This highly energetic lecture presents the pathophysiology of S-T elevation myocardial infarction in an easy to understand style to help you best identify, triage and treat patients presenting with acute coronary syndromes. Using the latest research behind the AHA Guidelines changes, AHA National Faculty Rom Duckworth will help you better coordinate with you partners along the continuum of cardiac care. Emphasis is placed on risk factors, recognizing truly sick patients and coordinating care with hospital personnel.
Learning Objectives: Students will learn:
-The pathophysiology of S-T elevation myocardial infarction.
-The difference between STEMI, NSTEMI and unstable angina.
-Differing treatment methods and priorities for different cardiac syndromes.
-The function and importance of 12 lead ECG and prehospital diagnostic testing.
-The roles and responsibilities of EMS providers as the key element in “door-to-balloon” and “door-to-needle” time for STEMI patients.
www.romduck.com
www.RescueDigest.com
Heart failure Update as per, 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the
Management of Heart Failure and 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Heart failure Update as per, 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the
Management of Heart Failure and 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Early and effective treatment of patients with acute coronary syndrome saves lives. Lot of progress has been made in last few years in understanding patho-physiology and management of these patients.
XIII Reunión anual de la sección de Insuficiencia Cardiaca de la SEC
OVIEDO, 16-18 JUNIO 2016 HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS (HUCA)
http://secardiologia.es/insuficiencia/cientifico/ic-oviedo-2016
¿Qué se recomienda y qué es lo que hacemos?
VIERNES, 17 DE JUNIO 12.45-14.15 SALÓN DE ACTOS
En la prevención y seguimiento de los pacientes en riesgo de cardiotoxicidad
Xavier Bosch Genover, Barcelona
Dr Avinash.KM is a Neurosurgeon with advanced training in Interventional vascular Neurosurgery(FINR) from Zurich, Switzerland, and FMINS-Fellowship in minimally invasive and Endoscopic Neurosurgery from Germany.
He is presently working in Columbia asia hospitals, Bangalore.
His main areas of interest are Vascular Neurosurgery, Stroke specialist, interventional neuroradiology, Endovascular Neurosurgery, Endoscopic and minimally invasive Neurosurgery, Endoscopic spine surgery.He has advanced training in both Brain Aneurysm coiling and clipping, Brain AVM embolizations and its surgical removal, carotid artery stenting and carotid endarterectomy. Since he is trained both in open microvascular Neurosurgery and in Interventional Neurosurgery he helps patients in choosing the right treatment options for brain vascular diseases with out any bias of one treatment over the other.
Good vehicle extrication demands a unique collaboration between rescue and emergency medical personnel. Incorporating key victim assessment information in the extrication size-up will improve your strategic and tactical plans. To save a patient (not just chop up a vehicle) rescue and EMS must understand each other’s’ jobs and work together effectively. This program uses a real-world approach to incorporate EMS care considerations in the extrication strategy and shows how most critical trauma encountered in vehicle collisions can be managed quickly and effectively by first re-sponders. This program will help you make better strategic extrication decisions and more safely deliver immediate life-saving treatment, reducing time from patient contact to patient removal to pa-tient surgery.
Prehospital Sepsis Research Update 2024 Rom DuckworthRommie Duckworth
Recently published papers have given us new insights into the next steps for prehospital care for sepsis patients. By looking at both macro and micro views of patient management this program presents our new understanding of the role of antibiotics, fluid administration, and coordination of clinical care as well as future tools, including advanced biomarkers and the application of antimicrobial nanotechnology. Arm yourself with indispensable knowledge to elevate your prehospital practice and make a real difference in patient outcomes.
Rommie L. Duckworth is a dedicated emergency responder, author, and educator from the United States with more than thirty years of experience working in fire departments, hospital healthcare systems, and private emergency medical services. Rom is a career fire captain and paramedic EMS Coordinator for Ridgefield (CT) Fire Department and director of the New England Center for Rescue and Emergency Medicine. Rom holds a master’s degree in public administration, is a graduate of the US National Fire Academy’s Executive Fire Officer program, and is the recipient of the NAEMT Presidential Award, American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award for Sepsis Education. Rom is the author of "Duckworth on Education," as well as chapters in more than a dozen EMS, fire, rescue, and medical textbooks and over 100 published articles in fire and EMS magazines. A member of the NAEMT Board of Directors and the Sepsis Alliance Advisory Board Rom continues to work for the advancement of emergency services.
