Early management of sepsis with Emergency Department Nurse Gladis Kabil
•Download as PPTX, PDF•
0 likes•91 views
Sepsis in other words ‘life-threatening organ dysfunction’ in response to infection is a leading cause of death worldwide and a global health priority recognised by the World Health Organisation. In Australia, for adults with sepsis admitted to the intensive care unit, the in-hospital mortality is estimated as 18–27%. Early recognition of sepsis, prompt administration of antibiotics and resuscitation with intravenous fluids for those with features of hypoperfusion or shock are the mainstays of initial treatment. Emergency departments often being the first point of contact for patients presenting with sepsis, are required to prioritise sepsis as a medical emergency. The “Sepsis Kills” program implemented across the nation aims to reduce unwarranted clinical practice variation in management of sepsis. In a recent Australian based study conducted across four emergency departments in Western Sydney Local Health District, among 7533 patients with suspected infection, a reduction in risk of in-hospital mortality was observed for each 1000 mL increase in intravenous fluids administered in patients with septic shock or admitted to ICU. However, despite evidence showing mortality benefits, not all aspects of sepsis care have been given the needed attention. In the same setting, out of 4146 patients with sepsis, 45% of them did not receive intravenous fluids in the emergency departments within the first 24 hours. Younger patients with greater severity of illness and presented to smaller hospitals were more likely to receive fluids. The unanswered questions regarding the facilitators and barriers influencing intravenous fluid administration in sepsis are being explored using qualitative methods. Several emergency physicians and nurses have provided insight into aspects that influence their ability to provide appropriate fluid resuscitation such as constantly overcrowded emergency departments with chronic staff shortages of skilled health professional, failure to recognise sepsis early, the complexity of the presentations and lack of resources. Awareness of these challenges among stakeholders is the need of the hour. Leaving no one behind and not disregarding the critical aspects of sepsis care are crucial. Recognition of these factors and sustainable interventions are necessary to improve clinical outcomes for patients. For more head to our podcast page #CodaPodcast
Report
Share
Report
Share
Recommended
HAI: Central Line–Associated Bloodstream Infections
This document discusses central line-associated bloodstream infections (CLABSIs). It defines central lines and CLABSIs. It describes the pathogenesis of CLABSIs, including potential routes of infection. It identifies risk factors for CLABSIs and techniques to prevent them, such as using bundled approaches during insertion and maximizing barrier precautions. It also discusses catheter site selection, dressing changes, hub cleaning, and antimicrobial locks and coatings to prevent infection. The goal of CLABSI prevention is to reduce patient morbidity, mortality, costs, and healthcare-associated infections.
Prehospital Sepsis Research Update 2024 Rom Duckworth
Recently published papers have given us new insights into the next steps for prehospital care for sepsis patients. By looking at both macro and micro views of patient management this program presents our new understanding of the role of antibiotics, fluid administration, and coordination of clinical care as well as future tools, including advanced biomarkers and the application of antimicrobial nanotechnology. Arm yourself with indispensable knowledge to elevate your prehospital practice and make a real difference in patient outcomes.
Rommie L. Duckworth is a dedicated emergency responder, author, and educator from the United States with more than thirty years of experience working in fire departments, hospital healthcare systems, and private emergency medical services. Rom is a career fire captain and paramedic EMS Coordinator for Ridgefield (CT) Fire Department and director of the New England Center for Rescue and Emergency Medicine. Rom holds a master’s degree in public administration, is a graduate of the US National Fire Academy’s Executive Fire Officer program, and is the recipient of the NAEMT Presidential Award, American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award for Sepsis Education. Rom is the author of "Duckworth on Education," as well as chapters in more than a dozen EMS, fire, rescue, and medical textbooks and over 100 published articles in fire and EMS magazines. A member of the NAEMT Board of Directors and the Sepsis Alliance Advisory Board Rom continues to work for the advancement of emergency services.
www.RomDuck.com
Risk factors for adverse coutcomes
This study analyzed data from over 30,000 patients with heart failure (HF) to identify predictors of adverse outcomes based on left ventricular ejection fraction (LVEF). Patients were categorized as having preserved LVEF (≥50%), borderline LVEF (41-49%), or reduced LVEF (≤40%). Over a median follow up of 1.8 years, 26.8% of patients died, 26.9% were hospitalized for HF, and 67.4% were hospitalized for any reason. Multivariable models found that nearly all tested predictors, such as demographics, medical history, and comorbidities, performed similarly for predicting death and hospitalization across the different LVEF
Kaposi Sarcoma in Immune Reconstitution Inflammatory Syndrome
Slides from a Microsoft PowerPoint presentation delivered by Jackson David Reynolds on March 30, 2017 for the Immunology (BIOL 4100) course of Dr. Chuck Fink, PhD at Dalton State College in Dalton, GA, USA.
SEPSIS Y SHOCK SEPTICO
The document presents new consensus definitions for sepsis and septic shock developed by an international task force. Key changes include:
- Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, rather than being triggered by systemic inflammation.
- Septic shock is a subset of sepsis with profound circulatory and metabolic abnormalities at higher risk of mortality than sepsis alone. It can be identified by vasopressor need and hyperlactatemia in the absence of hypovolemia.
- A quickSOFA score of 2 or more is recommended to help identify patients with suspected infection at greater risk of poor outcomes in out-of-hospital and emergency department settings.
3 discussion Board replies.docx
Sickle cell disease originated as an adaptation to provide resistance against malaria. Individuals with sickle cell trait have modified red blood cells that limit the growth and spread of the malaria parasite. While protective against malaria, sickle cell disease causes anemia and other health issues. Treatment focuses on managing pain and complications through medications, fluids, oxygen, and blood transfusions. Education is important for patients and families to understand the condition and treatment plan. Sickle cell disease remains prevalent in areas where malaria is or was historically common.
Sepsis 2016
The document summarizes the process undertaken by an international task force to update the definitions of sepsis and septic shock. The task force concluded that previous definitions had limitations and needed reexamination based on advances in understanding the pathobiology of sepsis. The task force developed new definitions of sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock was defined as a subset of sepsis with profound circulatory and metabolic abnormalities associated with high mortality. The task force also established new clinical criteria for identifying sepsis and septic shock in patients aimed at facilitating earlier recognition and management.
Hemodialysis catheter related infection
The document discusses hemodialysis catheter-related infections. It notes that catheter infections are a major cause of morbidity and mortality for hemodialysis patients. It provides statistics on catheter use and infection rates. It then describes different types of catheter infections including exit site infections, tunnel infections, and bloodstream infections. Signs and symptoms of infections are outlined. The document proposes a strict infection control protocol for nurses to follow during catheter care and dialysis to help reduce infection rates. This includes recommendations for site cleaning, dressing changes, tubing changes, and staff education.
Recommended
HAI: Central Line–Associated Bloodstream Infections
This document discusses central line-associated bloodstream infections (CLABSIs). It defines central lines and CLABSIs. It describes the pathogenesis of CLABSIs, including potential routes of infection. It identifies risk factors for CLABSIs and techniques to prevent them, such as using bundled approaches during insertion and maximizing barrier precautions. It also discusses catheter site selection, dressing changes, hub cleaning, and antimicrobial locks and coatings to prevent infection. The goal of CLABSI prevention is to reduce patient morbidity, mortality, costs, and healthcare-associated infections.
Prehospital Sepsis Research Update 2024 Rom Duckworth
Recently published papers have given us new insights into the next steps for prehospital care for sepsis patients. By looking at both macro and micro views of patient management this program presents our new understanding of the role of antibiotics, fluid administration, and coordination of clinical care as well as future tools, including advanced biomarkers and the application of antimicrobial nanotechnology. Arm yourself with indispensable knowledge to elevate your prehospital practice and make a real difference in patient outcomes.
Rommie L. Duckworth is a dedicated emergency responder, author, and educator from the United States with more than thirty years of experience working in fire departments, hospital healthcare systems, and private emergency medical services. Rom is a career fire captain and paramedic EMS Coordinator for Ridgefield (CT) Fire Department and director of the New England Center for Rescue and Emergency Medicine. Rom holds a master’s degree in public administration, is a graduate of the US National Fire Academy’s Executive Fire Officer program, and is the recipient of the NAEMT Presidential Award, American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award for Sepsis Education. Rom is the author of "Duckworth on Education," as well as chapters in more than a dozen EMS, fire, rescue, and medical textbooks and over 100 published articles in fire and EMS magazines. A member of the NAEMT Board of Directors and the Sepsis Alliance Advisory Board Rom continues to work for the advancement of emergency services.
www.RomDuck.com
Risk factors for adverse coutcomes
This study analyzed data from over 30,000 patients with heart failure (HF) to identify predictors of adverse outcomes based on left ventricular ejection fraction (LVEF). Patients were categorized as having preserved LVEF (≥50%), borderline LVEF (41-49%), or reduced LVEF (≤40%). Over a median follow up of 1.8 years, 26.8% of patients died, 26.9% were hospitalized for HF, and 67.4% were hospitalized for any reason. Multivariable models found that nearly all tested predictors, such as demographics, medical history, and comorbidities, performed similarly for predicting death and hospitalization across the different LVEF
Kaposi Sarcoma in Immune Reconstitution Inflammatory Syndrome
Slides from a Microsoft PowerPoint presentation delivered by Jackson David Reynolds on March 30, 2017 for the Immunology (BIOL 4100) course of Dr. Chuck Fink, PhD at Dalton State College in Dalton, GA, USA.
