Thoracentesis is a procedure to drain excess fluid from the pleural cavity between the lungs and chest wall. It can be performed for diagnostic or therapeutic purposes when fluid accumulation is causing symptoms or its cause is unknown. The procedure involves injecting local anesthetic, inserting a catheter through the chest wall to drain fluid for analysis. Complications can include pneumothorax or infection, but the procedure provides information to guide diagnosis and management of underlying conditions causing pleural effusions.
This document provides instructions for performing a thoracentesis procedure. It describes the indications, contraindications, necessary equipment, patient positioning, steps of the procedure, monitoring during the procedure, post-procedure care, potential complications, and instructions for abdominal paracentesis. The key steps are: administering local anesthesia, inserting a cannula or needle into the pleural space, draining pleural fluid for diagnostic testing or therapeutic relief of symptoms, and monitoring for complications such as pneumothorax after the procedure.
Thoracentesis is a procedure where a needle is inserted into the pleural space to remove pleural fluid for analysis or relief of symptoms. It can be done for diagnostic purposes to analyze the fluid or therapeutically to drain a large volume of fluid. Indications include evaluating an undiagnosed pleural effusion or atypical features in heart failure patients. Contraindications include bleeding risks or small effusions. The procedure involves localizing the site, administering anesthesia, inserting a needle while aspirating to drain fluid, and analyzing the fluid removed. Potential complications include pain, bleeding, pneumothorax, and infection, with pneumothorax being the most common clinically significant complication.
Thoracentesis is a procedure where a needle is inserted into the pleural space to remove pleural fluid for analysis or relief of symptoms. It can be done for diagnostic purposes to analyze the nature of a pleural effusion or therapeutically to drain a large volume of fluid. Common indications include pleural effusions to determine if they are transudative or exudative. Contraindications include coagulation disorders or bleeding risks, very small effusions, patients on mechanical ventilation, or skin infections where the needle will be inserted. The procedure involves selecting a puncture site between the ribs, administering local anesthesia, inserting a needle to aspirate 30-75mL of fluid, and checking for complications like pneum
Closed-tube thoracostomy (CTT) involves inserting a chest tube to drain fluid or air from the pleural space and allow the lung to re-expand. CTT is used to treat conditions causing lung collapse like pneumothorax, hemothorax, or empyema. The tube is inserted between the ribs and connected to a drainage system. Nursing care involves ensuring proper drainage and preventing complications like infection. The tube is removed once imaging shows full lung re-expansion.
This document provides information about chest tube insertion and care. It describes the indications for chest tubes including pneumothorax, hemothorax, and fluid drainage. It outlines the equipment, anatomy, procedure steps, post-procedure care, and potential complications of chest tube placement. The timing of chest tube removal depends on indication and imaging showing full lung re-expansion and cessation of fluid or air leaks.
Peripheral intravenous catheters are used to provide venous access for blood sampling, fluid administration, medications, and other purposes. They involve inserting a small gauge cannula into a superficial vein in the arm or hand. Central venous catheters are longer catheters placed into larger central veins to administer irritating or large volume substances. Proper techniques like using ultrasound guidance and the Seldinger technique aim to safely place the catheter and minimize complications like infection, bleeding, or injury to surrounding structures. Ongoing care of the insertion site and catheter is also important.
This document provides information on performing a thoracocentesis procedure. It defines thoracocentesis as inserting a needle into the pleural space to remove pleural fluid. It discusses indications such as large pleural effusions or diagnostic analysis of fluid. Contraindications include uncorrected bleeding and very small fluid volumes. The document describes the equipment, techniques, complications, and preparation needed to properly perform a thoracocentesis.
This document provides instructions for performing a thoracentesis procedure. It describes the indications, contraindications, necessary equipment, patient positioning, steps of the procedure, monitoring during the procedure, post-procedure care, potential complications, and instructions for abdominal paracentesis. The key steps are: administering local anesthesia, inserting a cannula or needle into the pleural space, draining pleural fluid for diagnostic testing or therapeutic relief of symptoms, and monitoring for complications such as pneumothorax after the procedure.