www.RomDuck.com
While the popular myth is that everyone learns from experience, we all know people who can pass through experience without ever learning a thing. We now know that real learning comes from ef-fective reflection on real-life and simulated experiences. This session will provide you with the tools to use for effective reflection and enhanced learning from any situation. These include the learning models that lead to successful debriefing as well as the modified Plus Delta debrief format. These tools are crucial for any emergency services leader, educator, or provider for continuous per-formance improvement.
www.romduck.com
The Steps to Succession Planning Emergency ServicesRommie Duckworth
Identifying and preparing the next generation of leaders for your department is a critical responsi-bility. What will happen to all of the hard work you’ve put into your organization when it comes time for you to leave? Who will take your organization to the next level? Will they be ready to face the challenges that await them? Will they know how? Training your replacement takes work. Mak-ing a plan, finding a candidate, helping them develop, and handing off the reins isn’t just a good strategy; it is the only choice for your organization to survive. It can take time, money, and work and may seem counterintuitive to train people for a job they aren’t currently doing, but the “Train Your Replacement” mindset, and the four steps it requires, will help your organization get ready for the next set of challenges. This intensively participative workshop helps attendees evaluate their organization and themselves with the goal of “deepening the bench” of future emergency services leaders.
Teaching Formats:
-Lecture
-Question and Answer
Learning Objectives: At the conclusion of this program students will be able to:
- Utilize the “first steps-next steps-step up-step out” format of successful succession planning.
- Ask the key questions necessary to frame a succession plan or program.
- Outline the job requirements as they exist now and as they may exist 5 to 15 years into the leader-ship development process.
- Apply NFPA 1020 or NEMSMA 7 Pillars to leadership development in their organization.
- Link job performance requirements to knowledge, skills, and attitude requirements for positions that will need to be filled.
Title: Designer Drug Evolution: Managing Uncontrolled Patients On Controlled Substances
Description: Emergency services are confronted by horrific events caused by a surge in the use of new types of designer drugs. In this program we'll use real world case studies to discuss the up-surge in mephedrone based drugs (“bath salts” and more), synthetic marijuana, salvia divinorum, datura weed, molly and more; what these drugs are, where they've come from, and what form they may take in the future. We'll also discuss what regulators and law enforcement are doing to stop them, and what field providers can do to manage the fallout from this new wave of designer drugs.
Teaching Formats:
-Lecture
-Discussion
-Case Studies
-Question and Answer
Learning Objectives: Students will be able to:
- Identify, assess and manage designer drug abusers in acute crises and overdose situations.
- Coordinate response and scene management across emergency services for designer drug emergencies.
- Provide both basic and advanced emergency medical care for designer drug abuse and ex-cited delirium.
- Understand past, present and future development of designer drugs presented through his-torical and contemporary case studies.
As seen in Fire Engineering Magazine’s Fire/EMS Column
Revised for 2024
To think of stroke as a life or death situation is to over-simplify. The concept of “Time Is Brain” doesn’t refer to inanimate neurons that die as a stroke progresses. Each moment of delay in stroke care can destroy not only a patient’s ability to perform activities to get through the day can also lose cells that contain personality and memories. Even patients who survive may lose part of their life. As hospitals are developing new methods of treatment for stroke victims, what role is there for EMS? This program will examine new in-hospital treatments like site-specific thrombolytics, clot corkscrews, cranial hypothermia, and the critical role of EMS in each phase of Stroke Systems of Care. These systems rely on both ALS and BLS providers to not simply save patients’ lives. This lively, pertinent, and through-provoking lecture shows how the actions of EMS providers are critical to every step of saving stroke patients’ life’s.
www.ROMDUCK.com
This program can help you answer the following ques-tions about UAVs and fire department operations
• How can sUAS be used to enhance emergency and non-emergency fire department operations?
• How do federal, state, and local laws and regulations impact fire de-partment use of sUAS?
• What are the potential costs of using SUASs in fire department opera-tions?
• What are the political, social, and other non-regulatory considerations of using sUAS in fire department operations?