SEPSIS Y SHOCK SEPTICO
The document presents new consensus definitions for sepsis and septic shock developed by an international task force. Key changes include:
- Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, rather than being triggered by systemic inflammation.
- Septic shock is a subset of sepsis with profound circulatory and metabolic abnormalities at higher risk of mortality than sepsis alone. It can be identified by vasopressor need and hyperlactatemia in the absence of hypovolemia.
- A quickSOFA score of 2 or more is recommended to help identify patients with suspected infection at greater risk of poor outcomes in out-of-hospital and emergency department settings.
3 discussion Board replies.docx
Sickle cell disease originated as an adaptation to provide resistance against malaria. Individuals with sickle cell trait have modified red blood cells that limit the growth and spread of the malaria parasite. While protective against malaria, sickle cell disease causes anemia and other health issues. Treatment focuses on managing pain and complications through medications, fluids, oxygen, and blood transfusions. Education is important for patients and families to understand the condition and treatment plan. Sickle cell disease remains prevalent in areas where malaria is or was historically common.
Sepsis 2016
The document summarizes the process undertaken by an international task force to update the definitions of sepsis and septic shock. The task force concluded that previous definitions had limitations and needed reexamination based on advances in understanding the pathobiology of sepsis. The task force developed new definitions of sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock was defined as a subset of sepsis with profound circulatory and metabolic abnormalities associated with high mortality. The task force also established new clinical criteria for identifying sepsis and septic shock in patients aimed at facilitating earlier recognition and management.
Hemodialysis catheter related infection
The document discusses hemodialysis catheter-related infections. It notes that catheter infections are a major cause of morbidity and mortality for hemodialysis patients. It provides statistics on catheter use and infection rates. It then describes different types of catheter infections including exit site infections, tunnel infections, and bloodstream infections. Signs and symptoms of infections are outlined. The document proposes a strict infection control protocol for nurses to follow during catheter care and dialysis to help reduce infection rates. This includes recommendations for site cleaning, dressing changes, tubing changes, and staff education.
Central Bloodstream Infections.docx
This literature review compares two studies on the use of chlorhexidine gluconate (CHG) baths to reduce central line-associated bloodstream infections (CLABSIs) in critically ill patients. Both studies were systematic reviews and meta-analyses that found CHG baths reduced the risk of CLABSIs and other healthcare-associated infections. The first study found a 56% reduction in CLABSIs while the second found a 0.67 reduction. While the studies used different primary outcomes, they both ultimately recommended the routine use of CHG baths to decrease CLABSIs in adult ICU patients.
Running head LITERATURE REVIEW 1LITERATURE REVIEW 2Daily Chlo.docx
Running head: LITERATURE REVIEW 1
LITERATURE REVIEW 2Daily Chlorhexidine(CHG) Bath in Oncology Patients to Prevent Hospital Acquired Infections(HAIs)
Introduction Comment by Stacey Minor: This should be after the title from title age and should be bold
Daily Chlorhexidine(CHG) Bath in Oncology Patients to Prevent Hospital Acquired Infections (HAIs)
Health-care-associated infections (HAIs) are infection patients catch while hospitalized, are getting a mounting sum of attention. Substantial skin microbial occupation aids in the spread and growth of HAIs (Denny & Munro, 2017). According to Donskey and Deshpande, (2016), “Patients colonized or infected with health care-associated pathogens often carry the organisms on their skin. Such contamination may lead to infection when factors such as devices, catheters, and wounds provide a route for pathogens on skin to reach normally sterile sites”. For instance, Pagan, (2016) stated that approximately 250,000 CLABSIs manifest in patients with central lines every year. Expenses for treatment of CLABSI is between sixteen thousand ($16,000) to twenty-nine ($29,000) for each infection, the effect is prolonged hospitalization, and an increased percentage of death, up to 35%. Additionally, Waknine, ( 2013) also stated that notwithstanding prevalent application of evidence based practice , up to $9.8 billion is disbursed yearly for management of HAIs, hence infection from wound post operatively is the most expensive to treat..]Comment by Stacey Minor: Should have and between
Nevertheless, skin infection can correspondingly be a contributory factor to the spread of pathogens because of environmental peeling and transference to the hands of employees. Consequently, there is a solid validation for efforts to diminish the problem of microorganism on skin (Donskey & Deshpande, 2016, P 17). Therefore, the aim for this work is to evaluate previously written literatures supportive of the writer’s PICOT statement “In Adult Oncology patients, does daily bathing using chlorhexidine gluconate compared to use of soap and water affect the incidence of HAIs (CLABSI) throughout period of hospitalization”. This work will also categorically identify evidences in the peer reviewed literatures. Additionally, the outline, comparing of research questions, sample populations, limitations of the study, conclusion and recommendation will be part of this work.
Comparing of Research Questions
In every research answering the stated research problem is the most important aspect of the study. In the literatures reviewed, the writer noted that most of the stated problems are unique in their respective ways, but all established the need for eradicating/ preventing HAIs using daily CHG bath. Climo, Yokoe, and Warren, (2013) in their study questioned effectiveness of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections, the researchers us.
Jsc160002
The task force updated the definitions of sepsis and septic shock based on advances in understanding the pathobiology of sepsis. Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified clinically as a SOFA score of 2 points or higher. Septic shock is defined as a subset of sepsis with profound circulatory and metabolic abnormalities requiring vasopressors to maintain blood pressure and with lactate above 2 mmol/L. The task force also proposed new clinical criteria called qSOFA to help identify patients with suspected infection who are likely to have poor outcomes typical of sepsis.
The third international consensus definitions for sepsis and septic shock (se...
The third international consensus definitions for sepsis and septic shock (se...Daniela Botero Echeverri
The document summarizes the process undertaken by an international task force to update the definitions of sepsis and septic shock based on advances in understanding of the pathobiology of sepsis since the prior definitions from 2001. The task force developed new definitions of sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection, and of septic shock as a subset of sepsis with profound circulatory and metabolic abnormalities. Clinical criteria including changes in SOFA scores and vasopressor requirements were recommended to operationalize the new definitions in practice.Bacteremia Article.pdf
This study compared characteristics, outcomes, and cytokine responses in solid organ transplant recipients and non-transplant patients with bacteremia. Transplant patients with gram-negative bacteremia had a lower rate of septic shock but similar 30-day mortality compared to non-transplant patients. Five cytokines were significantly lower in transplant patients, while one cytokine was higher in transplant patients with Staphylococcus aureus bacteremia. The study aims to better understand how immunosuppression impacts the immune response and outcomes of bacteremia in transplant recipients.
The Third International Consensus Definitions for Sepsis and Septic Shock (Se...
The task force updated the definitions of sepsis and septic shock based on advances in understanding the pathobiology of sepsis. Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified clinically as a Sequential Organ Failure Assessment (SOFA) score of 2 points or greater. Septic shock is defined as a subset of sepsis with profound circulatory and metabolic abnormalities associated with higher mortality than sepsis alone, and can be identified by vasopressor need and hyperlactatemia in the absence of hypovolemia. The task force also proposed new clinical criteria called quickSOFA to help rapidly identify patients with suspected infection who are at higher risk of poor outcomes
It's Not Always Sepsis
Sepsis is an emergent medical condition that kills more people annually than prostate cancer, breast cancer, and AIDS combined. For every two heart attack patients cared for by EMS, five patients are hospitalized by sepsis. EMS transports 60% of patients with severe sepsis arriving at the ED and yet EMS providers are often unaware of its presence or what they should do if they find it. This presentation discusses new sepsis criteria along with expert commentary as to how they can be applied in the field. This program includes real-world, practical methods for EMS identification, assessment and field treatment of life-threatening sepsis and looks at the current state of sepsis critical care as well as what we can anticipate in the coming months and years.
