Intravenous (IV) medication administration involves inserting a catheter into a vein to deliver fluids, medications, or collect blood. Potential complications include local issues like hematomas at the insertion site or systemic problems like thrombosis blocking the catheter. Proper insertion technique and ongoing monitoring can help prevent complications. Signs like swelling, pain, or slowed infusion rates may indicate issues like phlebitis (vein inflammation) or extravasation of fluids outside the vein. Healthcare workers must take precautions like following needle safety procedures to avoid accidental needle sticks which can expose them to bloodborne diseases.
A cardiologists perspective to current scenario in light of corona pandemic in india and world wide. cardiac procedures , heart disease , aceinhibitors , arni , heart failure , troponin, nt probnp
A cardiologists perspective to current scenario in light of corona pandemic in india and world wide. cardiac procedures , heart disease , aceinhibitors , arni , heart failure , troponin, nt probnp
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Indications for IV Medication
• Indications:
• Intravenous access to patient’s circulatory
system.
• Administration of Meds. & Fluids, as well as
blood collection
• Contraindications:
• IV access should be attempted as distal as
possible.
• Avoid veins that cross over joints, local
infection/injury
• Extremities with renal shunts or fistulas
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3. Procedure for Insertion of
Peripheral IV Catheter
1. Obtain and review the order
2. Ascertain allergies
3. Gather Equipment
4. Verify patient’s identity using two patient
identifiers
5. Explain procedure, benefits, care
management, and potential complications to
patient
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4. Procedure for Insertion of
Peripheral IV Catheter (cont)
6. Perform hand hygiene
7. Assemble equipment
8. Apply Tourniquet
9. Assess veins, keeping in mind the rational for
therapy and duration of therapy
10. Apply Non sterile gloves
11. Wash intended insertion site with antiseptic
soap and water. (as needed)
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5. Procedure for Insertion of A
Peripheral IV Catheter (cont)
13. Clean intended insertion site with
antiseptic solution, working
outward using back-and-forth
motion
14. Allow site to dry
15. Perform venipuncture while
stabilizing skin with the
nondominate hand
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6. Procedure for Insertion of A
Peripheral IV Catheter (cont)
16. Enter skin at a 10- to- 30 degree angle.
Decrease angle when the skin has been
penetrated. When blood is obtained in the
flash back chamber, advance catheter 1/16
inch, and then slightly pull stylet back,
advancing catheter gently into vessel.
Continue to advance catheter into vein until
the catheter hub is against the skin.
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7. Procedure for Insertion of A
Peripheral IV Catheter (cont)
17. Release tourniquet
18. Occlude tip of catheter by pressing
finger of non dominant hand over vein to
prevent blood spillage.
19. Activate needle safety device before
removing stylet. Connect IV
administration set or injection
cap/needless device. Begin infusing
solutions slowly.
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8. Procedure for Insertion of A
Peripheral IV Catheter (cont)
22.Discard stylet in
sharps container
23. Remove gloves.
Perform hand
hygiene
24. Document
procedure in the
patient’s medical
record.
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10. IV Procedure
• Use universal precautions (glove and eye
protection)
• Allergies (beta dine or latex)
• Explain procedure to Pt.
• Prepare all material
• Select vein. Apply tourniquet above the
elbow.
• Prepare site
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11. IV Procedure (cont.)
• Warn the patient of possible pain
• Bevel up at 30 degree above horizontal
• Look for flashback of blood into catheter
• Upon seeing flashback, advance catheter
another millimeter or two
• Advance the sheath completely into the vein
and release tourniquet
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12. IV Procedure (cont.)
• Connect the IV
tubing/heplock
• Secure catheter and
tubing
• Dispose of needles in
sharps container
• Document the IV site,
catheter size and date
on the patient’s chart
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13. Complications of IV Therapy
• Classified according to their location
–Local complication: at or near the
insertions site or as a result of
mechanical failure
–Systemic complications: occur within
the vascular system, remote from the
IV site. Can be serious and life
threatening
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15. Local complications
• Occur as adverse reactions or trauma to the
surrounding venipuncture site
• Assessing and monitoring are the key
components to early intervention
• Good venipuncture technique is the main
factor related to the prevention of most local
complications associated with IV Therapy.
• Local complications include:
hematoma, thrombosis, phlebitis, post
infusion
phlebitis, thrombophlebitis, infiltration, extrav
asation, local infection, and veno spasm.
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16. Hematoma
• Subcutaneous hematoma is the most common
complication
• Can be a starting point for other
complications: thrombophlebitis and infection
• Related to:
– Nicking the vein
– Discontinuing the IV without apply adequate
pressure
– Applying the tourniquet to tightly above a
previously attempted venipuncture site.
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17. Hematoma
• Signs and symptoms:
– Discoloration of the skin
– Site swelling and
discomfort
– Inability to advance the
cannula all the way into
the vein during insertion
– Resistance to positive
pressure during the lock
flushing procedure
• Document
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18. Hematoma
Prevention
• Use of an indirect method
• Apply tourniquet just before
venipuncture
• Use a small need in the elderly and
patients on steroids, or patients with thin
skin.