Presented by Capt. Rommie L. Duckworth, MPA, LP, EFO
Ridgefield (CT) Fire Department
What they didn't tell you about Anaphylaxis 2023.pptxRommie Duckworth
What’s the difference between anaphylactic and anaphylactoid, and should I care? Can a patient have a life-threatening reaction on a first exposure? What are the most important ALS medications for anaphylaxis after epinephrine? How bad is it to give epinephrine for a panic attack? What the heck is Kounis syndrome? Why didn't they teach me this in class? The past ten years have seen a dramatic increase in the number of cases of anaphylaxis across the United States. In response, the American College of Emergency Physicians and the World Allergy Organization have issued im-portant updates on initial emergency treatment for patients suffering from anaphylaxis. While epi-nephrine remains the front-line drug for all levels of care, recent studies show that in-hospital and pre-hospital providers alike aren’t giving it as often or as early as they should. This interactive case-study and pub-quiz style presentation answers these questions and many more with a focus on a rapid differential of anaphylaxis and effective initial and secondary treatments to manage these immediately life-threatening emergencies.
Regular medical and recreational use of cannabis is on the rise among all age groups. In most cases, this is associated with few side effects, but some regular users experience a wildly paradoxical reaction. While cannabis will normally suppress nausea and pain and stimulate appetite, weekly cannabis use can sometimes produce severe cramping, abdominal pain, vomiting, and nausea, known as cannabinoid hyperemesis syndrome (CHS). In this program, we explore the pathophysiology of CHS, discuss presentations that EMS may encounter, and review the current diagnostic and treatment criteria. Current estimates of cannabinoid hyperemesis syndrome affecting potentially 2.7 million people in the US annually, with significant increases in states with legalization. With complica-tions of CHS including kidney failure, electrolyte imbalance and skin burns on patient seeking self-treatment, can EMS providers afford to be unprepared?
Teaching Formats:
-Lecture
-Discussion
-Case Studies
-Question and Answer
Learning Objectives: Students will be able to:
- Appreciate the acute and chronic hazards presented by cannabinoid hyperemesis syndrome
- Describe the three phases of cannabinoid hyperemesis syndrome
- Identify prehospital presentation signs and symptoms of cannabinoid hyperemesis syndrome with a focus on differential diagnosis
- Debate current theories of the pathogenesis of cannabinoid hyperemesis syndrome
- Describe immediate EMS as well as long-term treatment for cannabinoid hyperemesis syndrome
Catch Them and Keep Them: Recruiting and retaining top employees and volunteersRommie Duckworth
Work in any organization, large or small, paid or volunteer, involves transactions of value where the member gets value from the organization and gives value back. Volunteer and employment ex-changes have traditionally focused on the perspective of the organization and what they could get from members. Today, leaders must flip that perspective and consider what the member is looking to gain rather than just what the organization is willing to give to the employee or volunteer. Getting this "employee value proposition" right can help organizations attract high-quality candidates, engage current members to boost performance, and improve the customer experience and business operations. With quality EMS candidates and providers at a premium, organizations that can provide good employee value propositions will thrive, and those that do not will fail to survive.
The Top 10 Resuscitation Headlines and Controversies: And How To Read Past Th...Rommie Duckworth
We’ve all heard controversies about cardiac resuscitation. “Use the right medications.”, “Medications don’t matter.”, “Airway first!”, “Don’t worry about the airway!” It is confusing for EMS professionals to sort out exactly what they’re supposed to do. Taking a look at the Top Ten Headlines for cardiac resuscitation, this program evaluates the strength of the science behind each recommendation as well as how they might be implemented in different EMS systems. Getting past the “Headlines,” attendees will return home well-equipped to open up discussions about optimizing EMS cardiac arrest resuscitation in their systems beyond “I read this study once” or “This is what the algorithms say now.”
The Top 10 Trauma Myths and Legends: Seeking the science beyond the textbooksRommie Duckworth
We’ve all heard the legends of trauma care. “ABCs vs. CABs!”, “Mechanism of Injury Matters!”, “Never remove a dressing!”, “Hyperventilate that head injury!” But what happens when what you were taught no longer matches what science says? Taking a look at the Top Ten Trauma Myths and Legends, this program evaluates the strength of the science behind each recommendation as well as how they might be implemented in different EMS systems. Getting past “we’ve always done it this way,” attendees will return home well-equipped to open up discussions about trauma care in their systems beyond, “This is what I was taught in class.” and “I read this study once.”