Thoracentesis is a procedure where a needle is inserted into the pleural space to remove pleural fluid for analysis or relief of symptoms. It can be done for diagnostic purposes to analyze the fluid or therapeutically to drain a large volume of fluid. Indications include evaluating an undiagnosed pleural effusion or atypical features in heart failure patients. Contraindications include bleeding risks or small effusions. The procedure involves localizing the site, administering anesthesia, inserting a needle while aspirating to drain fluid, and analyzing the fluid removed. Potential complications include pain, bleeding, pneumothorax, and infection, with pneumothorax being the most common clinically significant complication.
Thoracentesis is a procedure where a needle is inserted into the pleural space to remove pleural fluid for analysis or relief of symptoms. It can be done for diagnostic purposes to analyze the nature of a pleural effusion or therapeutically to drain a large volume of fluid. Common indications include pleural effusions to determine if they are transudative or exudative. Contraindications include coagulation disorders or bleeding risks, very small effusions, patients on mechanical ventilation, or skin infections where the needle will be inserted. The procedure involves selecting a puncture site between the ribs, administering local anesthesia, inserting a needle to aspirate 30-75mL of fluid, and checking for complications like pneum
Closed-tube thoracostomy (CTT) involves inserting a chest tube to drain fluid or air from the pleural space and allow the lung to re-expand. CTT is used to treat conditions causing lung collapse like pneumothorax, hemothorax, or empyema. The tube is inserted between the ribs and connected to a drainage system. Nursing care involves ensuring proper drainage and preventing complications like infection. The tube is removed once imaging shows full lung re-expansion.
This document provides information about chest tube insertion and care. It describes the indications for chest tubes including pneumothorax, hemothorax, and fluid drainage. It outlines the equipment, anatomy, procedure steps, post-procedure care, and potential complications of chest tube placement. The timing of chest tube removal depends on indication and imaging showing full lung re-expansion and cessation of fluid or air leaks.
Peripheral intravenous catheters are used to provide venous access for blood sampling, fluid administration, medications, and other purposes. They involve inserting a small gauge cannula into a superficial vein in the arm or hand. Central venous catheters are longer catheters placed into larger central veins to administer irritating or large volume substances. Proper techniques like using ultrasound guidance and the Seldinger technique aim to safely place the catheter and minimize complications like infection, bleeding, or injury to surrounding structures. Ongoing care of the insertion site and catheter is also important.
This document provides information on performing a thoracocentesis procedure. It defines thoracocentesis as inserting a needle into the pleural space to remove pleural fluid. It discusses indications such as large pleural effusions or diagnostic analysis of fluid. Contraindications include uncorrected bleeding and very small fluid volumes. The document describes the equipment, techniques, complications, and preparation needed to properly perform a thoracocentesis.
This document provides information on hematology and blood collection procedures. It discusses the composition of blood and where blood cells are produced. It also describes procedures for collecting blood samples from capillaries, veins, and arteries. Key steps are outlined for capillary puncture, venipuncture, arterial puncture, and proper handling and transport of blood samples. Potential errors at different stages of blood collection and patient care considerations are also reviewed.
A chest tube is a flexible plastic tube inserted between the pleural layers of the chest wall to drain air or fluid from the pleural space. It is used to treat conditions where air or fluid has accumulated in the pleural space such as pneumothorax, pleural effusions, or hemothorax. The tube is inserted using local anesthesia in the intercostal space and attached to a drainage system placed below chest level. It is secured with sutures and the insertion site is dressed. The tube remains in place until drainage stops and a chest x-ray confirms its proper position and resolution of the underlying condition.
This document provides an overview of thoracentesis, including:
- Definition, indications, contraindications, techniques/procedure, materials, and complications of thoracentesis.
- Thoracentesis is a procedure to remove fluid from the pleural space, either for diagnostic purposes or to relieve symptoms. It is indicated for large pleural effusions or those requiring diagnostic analysis.
- Potential complications include pneumothorax, hemothorax, organ injury, and infection, though minor complications like pain or dry tap are more common. Proper patient preparation, anesthesia, positioning, and sterile technique are emphasized to reduce risks.
Thoracentesis is a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall. This procedure is done to remove excess fluid, known as a pleural effusion, from the pleural space to help you breathe easier.
Thoracic surgery refers to operations on the organs in the chest including the heart, lungs, and esophagus. The document discusses various types of thoracic surgeries like lobectomy, pneumonectomy, wedge resection, and lung transplant that are performed to diagnose, treat, or repair conditions of the lungs. It also covers surgeries related to the heart like pericardiectomy and esophageal surgeries like esophagectomy. Important aspects of pre-operative, intra-operative and post-operative nursing management are outlined with a focus on airway maintenance, respiratory monitoring, coughing exercises, and chest tube care.
This document provides information about blood collection and processing. It defines blood and its functions. It describes the physical characteristics of blood and its composition. It discusses the purposes of blood collection and the techniques used for vein puncture, capillary puncture, and arterial puncture. It also covers sample handling, centrifugation, and factors to consider to prevent hemolysis.
The document discusses proper procedures for blood collection, including using universal safety precautions when handling needles and blood samples, selecting appropriate veins for venipuncture, collecting blood in tubes containing anticoagulants to prevent clotting, and taking care when collecting from babies or doing fingersticks to obtain small blood samples. Common anticoagulants added to blood collection tubes are EDTA, sodium citrate, heparin, and double oxalate, which work by binding calcium ions or inhibiting coagulation factors to prevent clotting.
This document defines intravenous infusion and outlines its purpose, types, equipment, procedures, documentation, calculations, factors affecting rate, site care, and complications. IV therapy is used to prevent or treat fluid/electrolyte imbalances when oral intake is not possible. It involves introducing fluids intravenously. The nurse is responsible for initiation, monitoring, and discontinuation. Common types include isotonic, hypotonic, and hypertonic solutions. Careful documentation and monitoring for complications like infiltration and infection is important when providing IV therapy.
PowerPoint presentation on Intercostal drainage (ICD) or Chest tube drainage. In this this presentation I have included different methods by which a chest tube can be inserted to drain fluid, pus, air from the Pleural cavity. please do mail me your feedback on this presentation at tinkujoseph2010@gmail.com.
The document provides information on ascites in children, including causes, pathophysiology, clinical presentation, investigations, and management. The most common causes of ascites in children are hepatic and renal disease, though it can also be caused by cardiac disease, trauma, infection, or neoplasia. Diagnostic evaluation involves physical exam, imaging like ultrasound or CT scan, and paracentesis with ascitic fluid analysis. Management depends on the underlying cause but may include diuretics, salt restriction, liver support therapies, or treatment of the primary disease. Complications can include respiratory distress, hernias, infections like spontaneous bacterial peritonitis.
This document provides guidelines for collecting blood samples through three main methods: capillary, venous, and arterial puncture.
For capillary collection, the finger or earlobe is punctured with a lancet. For venous collection, a vein in the arm is accessed with a needle and syringe. Proper site selection, cleaning, tourniquet use, and needle insertion technique are described.
Arterial puncture is used to collect blood gases and is more difficult than venous puncture. The radial, brachial, or femoral arteries can be used. Precautions are outlined to minimize hemolysis and contamination across all collection methods.
Physiotherapy in surgery in abdominal and thoracic surgeryDrKhushbooBhattPT
Rehabilitation is one of the important aspect in pre and post surgery care.
This presentation is mainly focusing on the "thoracic and abdominal rehabilitation" and also gives details about assessment and management of "intercostal drains".
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
This document provides guidance on care protocols for three medical devices: external ventricular drains (EVDs), tracheostomy tubes, and chest tubes. It outlines key steps for each device, including maintaining proper positioning and drainage, assessing the insertion site, monitoring output, and promoting lung re-expansion in the case of chest tubes. Adhering to careful handling and monitoring protocols is emphasized to prevent infections and ensure devices are functioning properly.