• Use blood pressure cuff to apply pressure
• Be gentle
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19. Hematoma
Treatment
• Apply direct, light
pressure for 2-3
minutes after needle
removed
• Have patient elevate
extremity
• Apply Ice
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20. Thrombosis
• Catheter-related obstructions can be
mechanical or non-thrombotic
• Trauma to the endothelial cells of the venous
wall causes red blood cells to adhere to the
vein wall, forms a clot or Thrombosis
• Drip rate slows, line does not flush easily,
resistance is felt
• Never forcible flush a catheter
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22. Thrombosis
• Signs and Symptoms
– Fever and Malaise
– Slowed or stopped infusion
rate
– Inability to flush
• Prevention
– Use pumps and controllers
to manage flow rate
– Micro drip tubing for rate
below50mL/hr
– Avoid areas of flexion
– Use filters
– Avoid lower extremities
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23. Thrombosis
• Treatment
– Never flush a cannula
to remove an
occlusion
– Discontinue the
cannula
– Notify the physician
and assess the site
for circulatory
impairment
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24. Phlebitis
• Inflammation of the vein
in which the endothelial
cells of the venous wall
become irritated and cells
roughen, allowing
platelets to adhere and
predispose the vein to
inflammation-induced
phlebitis
– Tender to touch and can
be very painful
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26. Phlebitis
• Mechanical:
– To large a catheter for the size of the vein
– Manipulation of the catheter: improper stabilization
• Chemical: vein becomes inflamed by irritating or
vesicant solutions or medication
– Irritation medication or solution
– Improperly mixed or diluted
– Too-rapid infusion
– Presence of particulate matter
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27. Phlebitis
• Chemical (cont):
– The more acidic the IV solution the greater the
risk
– Additives: Potassium
– Type of material
– Length of dwell:
• 30% by day 2, 39-40% by day 3 (Macki and Ringer)
– The slower the rate of infusion the less irritation
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28. Phlebitis
Bacterial
• Also called Septic phlebitis: least common
• Inflammation of the intima of the vein
• Contributing factors
– Poor aseptic technique
– Failure to detect breaks in the integrity of the equipment
– Poor insertion technique
– Inadequate stabilization
– Failure to perform site assessment
– Aseptic preparation of solutions
– Hand washing and preparing the skin
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29. Phlebitis
Post infusion
• Inflammation of the vein 48-96 hr after discontinued
• Factors that contribute:
– Insertion technique
– Condition of the vein used
– Type, compatibility, pH of solution used
– Gauge, size, length, and material
– Dwell time
– Infrequent dressing change
– Host factors: age, gender, age and presence of disease
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30. Phlebitis
• Immune system causes leukocytes to
gather at the inflamed site
• Pyrogens stimulate the hypothalamus to
raise body temperature
• Pyrogens stimulate bone marrow to
release more leukocytes
• Redness and tenderness increase
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31. Phlebitis
• Signs and Symptoms
– Redness at the site
– Site warm to touch
– Local swelling
– Palpable cord along the vein
– Sluggish infusion rate
– Increase in basal temperature of 1degree C or more
• Prevention
– Use larger veins for hypertonic solutions
– Central lines for Infusions lasting longer than 5 days
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32. Thrombophlebitis
• Thrombophlebitis denotes a twofold
injury: thrombosis and inflammation
• Related to:
–Use of veins in the lower extremity
–Use of hypertonic or highly acidic infusion
solutions
–Causes similar to those leading to phlebitis
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33. Thrombophlebitis
• Signs and Symptoms
–Sluggish flow rate
–Edema in the limbs
–Tender and cord like vein
–Site warm to the touch
–Visible red line above venipuncture site
–Diminished arterial pulses
–Mottling and cyanosis of the extremities
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34. Thrombophlebitis
• Prevention
– Use veins in the forearm rather than the hands
– Do not use veins in a joint
– Assess site q 4 hr in adults, q 2 hr in children
– Catheter securement
– Infuse at rate prescribed
– Use the smallest size catheter to do the job
– Proper dilution
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35. Thrombophlebitis
• Septic thrombophlebitis can be
prevented:
–Appropriate skin preparation
–Aseptic technique in the maintenance of
infusion
–Proper hand hygiene
• 60% from patients skin
• 35% from the line itself
• 5% from hands
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36. Extravasations
• Signs and Symptoms
– Complaints of pain or burning
– Swelling proximal to or distal to the IV site
– Puffiness of the dependent part of the limb
– Skin tightness at the venipuncture site
– Blanching and coolness of the skin
– Slow or stopped infusion
– Damp or wet dressing
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37. Extravasations
• Prevention:
– Use of skilled practitioners
– Knowledge of vesicants
– Condition of the patients veins
– Drug administration technique
• If continuous give in CVAD
• Only with brisk blood return of 3-5 cc
• Use of a free flow IV
• Do not use a pump on vesicants given peripherally
• Assess for blood return frequently
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38. Personal safety of Health
Care Workers
10/20/2012 Dr.T.V.Rao MD @ Hospital care 38
39. Steps to prevent
needle sticks
• Wear gloves
• Do Not Bend or Break Needles
• Never RECAP!!!
• If you must, use the One Handed technique
• Take your time
• Dispose of contaminated needles immediately
in puncture-resistant containers
10/20/2012 Dr.T.V.Rao MD @ Hospital care 39
40. Risks to you - if Careless
• Risks after needle Sticks Exposure
• Hepatitis B: 10-30%
• Hepatitis C: 2%
• HIV: 0.4 %
• Other blood borne pathogens
10/20/2012 Dr.T.V.Rao MD @ Hospital care 40
41. POLICY ON ACCIDENTAL NEEDLE
STICKS
• Immediately wash injured area.
• Report all needle sticks immediately to your instructor or
immediate supervisor.
• Complete an incident report and report to employee health
or ED.
• Determine if the needle was clean or dirty.
• Cleansing wound with antiseptic.
• Request that the identified patient be tested for Hepatitis B
surface antigen and HIV antibodies.
• Have your blood tested for Hepatitis B and HIV antibodies as
soon as possible.
• Begin drug treatment (if necessary) & counseling.
10/20/2012 Dr.T.V.Rao MD @ Hospital care 41
42. • Programme Created by Dr.T.V.Rao MD
for Medical and Paramedical
Professionals in the Developing World
• Email
• doctortvrao@gmail.com
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