This document discusses various trauma scoring systems used to assess injury severity and predict patient outcomes. It describes scales such as the Glasgow Coma Scale, Revised Trauma Score, Abbreviated Injury Scale, and Injury Severity Score which evaluate factors like vital signs, anatomical injuries, and physiological status. Higher scores on these scales generally indicate less severe injuries and better prognosis. The document also outlines prognostic factors for specific injury types and introduces the Nepal Trauma Index, a multi-factorial scoring system developed for trauma assessment in resource-limited settings.
polytrauma lecture prepare by three medical student in Kerbala university / college of medicine department of surgery to presented as seminar
for download as ppt
https://drive.google.com/open?id=1bc3HMEeJyhrOwag-AvTFMmPVKi12O1PU
classification of soft tissue injuries. gustilo anderson classification, tscheren classification, hanover fracture scale and ao soft tissue grading system, types of wounds. orthopedic open fracture classification for management of soft tissue injuries
Seminar presentation by 4th year medical student of Lincoln University College, supervised by HRPZ Orthopedic's specialist.
Reference were from reliable medical websites and also from texttbook; Apley and Solomon's Concise System of Orthopaedics and Trauma, 4th Ed.
Injuries to a ligament are common, especially during athletic activity. Ligaments in the ankle, knee, and wrist are consistently in action during athletic activity and thus are under a lot of stress.
Dr. Bharani Kumar Dayanandam is a prominent Orthopaedic Surgeon providing a wide range of treatments for Shoulder Injuries in Chennai, India
Visit us @ https://www.chennaiorthopaedics.com
The presentation is for the use of Physiotherapy students. It covers a brief introduction, classification, clinical features and general principles of management.
polytrauma lecture prepare by three medical student in Kerbala university / college of medicine department of surgery to presented as seminar
for download as ppt
https://drive.google.com/open?id=1bc3HMEeJyhrOwag-AvTFMmPVKi12O1PU
classification of soft tissue injuries. gustilo anderson classification, tscheren classification, hanover fracture scale and ao soft tissue grading system, types of wounds. orthopedic open fracture classification for management of soft tissue injuries
Seminar presentation by 4th year medical student of Lincoln University College, supervised by HRPZ Orthopedic's specialist.
Reference were from reliable medical websites and also from texttbook; Apley and Solomon's Concise System of Orthopaedics and Trauma, 4th Ed.
Injuries to a ligament are common, especially during athletic activity. Ligaments in the ankle, knee, and wrist are consistently in action during athletic activity and thus are under a lot of stress.
Dr. Bharani Kumar Dayanandam is a prominent Orthopaedic Surgeon providing a wide range of treatments for Shoulder Injuries in Chennai, India
Visit us @ https://www.chennaiorthopaedics.com
The presentation is for the use of Physiotherapy students. It covers a brief introduction, classification, clinical features and general principles of management.
This is a presentation which contains basics of polytrauma management,ATLS, triage, critical decision making skills, application of Glasgow coma scale and complications of different management strategies, if not applied properly.
Egyptian Critical Care Summit- Major Trauma Team ConceptDr.Mahmoud Abbas
Lecture presented by Dr Ahmed Kamal Consultant Emergency Medicine at the Egyptian Critical Care Summit the leading event and medical exhibition in Egypt
Lessons from the TTM trial and planning for the nexstscanFOAM
A presentation by Niklas Nielsen, Tobias Cronberg and Gisela Lilja at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Dr Nick Little is an experienced Neurosurgeon who's looked after patients with traumatic brain injury for his whole career. Here he discusses the difficulties of prognostication following traumatic brain injury (TBI). He talks about the statistics of outcomes following mild, moderate and severe TBI and then goes on to tackle the harder topic of how we try to work out what an individual would want if they knew the spectrum of outcomes that they may face. The issues with the clinical examination findings we use to prognosticate are covered, as well as which imaging findings he finds most helpful. He also mentions the difficulties with current prognostic calculators.
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.
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.
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
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
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
2. • Outcome of any injury are:
complete recovery
Recovery with residual effect
disability
death.
Outcome depends on:
• Timing of hospital care
• Mechanism of injury
• Vital signs in field and on arrival
• Outcome measures-ICU days, ventilator days
3. It has been suggested that trauma(commonest cause of
unnatural death) follows tri-modal distribution:
Immediate: severe head injury, aorta dissection.
dealt only by prevention and public education.
Early :epidural, subdural hematoma, hemothorax etc.
Correctable injury, pre hospital coordinated care
and definitive t/t can benefit these pt.
