"The role of epinephrine drug therapy during cardiac arrest:A properly evaluation of this traditional therapy seems necessary"
Clifton W. Callaway, MD, PhD on JAMA, dec 2012
1. A Cochrane review found that for untrained bystanders, continuous chest compressions without rescue breathing improved survival to hospital discharge compared to interrupted CPR. For trained professionals, interrupted CPR had slightly better outcomes.
2. The AHA recommends that untrained lay rescuers provide continuous chest compressions with or without dispatcher assistance for adults in cardiac arrest. For trained lay rescuers, compression-only CPR is recommended.
3. A study found no difference in outcomes between continuous compressions with asynchronous ventilations and 30:2 CPR. 30:2 CPR was associated with better outcomes than 15:2 CPR. It may be reasonable for EMS to use 10 breaths per
This study evaluated the effectiveness of low-fractional concentration continuous positive airway pressure (CPAP) in the prehospital setting. 340 patients with respiratory distress were treated with CPAP providing a fixed oxygen concentration of 28-30%. Improvements were seen in respiratory rate and oxygen saturation levels. CPAP was discontinued for 16.5% of patients, mostly due to anxiety or requiring intubation. 71.5% of patients' conditions were improved with CPAP treatment based on paramedic assessment. The results suggest CPAP with a low fixed oxygen concentration is effective for commonly encountered respiratory emergencies in the prehospital setting.
My talk in April 2015 Malaysia on Best Practices and Resuscitation Workflow. The new 2015 resuscitation guidelines is expected to be released in Oct 2015.
Assessment of Effects of Traditional Exercise on Galvanic Skin Response, Puls...BRNSS Publication Hub
This study assessed the effects of traditional pranayama exercise on galvanic skin response (GSR), pulse rate, and blood pressure in 15 prehypertensive patients over 30 days. No significant changes in GSR were seen after 15 days, but significant improvements were seen after 30 days. Pulse rate and blood pressure also significantly improved after 15 and 30 days. The study concluded that regular pranayama practice increases parasympathetic tone, reduces sympathetic tone, and has beneficial effects on GSR, pulse rate, and blood pressure.
Journal presentation on essential tremorEjaj Ahmed
1) Essential tremor is a syndrome of isolated tremor of the upper limbs that has been present for at least 3 years, with or without tremor in other locations like the head or voice.
2) Propranolol and primidone are first-line pharmacological treatments that can reduce tremor severity by 55-60% through effects on the cortico-ponto-cerebellar-thalamic circuit implicated in essential tremor pathophysiology.
3) When medications are ineffective, neurostimulation techniques like deep brain stimulation targeting the thalamus or focused ultrasound thalamotomy can provide relief of tremors, though effectiveness may diminish over time and risks include ataxia, dys
Combined Aripiprazole and Electroconvulsive Therapy in a Patient with Treatme...Zahiruddin Othman
This case report describes a 30-year-old man with treatment-resistant schizophrenia who developed prolonged QTc intervals while taking clozapine. He was stabilized using a combination of aripiprazole and electroconvulsive therapy (ECT). The patient's QTc intervals ranged from 460 to 494 ms while taking aripiprazole 15 mg daily combined with ECT. The report concludes that combining aripiprazole and ECT can be a safe treatment approach for patients with schizophrenia and prolonged QTc intervals.
This study prospectively analyzed 43 patients with idiopathic normal pressure hydrocephalus (INPH) who were randomized to either a flow-regulated (FR) or differential pressure (DP) shunt valve. Both groups showed improvement on the Neuropsychological Assessment Battery (NAB) and Berg Balance Scale at 6 and 12 months post-operation compared to baseline. The FR group demonstrated more striking improvement at 6 months on the NAB and Berg Balance Scale. The DP group experienced a higher rate of subdural hematomas, most of which were managed with shunt reprogramming. Both valve types were effective in treating INPH, but the FR valve showed earlier improvement and fewer complications.
EVALUATION OF CARDIAC AUTONOMIC REACTIVITY AMONG YOUNG HEALTHY MALE OFFSPRING...DR. SUJOY MUKHERJEE
This study evaluated cardiac autonomic reactivity in young healthy male offspring of hypertensive parents (NOHP) at rest and during recovery from submaximal aerobic exercise, compared to offspring of normotensive parents (NONP). 50 subjects aged 18-25 were divided into NOHP and NONP groups. Blood pressure, heart rate, rate pressure product, and heart rate variability frequency domain indices were analyzed at rest, immediately after exercise, and during the 15 minute recovery period. Results showed higher blood pressure after exercise, and increased sympathetic activity and decreased parasympathetic activity in NOHP both at rest and during recovery, indicating impaired cardiac autonomic modulation in NOHP even at rest, which could lead to future hypertension
1. A Cochrane review found that for untrained bystanders, continuous chest compressions without rescue breathing improved survival to hospital discharge compared to interrupted CPR. For trained professionals, interrupted CPR had slightly better outcomes.
2. The AHA recommends that untrained lay rescuers provide continuous chest compressions with or without dispatcher assistance for adults in cardiac arrest. For trained lay rescuers, compression-only CPR is recommended.
3. A study found no difference in outcomes between continuous compressions with asynchronous ventilations and 30:2 CPR. 30:2 CPR was associated with better outcomes than 15:2 CPR. It may be reasonable for EMS to use 10 breaths per
This study evaluated the effectiveness of low-fractional concentration continuous positive airway pressure (CPAP) in the prehospital setting. 340 patients with respiratory distress were treated with CPAP providing a fixed oxygen concentration of 28-30%. Improvements were seen in respiratory rate and oxygen saturation levels. CPAP was discontinued for 16.5% of patients, mostly due to anxiety or requiring intubation. 71.5% of patients' conditions were improved with CPAP treatment based on paramedic assessment. The results suggest CPAP with a low fixed oxygen concentration is effective for commonly encountered respiratory emergencies in the prehospital setting.