Vince Lombardi said, “The quality of a person’s life is in direct proportion to their commitment to excellence.” In our work, the quality of the lives of others is also in direct proportion to our commitment to excellence. So, if we have all agreed to work in the service of others in their time of need, why do some people in emergency services only go as far as “good enough”? How do people slide from doing what’s right to doing what’s “good enough,” and how do we reconnect them to a commitment to excellence? Inspiring and informative, Rom Duckworth shows how easy it can be for organizations and individuals to stray from the path of excellence and reminds us of the importance of what we do and why, in our unique profession, good enough is simply not good enough.
www.RomDuck.com
Prehospital traumatic cardiac arrest is relatively rare and highly complex event that will challenge even the most skilled providers and resuscitation teams. This is further complicated by a shortfall of clear consensus guidelines to help EMS providers rapidly identify, assess, prioritize and care for underlying life-threats as they simultaneously work to resuscitate the patient. What is the best bal-ance between simple algorithms that focus on core priorities versus critical think-ing recommendations that address issues more specifically? This session looks at the latest research and guidelines from key organizations such as the National Association of EMS Physicians, American College of Surgeons Committee on Trauma, and the American Heart Association as well as similar organizations from around the world to help us make the best decisions and take rapid action to give our patients the best hope of survival. Find more at www.RomDuck.com
Sepsis is an emergent medical condition that kills more people annually than prostate cancer, breast cancer, and AIDS combined. For every two heart attack patients cared for by EMS, five patients are hospitalized by sepsis. EMS transports 60% of patients with severe sepsis arriving at the ED and yet EMS providers are often unaware of its presence or what they should do if they find it. This presentation discusses new sepsis criteria along with expert commentary as to how they can be applied in the field. This program includes real-world, practical methods for EMS identification, assessment and field treatment of life-threatening sepsis and looks at the current state of sepsis critical care as well as what we can anticipate in the coming months and years.
In the United States each year approximately 75,00 children develop severe sepsis, ap-proximately 6,800 of whom will die. Many of these cases may include missed or delayed diagnosis. As an EMS provider you play a decisive role in the identification and early treatment of these critically ill children. This program will show EMS providers how to identify, assess, and begin treatment for pediatric patients with sepsis as well as how to coordinate care with emergency department and critical care staff. This program is in-tended for both advanced and basic providers whether working or not your EMS system currently has formal sepsis alert protocols. Learn the latest updates and take home the knowledge of how you can make the biggest difference for our littlest patients.
For more information go to www.RomDuck.com
The Top 10 Resuscitation Headlines and Controversies: And How To Read Past Th...Rommie Duckworth
We’ve all heard the controversies for cardiac resuscitation. “Use the right medications.”, “Medications don’t matter.”, “Airway first!”, “Don’t worry about the airway!” It is confus-ing for EMS professionals to sort out exactly what they’re supposed to do. Taking a look at the Top Ten Headlines for cardiac resuscitation this program evaluates the strength of the science behind each recommendation as well as how they might be implemented in dif-ferent EMS systems. Getting past the “Headlines”, attendees will return home well-equipped to open up discussions about optimizing EMS cardiac arrest resuscitation in their systems beyond “I read this study once” or “This is what the algorithms say now.”
It is a tremendous challenge to deliver quality emergency services education. The hurdles that have to be overcome by program directors and individual educators to meet objectives and help students achieve competencies can be discouraging at best. That's why we have to stick together. Here is a treasure-trove of top-tips for educators.
It is a tremendous challenge to deliver quality emergency services education. The hurdles that have to be overcome by program directors and individual educators to meet objectives and help students achieve competencies can be discouraging at best. That's why we have to stick together. Here is a treasure-trove of top-tips for educators.
Putting hands on teamwork back in your classroom ssRommie Duckworth
As a profession, emergency services is nearly unique in it’s demands for providers to be able to act as both coordinated team members and independent operators. Critical concepts such as group dynamics, teambuilding, leadership, followership, and interpersonal communications can be difficult to introduce in cognitive and affective domains, let alone practice as psychomotor skills. While there are plenty of “Get out of your seat” activities out there, many of them entertain and fill time, but few focus on teaching and evaluating team-based competencies. Featuring fifteen exercises that you can bring back to your EMS classroom today this program will help you help your students work together better both in the classroom and on the street.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
37. 1. Ischemia (Angina or NSTEMI)
a) lack of oxygenation
b) ST depression or T inversion
2. Injury (STEMI)
a) prolonged ischemia
b) ST elevation
3. Infarct (DEAD)
a) dead tissue
b) may or may not show in Q wave
38.