Late: sepsis, consequences of initial management
5. • Physiological status
Glasgow coma scale
Revised trauma score
• Anatomical scores
Abbreviated injury scale
Injury severity score
System used to : ∞ stratify injury pattern
∞ assess injuries to predict pt. survival
∞ predict functional outcome of injuries
• ∞ resource utilization
6. Glasgow coma scale
Eye opening :
spontaneously 4
verbal command 3
pain 2
no response 1
Best motor response:
to verbal command: obeys 6
painful stimulus: localized pain 5
withdrawal / flexion 4
abnormal flexion 3
extension decerebrate 2
none 1
Best verbal response:
oriented 5
disoriented 4
inappropriate words 3
incomprehensible words 2
nil 1
total 3—15
7. • Head injuries GCS score
Minor 13 – 15
Majority recover fully
Moderate 9 – 12
Severe <8
degree of eventual recovery depends on initial brain injury
8. Revised trauma score <RTS>
GCS score
13 -15 4
9 -12 3
6 -8 2
4 -5 1
3 0
Systolic BP
>90 4
76 -89 3
50 -75 2
1 - 49 1
o 0
Respiratory rate
10 -29 4
>29 3
6 -9 2
1 -5 1
0 0
total score 0 – 12
used for pre-hospital emergency room triage or for
comparative reassessment
during and after resuscitation without need for accurate
diagnosis
9. • As score diminishes --------- progressively probability
of survival decreases
• A score >4 for any variable --- survival rate of <90%
• A score <4 --------------------a survival rate of just over
45%
10. ABBREVIATED INJURY SCALE
o Developed to rate and compare injuries.
o Scores based on t/t period, life threatening injuries,
expected permanent impairment & energy dissipation.
o Coding is done for
anatomical site
nature
severity
1 minor
2 moderate
3 serious
4 severe
5 critical
6 fatal
11. Score <10: death rare in pt under age of
50
Score 10-15: response to t/t
Score 10-20: mortality 4-30% depending on
age
Score >50: only rare survival
12. INJURY SEVERITY SCORE
BODY IS DIVIDED INTO 6 PARTS:
Head
Face
Chest
Abdomen
Extremities (including pelvis)
External structures
ISS=A2+B2+C2
The total ISS score is calculated from the sum of the squares of
the three worst regional values
Generally, multiple trauma patient are defined as patient with
iss≥16.
ISS<30 good prognosis, unless associated with head injury.
ISS>60 usually fatal.
The score gives a correlation between ISS and mortality
13. ISS is the most frequently used injury scoring methodology
• Has major limitation i.e.
• Can underestimate injury severity of patient with multiple
injuries in same body region.
• When used as predictor of survival ISS tends to
overweigh combined non lethal injuries, like
Isolated severe head injury ,AIS=5,ISS=25
Liver laceration AIS=4 & femur fracture AIS=3 ,ISS=25
Despite equal ISS, mortality, short and long term
complication rate, resource utilization in these 2 injuries
are probably very different.
14. Prognostic factors in head injury
• Increasing age • Diffuse B/L CT lesions
• Pupil abnormalities • Multiple injuries resulting
in hypovolaemia
• Massive lesions
• Immediate coma/lucid
• Increasing ICP interval
15. Prognostic factors in thoracic trauma:
• Mechanical ventilation
• High PEEP(flial chest)
• Pulmonary contusion –progressive hypoxia
due to edematous lung leading to v-p
mismatch.
• Emergency surgery
• Hemodynamic instability
16. Immediately life threatning conditions
• Tension pneumothorax
• Sucking chest wound
• Flial chest
• Cardiac tamponade
• Massive hemothorax
Early interventions by trained personnel (paramedics,fire
fighters,police) and well equipped transport system and
emergency team are likely to modify the outcome
Complications like ARDS, fat embolism syndrome, DIC,
crush syndrome, multi system organ failure have less
favourable outcome.
17. NEPAL TRAUMA INDEX (NTI)
For trauma scoring in developing countries
(Multifactoral scoring system)
factors criteria score
Age < 12 years of > 55 years 2
12-55 years 1
Time gap after sustaining trauma and > 12 hours 3
6-12 hours 2
reporting to hospital
< 6 hours 1
Med. t/t received elsewhere after none 2
some 1
trauma
Pulse pulse less 3
100 – 120 per minute 2
100 per minute 1
b.P not recordable 3
< 100 syst. 2
> 100 syst 1
respiration cyanosis / gasping 3
tachypnoea 2
none 1
Level of consciousness no response to verbal commands 3
reposed but irritable or incoherent 2
normal response 1
Areas of suspected injuries - Viscera head face open arterial, associated burns long 3
bone fracture, fracture spine 2
- more than 2 long bone fractures, open or closed or 1
dislocations (no visceral injuries)
- one long bone injury or dislocation or closed soft tissue
injury
Hb. At first sample < 8 grams % 3
8-10 grams % 2
> 10 grams % 1
18. • Maximum (worst score)- 25
• Safest score-10 for extremes of age groups
9 for 12 – 55 years of age groups
.
19. • Rock wood n Green`s
fractures in adults, vol. 1
• Appley’s system of orthopedics n fracture
• Orthopedics' principle and their
applications Samuel L turek