This document discusses the laws governing the behavior of gases and their applications in anesthesia. It introduces Boyle's law, Charles' law, Gay-Lussac's law, Avogadro's law, Henry's law, and Dalton's law. It then discusses applications of these laws to oxygen, nitrous oxide, Entonox, Heliox, and volatile anesthetic agents. Specifically, it explains how the gas laws can be used to calculate oxygen volumes and nitrous oxide amounts in cylinders. It also discusses how Henry's law relates anesthetic vapor pressures to their blood concentrations.
Dalton's law of partial pressure states that total pressure of the mixture of inert gases is equal to the sum of partial pressures of each gas present in the mixture.
Dalton's law of partial pressure states that total pressure of the mixture of inert gases is equal to the sum of partial pressures of each gas present in the mixture.
Kinetic Gas Theory including Ideal Gas Equation. Temperature, Volume, Applications
Boyle's Law, Charles' Law and Avogadro's Law. Ideal Gas Theory, Dalton's Partial Pressure
Kinetic Gas Theory including Ideal Gas Equation. Temperature, Volume, Applications
Boyle's Law, Charles' Law and Avogadro's Law. Ideal Gas Theory, Dalton's Partial Pressure
Properties of gases: gas laws, ideal gas equation, dalton’s law of partial pressure, diffusion of gases, kinetic theory of gases, mean free path, deviation from ideal gas behavior, vander wails equation, critical constants, liquefaction of gases, determination of molecular weights, law of corresponding states and heat capacity
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
2. INTRODUCTION
All matter exists in one of three states or phases-solid,
liquid or gas.
When a gas co-exists in equilibrium with its
corresponding liquid, the gas is termed a vapour
The critical temperature is defined as the temperature
above which a substance cannot exist in a liquid state
3. Laws governing the flow of gases
Pressure, Volume and Temperature : when describing the
behavior of gases the temperature, pressure and volume are
related in a consistent manner, which makes it possible to
formulate three gas laws
Boyle’s law
Charles’s law
Gay-lussac’s law
Others are
Avogadro’s law
Henry’s law
Dalton’s law
4. Boyle’s law
This is the first gas law and states that at constant
temperature, the volume of a fixed mass of a perfect
gas varies inversely with pressure.
PV=K (at constant temperature)
5. Charles’s law
This is the second gas law and states that at constant
pressure, the volume of a fixed mass of a gas is
proportional to its temperature.
V/T =K (at constant pressure)
6. Gay-Lussac’s law
This is the third gas law and states that at constant
volume, pressure of a fixed mass of gas is directly
proportional to its temperature
P/T =K (at a constant volume)
7. The combined gas law
Is derived from all three gas laws and is as follows
PT= T OR alternatively expressed P1V1=P2V2
T T1T2
Provided two of the variables are known, the third can
be assumed to remain constant, the gas laws can be
used to calculate changes in one of the known
variables when the other alters. For example, if the
initial pressure and volume of an oxygen cylinder is
137bar and 1.2 litres respectively(and temperature is
assumed to remain constant), then the volume of the
oxygen at a pressure of 1 bar can be calculated.
8. Cont…
Assuming room pressure is also roughly 1 bar then this
approximates to the volume of oxygen available to the
patient, before the cylinder empties.
Furthermore, if the rate of oxygen use is known, then
the time remaining for use of that oxygen cylinder can
be calculated
When making these calculations it does not matter
which units are used for pressure or volume provided
consistency is maintained
9. Units of pressure
Units Equivalent value
Atmospheres (atm)
Bar (bar)
Kilopascal (KPa)
Millimeters of mercury(mmHg)
Torr (mmHg O0C)
Centimeters of water (cmH20)
Pounds per square inch(PSI)
1
1
1O1.3
760
760
1033.2
14.7
10. Avogadro’s law
Avogadro’s law states that at a constant temperature and
pressure a given volume of any gas will contain the same
number of molecules. The converse of this is that at a
given temperature and pressure, 1 mole of any gas will
occupy the same volume( 22.4 litres at 1 atmosphere and
0oC
Both Avogadro’s law and combined gas law are used to
derive the ideal gas law
PV=nRT
n=number of moles of gas, R=universal gas
constant(8.314). The ideal gas law is of relevance when
considering the behavior of nitrous oxide in cylinder
11. Henry’s law
States that at a constant temperature, the amount of a
given gas dissolved in a given liquid is directly
proportional to the partial pressure of the gas in
contact with the liquid.
Temperature affects the solubility of gases such that at
a higher temperatures gas will be less soluble in a
liquid
Henry’s law is of importance when considering the
way inhaled anaesthetic vapours and gases behave
physiologically
12. Dalton’s law
States that the pressure of a gas in a mixture of gases is
independent of the pressure of the other gases in the
mixture.