Nueva definicion de Sepsis 2016
The document presents new consensus definitions for sepsis and septic shock developed by an international task force. It summarizes limitations of previous definitions, which focused excessively on inflammation and lacked specificity. The task force developed updated definitions and clinical criteria through meetings, literature reviews, and consultation with international societies. The new definition of sepsis is "life-threatening organ dysfunction caused by a dysregulated host response to infection." Septic shock is defined as a subset of sepsis involving profound circulatory and metabolic abnormalities associated with higher mortality. Clinical criteria including changes in SOFA scores and vital signs were also developed to facilitate earlier recognition of at-risk patients. The task force aims to provide more consistency for research and management of sepsis.
Estimate of the Patients Commitment Concerning Medical Follow-Up with Angina ...
Angina pectoris above referred to as coronary course malady, is caused by the buildup of whittle core the arteries saunter source oxygen-rich blood for the heart. Break in, a mid of broad, cholesterol, and calcium deposits, rear entertain in the arteries over a long time. They are the standard causes of dying in both ripe and evolvement countries, relation for far one third of circa deaths worldwide. All grow pre-eminent groups may die stranger a heart attack. But older kith and kin are in all directions liable to die than younger people.
Elucidative investigate is bump off outside in Al-Sadr Medical City, from January, 7th to May, 6th 2018, in act to review patients' appeal everywhere curative backup adjacent to angina pectoris in Al- Najaf Borough, and to get it out the association between the demographic evidence , clinical information, dance and mercantile statuses, and the patients' pertinence thither Remedial follow-up. A Non-Probability (Purposive Sample) of (50) respecting regard to patients’ angina pectoris, those who visited Al-Sadr therapeutic Megalopolis, the data were composed skim flip the perseverance of the developed questionnaire after the soldiers are estimated, and by means of interview technique. The validity of the questionnaire is propensity look over (9) experts. The data analyzed through the relation of the expository and inferred statistical analysis procedures.
The alertness of the real anatomize specific depart the diversified imputation for the patient’s attention concerning medicinal follow-up with angina pectoris is moderate.
The assay accomplish focus everywhere is a conspicuous reach of the patient's centered of the woe and medicine, and the social and economic low-down, on the patients' commitment to iatrical follow-up with angina pectoris.
The Critique pertinent that benefit Sine qua non be working (e.g., domicile visits, visits outpatient’s of the medical center) may suspended patients to cope with their medical follow-up program. Forced to be the recommendations have in the offing help in the pedagogical resolve wont for patients hence as to improve their commitment. In helper healthiness, oriented pile media betterment should be employed to mass folk familiarity and knowledge of angina pectoris and the importance of the patient’s commitment to medical follow-up. Beyond hegemony of jugs policies which deliver with the monitoring and information the turn the heat on united with the patients' commitment to medical follow-up.
Searching for phenotypes of sepsis an application of machine learning to elec...
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
1Central Venous Catheter UsageCentral Venous Catheter .docx
1
Central Venous Catheter Usage
Central Venous Catheter Usage
Synethia Harris
Walden University
NURS 5051A
Dr. Debbie Beck
December 25, 2017
Informatics has been identified as one of the core competencies for nurses at all levels of practice. Nurses and computer documentation of patients with chronic kidney disease can significantly improve the quality of patient care and treatment. Healthy kidneys regulate the body’s levels of water and mineral and removes waste. I would find the most relevant information through searching the database on issues topicing or having a relationship with dialysis access. I would use search for words such as “dialysis access”, “problems with central venous catheters”, and “femoral venous access”. I would also trace illustrations in books and journals that touch on central venous catheters highlighting femoral access. The kidneys also secrete certain products that are important in metabolism. People with failed or damaged kidneys may have difficulty eliminating waste and unwanted water from the blood. (Fresenius, 2006). The cause might be a chronic, or long-term condition, or an acute problem, such as an injury or a short-term illness that affects the kidneys. Dialysis is an artificial way of carrying out this process. Dialysis substitutes the natural work of the kidneys. It is also known as renal replacement therapy (RRT).
Hemodialysis requires access to blood vessels capable of providing rapid extracorporeal blood flow. Immediate hemodialysis access should be straightforward, available for immediate use, and have minimal complications. That is where tunneled central venous catheters (CVCs) come in to play. I am aware of central venous catheters being used as a quicker method of access. During my research, said that femoral sites are associated with high risks of catheter-related bloodstream infections (CRBIs). During hemodialysis, the access site is the patient’s lifeline (Fresenius, 2006). So why is the femoral vein a considered site for surgeons?
The use of invasive monitoring technologies and aggressive hemodynamic resuscitation protocols has increased. Therefore, the ability to gain rapid and accurate vascular access has become a skill that is imperative for critical and emergency care physicians to possess. The predictable anatomic locations of the dialysis central venous catheter are the internal jugular, subclavian, and femoral vein. In the last ten years, tunneled central venous catheters (CVCs) have been increasingly utilized in chronic hemodialysis patients, sometimes in the place of fistulas. They have gained popularity for their unquestioned advantages, such as the possibility for immediate use. However, several problems have emerged following their diffusion. Infections, thrombosis and dysfunctions are the most important catheter-related complications. Infections may occur with and without symptoms of systemic illness. Early diagnosis and appropriate antibiotic tre ...
Respond on two different days who selected different alterations and
Respond on two different days who selected different alterations and factors than you, in one or more of the following ways:
Share insights on how the factor you selected impacts the cardiovascular alteration your colleague selected.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Main Post
The purpose of this paper is to explore coronary artery disease (CAD), the roles of hypertension and dyslipidemia affect CAD, and exploring if genetics is a factor in CAD. The progression of CAD can lead to myocardial ischemia, infarction, and even death if left untreated. Heart disease remains the number one cause of death in the United States, and understanding these factors plays a continued role in developing strategies, both preventive and treatment efforts.
Coronary Artery Disease
CAD is normally the result of atherosclerosis, the build-up of plaque due to damaged endothelium that allows fat to accumulate and decrease the diameter of the vessel. The decrease in vessel size allows for blockage and decreased blood flow to the coronary vessel; this leads to ischemia, where the cells are deprived of blood and begin the process of dying if left untreated. Persistent ischemia or the complete occlusion of a coronary artery causes the acute coronary syndromes, including infarction, or irreversible myocardial damage (Huether & McCance, 2017). Also, known as a heart attack or myocardial infarction (MI). Fortunately, the incidence and mortality statistics for CAD have been decreasing over the past 15 years because of more aggressive recognition, prevention, and treatment (Huether & McCance, 2017).
Hypertension’s Role in Coronary Artery Disease
Hypertension is a consistent elevation of systemic arterial blood pressure (Huether & McCance, 2017). Fortunately, hypertension a key factor in CAD is modifiable and can be monitored closely to prevent further disease progression. Hypertension is common; it ranks as the number one primary diagnosis in America. Pathophysiological mechanisms of blood pressure as a risk factor for CAD are complex and include the influence of blood pressure as a physical force on the development of the atherosclerotic plaque, and the relationship between pulsatile hemodynamics/arterial stiffness and coronary perfusion (Weber et al., 2016). The presence of hypertension further increases the risk of CAD and may explain why some individuals are more predisposed than others to developing coronary events (Rosendorff et al., 2015). Pathophysiological mechanisms of blood pressure as a risk factor for CAD are complex and include the influence of blood pressure as a physical force on the development of the atherosclerotic plaque, and the relationship between pulsatile hemodynamics/arterial stiffness and coronary perfus ...
Vit D Mrip chart-booklet-08-2018
This document provides information from GrassrootsHealth on vitamin D research and dosing recommendations. It includes the following:
- A summary of studies showing reductions in disease incidence as vitamin D levels increase from 25 to over 60 ng/ml. Many diseases such as cancer, diabetes and heart disease showed reductions of over 30% at levels of 40 ng/ml or higher.
- Charts showing the wide range of serum vitamin D levels achieved at different daily supplemental intake amounts, based on data from over 7,000 participants. Intakes of 4000 IU/day resulted in levels from 20-120 ng/ml, demonstrating individual variability.
- Recommendations that total daily vitamin D intake of around 12,000 IU
Hemodialysis catheter related infection 5
This document discusses hemodialysis catheter-related infections. It provides statistics on catheter use and infection rates. It describes different types of catheter infections including exit site infections, tunnel infections, and bloodstream infections. Signs and symptoms of infection and methods for diagnosis are outlined. The document proposes a strict infection control protocol for catheters and discusses efforts at one facility to reduce infection rates through improved catheter care and adherence to infection guidelines.
Vitamin C: fact or fiction?
In this podcast, Ken Sakurai provides an update on the recent randomised control trials (RCT) for Vitamin C in Sepsis.