My talk in April 2015 Malaysia on Best Practices and Resuscitation Workflow. The new 2015 resuscitation guidelines is expected to be released in Oct 2015.
Assessment of Effects of Traditional Exercise on Galvanic Skin Response, Puls...BRNSS Publication Hub
This study assessed the effects of traditional pranayama exercise on galvanic skin response (GSR), pulse rate, and blood pressure in 15 prehypertensive patients over 30 days. No significant changes in GSR were seen after 15 days, but significant improvements were seen after 30 days. Pulse rate and blood pressure also significantly improved after 15 and 30 days. The study concluded that regular pranayama practice increases parasympathetic tone, reduces sympathetic tone, and has beneficial effects on GSR, pulse rate, and blood pressure.
Journal presentation on essential tremorEjaj Ahmed
1) Essential tremor is a syndrome of isolated tremor of the upper limbs that has been present for at least 3 years, with or without tremor in other locations like the head or voice.
2) Propranolol and primidone are first-line pharmacological treatments that can reduce tremor severity by 55-60% through effects on the cortico-ponto-cerebellar-thalamic circuit implicated in essential tremor pathophysiology.
3) When medications are ineffective, neurostimulation techniques like deep brain stimulation targeting the thalamus or focused ultrasound thalamotomy can provide relief of tremors, though effectiveness may diminish over time and risks include ataxia, dys
Combined Aripiprazole and Electroconvulsive Therapy in a Patient with Treatme...Zahiruddin Othman
This case report describes a 30-year-old man with treatment-resistant schizophrenia who developed prolonged QTc intervals while taking clozapine. He was stabilized using a combination of aripiprazole and electroconvulsive therapy (ECT). The patient's QTc intervals ranged from 460 to 494 ms while taking aripiprazole 15 mg daily combined with ECT. The report concludes that combining aripiprazole and ECT can be a safe treatment approach for patients with schizophrenia and prolonged QTc intervals.
This study prospectively analyzed 43 patients with idiopathic normal pressure hydrocephalus (INPH) who were randomized to either a flow-regulated (FR) or differential pressure (DP) shunt valve. Both groups showed improvement on the Neuropsychological Assessment Battery (NAB) and Berg Balance Scale at 6 and 12 months post-operation compared to baseline. The FR group demonstrated more striking improvement at 6 months on the NAB and Berg Balance Scale. The DP group experienced a higher rate of subdural hematomas, most of which were managed with shunt reprogramming. Both valve types were effective in treating INPH, but the FR valve showed earlier improvement and fewer complications.
EVALUATION OF CARDIAC AUTONOMIC REACTIVITY AMONG YOUNG HEALTHY MALE OFFSPRING...DR. SUJOY MUKHERJEE
This study evaluated cardiac autonomic reactivity in young healthy male offspring of hypertensive parents (NOHP) at rest and during recovery from submaximal aerobic exercise, compared to offspring of normotensive parents (NONP). 50 subjects aged 18-25 were divided into NOHP and NONP groups. Blood pressure, heart rate, rate pressure product, and heart rate variability frequency domain indices were analyzed at rest, immediately after exercise, and during the 15 minute recovery period. Results showed higher blood pressure after exercise, and increased sympathetic activity and decreased parasympathetic activity in NOHP both at rest and during recovery, indicating impaired cardiac autonomic modulation in NOHP even at rest, which could lead to future hypertension
This document discusses the history and evolution of vasopressor use for treating maternal hypotension during spinal anesthesia for cesarean section. It describes how ephedrine was originally used but was found to be associated with worse fetal outcomes compared to phenylephrine or metaraminol. Phenylephrine then emerged as the preferred vasopressor due to studies showing it improved fetal acid-base status. Recent research has focused on optimizing phenylephrine administration, comparing continuous infusions to bolus doses and investigating optimal infusion rates and regimens. However, the ideal method to both control blood pressure and minimize side effects like hypertension is still unclear.
1) The study investigated whether adherence to lipid-lowering medications predicts initial adherence to CPAP therapy for obstructive sleep apnea.
2) The study found that higher adherence to lipid-lowering medications, as measured by medication refill rates in the previous year, closely predicted higher rates of at least 4 hours per night of CPAP use in the first week of therapy.
3) Demographic and clinical factors like age, race, apnea severity, and obesity did not predict initial CPAP adherence, but adherence to lipid medications did, suggesting a "healthy user bias" may confound studies linking poor CPAP adherence to health outcomes.
Current Issues In Emergency Medicine - A Selected UpdateChew Keng Sheng
This document summarizes several topics in emergency medicine, including:
1) Sensitivity, specificity, positive predictive value, and negative predictive value and how they relate to diagnostic testing.
2) The use of B-type natriuretic peptide (BNP) testing to diagnose acute decompensated heart failure and guidelines on BNP level interpretation.
3) Studies evaluating the use of non-invasive ventilation with continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) to treat acute cardiogenic pulmonary edema.
My talk in April 2015 in Malaysia on Best Practices and Resuscitation Workflow. The new 2015 resuscitation guidelines is expected to be released in Oct 2015.
This study evaluated the effects of prehospital continuous positive airway pressure (CPAP) on physiologic measures in 109 patients with acute dyspnea. CPAP improved respiratory rates in 46.4% of patients with an initial rate over 25 breaths per minute. Oxygen saturation improved to over 95% in 34.2% of patients with an initial saturation under 90%. End-tidal carbon dioxide levels improved to under 40 mmHg in 38.9% of patients with initial levels over 40 mmHg. Intubation was required for 11% of patients. The study found that prehospital CPAP resulted in similar levels of improvement in oxygenation and ventilation parameters as seen in previous studies.