This document provides information on abdominal paracentesis including:
1. It defines paracentesis as a procedure where a needle is inserted into the peritoneal cavity to obtain ascitic fluid for diagnostic or therapeutic purposes.
2. The indications for paracentesis include diagnostic testing of new ascites, suspected infections, and therapeutic removal of over 5 liters of fluid for relief of symptoms.
3. Potential complications include failed fluid collection, persistent leaks, infections, hematomas, organ perforation, and hypotension. Proper technique and monitoring can help reduce risks.
After delivery of the baby, the placenta normally detaches from the uterus within a few minutes and is expelled. Retention of the placenta for over 30 minutes can lead to bleeding due to interference with uterine contraction. If conservative measures like ensuring an empty bladder fail, manual removal of the placenta may be necessary while providing anesthesia and oxytocin to facilitate contraction. This involves gently separating the placenta from the uterus by hand under ultrasound guidance if needed. Uterine massage and antibiotics are then given.
1. Thoracentesis is a procedure to drain fluid from the pleural space for diagnostic or therapeutic purposes. It can be done blindly or under ultrasound guidance.
2. A thorough history, physical exam, chest x-ray and ultrasound are used to evaluate pleural effusions and determine if thoracentesis is needed. Samples of pleural fluid are analyzed to identify the cause of the effusion.
3. Thoracentesis involves inserting a small needle between the ribs to drain pleural fluid. Samples are taken for analysis and the procedure provides relief for patients with large effusions. Complications can include pneumothorax, infection and bleeding.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
This document provides information on hematology and blood collection procedures. It discusses the composition of blood and where blood cells are produced. It also describes procedures for collecting blood samples from capillaries, veins, and arteries. Key steps are outlined for capillary puncture, venipuncture, arterial puncture, and proper handling and transport of blood samples. Potential errors at different stages of blood collection and patient care considerations are also reviewed.
A chest tube is a flexible plastic tube inserted between the pleural layers of the chest wall to drain air or fluid from the pleural space. It is used to treat conditions where air or fluid has accumulated in the pleural space such as pneumothorax, pleural effusions, or hemothorax. The tube is inserted using local anesthesia in the intercostal space and attached to a drainage system placed below chest level. It is secured with sutures and the insertion site is dressed. The tube remains in place until drainage stops and a chest x-ray confirms its proper position and resolution of the underlying condition.
This document provides an overview of thoracentesis, including:
- Definition, indications, contraindications, techniques/procedure, materials, and complications of thoracentesis.
- Thoracentesis is a procedure to remove fluid from the pleural space, either for diagnostic purposes or to relieve symptoms. It is indicated for large pleural effusions or those requiring diagnostic analysis.
- Potential complications include pneumothorax, hemothorax, organ injury, and infection, though minor complications like pain or dry tap are more common. Proper patient preparation, anesthesia, positioning, and sterile technique are emphasized to reduce risks.
Thoracentesis is a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall. This procedure is done to remove excess fluid, known as a pleural effusion, from the pleural space to help you breathe easier.
Thoracic surgery refers to operations on the organs in the chest including the heart, lungs, and esophagus. The document discusses various types of thoracic surgeries like lobectomy, pneumonectomy, wedge resection, and lung transplant that are performed to diagnose, treat, or repair conditions of the lungs. It also covers surgeries related to the heart like pericardiectomy and esophageal surgeries like esophagectomy. Important aspects of pre-operative, intra-operative and post-operative nursing management are outlined with a focus on airway maintenance, respiratory monitoring, coughing exercises, and chest tube care.
This document provides information about blood collection and processing. It defines blood and its functions. It describes the physical characteristics of blood and its composition. It discusses the purposes of blood collection and the techniques used for vein puncture, capillary puncture, and arterial puncture. It also covers sample handling, centrifugation, and factors to consider to prevent hemolysis.
The document discusses proper procedures for blood collection, including using universal safety precautions when handling needles and blood samples, selecting appropriate veins for venipuncture, collecting blood in tubes containing anticoagulants to prevent clotting, and taking care when collecting from babies or doing fingersticks to obtain small blood samples. Common anticoagulants added to blood collection tubes are EDTA, sodium citrate, heparin, and double oxalate, which work by binding calcium ions or inhibiting coagulation factors to prevent clotting.
This document defines intravenous infusion and outlines its purpose, types, equipment, procedures, documentation, calculations, factors affecting rate, site care, and complications. IV therapy is used to prevent or treat fluid/electrolyte imbalances when oral intake is not possible. It involves introducing fluids intravenously. The nurse is responsible for initiation, monitoring, and discontinuation. Common types include isotonic, hypotonic, and hypertonic solutions. Careful documentation and monitoring for complications like infiltration and infection is important when providing IV therapy.
PowerPoint presentation on Intercostal drainage (ICD) or Chest tube drainage. In this this presentation I have included different methods by which a chest tube can be inserted to drain fluid, pus, air from the Pleural cavity. please do mail me your feedback on this presentation at tinkujoseph2010@gmail.com.
The document provides information on ascites in children, including causes, pathophysiology, clinical presentation, investigations, and management. The most common causes of ascites in children are hepatic and renal disease, though it can also be caused by cardiac disease, trauma, infection, or neoplasia. Diagnostic evaluation involves physical exam, imaging like ultrasound or CT scan, and paracentesis with ascitic fluid analysis. Management depends on the underlying cause but may include diuretics, salt restriction, liver support therapies, or treatment of the primary disease. Complications can include respiratory distress, hernias, infections like spontaneous bacterial peritonitis.
This document provides guidelines for collecting blood samples through three main methods: capillary, venous, and arterial puncture.
For capillary collection, the finger or earlobe is punctured with a lancet. For venous collection, a vein in the arm is accessed with a needle and syringe. Proper site selection, cleaning, tourniquet use, and needle insertion technique are described.
Arterial puncture is used to collect blood gases and is more difficult than venous puncture. The radial, brachial, or femoral arteries can be used. Precautions are outlined to minimize hemolysis and contamination across all collection methods.
Physiotherapy in surgery in abdominal and thoracic surgeryDrKhushbooBhattPT
Rehabilitation is one of the important aspect in pre and post surgery care.
This presentation is mainly focusing on the "thoracic and abdominal rehabilitation" and also gives details about assessment and management of "intercostal drains".
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
This document provides guidance on care protocols for three medical devices: external ventricular drains (EVDs), tracheostomy tubes, and chest tubes. It outlines key steps for each device, including maintaining proper positioning and drainage, assessing the insertion site, monitoring output, and promoting lung re-expansion in the case of chest tubes. Adhering to careful handling and monitoring protocols is emphasized to prevent infections and ensure devices are functioning properly.
This document provides information on abdominal paracentesis including:
1. It defines paracentesis as a procedure where a needle is inserted into the peritoneal cavity to obtain ascitic fluid for diagnostic or therapeutic purposes.
2. The indications for paracentesis include diagnostic testing of new ascites, suspected infections, and therapeutic removal of over 5 liters of fluid for relief of symptoms.
3. Potential complications include failed fluid collection, persistent leaks, infections, hematomas, organ perforation, and hypotension. Proper technique and monitoring can help reduce risks.
After delivery of the baby, the placenta normally detaches from the uterus within a few minutes and is expelled. Retention of the placenta for over 30 minutes can lead to bleeding due to interference with uterine contraction. If conservative measures like ensuring an empty bladder fail, manual removal of the placenta may be necessary while providing anesthesia and oxytocin to facilitate contraction. This involves gently separating the placenta from the uterus by hand under ultrasound guidance if needed. Uterine massage and antibiotics are then given.
1. Thoracentesis is a procedure to drain fluid from the pleural space for diagnostic or therapeutic purposes. It can be done blindly or under ultrasound guidance.
2. A thorough history, physical exam, chest x-ray and ultrasound are used to evaluate pleural effusions and determine if thoracentesis is needed. Samples of pleural fluid are analyzed to identify the cause of the effusion.
3. Thoracentesis involves inserting a small needle between the ribs to drain pleural fluid. Samples are taken for analysis and the procedure provides relief for patients with large effusions. Complications can include pneumothorax, infection and bleeding.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
2. • A potential space exists in the left and right side of the chest cavity between
the inner chest wall and lung. A trace amount of fluid is found in this space as
part of healthy lymphatic drainage, providing lubrication between the lung
parenchyma and musculoskeletal structures of the rib-cage during expansion
(inhalation) and recoil (exhale).
• Excess fluid is pathological. The volume of excessive fluid, the rate of
accumulation, the cellular content of the fluid, and the chemical composition
of the fluid are all used to guide the management and the differential
diagnosis of the underlying etiology.
• Thoracentesis is done in either a supine or sitting position depending on
patient comfort, underlying condition, and the clinical indication.
Anatomy and Physiology.
3. Indications
The indications for thoracentesis are relatively broad including diagnostic and
therapeutic clinical management.
• Thoracentesis should be performed diagnostically whenever the excessive fluid is
of unknown etiology. It can be performed therapeutically when the volume of fluid
is causing significant clinical symptoms.
• Typically, diagnostic thoracentesis is a small volume (single 20cc to 30cc syringe).
Unless the etiology is obvious, a first-time thoracentesis should have a diagnostic
sample collected for laboratory and pathology analysis.
• Typically, therapeutic thoracentesis is a large volume (multiple liters of fluid). A
small sample of a large volume thoracentesis should be sent for analysis when the
etiology of the fluid is unknown or there is a question of a change in the etiology
(e.g., new infection, decompensated chronic condition).
• If the volume of fluid is anticipated to reaccumulate quickly, a drain is often left in
place to collect this fluid. This often is seen in trauma (e.g., hemothorax), cancer
(e.g., malignant effusion), post-operatively (e.g., cardiothoracic post-operative
healing/inflammatory conditions), and end-stage metabolic conditions with the
systemic excessive colloid leak (e.g., cirrhosis or malabsorption syndromes).
• A fluid collection that is believed to be infected should be drained to eliminate the
source of infection and/or reservoirs of the infection.
4. Contraindications
• Coagulation abnormalities (however, fresh plasma can be used)
• . Pts receiving mechanical ventilation since positive pressure ventilation may bring
the lungs close to the thoracentesis needle and increase the risk of pneumothorax
• . Severe hemodynamic compromise (The thoracentesis needle should not pass
through sites of cutaneous infection such as cellulitis or herpes zoster)
5. Equipments
• IV needle catheter
• Skin cleansing agent
• Gauze
• Sterile gloves
• A drape
• Hemostat
• 1 or 2 % Lidocaine
• 10 mL syringe and 22 and 25 gauge needles
6. For collection of pleural fluid;
• 18 or 20 gauge over the needle catheter
• 60 mL syringe
• A 3-way stop cock
• A sterile drainage tubing
• Specimen tubes and large evacuated container for collection of the fluid
• Sterile occlusive dressing
7. Preparation
• Explain the procedure to the pt and obtain written informed consent
• Also, verify the pts identity
• Mark the correct site for puncture
• Conduct a procedural time out. It takes place immediately before the procedure
and it consist of (Confirmation by all members of care team, Pts identity, Procedure
he/she is to undergo and Site of the procedure are all correct)
8. Technique
• Place the pt. in a sitting position on the edge of the bed with his/her arms resting
on a table.
* (The height of the effusion is determined by auscultation and percussion of the
posterior chest wall)
• Using the skin marking pen, mark the needle insertion site.