Managing CV risk in Inflammatory Arthritis (Focusing on Gout)
Presentation made during the 1st Inter-Hospital Rheumatology Fellows' Case Discussion on 9 June 2018 at the Speaker Feliciano Belmonte Auditorium, 7/F East Avenue Medical Center. Presentation highlights the needs to recognize gout as one of the rheumatic conditions that put patients at risk for developing CV disease.
11 surgical bleeding and transfusions
The document summarizes the risks associated with surgical bleeding and blood transfusions. It discusses how bleeding can lead to hypovolemia and anemia, and the compensatory mechanisms the body employs. It then outlines the risks of transfusions, including transfusion reactions, infections transmitted through blood-borne pathogens, transfusion-related immune modulation that can increase infection risk and mortality, and the storage effects on red blood cells that are associated with increased morbidity and mortality. It notes that leukoreduction of blood products reduces some of these transfusion risks.
Vit D Chart booklet may2016
This document provides information from the GrassrootsHealth organization regarding vitamin D research and recommendations. It includes the following:
- A summary of several studies showing reductions in disease incidence as vitamin D serum levels increase from 25 ng/ml to higher levels such as 40-60 ng/ml. Diseases such as cancer, diabetes, fractures, and multiple sclerosis showed reductions.
- Charts analyzing data from over 7,000 participants in the GrassrootsHealth D*action project, showing a wide range of serum levels for any given supplemental vitamin D intake amount. Intakes of 4,000 IU/day resulted in serum levels from 10-150 ng/ml.
- Analysis suggesting supplemental intakes of 9,
management of LV thrombus
This review article summarizes the current literature on left ventricular thrombus (LVT) prevalence, risk factors, diagnosis, and treatment. The key points are:
1) The reported prevalence of LVT following ST-elevation myocardial infarction (STEMI) has decreased from historical rates of 20-40% to current rates of around 2-5% due to improved reperfusion techniques.
2) Predictors of LVT include anterior STEMI (especially involving the left ventricular apex), reduced ejection fraction, severe diastolic dysfunction, and large infarct size.
3) Cardiac magnetic resonance imaging has the highest diagnostic accuracy for detecting LVT, followed by echocardiography when used with contrast agents
Schallhorn Thesis
This document summarizes a thesis analyzing the association between periodontal disease, levels of inflammatory mediators (IL-18 and CXCL16), and coronary artery disease in patients undergoing cardiac catheterization. A clinical periodontal exam and blood tests were performed on 51 patients to determine relationships. Statistical analysis found significant associations between the extent of clinical attachment loss and serum levels of IL-18 and CXCL16. Clinical attachment loss was also significantly associated with the presence of coronary artery disease. These results suggest elevated inflammatory mediators from periodontal disease may indirectly increase the risk of atherosclerosis and coronary artery disease.
0830 CODA-McGain.pptx
This document discusses the environmental impacts of reusable versus single-use medical equipment from a life cycle assessment perspective. It notes that reusable anaesthetic equipment can save a hospital around $100,000 per year compared to single-use equipment. While reusable equipment reduces waste, most medical plastics are still made from fossil fuels like propylene gas. The document advocates transitioning to renewable electricity to power hospitals and manufacturing medical plastics, which could further reduce the carbon footprint of reusable equipment.
0815 Roslyn CODA 22 landscape.pptx
Roslyn Morgan from the Australian Nursing and Midwifery Federation (Vic Branch) spoke on September 12th about decarbonisation in clinical settings. She acknowledged the traditional custodians of the lands and paid respects to Elders past, present, and emerging. Her presentation focused on reviewing processes to reduce waste and encourage reuse in clinical settings in order to lower carbon emissions by millions of tonnes per year through small changes. She provided tools and resources from the ANMF to aid in these efforts.
More Related Content
Similar to Early management of sepsis with Emergency Department Nurse Gladis Kabil
Central Bloodstream Infections.docx
This literature review compares two studies on the use of chlorhexidine gluconate (CHG) baths to reduce central line-associated bloodstream infections (CLABSIs) in critically ill patients. Both studies were systematic reviews and meta-analyses that found CHG baths reduced the risk of CLABSIs and other healthcare-associated infections. The first study found a 56% reduction in CLABSIs while the second found a 0.67 reduction. While the studies used different primary outcomes, they both ultimately recommended the routine use of CHG baths to decrease CLABSIs in adult ICU patients.
Running head LITERATURE REVIEW 1LITERATURE REVIEW 2Daily Chlo.docx
Running head: LITERATURE REVIEW 1
LITERATURE REVIEW 2Daily Chlorhexidine(CHG) Bath in Oncology Patients to Prevent Hospital Acquired Infections(HAIs)
Introduction Comment by Stacey Minor: This should be after the title from title age and should be bold
Daily Chlorhexidine(CHG) Bath in Oncology Patients to Prevent Hospital Acquired Infections (HAIs)
Health-care-associated infections (HAIs) are infection patients catch while hospitalized, are getting a mounting sum of attention. Substantial skin microbial occupation aids in the spread and growth of HAIs (Denny & Munro, 2017). According to Donskey and Deshpande, (2016), “Patients colonized or infected with health care-associated pathogens often carry the organisms on their skin. Such contamination may lead to infection when factors such as devices, catheters, and wounds provide a route for pathogens on skin to reach normally sterile sites”. For instance, Pagan, (2016) stated that approximately 250,000 CLABSIs manifest in patients with central lines every year. Expenses for treatment of CLABSI is between sixteen thousand ($16,000) to twenty-nine ($29,000) for each infection, the effect is prolonged hospitalization, and an increased percentage of death, up to 35%. Additionally, Waknine, ( 2013) also stated that notwithstanding prevalent application of evidence based practice , up to $9.8 billion is disbursed yearly for management of HAIs, hence infection from wound post operatively is the most expensive to treat..]Comment by Stacey Minor: Should have and between
Nevertheless, skin infection can correspondingly be a contributory factor to the spread of pathogens because of environmental peeling and transference to the hands of employees. Consequently, there is a solid validation for efforts to diminish the problem of microorganism on skin (Donskey & Deshpande, 2016, P 17). Therefore, the aim for this work is to evaluate previously written literatures supportive of the writer’s PICOT statement “In Adult Oncology patients, does daily bathing using chlorhexidine gluconate compared to use of soap and water affect the incidence of HAIs (CLABSI) throughout period of hospitalization”. This work will also categorically identify evidences in the peer reviewed literatures. Additionally, the outline, comparing of research questions, sample populations, limitations of the study, conclusion and recommendation will be part of this work.
Comparing of Research Questions
In every research answering the stated research problem is the most important aspect of the study. In the literatures reviewed, the writer noted that most of the stated problems are unique in their respective ways, but all established the need for eradicating/ preventing HAIs using daily CHG bath. Climo, Yokoe, and Warren, (2013) in their study questioned effectiveness of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections, the researchers us.
Jsc160002
The task force updated the definitions of sepsis and septic shock based on advances in understanding the pathobiology of sepsis. Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified clinically as a SOFA score of 2 points or higher. Septic shock is defined as a subset of sepsis with profound circulatory and metabolic abnormalities requiring vasopressors to maintain blood pressure and with lactate above 2 mmol/L. The task force also proposed new clinical criteria called qSOFA to help identify patients with suspected infection who are likely to have poor outcomes typical of sepsis.
The third international consensus definitions for sepsis and septic shock (se...
The third international consensus definitions for sepsis and septic shock (se...Daniela Botero Echeverri
The document summarizes the process undertaken by an international task force to update the definitions of sepsis and septic shock based on advances in understanding of the pathobiology of sepsis since the prior definitions from 2001. The task force developed new definitions of sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection, and of septic shock as a subset of sepsis with profound circulatory and metabolic abnormalities. Clinical criteria including changes in SOFA scores and vasopressor requirements were recommended to operationalize the new definitions in practice.Bacteremia Article.pdf
This study compared characteristics, outcomes, and cytokine responses in solid organ transplant recipients and non-transplant patients with bacteremia. Transplant patients with gram-negative bacteremia had a lower rate of septic shock but similar 30-day mortality compared to non-transplant patients. Five cytokines were significantly lower in transplant patients, while one cytokine was higher in transplant patients with Staphylococcus aureus bacteremia. The study aims to better understand how immunosuppression impacts the immune response and outcomes of bacteremia in transplant recipients.
The Third International Consensus Definitions for Sepsis and Septic Shock (Se...