This document summarizes a presentation on sedation in intensive care units. It begins by defining concepts like sedation, anxiety, delirium and protocols for daily sedation interruption. It then reviews commonly used sedative drugs like midazolam, lorazepam and propofol, discussing their risks, pharmacokinetics and evidence regarding outcomes. Studies show benzodiazepines are associated with worse outcomes like oversedation, delirium, delayed extubation and prolonged ICU stays. Evidence suggests non-benzodiazepines like propofol may have better results. The document reviews two clinical trials comparing propofol to benzodiazepines that found propofol associated with lower mortality, shorter
ACLS 2015 Updates - The Malaysian PerspectiveChew Keng Sheng
This set of slide was presented during the Kelantan Resuscitation Update 22 Nov 2015 in accordance to the latest ACLS/ILCOR 2015 Guidelines. However, I have emphasized on certain important aspects relevant within the Malaysian context. Nonetheless, in general, there are no major changes for this year 2015
Lee Guion presented on pulmonary palliation for patients at end of life. The presentation discussed pharmacologic and non-pharmacologic options for managing dyspnea and other symptoms, including opioids, benzodiazepines, oxygen therapy, and noninvasive ventilation. It also reviewed recommendations from the Institute of Medicine's report on improving end of life care and definitions of key terms like palliation, respiration, and dyspnea.
Mangement of chronic heart failure 93432-rephrasedIrfan iftekhar
Cardiac resynchronization therapy significantly reduces morbidity and mortality in patients with heart failure. A randomized controlled trial found that cardiac resynchronization reduced the primary endpoint of death from any cause by 36% compared to medical therapy alone. Mortality was lower in the cardiac resynchronization group, demonstrating improved outcomes. While cardiac resynchronization is an effective treatment, its cost-effectiveness remains uncertain due to the therapy's expense. Further research is still needed to determine its overall value.
This document describes a study evaluating the effectiveness of different airway clearance therapies for patients with ALS. The study aims to compare the combination of mechanical insufflation/exsufflation (MIE) and high frequency chest wall oscillation (HFCWO) devices to using each device alone. 28 participants were randomized into three groups testing MIE alone, MIE+HFCWO, or HFCWO alone. The primary outcome is to evaluate respiratory complications severity using scales. Participants commit to daily device use and clinic visits at 3 months. Descriptive results found attrition with 10 completing the study. Discussion notes the difficulties conducting research in ALS and that patients may present at later disease stages.
Presentation 209 ray onders & mary jo elmo diaphramg pacing- what we have ...The ALS Association
This document summarizes research on diaphragm pacing (DP) for patients with respiratory muscle weakness. Key points include: DP was first used in spinal cord injury patients and has since been trialed in over 300 ALS patients. It functions by electrically stimulating the diaphragm to improve breathing. Studies found DP can delay respiratory decline, improve survival rates, treat hypercarbia, and enhance sleep compared to ventilation alone. Optimal candidates have stimulatable diaphragms and meet criteria for non-invasive ventilation. DP is considered a treatment option rather than a last resort measure.
The CORTICUS trial investigated whether low-dose hydrocortisone therapy improves survival in critically ill patients with septic shock. The trial randomized 499 patients with septic shock to receive hydrocortisone or placebo. It found that hydrocortisone hastened the reversal of shock in patients whose shock was reversed, but did not confer an overall survival benefit. Based on this trial and others, corticosteroids should not be routinely used in adult patients with septic shock, though they may benefit selected patients.
Comparison of Efficacy of Various Doses of Esmolol In Attenuating Presssor Re...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
1) A randomized controlled trial compared fixed lower energy (150-150-150 J) versus escalating higher energy (200-300-360 J) biphasic defibrillation for out-of-hospital cardiac arrest.
2) Among patients requiring multiple shocks, conversion rates were significantly higher with escalating higher energy (36.6% vs 24.7%). Ventricular fibrillation termination rates were also significantly higher with escalating higher energy.
3) For first shock success, conversion and ventricular fibrillation termination rates were similar between the two groups. There were no differences in survival outcomes or adverse effects.
1. Continuous CSF sampling studies are generally well tolerated, with the most common adverse events being post-dural puncture headache and back pain.
2. Some patient groups, such as females, the elderly, and those with mood disorders, report a higher frequency of adverse events.
3. Factors such as larger CSF needle size, higher CSF volumes removed, and multiple sampling periods increased adverse event rates, while smaller needle sizes reduced adverse events.
4. CSF sampling windows of 26-36 hours were equally tolerated, and a 14-day interval between repeated sampling allowed for good tolerability.
Subarachnoid Block With Low Dose Bupivacaine And Fentanyl In Elderly Hyperten...lgmitra01
This study assessed the effects of low-dose subarachnoid block with bupivacaine and fentanyl in elderly hypertensive female patients undergoing vaginal hysterectomy. Sixty-two patients were randomly assigned to receive either 12.5 mg bupivacaine alone or 7.5 mg bupivacaine with 25 mg fentanyl. The combination led to a faster onset and longer duration of sensory blockade without prolonging motor blockade. It also resulted in fewer episodes of hypotension, less need for vasopressors, and longer duration of postoperative analgesia. The low-dose combination provided effective spinal anesthesia with improved hemodynamic stability and pain relief.
