and the density of the
gas will very directly with the
pressure.”
If T= constant, then V 1/P and
Density P
(Never hold your breath!)
18. Charles’s Law
For any gas at a constant pressure, the
volume of the gas will very directly
with the absolute temperature.
If P= constant, then V T
Or
For any gas at a constant volume, the
pressure of the gas will vary with the
absolute temperature.
If V= constant, then P T
19. Henry’s Law
The amount of any given gas will dissolve in a
liquid at a given temperature is proportional
to the partial pressure of that gas in
equilibrium with the liquid and the solubility
coefficient of the gas in the particular liquid.
An increase in pressure will increase absorption
(Oxygen in your blood dissolves at a given pressure.)
20. Henry's Law
Gas molecules will dissolve into the blood in
proportion to the partial pressure of that gas in the
lungs.
21. Henry’s Law
• At sea level, the dissolved gases
in the blood and tissues are in
proportion to the partial pressures
of the gases in the person's lungs
at the surface.
• As the diver descends,the
ambient pressure increases, and
therefore the pressure of the gas
inside the lungs increases.
22. Main Pathologies
Barotrauma – Ear, Sinus,
Pulmonary & Air Embolism
Decompression sickness
Pulmonary edema
Pharmacological and toxic
effects of increased partial
pressures of gases
23. Ear Barotrauma
Most common disorder among
divers (Middle ear involvement).
Unable to equilibrate the pressure
between the nasopharynx and the
middle ear through the eustachian
tube can result in middle ear pain.
Ringing in the ears, dizziness,
hearing loss.
In severe cases, rupture of the ear
drum can occur.
24. Sinus Barotrauma
Second most common disorder
among divers.
During descent, increase in ambient
environmental pressure can lead to
mucosal engorgement, edema and
inflammation producing blockage of
the sinus ostia.
Frontal sinus – most commonly
affected.
Headache, epistaxis.
Pneumocephalus.
25. Air Embolism
Any person using SCUBA equipment
presenting with neurologic deficits
during or immediately after ascent,
should be suspected of air embolism
Form of barotrauma of ascent.
Very serious condition in which air
bubbles enter the circulatory system
through rupture of small pulmonary
vessels.
Air can also be trapped in blebs, air
pockets, within the pulmonary tissue
26. Air Embolism- Pathophysiology
Arterial gas embolism is the most serious potential
sequel of pulmonary barotrauma.
Arterial gas emboli can result from any of three
processes:
1. Passage of gas bubbles into the pulmonary veins
and from there into the systemic circulation
2. Development of venous gas emboli (either from
barotrauma or decompression sickness), which
overwhelm the filtering capacity of the pulmonary
capillaries to appear in the systemic arterial
circulation.
27. 3. Development of venous gas emboli that reach the
arterial circulation "paradoxically" via a functional
right-to-left shunt, such as a patent foramen ovale.
Reach the systemic arterial circulation.
Gas emboli typically break up as they reach vascular
branch points.
Lodge in vessels with diameters ranging from 30 to
60 µm.
They produce distal ischemia and local activation of
inflammatory cascades.
Air Embolism-Pathophysiology
28. Air Embolism-Clinical features
Cardiac-: Dysrhythmias, myocardial
infarction, and/or cardiac arrest (0.5ml
air can cause)
CNS-: focal motor, sensory, or visual
deficits to seizures, loss of
consciousness, apnea, and death.
Skin-: cyanotic marbling of the skin, focal
pallor of the tongue.
Renal-: hematuria, proteinuria, and renal
failure.
Uterine & GI bleeds
29. Air Embolism- Treatment
Immediate administration of 100 percent
oxygen.
Shift to hyperbaric oxygen facility as soon
as possible.
Widen the pressure gradient for nitrogen
between the bubble and the circulation.
Accelerate re-absorption of gas bubbles,
and hydration to decrease vascular
obstruction and augment collateral flow.
Divers Alert Network at (919) 684-9111.