The task force updated the definitions of sepsis and septic shock based on advances in understanding the pathobiology of sepsis. Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified clinically as a Sequential Organ Failure Assessment (SOFA) score of 2 points or greater. Septic shock is defined as a subset of sepsis with profound circulatory and metabolic abnormalities associated with higher mortality than sepsis alone, and can be identified by vasopressor need and hyperlactatemia in the absence of hypovolemia. The task force also proposed new clinical criteria called quickSOFA to help rapidly identify patients with suspected infection who are at higher risk of poor outcomes
It's Not Always Sepsis
Sepsis is an emergent medical condition that kills more people annually than prostate cancer, breast cancer, and AIDS combined. For every two heart attack patients cared for by EMS, five patients are hospitalized by sepsis. EMS transports 60% of patients with severe sepsis arriving at the ED and yet EMS providers are often unaware of its presence or what they should do if they find it. This presentation discusses new sepsis criteria along with expert commentary as to how they can be applied in the field. This program includes real-world, practical methods for EMS identification, assessment and field treatment of life-threatening sepsis and looks at the current state of sepsis critical care as well as what we can anticipate in the coming months and years.
Nueva definicion de Sepsis 2016
The document presents new consensus definitions for sepsis and septic shock developed by an international task force. It summarizes limitations of previous definitions, which focused excessively on inflammation and lacked specificity. The task force developed updated definitions and clinical criteria through meetings, literature reviews, and consultation with international societies. The new definition of sepsis is "life-threatening organ dysfunction caused by a dysregulated host response to infection." Septic shock is defined as a subset of sepsis involving profound circulatory and metabolic abnormalities associated with higher mortality. Clinical criteria including changes in SOFA scores and vital signs were also developed to facilitate earlier recognition of at-risk patients. The task force aims to provide more consistency for research and management of sepsis.
Estimate of the Patients Commitment Concerning Medical Follow-Up with Angina ...
Angina pectoris above referred to as coronary course malady, is caused by the buildup of whittle core the arteries saunter source oxygen-rich blood for the heart. Break in, a mid of broad, cholesterol, and calcium deposits, rear entertain in the arteries over a long time. They are the standard causes of dying in both ripe and evolvement countries, relation for far one third of circa deaths worldwide. All grow pre-eminent groups may die stranger a heart attack. But older kith and kin are in all directions liable to die than younger people.
Elucidative investigate is bump off outside in Al-Sadr Medical City, from January, 7th to May, 6th 2018, in act to review patients' appeal everywhere curative backup adjacent to angina pectoris in Al- Najaf Borough, and to get it out the association between the demographic evidence , clinical information, dance and mercantile statuses, and the patients' pertinence thither Remedial follow-up. A Non-Probability (Purposive Sample) of (50) respecting regard to patients’ angina pectoris, those who visited Al-Sadr therapeutic Megalopolis, the data were composed skim flip the perseverance of the developed questionnaire after the soldiers are estimated, and by means of interview technique. The validity of the questionnaire is propensity look over (9) experts. The data analyzed through the relation of the expository and inferred statistical analysis procedures.
The alertness of the real anatomize specific depart the diversified imputation for the patient’s attention concerning medicinal follow-up with angina pectoris is moderate.
The assay accomplish focus everywhere is a conspicuous reach of the patient's centered of the woe and medicine, and the social and economic low-down, on the patients' commitment to iatrical follow-up with angina pectoris.
The Critique pertinent that benefit Sine qua non be working (e.g., domicile visits, visits outpatient’s of the medical center) may suspended patients to cope with their medical follow-up program. Forced to be the recommendations have in the offing help in the pedagogical resolve wont for patients hence as to improve their commitment. In helper healthiness, oriented pile media betterment should be employed to mass folk familiarity and knowledge of angina pectoris and the importance of the patient’s commitment to medical follow-up. Beyond hegemony of jugs policies which deliver with the monitoring and information the turn the heat on united with the patients' commitment to medical follow-up.
Searching for phenotypes of sepsis an application of machine learning to elec...
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
1Central Venous Catheter UsageCentral Venous Catheter .docx
1
Central Venous Catheter Usage
Central Venous Catheter Usage
Synethia Harris
Walden University
NURS 5051A
Dr. Debbie Beck
December 25, 2017
Informatics has been identified as one of the core competencies for nurses at all levels of practice. Nurses and computer documentation of patients with chronic kidney disease can significantly improve the quality of patient care and treatment. Healthy kidneys regulate the body’s levels of water and mineral and removes waste. I would find the most relevant information through searching the database on issues topicing or having a relationship with dialysis access. I would use search for words such as “dialysis access”, “problems with central venous catheters”, and “femoral venous access”. I would also trace illustrations in books and journals that touch on central venous catheters highlighting femoral access. The kidneys also secrete certain products that are important in metabolism. People with failed or damaged kidneys may have difficulty eliminating waste and unwanted water from the blood. (Fresenius, 2006). The cause might be a chronic, or long-term condition, or an acute problem, such as an injury or a short-term illness that affects the kidneys. Dialysis is an artificial way of carrying out this process. Dialysis substitutes the natural work of the kidneys. It is also known as renal replacement therapy (RRT).
Hemodialysis requires access to blood vessels capable of providing rapid extracorporeal blood flow. Immediate hemodialysis access should be straightforward, available for immediate use, and have minimal complications. That is where tunneled central venous catheters (CVCs) come in to play. I am aware of central venous catheters being used as a quicker method of access. During my research, said that femoral sites are associated with high risks of catheter-related bloodstream infections (CRBIs). During hemodialysis, the access site is the patient’s lifeline (Fresenius, 2006). So why is the femoral vein a considered site for surgeons?
The use of invasive monitoring technologies and aggressive hemodynamic resuscitation protocols has increased. Therefore, the ability to gain rapid and accurate vascular access has become a skill that is imperative for critical and emergency care physicians to possess. The predictable anatomic locations of the dialysis central venous catheter are the internal jugular, subclavian, and femoral vein. In the last ten years, tunneled central venous catheters (CVCs) have been increasingly utilized in chronic hemodialysis patients, sometimes in the place of fistulas. They have gained popularity for their unquestioned advantages, such as the possibility for immediate use. However, several problems have emerged following their diffusion. Infections, thrombosis and dysfunctions are the most important catheter-related complications. Infections may occur with and without symptoms of systemic illness. Early diagnosis and appropriate antibiotic tre ...
Respond on two different days who selected different alterations and
Respond on two different days who selected different alterations and factors than you, in one or more of the following ways:
Share insights on how the factor you selected impacts the cardiovascular alteration your colleague selected.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Main Post
The purpose of this paper is to explore coronary artery disease (CAD), the roles of hypertension and dyslipidemia affect CAD, and exploring if genetics is a factor in CAD. The progression of CAD can lead to myocardial ischemia, infarction, and even death if left untreated. Heart disease remains the number one cause of death in the United States, and understanding these factors plays a continued role in developing strategies, both preventive and treatment efforts.
Coronary Artery Disease
CAD is normally the result of atherosclerosis, the build-up of plaque due to damaged endothelium that allows fat to accumulate and decrease the diameter of the vessel. The decrease in vessel size allows for blockage and decreased blood flow to the coronary vessel; this leads to ischemia, where the cells are deprived of blood and begin the process of dying if left untreated. Persistent ischemia or the complete occlusion of a coronary artery causes the acute coronary syndromes, including infarction, or irreversible myocardial damage (Huether & McCance, 2017). Also, known as a heart attack or myocardial infarction (MI). Fortunately, the incidence and mortality statistics for CAD have been decreasing over the past 15 years because of more aggressive recognition, prevention, and treatment (Huether & McCance, 2017).
Hypertension’s Role in Coronary Artery Disease
Hypertension is a consistent elevation of systemic arterial blood pressure (Huether & McCance, 2017). Fortunately, hypertension a key factor in CAD is modifiable and can be monitored closely to prevent further disease progression. Hypertension is common; it ranks as the number one primary diagnosis in America. Pathophysiological mechanisms of blood pressure as a risk factor for CAD are complex and include the influence of blood pressure as a physical force on the development of the atherosclerotic plaque, and the relationship between pulsatile hemodynamics/arterial stiffness and coronary perfusion (Weber et al., 2016). The presence of hypertension further increases the risk of CAD and may explain why some individuals are more predisposed than others to developing coronary events (Rosendorff et al., 2015). Pathophysiological mechanisms of blood pressure as a risk factor for CAD are complex and include the influence of blood pressure as a physical force on the development of the atherosclerotic plaque, and the relationship between pulsatile hemodynamics/arterial stiffness and coronary perfus ...
Vit D Mrip chart-booklet-08-2018
This document provides information from GrassrootsHealth on vitamin D research and dosing recommendations. It includes the following:
- A summary of studies showing reductions in disease incidence as vitamin D levels increase from 25 to over 60 ng/ml. Many diseases such as cancer, diabetes and heart disease showed reductions of over 30% at levels of 40 ng/ml or higher.