Dalton’s law can be explained by the fact that in a
mixture of gases the molecules are so far apart from
one another, that each gas behaves as though the
others were not present
Dalton’s law explains why vapour pressure is not
affected by ambient pressure.
13. Imperfections of the gas laws
In reality, the gas laws described are not always true
and they refer to a theoretical “ideal” gas
However, these concepts generally hold true and as
long as correction factors are used, the gas laws have
practical applications
Note that the gas laws are only accurate when applied
to gases above their critical temperature
14. APPLICATIONS: OXYGEN
Boiling point -1830C, critical temperature of -1190C , it
exists as gas at room temperature and therefore obeys
gas laws
Boyle’s law can be applied to oxygen, which means that
the reading on the pressure gauge of an oxygen
cylinder gives a true indication of the volume
remaining.
However, inaccuracies may arise in this respect if large
alterations in ambient temperature occur.
15. Cont..
Oxygen can be stored under pressure in cylinders, it can
also be combined to form cylinder banks attached to
manifold to reduce cost, transportation and constant
change of exhausted cylinders.
Oxygen has to be cooled to below -1180C to change to a
liquid and as the change occurs , it occupies a much
smaller volume.
When a small volume of liquid oxygen is warmed it will
make a very large volume of oxygen gas
In liquid form, a very large quantity of oxygen can be
transported or stored in a low volume
17. Nitrous oxide
Boiling point of -88.60C and critical temperature is
+360C. Since in most countries it exists as a vapour in
equilibrium with its liquid phase, the gas laws do not
apply to nitrous oxide.
Unlike oxygen, the pressure gauge tells you nothing
about the amount of nitrous oxide remaining in the
cylinder- it always reads around 52 bar at room
temperature
To determine the quantity left in a cylinder it must be
weighed, the weight of the empty cylinder subtracted,
and then the number of moles of nitrous oxide
calculated using the Avogadro’s number
18. Cont…
The ideal gas law can then be used to calculate the
approximate volume of gas remaining
It is now easy to understand why nitrous oxide cylinders
are not filled to a given pressure.
A value called the filling ratio is used
Is the ratio of the weight of the cylinder filled with nitrous
to the weight of the cylinder when filled with water
Filling ratio in U.K is 0.75, however this is reduced to 0.67
in hotter climates
19. Entonox
BOC Medical trade name for 50% oxygen and 50% nitrous
oxide.
For Entonox the critical temp. is termed the pseudo
critical temperature. The term is used to describe the
temperature at which Entonox starts to separate into its
constituent parts.
The pseudo critical temperature of Entonox is -60C
(occurs mainly in temperate climate)
If there is a possibility of separation occurring, the
manufacturers recommended that prior to use, cylinders
should be stored horizontally for 24hours at temp. above
100C or warmed to 100C for two hrs (or body temp. for 5
mins and then completely inverted 3 times
20. Heliox
A mixture of oxygen and helium. Percentage of O2
may be as low as 21% but not higher than 50%
Heliox is useful in patients with upper airway
obstruction.
Theoretically patients with airway obstruction have
greater amount of turbulent compared to laminar flow
within their airways
Helium has a lower density than oxygen ( and
nitrogen) and this may increase airway gas flow when
flow is turbulent. The density of a gas has no effect on
flow when the flow is laminar.
21. Application to volatile anaesthetic
agents
Volatile anaesthetic agents exert their effects according
to the partial pressure of the agent in the blood
According to Henry’s law, the partial pressure of
anaesthetic agent dissolved in the blood is
proportional to the partial pressure exerted by the
anaesthetic vapour in the alveli
Dalton’s law tells us that the partial pressure exerted by
the anaesthetic vapour in the alveoli is independent of
the other gases present in the mixture.
22. Application to vaporizers
A vaporizer does not generally alter the vapour
pressure of an anaesthetic agent, and this remains
relatively constant.
One variable that can alter the anaesthetic vapour
pressure in a vaporizer is temperature
During vaporization latent heat of vaporization cools
the liquid agent and cause a fall in the vapour pressure
and agent concentration
Modern vaporizers incorporates various mechanisms
to compensate for any drop in temp. to overcome this
problem
23. Do you need to adjust your
vaporizer at high altitude
Two concepts answer this question
First, anaesthetic dept is controlled by altering the
partial pressure of anaesthetic agent in the alveolus
(Henry’s law)
Second, only two factors affect the partial pressure
namely the vapour pressure of agent in the vaporizer
and the conc. of vapour in the inhaled gas mixture.
The answer is that no change needs to be made to
vaporizer setting at altitude