30. Air Embolism-Treatment
1. Assess ABCs.
2. Administer oxygen.
3. Place patient in left lateral
Trendelenburg position/Supine
position
4. Monitor vital signs frequently.
5. Administer IV fluids.
6. Corticosteroid.
7. Lidocaine.
8. combination of prostacyclin,
indomethacin, and heparin h
31. Pneumomediastinum
Alveolar rupture- gas can dissect along the
perivascular sheath into the mediastinum.
Clinical Features:
Substernal chest pain.
Irregular pulse.
Abnormal heart sounds.
Reduced blood pressure/narrowing pulse pressure.
Change in voice.
May or may not be evidence of cyanosis.
Crepitation in the neck
Hamman’s sign
32. Pneumomediastinum - Treatment
Administration of high-concentration oxygen via
non-rebreathing face mask
Treatment generally ranges from observation to
recompression
33. Pneumothorax
Relatively uncommon
Developing in only approximately 10 percent
of episodes of pulmonary barotrauma
Patients with a history of spontaneous
pneumothorax, bullae, or cystic lung disease
are at increased risk.
34. Injuries at the Bottom
• Nitrogen narcosis.
Caused by raised partial pressure of
nitrogen in nervous system tissue.
Usually occurs at depths greater than
100 feet.
Rapture of the deep, the martini effect.
Direct toxic effect of high nitrogen
pressure on nerve conduction.
Variable sensation but always depth-
related.
35. Nitrogen Narcosis
Some divers experience no
narcotic effect at depths up to
40 m. whereas others feel
some effect at around 25 m.
The diver may feel and act
totally drunk.
Takes the regulator out of
their mouth and hands it to a
fish !
36. Pressure Disorders
Decompression Sickness (Bends)
Condition that develops in
divers subjected to rapid
reduction of air pressure after
ascending to the surface
following exposure to
compressed air.
37. Decompression Sickness (Bends)
"caisson disease“
First recognized in 1843 among tunnel
workers following return from the
compressed environment of the
caisson to atmospheric pressure.
Term "the bends" is frequently applied
to this illness.
Laborers with decompression sickness
sometimes walked with a slight stoop.
A posture affected by female socialites
around the time of construction of the
Brooklyn Bridge in the late 19th
century.
38. Diver descends -: breathes air under increased
pressure.
Tissues become loaded with increased quantities
of oxygen and nitrogen as predicted by Henry's
law.
Diver ascends-: the sum of the gas tensions in the
tissue may exceed the ambient pressure.
Leads to the liberation of free gas from the tissues
in the form of bubbles.
Pathophysiology
39. The liberated gas bubbles can alter organ
function by blocking vessels, rupturing or
compressing tissue, or activating clotting and
inflammatory cascades.
The volume and location of these bubbles
determine if symptoms occur or not.
Effects on the body can be direct or indirect.
Pathophysiology
40. Direct Effects
Intravascular: blood flow will be
decreased, leading to ischemia or
infarct.
Extravascular: tissues will be
displaced, which further results in
pressure on neutral tissue
Audiovestibular: air can diffuse into
the audiovestibular system, causing
vertigo
41. Indirect Effects
Surface of air emboli may initiate
platelet aggregation and
intravascular coagulation
Extravascular plasma loss may lead
to edema
Electrolyte imbalances may occur
Lipid emboli are released.
42. General factors relating to development
Cold water dives
Diving in rough water
Overstaying time at given dive depth
Dive at 25 m. or greater
Rapid ascent – panic, inexperience,
unfamiliarity with equipment.
Flying after diving – 24 hour wait is
recommended.
Driving to high altitude.
43. Individual factors relating to development
Age – older individuals.
Obesity.
Fatigue – lack of sleep prior to dive
Alcohol – consumption prior or after dive
History of other medical problems .Rt to lft shunt
COPD, Asthma, prior pneumothorax, thoracic
surgery, IHD, pregnancy, Inguinal hernia,
Panic disorders
45. Type I
Usually referred to as the “bends”.
Musculoskeletal-: Patient experiences pain (joints).
Caused by expansion of gases present in the joint
space. (Elbow & shoulder)
Skin manifestations -: pruritus (itch), localized
erythema.
Lymphatic-: lymphadenopathy and localized edema.
46. Neurologic
60% of divers
Damage to spinal cord.
Paresthesias and weakness
Paraplegia
Loss of bladder control
Memory loss
Ataxia
Visual and speech
disturbances.
Pulmonary
Venous gas embolism (5%)
Gas bubbles – occlude
portions of Pulmonary
circulation.
Chest pain, dyspnea
Right ventricular outflow
obstruction
Circulatory collapse
Type II
Broad spectrum of complaints and could include symptoms of
Type I
49. Treatment
Hydration
Administration of 100 percent oxygen
Positioning the patient in the left lateral decubitus
(Durant's maneuver).
Mild Trendelenburg (bed angled downward toward
head) position in an effort to restore forward blood
flow by placing the right ventricular outflow tract
inferior to the right ventricular cavity, permitting air
to migrate superiorly to a non obstructing position
50. Hyperbaric oxygen therapy – definitive
treatment
In a recompression chamber initiated as
quickly as possible.
Time to initiation of treatment is one of
the main determinants of outcome .
Hyperbaric oxygen therapy decreases
the volume of air bubbles according to
Boyle's law.
Provides oxygenation to hypoxic tissue
by increasing the dissolved oxygen
content of arterial blood.
Treatment
51. Plasma nitrogen concentration
decreases, increasing the gradient
of nitrogen from bubble to plasma,
thus accelerating the absorption of
bubbles.
Hyperbaric therapy should be
undertaken for at least four hours.
Bubble elimination may be poor in
areas of reduced flow where
edema and sludging are present.
HYPERBARIC OXYGEN CHAMBER
53. POTENTIAL COMPLICATIONS
HYPERCAPNIA
ABSORPTIN ATELECTASIS
DRYING & CRUSTING OF SECRETIONS
PULMONARY OXYGEN TOXICITY
-Decreased hypoxemic drive and increased VD in
COPD.
-Mucosal damage due to lack of humidity
RETROLENTAL FIBROPLASIA
CEREBRAL O2 TOXICITY Seizures (hyperbaric)
FIRE (airway fires)
IGNITION HAZARD.
RISK OF RESPIRATORY DEPRESSION IN SOME PATIENTS
WITH COPD IF HIGH CONCENTRATIONS OF OXYGEN
ADMINISTERED (CO2 RETAINERS).
54. Complete resolution of
symptoms in Type II
decompression sickness 75% of
cases
16% - residual symptoms for up
to three months
Adjunctive therapies-: NSAID,
anticoagulants, and
glucocorticoids.
Treatment
55. General Assessment of Diving
Emergencies
• Early assessment and treatment.
• Must develop the diving history or
profile. This includes:
1. Time at which the signs and
symptoms occurred
2. Type of breathing apparatus utilized
3. Type of hypothermia protective
garment worn
56. Diving History
4. Parameters of the dive:
* Depth of dive
* Number of dives
* Duration of dive
5. Aircraft travel following a dive
6. Rate of ascent
7. Associated panic forcing rapid
ascent
8. Experience of the diver
9. Properly functioning depth gauge
57. Diving History
10. Previous medical diseases
11. Old injuries
12. Previous episodes of decompression
illness
13. Use of medication
14. Use of alcohol
• This history will assist in determining if
the diver has incurred a pressure
disorder
58. Conclusion
Recreational SCUBA diving continues to
increase in popularity, and diving-related
injuries have increased proportionally.
Barotrauma is the most common form of
diving-related injury.
Decompression sickness occurs when a
diver returns to the surface and gas
tensions in the tissue exceed the ambient
pressure, leading to the liberation of free
gas from the tissues in the form of
bubbles.
59. The liberated gas bubbles can alter
organ function by blocking blood
vessels, rupturing or compressing
tissue, or activating clotting and
inflammatory cascades.
Treatment of significant
decompression sickness includes
hydration, administration of 100
percent oxygen, positioning the patient
to improve forward blood flow, and
hyperbaric oxygen therapy.
Conclusion