- Charts showing the wide range of serum vitamin D levels achieved at different daily supplemental intake amounts, based on data from over 7,000 participants. Intakes of 4000 IU/day resulted in levels from 20-120 ng/ml, demonstrating individual variability.
- Recommendations that total daily vitamin D intake of around 12,000 IU
Hemodialysis catheter related infection 5
This document discusses hemodialysis catheter-related infections. It provides statistics on catheter use and infection rates. It describes different types of catheter infections including exit site infections, tunnel infections, and bloodstream infections. Signs and symptoms of infection and methods for diagnosis are outlined. The document proposes a strict infection control protocol for catheters and discusses efforts at one facility to reduce infection rates through improved catheter care and adherence to infection guidelines.
Vitamin C: fact or fiction?
In this podcast, Ken Sakurai provides an update on the recent randomised control trials (RCT) for Vitamin C in Sepsis.
Managing CV risk in Inflammatory Arthritis (Focusing on Gout)
Presentation made during the 1st Inter-Hospital Rheumatology Fellows' Case Discussion on 9 June 2018 at the Speaker Feliciano Belmonte Auditorium, 7/F East Avenue Medical Center. Presentation highlights the needs to recognize gout as one of the rheumatic conditions that put patients at risk for developing CV disease.
11 surgical bleeding and transfusions
The document summarizes the risks associated with surgical bleeding and blood transfusions. It discusses how bleeding can lead to hypovolemia and anemia, and the compensatory mechanisms the body employs. It then outlines the risks of transfusions, including transfusion reactions, infections transmitted through blood-borne pathogens, transfusion-related immune modulation that can increase infection risk and mortality, and the storage effects on red blood cells that are associated with increased morbidity and mortality. It notes that leukoreduction of blood products reduces some of these transfusion risks.
Vit D Chart booklet may2016
This document provides information from the GrassrootsHealth organization regarding vitamin D research and recommendations. It includes the following:
- A summary of several studies showing reductions in disease incidence as vitamin D serum levels increase from 25 ng/ml to higher levels such as 40-60 ng/ml. Diseases such as cancer, diabetes, fractures, and multiple sclerosis showed reductions.
- Charts analyzing data from over 7,000 participants in the GrassrootsHealth D*action project, showing a wide range of serum levels for any given supplemental vitamin D intake amount. Intakes of 4,000 IU/day resulted in serum levels from 10-150 ng/ml.
- Analysis suggesting supplemental intakes of 9,
management of LV thrombus
This review article summarizes the current literature on left ventricular thrombus (LVT) prevalence, risk factors, diagnosis, and treatment. The key points are:
1) The reported prevalence of LVT following ST-elevation myocardial infarction (STEMI) has decreased from historical rates of 20-40% to current rates of around 2-5% due to improved reperfusion techniques.
2) Predictors of LVT include anterior STEMI (especially involving the left ventricular apex), reduced ejection fraction, severe diastolic dysfunction, and large infarct size.
3) Cardiac magnetic resonance imaging has the highest diagnostic accuracy for detecting LVT, followed by echocardiography when used with contrast agents
Schallhorn Thesis
This document summarizes a thesis analyzing the association between periodontal disease, levels of inflammatory mediators (IL-18 and CXCL16), and coronary artery disease in patients undergoing cardiac catheterization. A clinical periodontal exam and blood tests were performed on 51 patients to determine relationships. Statistical analysis found significant associations between the extent of clinical attachment loss and serum levels of IL-18 and CXCL16. Clinical attachment loss was also significantly associated with the presence of coronary artery disease. These results suggest elevated inflammatory mediators from periodontal disease may indirectly increase the risk of atherosclerosis and coronary artery disease.
Similar to Early management of sepsis with Emergency Department Nurse Gladis Kabil (20)
Running head LITERATURE REVIEW 1LITERATURE REVIEW 2Daily Chlo.docx
Running head LITERATURE REVIEW 1LITERATURE REVIEW 2Daily Chlo.docx
The third international consensus definitions for sepsis and septic shock (se...
The third international consensus definitions for sepsis and septic shock (se...
The Third International Consensus Definitions for Sepsis and Septic Shock (Se...
The Third International Consensus Definitions for Sepsis and Septic Shock (Se...
Estimate of the Patients Commitment Concerning Medical Follow-Up with Angina ...
Estimate of the Patients Commitment Concerning Medical Follow-Up with Angina ...
Searching for phenotypes of sepsis an application of machine learning to elec...
Searching for phenotypes of sepsis an application of machine learning to elec...
1Central Venous Catheter UsageCentral Venous Catheter .docx
1Central Venous Catheter UsageCentral Venous Catheter .docx
Respond on two different days who selected different alterations and
Respond on two different days who selected different alterations and
Managing CV risk in Inflammatory Arthritis (Focusing on Gout)
Managing CV risk in Inflammatory Arthritis (Focusing on Gout)
More from Coda Change
0830 CODA-McGain.pptx
This document discusses the environmental impacts of reusable versus single-use medical equipment from a life cycle assessment perspective. It notes that reusable anaesthetic equipment can save a hospital around $100,000 per year compared to single-use equipment. While reusable equipment reduces waste, most medical plastics are still made from fossil fuels like propylene gas. The document advocates transitioning to renewable electricity to power hospitals and manufacturing medical plastics, which could further reduce the carbon footprint of reusable equipment.
0815 Roslyn CODA 22 landscape.pptx
Roslyn Morgan from the Australian Nursing and Midwifery Federation (Vic Branch) spoke on September 12th about decarbonisation in clinical settings. She acknowledged the traditional custodians of the lands and paid respects to Elders past, present, and emerging. Her presentation focused on reviewing processes to reduce waste and encourage reuse in clinical settings in order to lower carbon emissions by millions of tonnes per year through small changes. She provided tools and resources from the ANMF to aid in these efforts.
Nick Watts 1.pptx
In today's #Coda22 podcast, Nick Watts - chief sustainability officer at the NHS - talks about the NHS's response to climate change.
Nick Watts 1.pptx
Nick Watts
In today’s podcast, Nick Watts - chief sustainability officer at the NHS speaks about the NHS's response to climate change.
A Research Perspective with Simon Finfer
As with everything else, ICU management of sepsis should ideally the evidence based. Evidence based practice combines the best scientific knowledge (evidence) with patient preferences and clinical assessment and judgement.
While the pursuit of specific pharmaceutical agents to treat Sepsis has resulted in the expenditure of billions of dollars without producing a single effective agent, much of what we do in the treatment of patience with Sepsis can be evidence based. Clinicians make literally hundreds of decisions day on the management of an individual patient in the ICU, often these decisions are made routinely without a great deal of thought about the reasoning behind them. Every decision made about the treatment of a critically ill patient should be based on evidence or the belief that the action resulting from that decision will improve a patient centred outcome for that particular patient. A patient centred outcome is an outcome that affects how the patient feels, functions or survives meaning we should question every decision we make to ask whether it is going to improve one of those outcomes.
The best evidence on which to base of such decisions comes from large robust randomised controlled trials conducted by unbiased investigators. The last 20 years has seen the emergence and maturing of regional and national clinical trials groups who conduct such studies and increasingly collaborate with each other. (2) Such collaboration is often essential to perform studies large enough to provide evidence to guide clinical practice such collaboration is often essential to perform studies large enough to provide evidence to guide clinical practice. As someone who designs and contacts clinical trials I am well aware that they provide evidence on a population basis. Each trial result is the net of harm and benefit resulting from the treatment being studied and even when a treatment is proven to have a net benefit there may be some patients who are harmed by the use of that treatment. A graphic example of this is someone who suffers a massive intracranial haemorrhage when treated with thrombolysis. Causing visible harm to a patient may shake a clinician's faith in an effective treatment making it important that we accept such tragic events without changing our practice to deny that effective treatment to future patients.
Research, like clinical practice, has inherent imperfections. Researchers, like clinicians, need to recognise this and be prepared to put their hand up and admit when they have been wrong. Conducting robust studies of appropriate size in an effective collaborative research group is the best way to avoid being wrong too often!
For more head to our podcast page #CodaPodcast
Derick_Adigbli.pptx
Introduction to the Sepsis Workshop
"Effective care of critically ill patients with sepsis requires much more than good medical care. In this trans-disciplinary workshop we pay homage to the many specialists involved in caring for patients with sepsis, from pre-ICU admission to post-sepsis recovery.
We will hear from experts from diverse backgrounds and settings including nursing, physiotherapy, speech pathology, medicine and academia. In addition, we are privileged to be joined by a sepsis survivor who will provide us with their own perspective and lived experience.