RespireRx Pharmaceuticals Inc. Announces Publication of Phase 2B PACE Study: ...RespireRX
Subjects receiving 10mg/day of dronabinol expressed the highest overall satisfaction with treatment (p=0.04). In comparison to placebo, dronabinol dose-dependently reduced AHI by 10.7±4.4 (p=0.02) and 12.9±4.3 (p=0.003) events/hour at doses of 2.5 and 10 mg/day, respectively. Dronabinol at 10 mg/day reduced ESS score by -3.8±0.8 points from baseline (p<0.0001) and by -2.3±1.2 points in comparison to placebo (p=0.05). Body weights, MWT sleep latencies, gross sleep architecture and overnight oxygenation parameters were unchanged from baseline in any treatment group. The number and severity of adverse events and treatment adherence (0.3±0.6 missed doses/week) were equivalent among all treatment groups.
OSA affects approximately 30 million Americans, according to the American Academy of Sleep Medicine. Besides causing next day sleepiness, a major cause of motor vehicle and industrial accidents, OSA is co-morbid with cardiovascular disease, type 2 diabetes, and other conditions. Treatment options are limited and the most effective treatment, the CPAP device, has an extremely high non-compliance rate. “There is a tremendous need for effective, new treatments in obstructive sleep apnea,” said Dr. Carley in a press release by the University of Illinois at Chicago.
In the same press release, Dr. Zee commented that “The CPAP device targets the physical problem but not the cause. The drug targets the brain and nerves that regulate the upper airway muscles. It alters the neurotransmitters from the brain that communicate with the muscles.”
Adding Heparin to Aspirin Reduces the Incidence of Myocardial Infarction and ...Andres D'Amico
1) A meta-analysis of 6 randomized trials examined whether treating patients with unstable angina with aspirin plus heparin is more effective than aspirin alone in preventing myocardial infarction (MI) or death.
2) The analysis found a 33% reduction in the relative risk of MI or death for patients treated with aspirin plus heparin compared to aspirin alone.
3) While no individual trial found a statistically significant difference, the bulk of evidence from this meta-analysis suggests that most patients with unstable angina should be treated with both aspirin and heparin.
This study evaluated the outcomes of 23 patients presenting with pulseless electrical activity (PEA) due to confirmed pulmonary embolism (PE) who were treated with thrombolysis. All patients received 50 mg of tissue plasminogen activator (tPA) intravenously during ongoing cardiopulmonary resuscitation (CPR). Return of spontaneous circulation occurred in most patients within 15 minutes of tPA administration. At a mean follow up of 22 months, 20 of the 23 patients (87%) were still alive with significant reductions in pulmonary artery pressures and right ventricular enlargement. The study demonstrated that rapid administration of low-dose tPA during CPR for PEA due to PE is safe and effective for restoring circulation and
Journal Club - EMS - "Effect of adrenaline on survival in out-of-hospital car...Farooq Khan
Summary and Critical Appraisal of:
Jacobs et al,"Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial" Resuscitation 82 (2011) 1138– 1143
This document discusses the history and evolution of vasopressor use for treating maternal hypotension during spinal anesthesia for cesarean section. It describes how ephedrine was originally used but was found to be associated with worse fetal outcomes compared to phenylephrine or metaraminol. Phenylephrine then emerged as the preferred vasopressor due to studies showing it improved fetal acid-base status. Recent research has focused on optimizing phenylephrine administration, comparing continuous infusions to bolus doses and investigating optimal infusion rates and regimens. However, the ideal method to both control blood pressure and minimize side effects like hypertension is still unclear.
1) The study investigated whether adherence to lipid-lowering medications predicts initial adherence to CPAP therapy for obstructive sleep apnea.
2) The study found that higher adherence to lipid-lowering medications, as measured by medication refill rates in the previous year, closely predicted higher rates of at least 4 hours per night of CPAP use in the first week of therapy.
3) Demographic and clinical factors like age, race, apnea severity, and obesity did not predict initial CPAP adherence, but adherence to lipid medications did, suggesting a "healthy user bias" may confound studies linking poor CPAP adherence to health outcomes.
Current Issues In Emergency Medicine - A Selected UpdateChew Keng Sheng
This document summarizes several topics in emergency medicine, including:
1) Sensitivity, specificity, positive predictive value, and negative predictive value and how they relate to diagnostic testing.
2) The use of B-type natriuretic peptide (BNP) testing to diagnose acute decompensated heart failure and guidelines on BNP level interpretation.
3) Studies evaluating the use of non-invasive ventilation with continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) to treat acute cardiogenic pulmonary edema.
My talk in April 2015 in Malaysia on Best Practices and Resuscitation Workflow. The new 2015 resuscitation guidelines is expected to be released in Oct 2015.
This study evaluated the effects of prehospital continuous positive airway pressure (CPAP) on physiologic measures in 109 patients with acute dyspnea. CPAP improved respiratory rates in 46.4% of patients with an initial rate over 25 breaths per minute. Oxygen saturation improved to over 95% in 34.2% of patients with an initial saturation under 90%. End-tidal carbon dioxide levels improved to under 40 mmHg in 38.9% of patients with initial levels over 40 mmHg. Intubation was required for 11% of patients. The study found that prehospital CPAP resulted in similar levels of improvement in oxygenation and ventilation parameters as seen in previous studies.
This document summarizes a presentation on sedation in intensive care units. It begins by defining concepts like sedation, anxiety, delirium and protocols for daily sedation interruption. It then reviews commonly used sedative drugs like midazolam, lorazepam and propofol, discussing their risks, pharmacokinetics and evidence regarding outcomes. Studies show benzodiazepines are associated with worse outcomes like oversedation, delirium, delayed extubation and prolonged ICU stays. Evidence suggests non-benzodiazepines like propofol may have better results. The document reviews two clinical trials comparing propofol to benzodiazepines that found propofol associated with lower mortality, shorter
ACLS 2015 Updates - The Malaysian PerspectiveChew Keng Sheng
This set of slide was presented during the Kelantan Resuscitation Update 22 Nov 2015 in accordance to the latest ACLS/ILCOR 2015 Guidelines. However, I have emphasized on certain important aspects relevant within the Malaysian context. Nonetheless, in general, there are no major changes for this year 2015
Lee Guion presented on pulmonary palliation for patients at end of life. The presentation discussed pharmacologic and non-pharmacologic options for managing dyspnea and other symptoms, including opioids, benzodiazepines, oxygen therapy, and noninvasive ventilation. It also reviewed recommendations from the Institute of Medicine's report on improving end of life care and definitions of key terms like palliation, respiration, and dyspnea.
