Thoracic trauma can result from blunt or penetrating injuries. Blunt injuries cause damage through deceleration, shearing, and compression forces. The "lethal six" blunt chest traumas that can be immediately life-threatening are airway obstruction, tension pneumothorax, cardiac tamponade, open pneumothorax, massive hemothorax, and flail chest. The trauma assessment follows the ABCDE approach of airway, breathing, circulation, disability, and exposure/environmental control. Diagnostic tools like chest x-rays, FAST ultrasound, and further imaging can identify injuries but not delay resuscitation. Specific injuries discussed include pneumothorax, hemothorax, flail chest
Water seal drainage, intercostal drainage ,chest tube drainage and nursing ,principles of water seal drainage ,chest tube ,intercostal chest drainage and nursing responsibilities - topic is from medical surgical nursing. Self explanatory notes prepared during corona lockdown.
Water seal drainage, intercostal drainage ,chest tube drainage and nursing ,principles of water seal drainage ,chest tube ,intercostal chest drainage and nursing responsibilities - topic is from medical surgical nursing. Self explanatory notes prepared during corona lockdown.
chest trauma is one of the leading cause of death in poly trauma patients. ER doctor should be aware of how to suspect and how to deal with life threatening conditions resulting from chest trauma
Materi ini saya sampaikan untuk pengenalan teknik bantuan hidup dasar pada korban henti jantung untuk orang awam dan paramedis, saya rangkum dari AHA Guidelines 2010 dan beberapa Pustaka lainnya. Semoga Bermanfaat.
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
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.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
6. In the setting of Trauma
What you should do?
GOAL : PATIENT STAY ALIVE
PRIMARY SURVEY
With simultaenous resuscitation
7. PRIMARY SURVEY | A-irway and Cervical Movement Restriction
CHECK AIRWAY STATUS : PATENCY
SECURE THE AIRWAY IMMEDIATELY IF NEEDED : INTUBATION
*CRICOTHYROIDECTOMY FOLLOWED BY TRACHEOSTOMY IF
UPPER AIWAY IS COMPROMISED !
ASSUME CERIVAL INJURY!
C-SPINE CONTROL :
UNTIL PROVEN OTHERWISE
9. PRIMARY SURVEY | C-IRCULATION AND HEMMORHAGE CONTROL
ASSESS TISSUE PERFUSION
BLOOD PRESSURE, Heart Rate, skin perfusion, level of consciousness,
urine output
SOURCE CONTROL OF BLEEDING!
EXTERNAL OR INTERNAL
INTERNAL SOURCE :
CHEST, ABDOMEN, RETROPERITONEUM, PELVIS, LONG BONES?
Aggressive and continued volume resuscitation
Is not a substitute
for definitive control of hemorrhage.
10. PRIMARY SURVEY | D-ISABILITY (NEUROLOGIC EVALUATION)
A decrease in a patient’s level of consciousness may indicate
decreased cerebral oxygenation and/or perfusion, or it may be
caused by direct cerebral injury.
Always REEVALUATE the patient’s oxygenation, ventilation, and
perfusion status
a patient’s level of consciousness can be altered by:
Hypoglycemia,
Alcohol
narcotics,
other drugs
Until proven otherwise, always presume that changes in level of
consciousness are a result of central nervous system injury
11. PRIMARY SURVEY | E-XPOSURE AND ENVIRONMENTAL CONTROL
Hypothermia is a potentially lethal complication in injured patients,
à prevent the loss of body heat and restore body temperature
Warm intravenous
fl
uids before infusing them, and maintain a warm
environment.
The temperature of the resuscitation area should be increased to
minimize the loss of body heat
A microwave can be used to warm crystalloid
fl
uids to 39°C, but it
should never be used to warm blood products.
12. ADJUNCT TO PRIMARY SURVEY
continuous electrocardiography,
pulse oximetry,
urinary catheters à urine output and assess for hematuria.
Gastric catheters à decompress distention and assess for evidence of blood.
x-ray examinations (e.g., chest and pelvis),
FAST, extended focused assessment with sonography for trauma (eFAST),
DPL.
arterial blood gas (ABG) measurement and blood lactate
13. Chest x-rays can show potentially life-
threatening injuries that require treatment or
further investigation,
These films can be taken in the resuscitation
area with a portable x-ray unit,
!!! but not interrupting the resuscitation
process !!!
Do not hesitate to obtain essential diagnostic
x-rays, even in pregnant patients.
X-RAY EXAMINATIONS AND DIAGNOSTIC STUDIES
14. FAST or now, eFAST are useful tools for quick
detection of intraabdominal blood, pneumothorax,
hemothorax, and cardiac tamponade.
Multiple studies have shown ultrasound to be more
sensitive than supine chest radiography for the
detection of pneumothorax.
Sensitivities 86% to 100%,
Speci
fi
cities 92% to 100%.
A study by Zhang et al. found :
the sensitivity of eFAST vs chest xray for
pneumothorax was 86% vs 27%
the average time to obtain eFAST vs chest xray was
2.3 vs 19.9 minutes
FAST : FOCUSED ASSESSMENT SONOGRAPHY IN TRAUMA
19. Lung
B-MODE
In the normal lung, the visceral and parietal pleura can be seen
to slide against each other, with a glistening or shimmering
appearance, as the patient breathes
In pneumothorax, the pleural line seen consists only of the
parietal layer, seen as a stationary line.
23. Open Pneumothorax
•Defek pada dinding dada dgn diameter > 2/3 trakhea shg
udara masuk melalui dinding dada lbh bsr d.p masuk
trakhea
••Tutup dgn pembalut steril 3 sisi -> LALU PASANG CTT
24. Tension Pneumothorax
•Chest pain
•Air hunger
• Tachypnea
•Respiratory distress
•Tachycardia
•Hypotension
•Tracheal deviation away from the side of the injury
•Unilateral absence of breath sounds
•Elevated hemithorax without respiratory movement
•Neck vein distention
•Cyanosis (late manifestation)
27. When we can say it is massive?
• Initial production > 1000 ml
• in fresh trauma onset
• or:
• Continuous bleeding of 200 cc/
hr for 2 hrs
Hemothorax
Chest Tube Thoracostomy!
28.
29.
30.
31.
32. Cardiac Tamponade
Beck's Triad
• Hypotension
• Distended Neck Vein
• Mu
ffl
ed heart sounds
Pericardiocentesis
Subxyphoid
Pericardiostomy ?
Or
33. Management?
• Analgesia
• Respiratory status?
• Pneumonatic
fi
xation
(Mechanical Ventilation)
• Costa Internal Fixation
• Plate, clipping costae
Rib Fracture, Flail Chest
and Lung Contusion
34.
35. •Its multiple rib fractures
that result in an unstable
chest wall.
•It occurs when a
segment of the thoracic
cage is separated from
the rest of the chest wall.
•more than two (>2)
segmental fractures on at
least two adjacent ribs.
Flail Chest
36. Aim to:
• Restore mechanical integrity
• Reduce the pain associated with
spontaneous ventilation
Resulting in:
• Reduced need for prolonged
mechanical ventilation &
tracheostomy
• Reduced incidence of complications
associated with
fl
ail chest injury
• Reduced length of stay: ICU,
hospital, rehabilitation
• Improved quality of life
• Health system cost savings
37.
38. •Bruised lung, usually
caused by blunt force
trauma and may not
show up on chest x-ray
for a couple days.
Lung
Contusion