This workshop will expose evidence and equity gaps across the spectrum of specialists involved in providing sepsis care. We will improve your knowledge and ability to provide holistic patient centred care, with a focus on ensuring no patient or aspect of care is left behind."
For more head to our podcast page #CodaPodcast
Michelle_Paton.pptx
A Physiotherapist Perspective with Michelle Paton
Physiotherapists form a key part of the multi-disciplinary team in the Intensive Care, focusing on both respiratory care and optimisation of function. This talk will discuss the role of physiotherapy across the continuum specifically in the management of an acutely unwell septic patient. I will discuss the focus of a physiotherapy assessment, main treatment aims, some of the barriers for the implementation of physiotherapy in ICU, while identifying strategies to enable appropriate application of physiotherapy techniques.
A Pre-hospital Physician Perspective with David Anderson
Sepsis is a common presentation in the prehospital and retrieval environment, with most cases having a respiratory, urinary or soft tissue origin. However the best practice for identifying and management sepsis in the prehospital environment remains unclear. Despite sepsis having been a priority for in hospital guidelines and protocols for decades now, relatively little attention has been paid to prehospital sepsis management. Traditional teaching is that early antibiotics in sepsis save lives, however trials examining this are observational and confounded by outdated ICU care. An appropriately sensitive and specific tool for the prehospital identification of sepsis remains elusive. NEWS2 is common and lactate-modified QSOFA emerging (although prehospital lactate measurement remains difficult). The role of prehospital antibiotics, and the most appropriate one are also unclear. Most ambulance services that carry antibiotics use ceftriaxone. The retrieval environment is similar, with sepsis probably being the single commonest reason to call a retrieval service.
For more head to our podcast page #CodaPodcast
Amy_Freeman_Sanderson.pptx
A Speech Pathology Perspective with Amy Freeman-Sanderson
Sepsis causes organ and tissue dysfunction in response to severe infection, resulting in significant physical and cognitive morbidities. For patients diagnosed with severe sepsis, admission to an intensive care unit and use of an artificial airway are often required. The sequalae of severe sepsis necessitating critical care can result in significant changes to a patient’s swallowing and communication function. These negative changes and impacts to function can occur during and after a diagnosis of sepsis, and ultimately impact a patient’s health and functional status. The nature and long-term recovery of swallowing and communication function is still to be completely understood; however evidence affirms recovery continues well beyond hospital discharge.
This presentation will focus on tasks we do daily – eating, drinking and speaking. Specifically, the nature of swallow impairments will be described, and the impact of this new disability will be explored from the perspective of the patient’s body structure, function and activities. Core components of swallowing safety and efficiency will be described, alongside the role of assessment and management within and beyond the ICU. Changes to communication including altered voice, speech and language function will be described. Outcomes of altered communication function over the continuum of care during, and after hospital will be explored. The evidence base and the lived experience of sepsis and patient stories will underpin the content delivered in this presentation.
The final aim of the presentation will be to describe and highlight the role of speech pathology, an allied health profession, in the management of swallowing and communication function. Following the workshop attendees will be able to (1) describe the characteristics of swallowing and communication disorders; (2) have knowledge of the impact of these new disabilities; and (3) will be able to describe the role of speech pathology in the healthcare team for the patient with sepsis.
For more head to our podcast page #CodaPodcast
Delivering change now
Healthcare Saves!
Healthcare Pollutes!
Healthcare is responsible for 7% of Australia's carbon emissions, consumes 10% of Australia's GDP, and has numerous other adverse environmental effects.
This talk introduces healthcare's polluting ways, and how clinicians can mitigate their own carbon footprint. Action is the Antidote to Anxiety!
For more head to our podcast page #CodaPodcast
2 weeks: a case from India
2 weeks: a case from India
Ankur Verma opens the podcast by telling his listeners that he’s going to share with them something that happened during the time that Delta was in its dreadful stages in both Australia and India. He goes on to talk about a case that took place during the Delta wave, when minutes matter.
He recounts a patient - Mrs P - who had come in gasping and immediately went into cardiac arrest, and notes that – as is often the case – she immediately became part of the ward’s family. After testing positive for Covid, they then gave her a CT scan to see if she had pneumonia and subsequently put her on various experimental medications, including steroids. She got better over the next four or five days and was weaned off the ventilator and over the next couple of days we removed her TPI (trigger point injection) but then her sugars went up.
Ankur explains that just when he thought she was becoming much better, she started becoming hypoxic again and he then found out her left lung had collapsed. She then went on to improve – and, understandably – her family were thrilled, especially her son. After a two-week rollercoaster ride, she was discharged, much to the joy of everyone involved. At a time of great distress, Ankur explains that Mrs P reminded him and his co-workers of the power of determination and motivation, and it was through a combination of compassion and great determination and motivation that she survived.
He notes that Mrs P gave the hospital staff a ray of hope and a much-needed silver lining during what was an otherwise hellish Covid wave, and notes that he owed her more than she owed him for saving her life.
But, continues Ankur, she had other plans. She had been a ray of hope during the dreadful delta in India and the world and sadly, she died.
But Ankur says that he and his co-workers didn’t lose sight of the vision and the hope that she gave them and that they continued to support each other.
He concludes the podcast with an important lesson learnt: take care of yourself and those around you because when the dark times come, those people will be the ones surrounding you.
1420 Rebecca Szabo.pptx
Bec Szabo – an obstetrician, gynaecologist, and medical educator – begins the podcast by asking the audience to go back to Melbourne with her on a journey through the looking glass. She notes that while taking her listeners to Wonderland might be a bit quirky, but that it’s essential for the point of the story. Bec also wants to preface the talk with a trigger warning; and acknowledges that the subject matter of her talk might be triggering – so please do bear in mind that this talk covers Covid, ICU and pregnancy before listening.
As per the notion of taking her readers through the looking glass, Bec wants to take listeners back to spring 2021 – a time that Melbourne was looking down the barrel of a sixth lockdown. Known as having had one of the longest – and strictest – lockdowns in the world - people in Melbourne were tired and had done a lot. Many were already vaccinated.
Bec then goes on to say that she wants to talk about Covid and pregnancy and, explains to listeners that she wants to paint a picture of inequality and sexism.
She runs through a case of what happened shortly after the Delta strain had arrived in Melbourne – it was a time when things were changing rapidly during covid with delta things came thick and fast. A pregnant woman was admitted to hospital; it was her third child, and her two toddlers, partner and parents were all sick with Covid; and despite concerns over a post-partum haemorrhage, a healthy baby was delivered, and the woman went back to the ICU.
Except, says Bec, this wasn’t what actually happened; what she described was a simulation, carried out in order to ensure they had everything prepared in the case that something similar happened.
She goes on to say that teamwork and communication are everything, but so too is listening to the voice of the patient. And that while we’ve heard that belonging and community and connection are important, having those values and shared goals to keep us doing what we’re doing.
Bec closes the podcast by that we need to remember we’re the captains of our soul. And that if we can be human and kind, we can deal with emotionally fraught situations.
For more head to our podcast page #CodaPodcast
Is Burnout Burning Us Out?
In this week’s podcast Liz Crowe – an advanced clinician social worker who has worked in Brisbane’s major children’s hospitals in intensive care, emergency departments and cancer wards - begins the podcast with the question – is all this talk of burn out, actually making us burnt out?
In this podcast, Liz goes on to address exactly what the term burn out actually means and discusses how the literature on burnout in healthcare workers is prolific. She discusses how healthcare presents as an occupation of high risk, distress, and despair, with an escalation of risk post pandemic. Yet, she says, burnout is not the whole story even though it is the only story being told. Liz speaks about the extensive research into burnout and what it reveals, and the risk factors for burnout, which include excessive workload, lack of control or recognition, mismatch of values, lack of meaning and emotional contagion. However, she notes that none of these are individual deficits and says that it is concerning that ‘wellbeing’ in healthcare is never discussed in terms of meaning making, purpose, contribution, community, stimulating work or growth and development.
Yet, she goes on to say, for many critical care staff these positive factors for wellbeing are found in abundance.
Liz also states that her research shows that people want to believe that the bad stuff happens on one side of life; the good on the other, and people want to know how they get to the other side. Whereas, she says, in reality, life is a crappy mess that sits somewhere in the middle.
The podcast concludes with Liz stating that purpose and community are everything, that life is messy, but some days - despite how awful we feel - we soar because of the opportunities we have. She encourages listeners to savour life, and to remember that even on the worst day of their working life, their patients are doing it tougher.
For more head to our podcast page #CodaPodcast
4 Seconds: A Case from Afghanistan
"Death is not the enemy but occasionally needs help with timing."
