Objetive of a box of critical
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1) The document analyzes patients attended to at the critical care box of the High Resolution Hospital Guadix over 12 months in 2010. 2) A total of 1012 emergencies were attended to at the critical care box, with an average age of 69 years old and most being male. 3) The most common reasons for consultation were dyspnea, chest pain, palpitations, fainting, and loss of strength. Most patients arrived in the morning and average time before being attended to was 25 seconds.
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![INTRODUCTION OBJECTIVE OF A “ BOX OF CRITICAL” AUTHORS: Aguilar Cruz, Iván; López Pérez, Maria Lourdes; Amini Shervin, Bahareh; Amezcua Fernández, Ángel; García Morón, Alejandro. EMAIL : [email_address] WEB: http://ephpo.es/hguadix INSTITUTIONS: HAR Guadix. Granada . OBJECTIVE CONCLUSIONS Hospital de Alta Resolución Guadix Critical box, is the Emergency Service room reserved to take care of the patient with emergent pathology. To analyze the patients who have been taken care of at our High Resolution Hospital at critical box during twelve months 2010. We completed an individual file for each one of the patients taken attendend at the critical box, which contains all the variables that we want to analyze. It has been used a descriptive and bivariant analysis by chi-square test or Fishers exact test used for qualitative variables and t-student and Pearsons correlation or Spearman for quantitative variables. METHODOLOGY A total of 53193 emergencies were attended 2010, of which 1012 were attended at critical box , with an age average of 69±3 years, 61% men. To emphasis 16 patients below 2 years, mainly febrile convulsions. The consultation reasons were distributed: disnea 35% patients, thoracic pain 20%, palpitations 7%, fainting 4%, hematemesis 2%, politraumatism 3%, loss of forces 6%, fever 4%, convulsive crisis 2%, other 8%. Arrival time 45% in the morning, 37% in the evening and 18% by the night. The time took before being attended was of 25 seconds with p=0.347.Level of priority I(triage done by nurses) in all the cases. Average time of permanence in box was 37minutes with one p=0.357. Derivation:56% hospitalization,31% domiciliary discharge in less than 24 hours,13% transferred or by nurse attended ambulance, medical ambulance or aerial medical transport. Average staying time 55±3 hours. Of the admitted patients 72% were discharged with complete study,24% transfered because of the resource shortage and 3% died. RESULTS Critical box, can be considered the most important room of a hospital, the only place of the hospital where the schedule does not matter. The organization, synchronization and the resources use, must be perfect. It is Medical Physician obligation to know and dominate all the things included in this room, from medication until invasive mechanical ventilation. The Emergency Medical Physician is the one that gives the primary attendance to all critical patient. Agencia Pública Empresarial Sanitaria Hospital de Poniente](https://image.slidesharecdn.com/objetiveofaboxofcritical-111109065227-phpapp01/85/Objetive-of-a-box-of-critical-1-320.jpg)
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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
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
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The Electrocardiogram - Physiologic Principles
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
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Objetive of a box of critical
- 1. INTRODUCTION OBJECTIVE OF A “ BOX OF CRITICAL” AUTHORS: Aguilar Cruz, Iván; López Pérez, Maria Lourdes; Amini Shervin, Bahareh; Amezcua Fernández, Ángel; García Morón, Alejandro. EMAIL : [email_address] WEB: http://ephpo.es/hguadix INSTITUTIONS: HAR Guadix. Granada . OBJECTIVE CONCLUSIONS Hospital de Alta Resolución Guadix Critical box, is the Emergency Service room reserved to take care of the patient with emergent pathology. To analyze the patients who have been taken care of at our High Resolution Hospital at critical box during twelve months 2010. We completed an individual file for each one of the patients taken attendend at the critical box, which contains all the variables that we want to analyze. It has been used a descriptive and bivariant analysis by chi-square test or Fishers exact test used for qualitative variables and t-student and Pearsons correlation or Spearman for quantitative variables. METHODOLOGY A total of 53193 emergencies were attended 2010, of which 1012 were attended at critical box , with an age average of 69±3 years, 61% men. To emphasis 16 patients below 2 years, mainly febrile convulsions. The consultation reasons were distributed: disnea 35% patients, thoracic pain 20%, palpitations 7%, fainting 4%, hematemesis 2%, politraumatism 3%, loss of forces 6%, fever 4%, convulsive crisis 2%, other 8%. Arrival time 45% in the morning, 37% in the evening and 18% by the night. The time took before being attended was of 25 seconds with p=0.347.Level of priority I(triage done by nurses) in all the cases. Average time of permanence in box was 37minutes with one p=0.357. Derivation:56% hospitalization,31% domiciliary discharge in less than 24 hours,13% transferred or by nurse attended ambulance, medical ambulance or aerial medical transport. Average staying time 55±3 hours. Of the admitted patients 72% were discharged with complete study,24% transfered because of the resource shortage and 3% died. RESULTS Critical box, can be considered the most important room of a hospital, the only place of the hospital where the schedule does not matter. The organization, synchronization and the resources use, must be perfect. It is Medical Physician obligation to know and dominate all the things included in this room, from medication until invasive mechanical ventilation. The Emergency Medical Physician is the one that gives the primary attendance to all critical patient. Agencia Pública Empresarial Sanitaria Hospital de Poniente