Mangement of chronic heart failure 93432-rephrasedIrfan iftekhar
Cardiac resynchronization therapy significantly reduces morbidity and mortality in patients with heart failure. A randomized controlled trial found that cardiac resynchronization reduced the primary endpoint of death from any cause by 36% compared to medical therapy alone. Mortality was lower in the cardiac resynchronization group, demonstrating improved outcomes. While cardiac resynchronization is an effective treatment, its cost-effectiveness remains uncertain due to the therapy's expense. Further research is still needed to determine its overall value.
This document describes a study evaluating the effectiveness of different airway clearance therapies for patients with ALS. The study aims to compare the combination of mechanical insufflation/exsufflation (MIE) and high frequency chest wall oscillation (HFCWO) devices to using each device alone. 28 participants were randomized into three groups testing MIE alone, MIE+HFCWO, or HFCWO alone. The primary outcome is to evaluate respiratory complications severity using scales. Participants commit to daily device use and clinic visits at 3 months. Descriptive results found attrition with 10 completing the study. Discussion notes the difficulties conducting research in ALS and that patients may present at later disease stages.
Presentation 209 ray onders & mary jo elmo diaphramg pacing- what we have ...The ALS Association
This document summarizes research on diaphragm pacing (DP) for patients with respiratory muscle weakness. Key points include: DP was first used in spinal cord injury patients and has since been trialed in over 300 ALS patients. It functions by electrically stimulating the diaphragm to improve breathing. Studies found DP can delay respiratory decline, improve survival rates, treat hypercarbia, and enhance sleep compared to ventilation alone. Optimal candidates have stimulatable diaphragms and meet criteria for non-invasive ventilation. DP is considered a treatment option rather than a last resort measure.
The CORTICUS trial investigated whether low-dose hydrocortisone therapy improves survival in critically ill patients with septic shock. The trial randomized 499 patients with septic shock to receive hydrocortisone or placebo. It found that hydrocortisone hastened the reversal of shock in patients whose shock was reversed, but did not confer an overall survival benefit. Based on this trial and others, corticosteroids should not be routinely used in adult patients with septic shock, though they may benefit selected patients.
Comparison of Efficacy of Various Doses of Esmolol In Attenuating Presssor Re...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
1) A randomized controlled trial compared fixed lower energy (150-150-150 J) versus escalating higher energy (200-300-360 J) biphasic defibrillation for out-of-hospital cardiac arrest.
2) Among patients requiring multiple shocks, conversion rates were significantly higher with escalating higher energy (36.6% vs 24.7%). Ventricular fibrillation termination rates were also significantly higher with escalating higher energy.
3) For first shock success, conversion and ventricular fibrillation termination rates were similar between the two groups. There were no differences in survival outcomes or adverse effects.
1. Continuous CSF sampling studies are generally well tolerated, with the most common adverse events being post-dural puncture headache and back pain.
2. Some patient groups, such as females, the elderly, and those with mood disorders, report a higher frequency of adverse events.
3. Factors such as larger CSF needle size, higher CSF volumes removed, and multiple sampling periods increased adverse event rates, while smaller needle sizes reduced adverse events.
4. CSF sampling windows of 26-36 hours were equally tolerated, and a 14-day interval between repeated sampling allowed for good tolerability.
Subarachnoid Block With Low Dose Bupivacaine And Fentanyl In Elderly Hyperten...lgmitra01
This study assessed the effects of low-dose subarachnoid block with bupivacaine and fentanyl in elderly hypertensive female patients undergoing vaginal hysterectomy. Sixty-two patients were randomly assigned to receive either 12.5 mg bupivacaine alone or 7.5 mg bupivacaine with 25 mg fentanyl. The combination led to a faster onset and longer duration of sensory blockade without prolonging motor blockade. It also resulted in fewer episodes of hypotension, less need for vasopressors, and longer duration of postoperative analgesia. The low-dose combination provided effective spinal anesthesia with improved hemodynamic stability and pain relief.
RespireRx Pharmaceuticals Inc. Announces Publication of Phase 2B PACE Study: ...RespireRX
Subjects receiving 10mg/day of dronabinol expressed the highest overall satisfaction with treatment (p=0.04). In comparison to placebo, dronabinol dose-dependently reduced AHI by 10.7±4.4 (p=0.02) and 12.9±4.3 (p=0.003) events/hour at doses of 2.5 and 10 mg/day, respectively. Dronabinol at 10 mg/day reduced ESS score by -3.8±0.8 points from baseline (p<0.0001) and by -2.3±1.2 points in comparison to placebo (p=0.05). Body weights, MWT sleep latencies, gross sleep architecture and overnight oxygenation parameters were unchanged from baseline in any treatment group. The number and severity of adverse events and treatment adherence (0.3±0.6 missed doses/week) were equivalent among all treatment groups.
OSA affects approximately 30 million Americans, according to the American Academy of Sleep Medicine. Besides causing next day sleepiness, a major cause of motor vehicle and industrial accidents, OSA is co-morbid with cardiovascular disease, type 2 diabetes, and other conditions. Treatment options are limited and the most effective treatment, the CPAP device, has an extremely high non-compliance rate. “There is a tremendous need for effective, new treatments in obstructive sleep apnea,” said Dr. Carley in a press release by the University of Illinois at Chicago.