Peter Josef Safar (1924 – 2003) 'The Father of Modern CPR'
In this week’s episode of the Coda podcast, former flight paramedic Gary Berkowitz – who previously worked in Afghanistan and now works for Queensland Ambulance Service - explores how when death is inevitable, the way of dying matters.
To open the discussion, he addresses the fact that out of hospital emergency care practitioners are often faced with time critical decisions. He notes that fortunately, most of these situations often have clear guidelines because – generally speaking - they follow pathways with expected outcomes.
When it comes to ethics in healthcare, however, it can be a nuanced topic. For example, the decision to not commence resuscitation, or to withdraw life saving measures in a patient who appears to have no meaningful prospect of recovery, can be a difficult one. Gary goes on to note that in this environment, it’s impossible to design a guideline that could encompass all the elements of such a complex decision.
In this talk Gary examines providing care to patients rather than always trying to fight death. By way of example, Gary tells listeners how he was working closely with the various western military forces, when one day they asked a favour – a young Afghani soldier had been badly burnt fighting against the Taliban, and while his treatment had begun in a military hospital, it was decided it shouldn’t be continued there.
Gary was asked if he could assist transporting the soldier to a hospital in the city, and he goes on to talk about the fact that he had two options – to take the easy choice, which would have involved giving the soldier enough medication that he wouldn’t have to see him suffer; or the brave choice – which would have been to give him enough medication so he wouldn’t be suffering at all.
He discusses the ethics around each alternative – and how he came to sit with his final choice. Gary notes that the decision he made that day has remained with him ever since, and continues to influence his decisions in his everyday practice.
For more head to our podcast page #CodaPodcast
Prehospital resuscitation of TBI
In this podcast, Marty Nichols talks us through managing patients with TBI in a prehospital environment. This involves avoiding hypoxia and hypotension, ensuring a safe transportation and getting to the right treatment centre the first time.
Top 10 Critical Care Papers of 2020
- A cluster crossover RCT of 6 US PICUs found that limiting duration of patient care shifts to <16 hours (versus >24 hours) increased serious medical errors and unintended consequences from increased workload.
- An RCT of 168 ICUs across 15 countries found no difference in mortality or RRT dependence between an accelerated versus standard strategy for initiating RRT in patients with AKI, but the intervention group had more hypotension and adverse events.
- An RCT of early ECMO versus standard ACLS in 30 patients with refractory VF found lower hospital mortality in the intervention group, but the study was conducted at a single highly invested center and may not be generalizable.
Advanced support of Acute Liver Injury
From CodaZero Live, Alex Rowell reviews the available advanced liver supports for patients with acute liver failure.
Artificial supports for the liver are quite complex and difficult. This is largely due to the liver's complex function.
Some of the advanced liver supports include CVVHDF, Molecular Adsorbent Recirculating System (MARS), Single Pass Albumin Dialysis (SPAD) and high volume plasma exchange.
In this podcast, Alex takes us through the research and evidence for these supports and shares some guidance on when they should be used.
CVVHDF is familiar and effective but we need to remember to use it early with acute liver failure patients.
Furthermore, Molecular Adsorbent Recirculating System (MARS) is widely studied but unfortunately not available in all places.
Single Pass Albumin Dialysis (SPAD) is easily implemented. Although there is less evidence on SPAD, it is generally agreed to be an effective support.
Unfortunately, there are no mortality benefits in any of these supports. They are however, useful tools in bridging to transplant.
From #CodaZero tune in to a quick, sharp & informative talk by Alex Rowell on Acute Liver Injury.
Surgical considerations in the injured spine patient
This document discusses the surgical management of a patient with injuries to the spine and chest from a traumatic accident. The patient had a burst fracture at L2 with fragments in the spinal canal, as well as transverse process fractures from L1-L3 and injuries to the right chest including broken ribs and lung damage. The surgical procedures performed included fixing the broken ribs in the chest, removing the bone fragments in the spinal canal from L1-L2, fusing the spine from T11 to L4 with internal fixation, and placing an expandable interbody cage at L2. The patient had a lengthy recovery but was eventually able to walk with a stick after six months.
Echo in Cardiac Arrest
Echo in Cardiac Arrest by Behny Samadi
From #CodaZero Live, Behny explains the importance of Echo and lists some of the ways in which Echo can help us during a cardiac arrest. It is more than we think!
Echo is a quick, easy and simple tool, making it invaluable in many situations including cardiac arrests.
It is a bedside test that is non invasive and painless for the patient. It is easily taught to any doctor or nurse and done in real time at the bedside. It can be used to guide and inform management and treatment... so why isn't everyone embracing Echo?
Behny challenges us to consider another bedside tool which compares to the effectiveness and usefulness of Echo.
Furthermore, in the chaos of cardiac arrests, Echo can help to exclude some of the 4Hs & 4Ts. It can help to check the rhythm, check the quality of compressions and assess for post-resuscitation care.
It is an invaluable tool in managing patients suffering from cardiac arrest.
Behny suggests that the focused 2D echo is our generations stethoscope. We need to open our minds and embrace the capabilities of Echo and challenge each other to learn how to effectively utilise this tool in times that matter.
Tune in to a fascinating podcast by Behny Samadi on the value of Echo in Cardiac Arrest.
As a self-confessed Echo enthusiast - Behny is here to share her knowledge on the benefits of Echo.
For more like this, head to our podcast page. #CodaPodcast
Update on delayed cerebral ischaemia
Update on delayed cerebral ischaemia by Christopher Andersen. Chris discusses the postulated underlying mechanisms involved in subarachnoid haemorrhage.
More from Coda Change (20)
A Pre-hospital Physician Perspective with David Anderson
A Pre-hospital Physician Perspective with David Anderson
Surgical considerations in the injured spine patient
Surgical considerations in the injured spine patient
Recently uploaded
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
This quiz was conducted as a promotional event for the 2024 Annual Meet of Kerala Chapter of API.
More than 20 participants took part everyday !
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...ayushrajshrivastava7
Regulatory Affairs
Full hand written notes
M.pharm - 1st year .STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
What is Obesity? How to overcome Obesity?
Obesity is a chronic complex disease defined by excessive fat deposits that can impair health.
biomechanics of running. Dr.dhwani.pptx
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Nano-gold for Cancer Therapy chemistry investigatory project
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
How to choose the best dermatologists in Indore.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Know the difference between Endodontics and Orthodontics.
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Fallopian tube blockage may cause female infertility. For treatment, herbal medicine Fuyan Pill can be a solution.
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
cosmetics and cosmeceuticals
Muskan
mpharm
2nd semester
Guru Gobind Singh college of pharmacy, yamunanagar, haryana
Pharmacology of 5-hydroxytryptamine and Antagonist
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
5 Effective Homeopathic Medicines for Irregular Periods
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
une 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Pollen and Fungal allergy: aeroallergy.pdf
Pollen and Fungal allergy: aeroallergy.pdfChulalongkorn Allergy and Clinical Immunology Research Group
Pollen and Fungal allergy
Presented by Chaloemchai Chumsaengchotsakul, MD.
June 14, 2024Recently uploaded (20)
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
Tele Optometry (kunj'sppt) / Basics of tele optometry.
Tele Optometry (kunj'sppt) / Basics of tele optometry.
Nano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory project
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
5 Effective Homeopathic Medicines for Irregular Periods
5 Effective Homeopathic Medicines for Irregular Periods
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Early management of sepsis with Emergency Department Nurse Gladis Kabil
- 1. Sepsis: Leaving nothing and no one behind Gladis Kabil – ED Registered Nurse, Nursing Lecturer
- 3. Fluid Management in sepsis in Emergency Department – knowing what we
- 6. Mortality Benefits from intravenous fluids Normal text is in Gotham Book font Kabil, G., Liang, S., Delaney, A., Macdonald, S., Thompson, K., Saavedra, A., Suster, C., Moscova, M., McNally, S., Frost, S., Hatcher, D. and Shetty, A. (2022), Association between intravenous fluid resuscitation and outcome among patients with suspected infection and sepsis: A retrospective cohort study. Emergency Medicine Australasia, 34: 361-369. https://doi.org/10.1111/1742-6723.13893
- 7. How many received fluids? Normal text is in Gotham Book font Kabil, G., Frost, S.A., McNally, S. et al. Identifying factors associated with intravenous fluid administration in patients with sepsis presenting to the emergency department: a retrospective cohort study. BMC Emerg Med 22, 98 (2022). https://doi.org/10.1186/s12873-022-00650-4
- 8. How much and how fast did they receive fluids? Kabil, G., Frost, S.A., McNally, S. et al. Identifying factors associated with intravenous fluid administration in patients with sepsis presenting to the emergency department: a retrospective cohort study. BMC Emerg Med 22, 98 (2022). https://doi.org/10.1186/s12873-022-00650-4