39. ST segment elevation (STEMI)
• Limb leads [I, II, III, AVL, AVF] >one mm (1 small box)
• Precordial leads [V1-V6] >two mm (2 small boxes)
New or presumed new LBBB = ST elevation (STEMI)
ST segment depression (Angina or NSTEMI)
• One mm or more (one small box)
T Wave Inversion (Angina or NSTEMI)
Q Wave (MI)?
• One mm or more (1 small box)
40.
41.
42.
43.
44.
45.
46.
47.
48. A “normal” ECG does NOT rule out ACS. “Non-Diagnostic”
ST segment depression or T wave inversion represents ischemia (Angina, NSTEMI).
ST segment elevation is evidence of injury (STEMI).
Q wave indicative of MI. Not all MI=Q wave
Indicators can come in any combination.
Process may go forwards or backwards.
There are always exceptions to the rules.
Look for reciprocal changes
Evaluate Rate and Rhythm (DEFIB)
Evaluate for Axis Deviation
Evaluate QRS Duration and more…
49.
50. • Morphine (class I, level C)
• Analgesia
• Reduce pain/anxiety—decrease sympathetic tone,
peripheral vascular resistance and oxygen demand.
• Careful with hypotension, hypovolemia, respiratory
depression, RVI
• Oxygen (> 94% sPO2) (class I, level C)
• Up to 70% of ACS patient demonstrate hypoxemia
• May limit ischemic myocardial damage by increasing
oxygen delivery/reduce ST elevation
• Shown to have limited benefit, possible harm if >100%
51. • Nitroglycerin (class I, level B)
• Analgesia—titrate infusion to keep patient pain free
• Dilates coronary vessels—increase blood flow
• Reduces systemic vascular resistance and preload
• Careful with recent ED meds, hypotension, bradycardia, tachycardia,
RVI
• Aspirin (160-325mg chewed &
swallowed) (class IIa, level B)
• Irreversible inhibition of platelet aggregation
• Stabilize plaque and arrest thrombus
• Reduce mortality in patients with STEMI
• Careful with active ulcers, hypersensitivity, bleeding disorders
In AMI, ASA reduced the risk of death by 20-25%
In UA, ASA reduced the risk of fatal or nonfatal MI by 71% during the
acute phase.
52. • Thienopyridines (Prasugrel, Plavix)
(class I, level A)
• Irreversible inhibition of platelet aggregation
• Used in support of cath / PCI intervention or if
unable to take aspirin
• 3 to 12 month duration depending on scenario
• Glycoprotein IIb/IIIa inhibitors (Integrilin)
(class IIa, level B)
• Inhibition of platelet aggregation at final common
pathway
• In support of PCI intervention as early as possible
prior to PCI.
53. • Proton Pump Inhibitors (Prilosec, Pepcid)
• Given to reduce ulcers and increase compliance
• May reduce blood thinning mechanisms of Plavix.
• Hyperglycemia control in STEMI (Insulin)
(class IIa, level B)
• Control of hyperglycenia (180 mg/dl) recommended.
• May reduce inflammation and increase LV Ejection
Fraction.
54. • Beta-Blockers (class I, level A)
• 14% reduction in mortality risk at 7 days at 23% long
term mortality reduction in STEMI
• Approximate 13% reduction in risk of progression to MI
in patients with threatening or evolving MI symptoms
• Be aware of contraindications (CHF, Heart block,
Hypotension)
• Reassess for therapy as contraindications resolve.
• ACE-Inhibitors (class I, level A)
• Start in patients with anterior MI, pulmonary
congestion, LVEF < 40% in absence of
contraindication/hypotension
• Start in first 24 hours
55. • Unfractionated Heparin (class I, level A)
– Concurrent with reperfusion therapies of all types.
• Reduces clotting during acute in-hospital treatment.
• Aldosterone blockers (class I, level A)
– Post-STEMI patients
• no significant renal failure (cr < 2.5 men or 2.0 for women)
• No hyperkalemis > 5.0
• LVEF < 40%
• Symptomatic CHF or DM