In the same press release, Dr. Zee commented that “The CPAP device targets the physical problem but not the cause. The drug targets the brain and nerves that regulate the upper airway muscles. It alters the neurotransmitters from the brain that communicate with the muscles.”
Adding Heparin to Aspirin Reduces the Incidence of Myocardial Infarction and ...Andres D'Amico
1) A meta-analysis of 6 randomized trials examined whether treating patients with unstable angina with aspirin plus heparin is more effective than aspirin alone in preventing myocardial infarction (MI) or death.
2) The analysis found a 33% reduction in the relative risk of MI or death for patients treated with aspirin plus heparin compared to aspirin alone.
3) While no individual trial found a statistically significant difference, the bulk of evidence from this meta-analysis suggests that most patients with unstable angina should be treated with both aspirin and heparin.
This study evaluated the outcomes of 23 patients presenting with pulseless electrical activity (PEA) due to confirmed pulmonary embolism (PE) who were treated with thrombolysis. All patients received 50 mg of tissue plasminogen activator (tPA) intravenously during ongoing cardiopulmonary resuscitation (CPR). Return of spontaneous circulation occurred in most patients within 15 minutes of tPA administration. At a mean follow up of 22 months, 20 of the 23 patients (87%) were still alive with significant reductions in pulmonary artery pressures and right ventricular enlargement. The study demonstrated that rapid administration of low-dose tPA during CPR for PEA due to PE is safe and effective for restoring circulation and
Journal Club - EMS - "Effect of adrenaline on survival in out-of-hospital car...Farooq Khan
Summary and Critical Appraisal of:
Jacobs et al,"Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial" Resuscitation 82 (2011) 1138– 1143
Is Lignocaine Preconditioning Effective to Treat Severe Pulmonary Vasoconstri...semualkaira
Protamine is a low molecular weight protein fraction (5.5-13.0 kDa) that is rich in basic arginine (67%) and lysine amino acids. They are basic polypeptides that neutralize the strongly negatively charged heparin. This study was aimed to explore the effect of lignocaine preconditioning on protamine-induced pulmonary vasoconstriction, which is used to reverse the effect of heparin during cardiac surgery. This was a prospective, single-center, double- blind and randomized study performed among eighty pediatric patients of either sex in the age group between 1 to 12 years with a cyanotic congenital heart disease, scheduled for elective on-pump cardiac surgery under general Anaesthesia.
Nursing Research MarchApril 2002 Vol 51, No 2 125 Back.docxcherishwinsland
Nursing Research March/April 2002 Vol 51, No 2 125
� Background: The mechanisms for postoperative nausea and
vomiting are numerous and pathways not well elucidated.
Although many medications have been developed to help
prevent postoperative nausea and vomiting, the search for
better approaches to recovery treatment continues.
� Objective: The purpose of this study was to evaluate the effec-
tiveness of isopropyl alcohol (IPA) inhalation for treatment of
postoperative nausea and vomiting for patients who have
general anesthesia for a surgical procedure.
� Method: Participants were recruited from an urban hospital on
the East Coast of the United States. Participants were
assigned to an experimental or control group and IPA inhala-
tion was compared to the standard anti-emetic treatment for
rescue treatment in the immediate postoperative period.
Postoperative nausea and vomiting was rated using a
descriptive ordinal scale.
� Results: The results of this study show IPA to be effective and
that there was no significant difference between the stan-
dard treatment protocol and treatment with IPA. Treatment
with IPA was significantly more cost effective than standard
drug treatment.
� Discussion: Further research is recommended to evaluate the
length of effectiveness, standard dose needed, most effec-
tive mode of inhalation, and factors blocking IPA effective-
ness.
� Key Words: alternative treatment • IPA • nausea • postopera-
tive • vomiting
oday’s healthcare concerns center on decreasing
costs, shortening hospital stays, and facilitating a
quick return to normal activity for patients. Post-operative
nausea and vomiting (PONV) is a major concern for
patients having same-day surgery under general anesthesia
as it causes increased complications and delays in dis-
charge from the hospital (Hirsch, 1994).
Approximately one-third of the 11 million patients under-
going outpatient surgery under general anesthesia will
experience significant nausea or emesis in the postopera-
tive period (Claybon, 1994). The mechanisms for PONV
are numerous and the causative pathways not well eluci-
dated. Many factors may play a role in an episode of nau-
sea and vomiting, and despite advances in new drug thera-
pies in minimizing the incidence, no ideal drug has been
found to prevent all the causes of PONV.
Aromatherapy is a relatively new and under-researched
alternative treatment that might hold promise in treating
PONV. Isopropyl alcohol (IPA) is among several aromas
displaying possible anti-emetic properties. Isopropyl alco-
hol inhalation is a new treatment with only limited inves-
tigations to date (Langevin & Brown, 1997).
Literature Review
Current PONV treatment strategies are based on the
understanding of the vomiting reflex; however, the lack of
well-elucidated pathways in the control of PONV has con-
tributed to the problems with these treatment strategies
and medications. It has been well documented that some
patients are more susceptible to P.
1) Acute decompensated heart failure (ADHF) is a major public health problem, leading to high rates of hospitalization and mortality in older patients.
2) Measurement of plasma B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) can help diagnose ADHF in patients presenting with dyspnea and compatible symptoms when the diagnosis is uncertain.
3) Elevated BNP/NT-proBNP levels also provide prognostic information, with higher levels predicting worse outcomes including rehospitalization and death.
1) A large clinical trial found no difference in 7-day or 30-day mortality between patients receiving noninvasive ventilation (CPAP or NIPPV) and standard oxygen therapy for acute cardiogenic pulmonary edema.
