The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Infection control protocols in intensive care unitsANILKUMAR BR
Hospital acquired infections (HAIs) are common in intensive care unit (ICU) patient and are associated with increased morbidity and mortality.
The main reason being severity of illness, interruption of normal defense mechanism (e.g. mechanical ventilation), malnutrition & inability to ambulate make it more susceptible to multi drug resistant organism (MDRO).
The most frequent mode of transmission is Contact transmission, this may be direct or indirect other modes include droplet transmission, airborne transmission, common vehicle such as ventilator etc.
A cardiac event monitor is a device that you control to record the electrical activity of your heart (ECG). This device is about the size of a pager. It records your heart rate and rhythm. Cardiac event monitors are used when you need long-term monitoring of symptoms that occur less than daily
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Infection control protocols in intensive care unitsANILKUMAR BR
Hospital acquired infections (HAIs) are common in intensive care unit (ICU) patient and are associated with increased morbidity and mortality.
The main reason being severity of illness, interruption of normal defense mechanism (e.g. mechanical ventilation), malnutrition & inability to ambulate make it more susceptible to multi drug resistant organism (MDRO).
The most frequent mode of transmission is Contact transmission, this may be direct or indirect other modes include droplet transmission, airborne transmission, common vehicle such as ventilator etc.
A cardiac event monitor is a device that you control to record the electrical activity of your heart (ECG). This device is about the size of a pager. It records your heart rate and rhythm. Cardiac event monitors are used when you need long-term monitoring of symptoms that occur less than daily
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
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
- 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
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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2. Out lines:
Objectives
Definition of M.V
Indications
Modes of M.V
Adjustment of M.V
Complications of M.V
Nursing Management
3. Objectives
To define what is the mechanical ventilator.
To know what are the indications for M.V .
To determine modes of mechanical
ventilation .
To know how to adjust M.V .
To know how to deal with complications of
M.V .
To determine what is the nursing
management of ventilated patient .
5. Is a machine that generates a controlled flow of
gas into a patient’s airways. Oxygen and air are
received from cylinders or wall outlets, the gas is
pressure reduced and blended according to the
prescribed inspired oxygen tension
(FiO2), accumulated in a receptacle within the
machine, and delivered to the patient using one
of many available modes of ventilations.
6. Indications
Need for sedation/
neuromuscular blockage.
Need to decrease systemic or
myocardial oxygen
consumption.
Use of hyperventilation to
reduce intracranial pressure.
10. Modes of Ventilation:
The machine is not giving pressure breath.
The Pt. breath spontaneously.
The Pt. needs only specific FIO2 to maintain its
normal blood gases.
11. The machine controls the patient ventilation according
to set tidal volume and respiratory rate . spontaneous
respiratory effort of Pt. is locked out , ( patient who
receives sedation and paralyzing drugs he will on
controlled Mode).
12. :
Machine allows the Pt to breath
spontaneously while providing preset FIO2
, and a number of ventilator breaths to ensure
adequate ventilation without fatigue.
13. The Pt. triggers the machine with negative
inspiratory effort. If the Pt. fails to breath the
machine will deliver a controlled breath at a
minimum rate and volume already set.
14. Adjustment on the
:ventilator
The ventilator is adjusted so that the pt. is comfortable
and "in sync " with the machine.
Minimal alteration of the normal cardiovascular
and pulmonary dynamics is desired.
If the volume of ventilator is adjusted appropriately , the
pt. arterial blood level will be satisfactory and there will
be no or little cardiovascular compromise.
15. The Following Guidelines
:are Recommended
1. set the machine to deliver the required tidal
volume ( 6 to 8 ml/kg)
2. adjust the machine to deliver the lowest
concentration of the oxygen to maintain normal
PaO2 (80 to 100mmhg).The setting may be set
high and gradually reduced based on ABGs
result.
16. 3. Record peak inspiratory pressure.
4. Set mode (assist/control or SIMV)and rate
according to physician order.
5. If Pt. is on assist/control mode , adjust
sensitivity so that the Pt. can trigger the
ventilator with the minimum effort( usually
2mmHg negative inspiratory force)
17. 6. Record minute volume and measure carbon
dioxide partial pressure PaCO2, PH after 20
minutes of mechanical ventilation.
7. Adjust FIO2 and rate according to results of ABG
to provide normal values or those set by the
physician.
18. 8. In case of sudden onset of confusion , agitation
or unexplained " bucking the ventilator " the Pt.
should be assessed for hypoxemia and manually
ventilated on 100% oxygen with resuscitation
bag ( AMBU bag) Bag – Valve – mask.
9. Patient who are on controlled ventilation and
have spontaneous respiration may " fight or
buck " the ventilator, because they cannot
synchronize their own respiration with the
machine cycle.
