This document discusses neonatal resuscitation for newborn babies having difficulty transitioning from intrauterine to extrauterine life. It involves maintaining an open airway through positioning and suctioning, initiating breathing through tactile stimulation or positive pressure ventilation, and maintaining circulation through chest compressions if the heart rate is low. The key steps and equipment used are outlined, including correct techniques for bag-mask ventilation and chest compressions. Signs of improvement and next steps based on heart rate are also described.
This slides contain detailed description of radiant warmer used in hospital setting, various modes , alarms, do's and don't of radiant warmer and nursing care management for the baby under radiant warmer
This slides contain detailed description of radiant warmer used in hospital setting, various modes , alarms, do's and don't of radiant warmer and nursing care management for the baby under radiant warmer
neonatal hypothermia is a very emergency condition. if we identify this in early stage we can save the life of neonate. all should know about the maintaining the temperature if the neonate is in our home.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
Title: "Comprehensive Care of Pediatric Patients on Ventilators: A Guide for 3rd Year BSN Students"
Slide Description:
Welcome to our presentation on the "Care of Child on Ventilator," designed specifically for 3rd-year Bachelor of Science in Nursing (BSN) students. In this comprehensive guide, we will delve into the essential aspects of providing high-quality care to pediatric patients requiring mechanical ventilation.
Slide 1: Introduction
- Provide an overview of the presentation's content.
- Highlight the importance of understanding pediatric ventilation care for nursing students.
- Set the stage for an in-depth exploration of the topic.
Slide 2: Pediatric Respiratory Anatomy and Physiology
- Explain the unique characteristics of the pediatric respiratory system.
- Discuss how these differences impact the care of ventilated children.
Slide 3: Indications for Pediatric Ventilation
- Enumerate common medical conditions necessitating ventilator support in children.
- Emphasize the importance of early recognition and intervention.
Slide 4: Types of Pediatric Ventilators
- Describe the various types of ventilators used in pediatric care.
- Highlight their features and functionalities.
Slide 5: Ventilator Settings and Modes
- Explain the key ventilator settings and modes relevant to pediatric patients.
- Provide practical insights into their adjustment and monitoring.
Slide 6: Nursing Assessment
- Outline the comprehensive nursing assessment required for children on ventilators.
- Discuss the importance of monitoring vital signs and respiratory parameters.
Slide 7: Pediatric Ventilation Troubleshooting
- Address common issues and complications that may arise during ventilation.
- Offer guidance on troubleshooting and appropriate nursing interventions.
Slide 8: Infection Control and Preventing Ventilator-Associated Pneumonia (VAP)
- Discuss the significance of infection prevention in ventilated pediatric patients.
- Share best practices for minimizing the risk of VAP.
Slide 9: Family-Centered Care
- Stress the importance of involving families in the care process.
- Provide strategies for effective communication and support.
Slide 10: Case Studies and Clinical Scenarios
- Present real-life case studies and clinical scenarios to enhance practical understanding.
- Encourage active participation and problem-solving among students.
Slide 11: Nursing Responsibilities and Ethical Considerations
- Detail the ethical considerations surrounding pediatric ventilation care.
- Highlight the responsibilities of nurses in advocating for their young patients.
Slide 12: Conclusion and Resources
- Summarize key takeaways from the presentation.
- Provide references and resources for further learning.
Slide 13: Q&A
- Open the floor for questions and discussions.
- Foster an interactive learning environment.
Slide 14: Thank You
- Express gratitude for the audience's participation.
- Provide contact information for further inquiries.
neonatal hypothermia is a very emergency condition. if we identify this in early stage we can save the life of neonate. all should know about the maintaining the temperature if the neonate is in our home.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
Title: "Comprehensive Care of Pediatric Patients on Ventilators: A Guide for 3rd Year BSN Students"
Slide Description:
Welcome to our presentation on the "Care of Child on Ventilator," designed specifically for 3rd-year Bachelor of Science in Nursing (BSN) students. In this comprehensive guide, we will delve into the essential aspects of providing high-quality care to pediatric patients requiring mechanical ventilation.
Slide 1: Introduction
- Provide an overview of the presentation's content.
- Highlight the importance of understanding pediatric ventilation care for nursing students.
- Set the stage for an in-depth exploration of the topic.
Slide 2: Pediatric Respiratory Anatomy and Physiology
- Explain the unique characteristics of the pediatric respiratory system.
- Discuss how these differences impact the care of ventilated children.
Slide 3: Indications for Pediatric Ventilation
- Enumerate common medical conditions necessitating ventilator support in children.
- Emphasize the importance of early recognition and intervention.
Slide 4: Types of Pediatric Ventilators
- Describe the various types of ventilators used in pediatric care.
- Highlight their features and functionalities.
Slide 5: Ventilator Settings and Modes
- Explain the key ventilator settings and modes relevant to pediatric patients.
- Provide practical insights into their adjustment and monitoring.
Slide 6: Nursing Assessment
- Outline the comprehensive nursing assessment required for children on ventilators.
- Discuss the importance of monitoring vital signs and respiratory parameters.
Slide 7: Pediatric Ventilation Troubleshooting
- Address common issues and complications that may arise during ventilation.
- Offer guidance on troubleshooting and appropriate nursing interventions.
Slide 8: Infection Control and Preventing Ventilator-Associated Pneumonia (VAP)
- Discuss the significance of infection prevention in ventilated pediatric patients.
- Share best practices for minimizing the risk of VAP.
Slide 9: Family-Centered Care
- Stress the importance of involving families in the care process.
- Provide strategies for effective communication and support.
Slide 10: Case Studies and Clinical Scenarios
- Present real-life case studies and clinical scenarios to enhance practical understanding.
- Encourage active participation and problem-solving among students.
Slide 11: Nursing Responsibilities and Ethical Considerations
- Detail the ethical considerations surrounding pediatric ventilation care.
- Highlight the responsibilities of nurses in advocating for their young patients.
Slide 12: Conclusion and Resources
- Summarize key takeaways from the presentation.
- Provide references and resources for further learning.
Slide 13: Q&A
- Open the floor for questions and discussions.
- Foster an interactive learning environment.
Slide 14: Thank You
- Express gratitude for the audience's participation.
- Provide contact information for further inquiries.
About 10% of all newborn require some assistance to begin breathing after birth, and 1% require extensive resuscitation efforts. Newborn resuscitation cannot always be anticipated in time to transfer the mother before delivery to a facility with specialized neonatal support. Therefore, every hospital with a delivery suite should have an organized, skilled resuscitation team and appropriate equipments available.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- 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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Cardio pulmonary Resuscitation
It is a technique of basic life support for the patient
who is not breathing and has no pulse. It involves a
series of steps used to establish artificial ventilation
and circulation.
3. Neonatal Resuscitation
Resuscitation of newborn child with birth asphyxia is called neonatal
resuscitation.
It is a series of actions used to assist newborn babies having difficulty in
making physiological transition from intrauterine life to extra uterine
life.
4. Purposes
• To maintain open and clear airway.
• To maintain breathing by artificial ventilation.
• To maintain blood circulation by external cardiac massage.
• To save life of neonates having weak or no respiratory efforts.
• To provide basic life support till medical and the advanced life support
arrives.
5. Indications
• Birth asphyxia
• Meconium aspiration syndrome
• Preterm birth with least respiratory efforts
• Fetal distress
6. Articles
Suctioning Articles
• Bulb syringe
• De lee mucus trap with No-10 Fr catheter or mechanical suction
• Suction catheters 6,8,10 Fr
• Feeding tube 6 and 8Fr
• 10&20 ml syringe
7. • Bag & Mask articles
• Infant resuscitation bag (C pressure release value or pressure gauge
with reservoir capable of delivering 90-100% oxygen)
• Face Mask- newborn and premature size (with cushioned rim)
• Oral airways
• Oxygen with flow meter & tubing
• Intubation articles
• Laryngoscope with straight blades No. 0,1
• Extra bulb & batteries
• Endotracheal tubes size – 2.5, 3.0, 3.5 & 4.0 mm
• Stylet
8. • Medications
• Epinephrine (1:10,000)
• Naloxone hydrochloride
• Volume expanders (5% albumin solution, Normal saline, Ringer
lactate)
• Sodium bicarbonate
• Dextrose 10%
• Sterile water
9. Miscellaneous
• Radiant warmer
• Stethoscope
• Adhesive tape, bandage, scissor
• Syringe 1ml, 2ml, 5ml, 10ml &
20ml
• Needles no. 21,22,26 G
• Umbilical catheter 3.5, 5 F
• Three-way stopcock
• Umbilical cord clamp
• Gloves, Warm dry towels
• Watch with second hand
• Linen, Shoulder roll
11. Principle of neonatal resuscitation
T= Temperature
• Receive the baby in a prewarmed linen.
• Keep the baby under radiant warmer.
• Dry the baby immediately.
• Remove the wet linen.
• Maintaining room temperature 25 + 20 C
• Cover head of the baby.
12. A=Airway
Positioning:
Place the baby on its back.
•Position the head so that it is slightly extended to open the
airway.
•Place a folded piece of cloth under the shoulder of baby to
help to maintain the position. The folded cloth under the
baby’s shoulder should not be too thick or thin that may lead to
overextension or flexion of airway.
13. Suctioning:
• Suction first the MOUTH & then the NOSE with the help of bulb syringe or
mechanical suction.
• Do suction gently by introducing the suction tube 5cms in baby’s mouth
until the 5cms mark is at baby’s lips.
• Use suction while withdrawing the tube.
• Next introduce the suction tube upto 3 cms into each nostril.
• Suction for less than 15 seconds. If the infant has copious secretions from
the mouth, the head should be turned to the side.
• The size of suction catheter should be 6,8 or 10 F.
• The suction pressure should be kept 40-60 mm Hg for pre-term infant and
60-80 mm Hg for term neonate.
14. B= Initiating Breathing
• Tactile stimulation:
• Both drying & suctioning the infant produces stimulation, which is for many infants is enough to
induce respiration.
• If respiration is inadequate, tactile stimulation is given by slapping or flicking the soles & rubbing
the newborn’s back, trunk or extremities. These slaps/flicks should be given once/twice.
• If the infant remains apneic, positive pressure ventilation should be started
• PPV if necessary
• Positive pressure ventilation: Bag and mask ventilation is indicated if after tactile stimulation
• The infant is apneic or gasping.
• HR< 100 bpm
• Persistent central cyanosis despite of administration of 100% free flow oxygen.
• PPV should be given with self-inflating bag and face mask. The resuscitation bag should have a
capacity of 240-750 ml. If the bag is attached to an oxygen source (at 5-6 Liter/min.) & a reservoir
which delivers 90-100% oxygen.
15. Procedure of giving PPV:
• Place the infant in neck slightly extended position to ensure open airway.
• Place the correct size mask on the baby's face so that it covers the baby's
chin, mouth and the nose.
• Make a seal between the mask and the baby's face.
• Hold the mask in place gently but firmly. Keep the head in position.
• Squeeze the bag attached to the mask with the thumb and two fingers so
as to cause adequate chest rise with each ventilation. Ventilate at a rate of
40-60 breaths/minute.
• Count out loud. SQUEEZE-count a loud' one hundred and one, SQUEEZE
one hundred and two, SQUEEZE one hundred and three, SQUEEZE……..'
and continue until you reach 'One hundred and twenty'(i.e. For 30
seconds).
• If the chest is not rise and there no audible breath sounds, the following
steps to be undertaken:
16. VENTILATION CORRECTIVE STEPS (MRSOPA)
Action Remedial steps
Inadequate seal Reapply Mask
Blocked airways Reposition the head in sniffing position
Blocked airway
Suction the airway
Open baby’s mouth and ventilate
Inadequate pressure
Increase Pressure by squeezing the bag with
more Pressure till a chest rise is visible
No improvement with
above steps
Consider endo tracheal intubation (Airway
maintain)
17. • Provide uninterrupted effective ventilation for 30 seconds and assess
for spontaneous
• breathing and heart rate. If spontaneous breathing present and heart
rate is 100 or more, then gradually discontinue PPV.
• After 30 seconds of bag and mask ventilation, reassess respiratory
efforts, heart rate every 30 seconds (oxygen saturation may be
monitored continuously if available) and look for the following signs
of improvement:
18. Response to ventilation should be seen by:
Improvement in baby’s color from blue to pink
Improved respiration
Heart rate >100 bpm.
19. FOLLOW-UP ACTIVITY FOR HEART RATE RESPONSE:
HR ACTION
Above 100
STOP ventilation if spontaneous respirations are present;
provide tactile stimulation by gently rubbing the body, &
monitor HR, Respiration & color.
If gasping or not breathing, continue ventilation
60 to 100 Continue bag and mask ventilation, take corrective steps
measures
Below 60 Begin chest compressions; Continue to ventilate
20. C= Maintain circulation
• Chest compressions: When the infant is hypoxic, there is diminished
blood and oxygen flow to the vital organs. Chest compressions are
used to temporarily increase circulation and oxygen delivery. Chest
compressions should be accompanied with 100% oxygen, so that the
blood being circulated during chest compressions gets oxygenated.
21. Indication of providing chest compressions:
•HR<60, even after 30 seconds of PPV.
•HR is between 60-80 but not increasing
22. PROCEDURE OF PROVIDING CHEST COMPRESSIONS:
• Techniques of providing chest compressions:
• Thumb technique
• Two-finger technique
• When chest compression is performed on a neonate, pressure is applied to the lower third of the
sternum. To locate the area, one should slide the fingers on the lower edge of thoracic cage and
locate xiphisternum. The lower third of sternum is just above it.
• Rate: In one minute, 90 chest compressions and 30 breaths are administered (a total of 120 events)
in a ratio of 3:1
• Thumbs or tips of fingers remain in contact with chest during compressions and release. Don’t lift
your thumb or fingers off the chest between compressions.
• To determine efficiency of chest compressions, the carotid or femoral pulsations should be checked
periodically.
• Evaluation: after a period of 30 seconds of chest compressions, the HR is checked.
• HR<60 bpm: Chest compressions should be continued with bag and mask ventilation. Endotracheal
intubation and Medications can be administered.
25. • Care after procedure
• Make sure that baby’s pulse rate & respiratory rate are normal.
• Remove all equipments from bed side.
• Provide oxygen if necessary & maintain normal saturation.
• Wash all articles.
• Wash hand to prevent infection.
• Record the procedure.