2) While noninvasive ventilation improved symptoms and physiological measures more than standard oxygen, these benefits did not translate to improved survival.
3) There were also no differences found between CPAP and NIPPV in terms of efficacy, safety, or effects on mortality.
This study investigated the effectiveness of different antipsychotic treatment strategies in 1011 acutely hospitalized patients with schizophrenia over 1 year. The results showed that treatment with long-acting injectable antipsychotics (LAIs) or antipsychotic polytherapy (APEC) was associated with a lower risk of treatment failure compared to antipsychotic monotherapy. Specifically, treatment with LAIs was associated with a 19% lower risk of failure, while APEC was associated with a 17% lower risk. The only antipsychotic combination found to be significantly associated with lower failure risk than monotherapy was olanzapine and paliperidone.
This article reviews standard therapies used to treat pulmonary arterial hypertension (PAH), including oxygen supplementation, calcium channel blockers, diuretics, digoxin, and anticoagulation. While these therapies are commonly used, the evidence supporting their use is limited as large prospective clinical trials have not been conducted. Oxygen supplementation in hypoxemic patients with COPD has shown improved survival in some studies, but its value for patients with PAH specifically has not been well evaluated. Calcium channel blockers are effective for some acute responders, but long-term success rates are low. More research is still needed to fully understand the risks and benefits of standard therapies for PAH.
Dra. Margaret Redfield. Congreso ACC 2013, Estados Unidos. RELAX: Inhibidor de la fosfodiesterasa-5 no mostró beneficio en la insuficiencia cardiaca con función ventricular preservada. Encuentre más presentaciones de este congreso en la página oficial de SOLACI: www.solaci.org/
This document discusses the goals and treatment modalities for pulmonary arterial hypertension (PAH) management. The goals are to prevent disease progression in stable patients, and stabilize right-sided heart function and provide symptomatic relief in unstable patients. Treatment includes pharmacological therapies like prostanoids, endothelin receptor antagonists, phosphodiesterase type-5 inhibitors, and combinations. Non-pharmacological options discussed include balloon atrial septostomy surgery. The document provides detailed information on specific drugs, their mechanisms, studies demonstrating efficacy, dosing, and side effects.
1) Intracerebral hemorrhage is now understood as a dynamic process that evolves over days rather than a single event. Recent studies have provided insights into hematoma expansion, edema formation, and optimal blood pressure control.
2) Ongoing clinical trials are exploring intensive blood pressure control, induced hypothermia, hypertonic saline use, and other therapies to reduce hematoma growth and edema, with the goal of improving outcomes.
3) For anticoagulant-related hemorrhages, rapidly reversing coagulopathy through agents like prothrombin complex concentrates or recombinant factor VIIa may help limit expansion and improve prognosis over traditional fresh frozen plasma therapy alone.
Relative Efficacies of Nitroglycerine Infusion, Sublingual Nifedipine, and In...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Vasopressors and inotropes are commonly used in the intensive care unit to treat low blood pressure and cardiac dysfunction. This document discusses the physiology and clinical use of various agents. It defines vasopressors as agents that increase vascular tone and blood pressure, while inotropes increase myocardial contractility. Common vasopressors described include norepinephrine, phenylephrine, vasopressin, and epinephrine. The document outlines key principles for the rational use of vasopressors, such as correcting hypovolemia first, titrating the dose based on blood pressure and organ perfusion targets, and considering an agent's effects on various receptor subtypes. Practical issues are also reviewed
This article reviews chest physical therapy techniques used in the intensive care unit (ICU) to clear pulmonary secretions and improve lung function in critically ill patients. Chest physical therapy typically includes postural drainage, percussion, vibration, cough stimulation, breathing exercises, suctioning, and patient mobilization. While studies on the efficacy of chest physical therapy in ICU patients are limited, the resolution of atelectasis and improvements in oxygenation seen in some studies suggest it may help patients in the ICU by removing retained secretions and improving lung function. The article describes indications for treatment and provides details on appropriate chest physical therapy techniques for critically ill patients in the ICU.
1) The article summarizes guidelines for treating pulmonary arterial hypertension in adults, last updated in 2014. It discusses the history of guidelines and new therapies approved since then.
2) Key points include recommending initial combination therapy with ambrisentan and tadalafil for treatment-naive patients, and adding tadalafil to existing ambrisentan therapy. The addition of oral treprostinil or bosentan to other therapies showed insufficient evidence of benefit.
3) Non-drug recommendations include incorporating palliative care and pulmonary rehabilitation into overall management of PAH patients.
1) The document discusses a study examining the effect of enhanced external counterpulsation (EECP) therapy on subsequent emergency department visits and hospitalizations in patients with severe angina and left ventricular dysfunction.
2) The study included 450 patients who underwent EECP therapy for refractory angina and had a left ventricular ejection fraction of 40% or less.
3) The results showed that despite the patients' high risk profile, they experienced a substantial reduction in all-cause emergency department visits and hospitalization rates in the 6 months following EECP therapy compared to the 6 months prior to treatment.
This article summarizes a study that evaluated the efficacy and safety of bosentan for pulmonary arterial hypertension. The study found that patients treated with bosentan had improved exercise capacity and pulmonary function compared to placebo, as well as reduced clinical worsening. Bosentan was well tolerated at a dose of 125 mg twice daily and showed benefits for pulmonary arterial hypertension patients. Long-term experience with bosentan is still needed, but initial results suggest it is an effective oral therapy for pulmonary arterial hypertension.
Hemodynamic responses with different dose of ketamine and propofol in day car...Dr. Ashvind Bawa
Day care gynaecological surgeries mandate use of hemodynamically stable combination of commonly used intravenous agents, propofol & ketamine. Hence we proposed to evaluate the hemodynamic profile of different dose combination of propofol & ketamine as induction agents in ambulatory gynecological surgeries.