19. Sedative and neuromuscular blocking
agents may be given such as:
Pancuornium bromide(Pavulon)
Midazolam
Neuromuscular blocking agents block the
transmission of nerve impulses and result in
muscle paralysis.
21. A- Decreased Cardiac Output
Cause - venous return to the right atrium impeded by the dramatically
increased intrathoracic pressures during inspiration from positive
pressure ventilation. Also reduced sympatho-adrenal stimulation
leading to a decrease in peripheral vascular resistance and reduced
blood pressure.
Symptoms – increased
heart rate,
decreased blood pressure and perfusion to vital organs, decreased CVP,
and cool clammy skin.
Treatment – aimed at increasing preload (e.g. fluid administration)
and decreasing the airway pressures exerted during mechanical
ventilation by decreasing inspiratory flow rates and TV, or using other
methods to decrease airway pressures (e.g. different modes of
ventilation).
22. B. Barotrauma
Cause – damage to pulmonary system due to alveolar
rupture from excessive airway pressures and/or
overdistention of alveoli.
Symptoms – may result in
pneumothorax, pneumomediastinum and subcutaneous
emphysema.
Treatment - aimed at reducing T.V, cautious use of
PEEP, and avoidance of high airway pressures resulting in
development of auto-PEEP in high risk patients (patients
with obstructive lung
diseases (asthma, bronchospasm), unevenly
distributed lung diseases (lobar pneumonia), or
hyperinflated lungs (emphysema).
23. C. Nosocomial Pneumonia
Cause – invasive device in critically ill patients becomes
colonized with pathological bacteria within 24 hours in almost
all patients. 20-60% of these, develop nosocomial pneumonia.
Treatment – aimed at prevention by the following:
Avoid cross-contamination by frequent handwashing
Decrease risk of aspiration (cuff occlusion of trachea,
positioning, use of small-bore NG tubes)
Suction only when clinically indicated, using sterile technique
Maintain closed system setup on ventilator circuitry and avoid
pooling of condensation in the tubing
Ensure adequate nutrition
Avoid neutralization of gastric contents with antacids and H2
blockers
24. E. Decreased Renal Perfusion – can be treated with
low dose dopamine therapy.
F. Increased Intracranial Pressure (ICP) – reduce
PEEP
G. Hepatic congestion – reduce PEEP
H. Worsening of intracardiac shunts –reduce PEEP
25. . Other common potential problems
related to mechanical
ventilation:
Aspiration,
GI bleeding,
Inappropriate ventilation
(respiratory acidosis or alkalosis,
Thick secretions,
Patient discomfort due to pulling or jarring of ETT or tracheostomy,
High PaO2, Low PaO2,
Anxiety and fear,
Dysrhythmias
or vagal reactions during or after suctioning,
Incorrect PEEP setting,
Inability to tolerate ventilator mode.
27. Nursing Management:
1. Promote respiratory function.
2. Monitor for complications
3. Prevent infections.
4. Provide adequate nutrition.
5. Monitor GI bleeding.
28. PROMOTE RESPIRATORY
FUNCTION
1. Auscultate lungs frequently to
assess for abnormal sounds.
2. Suction as needed.
3. Turn and reposition every 2
hours.
4. Secure ETT properly.
5. Monitor ABG value and pulse
oximetry.
29. Suction of an Artificial
Airway
1. To maintain a patent airway
2. To improve gas exchange.
3. To obtain tracheal aspirate
specimen.
4. To prevent effect of retained
secretions.
( Its important to OXYGENATE
before and after suctioning)
30. MONITOR FOR COMPLICATIONS
1. Assess for possible early complications
Rapid electrolyte changes.
Severe alkalosis.
Hypotension secondary to change in
Cardiac output.
2. Monitor for signs of respiratory distress:
Restlessness
Apprehension
Irritability and increase HR.
31. 3. Assess for signs and symptoms of
barotrauma(rupture of the lungs)
Increasing dyspnea
Agitation
Decrease or absent breath sounds.
Tracheal deviation away from affected
side.
Decreasing PaO2 level .
1. Assess for cardiovascular depression:
Hypotension
Tachy. and Bradycardia
Dysrhythmias.
32. PREVENT INFECTION
1. Maintain sterile technique when suctioning.
2. Monitor color, amount and consistency of sputum.
PROVIDE ADEQUATE NUTRITION
1. Begin tube feeding as soon as it is evident the patient will
remain on the ventilator for a long time.
2. Weigh daily.
3. Monitor I&O .
MONITOR FOR GI BLEEDING
1. Monitor bowel sounds.
2. Monitor gastric PH and hematest gastric secretions every shift.