* (The site should be 5 to 10 cm lateral to the spine and at least 1 or 2 intercostal
spaces below the top of the effusion. Note that the needle should not be inserted
below the 9th rib)
• Prepare the area with antiseptic solution and apply a sterile drape
• Using a 25 gauge needle, place wheel of local anaesthetics like 1 0 or 2 % Lidocaine
along the superior edge of the rib that lies below the selected intercostal space.
9. • Switch to a 22 gauge needle and begin to anaesthetize the deeper tissues.
• (The inferior surface of the rib must be avoided since the intercostal vessels
and nerve are located in this region, hence, ensure that you walk the needle
over the superior aspect of the rib alternately injecting anaesthetic ad
pulling back on the plunger as you advance.
• Once the needle enters the pleural space, the pleural fluid will begin to fill
the syringe.
• Then, inject more anaesthetic at this point to anaesthetize the highly
sensitive parietal pleura.
• Note the depth of penetration and then withdraw the needle. If needed,
you can use the hemostat to the exposed portion of the needle in order to
mark the depth of the pleural space.
10. Pleural Fluid Aspiration
• Attach on 18 gauge over the needle catheter to a syringe and advance it along the
superior surface of the rib. Keep pulling back on the plunger as you proceed to the
predetermined depth of the pleural space.
• Once fluid is aspirated, immediately stop advancing the needle and guide the
plastic catheter over the needle.
• When the catheter is finally inserted, remove the needle as the pt. exhales or
hums. The exposed hub of the catheter should be covered immediately with your
finger to prevent the entry of air into the pleural space.
• Then attach a 3-way stopcock and large syringe to the catheter and continue to
aspirate the fluid
• When the syringe is full, adjust the stopcock so that it’s close to the pt. only when
fluid is being actively drained.
* If additional fluid needs to be drained for therapeutic purposes, attach the
collecting tubing to the stopcock and to the evacuated container.
11. • Open the stopcock to the pt. and to the tubing and allow the evacuated container
to fill.
* Generally, you should remove no more than 1500 ml of pleural fluid. The removal
of large volumes may result in post expansion pulmonary edema
• On completion of fluid collection you should rapidly remove the catheter as the pt.
holds his/her breath at end expiration.
• Cover the needle insertion site with an occlusive dressing and clean the
surrounding skin.
* At the end of the procedure make sure that all needles are placed into the
appropriate safety devices.
12. Pleural Fluid Analysis
• Aspirated fluid should be placed in specimen tubes before the large evacuated
container is filled or while it’s filling.
* A tube without additives should be used for chemical analysis such as the
measurement of LDH, protein and glucose levels.
• An EDTA (Ethylenediaminetetraacetic acid) treated tube should be used for the cell
count.
• Specimens for cytologic and microbiologic analysis and for other tests may be
required depending on the clinical circumstances.
* Analysis of pleural fluid helps to differentiate the Transudate commonly caused by
congestive heart failure/cirrhosis from an Exudate which can be caused by processes
such as bacteria, cancer and trauma.
13. Transudate/Exudate Difference
Transudate
• Pleural fluid protein is < 0.5 serum protein
• Pleural fluid LDH < 0.6 serum LDH
• Pleural fluid LDH <2/3 upper limit normal
Exudate
• Pleural fluid protein is > 0.5 serum protein
• Pleural fluid LDH > 0.6 serum LDH
• Pleural fluid LDH > 2/3 upper limit normal
14. Complications
• Pneumothorax though uncommon hence chest x-ray should be performed if air is
aspirated during procedure, If the pt. develops chest pain, dyspnea, hypoxemia or
if the pt is critically ill or mechanically ventilated.
• Other complications include pain, coughing and localized infection.
• More serious complications are hemothorax, intraabdominal organ injury, air
embolism and post expansion pulmonary edema.
15. Questions…
1. What are the indications and contraindications for thoracentesis?
2. Which part of the rib should you place a wheel of local anaesthetics
using a 25 gauge?
3. On which surface of the rib are the intercostal vessels and nerve are
located?
4. What are the ifferences between exudate and transudate?
5. What are the complications of thoracentesis?