Similar to Questioning the Use of Epinephrine to Treat Cardiac Arrest (20)
Riprendendo le basi di quanto già realizzato con gli NVG durante l'anno 2017 in Piemonte, EMSpedia ed Emergency Live hanno concluso una interessante intervista con il dottor Roberto Vacca del 118 di Torino
APERTE LE ISCRIZIONI!
Elisoccorso Sanitario Tra Prospettive E Realtà
Dal 24 Al 26 Maggio a Palermo, per il ventennale di SEUS
https://www.emergency-live.com/it/news/elisoccorso-sanitario-tra-prospettive-e-realta-dal-24-al-26-maggio-a-palermo/
Poster IRC 2016 - Follow up dopo arresto cardiaco pre-ospedalieroEmergency Live
Valutare la sopravvivenza a lungo termine nei pazienti con STEMI sottoposti a PCI con o senza OHCA. Un follow up post arresto cardiaco extra-ospedaliero
#SCUOLESICURE un progetto sostenibile per insegnare con efficacia RCP nelle s...Emergency Live
#Scuolesicure è il paper presentato da: E. Baldi, E. Contri, S. Cornara, F. Epis, D. Fina, C. Dossena, F. Fichtner, M. Tonani, A. Somaschini
Avendo chiaro che i bambini imparano la RCP in modo più rapido ed efficace degli adulti, e partendo dagli assunti che dal 2015 è obbligatorio l'insegnamento del primo soccorso nelle scuole, e manca ancora uno schema di insegnamento dimostrato come efficace e sostenibile, il progetto si è posto come obiettivo di valutare se #SCUOLESICURE - progetto su base provinciale realizzato da Pavia nel Cuore e Robbio nel Cuore - è un valido sistema da adottare in tutta Italia per l'insegnamento delle manovre salva-vita all'interno del percorso curricolare scolastico.
Progetto presentato a IRC2016 - Milano
Corso TSSA - Manovre pediatriche: l'immobilizzazione nel trauma dal neonato a...Emergency Live
In Italia e in Europa l’incidente stradale rappresenta la prima causa di morte nella popolazione al di sotto dei 40 anni, seguito dall'incidente domestico,dal fuoco e della caduta in genere.
Al termine politraumatizzato si associa, per definizione, un soggetto,vittima di un incidente,che presenta lesioni a carico di due o più distretti corporei.Un bambino è,per le sue caratteristiche anatomiche, da considerare sempre un politraumatizzato in questi casi. Quindi bisogna trattare il bimbo con moltissima cautela. Non bisogna trattare il bambino come un adulto di taglia ridotta.Conoscere e ricordare le differenze anatomico-fisiologico che rendono diverso l’approccio diagnostico-terapeutico è fondamentale. Il bambino infatti ha ridotta massa muscolare, ridotta quantità di grasso corporeo con conseguente vicinanza degli organi interni alla superficie esterna, ridotta calcificazione ossea e una aumentata elasticità del tessuto connettivo.
22 Corso TSSA Croce Rossa - Traumi dell’apparato muscolo scheletricoEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
23 Corso TSSA - comportamento con ferite, emorragie, lesioni da caldo e da f...Emergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
24 corso TSSA - Comportamento in caso di traumi particolariEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
24b - Corso TSSA Croce Rossa. Gli indici di gravità in sintesiEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
25 Corso TSSA - Il soccorritore volontario nelle maxi emergenzeEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
25 - TSSA Croce Rossa Protocollo START esercitazione pratica corso Maxi Emerg...Emergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
26 Corso TSSA Croce Rossa - L'uso di tecniche e presidiEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
28 Corso TSSA Croce Rossa - Approccio psico-socialeEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
29 Corso TSSA - Lo stress nel soccorritore e il lavoro di equipeEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze.
La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale.
Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
31 Corso TSSA - Manovre di immobilizzazione del neonato traumatizzatoEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze.
La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale.
Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
30 Corso TSSA Croce Rossa: abusi di sostanze e intossicazioniEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze.
La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale.
Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
Corso TSSA riconoscimento e trattamento trauma cranico e spinaleEmergency Live
Il trauma costituisce oggi in Italia, come tutti i paesi industrializzati, la causa più frequente di morte nella popolazione di età inferiore ai 44 anni, con un'incidenza di circa 120 casi ogni 100.000 abitanti. Il politraumatizzato è un paziente che presenta una o più lesioni traumatiche ad organi o apparati differenti con compromissione attuale o potenziale delle funzioni vitali.
L'evento traumatico costituisce un enorme costo sociale in quanto interessa le fasce di età maggiormente produttive. Inoltre in molti traumatizzati permangono condizioni invalidanti che aggravano ulteriormente la sequenza di negatività sia su un piano umano che economico. È stato dimostrato che una buona organizzazione del trattamento pre-ospedaliero comporta una notevole riduzione della mortalità e dell'invalidità. Diversi studi confermano che la percentuale di "morti evitabili" per trauma è significativamente più elevata quando non esistono strutture e personale adeguatamente formato. È quindi necessaria una precisa crescita della professionalità del personale addetto al soccorso pre-ospedaliero munito di attrezzature adeguate.
[url="http://www.emergency-live.com/it/?p=13218"] MAGGIORI INFORMAZIONI SUL TRAUMA SPINALE E CERVICALE QUI [/url]
Corso TSSA - parte 9: le emergenze urgenze pediatricheEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio, per la scelta di mettere il materiale online e disponibile a tutto il pubblico. Questo articolo presenta le schede sulle emergenze pediatriche
- 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
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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!
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis