1) The document discusses unconsciousness in dentistry, including general causes, predisposing factors, prevention, clinical manifestations, and management.
2) Important causes of unconsciousness discussed include neurogenic syncope, postural hypotension, cardiogenic issues, failed oxygenation, drugs, and acute adrenal insufficiency.
3) The basic steps for management of unconsciousness are: recognition (R), termination of the dental procedure (T), positioning the patient supine with feet elevated (P), then addressing airway (A), breathing (B), and circulation (C). Definitive care then depends on the underlying cause.
The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial as well as subsequent assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used modified or revised scale).
The GCS assess a persons based on their ability to perform eye movements,, speak, and move their body. These three behaviors make up the three elements of scale: eye, verbal,& motor. A persons GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score used to guide immediate medical care after a brain injury (such as car accident) and also to monitor hospitalized patients and track their level of consciousness.
The Glasgow coma scale was first published in 1974 at the university of Glasgow by neurosurgery professors Graham Teasdale & Bryan Jennett. The Glasgow coma scale is used to objectively describe the extent of impaired consciousness in all type of acute medical and trauma patients.
The Glasgow coma scale (GCS) is a clinical scale used to reliably measure a persons level of consciousness after a brain injury.
Or
The GCS is the summation of scores for eye, verbal, & motor responses. The minimum score is 3 which indicates deep coma or a brain dead state. The maximum is 15 which indicates a fully awake patients.
It's a presentation on GCS 2023.
The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial as well as subsequent assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used modified or revised scale).
The GCS assess a persons based on their ability to perform eye movements,, speak, and move their body. These three behaviors make up the three elements of scale: eye, verbal,& motor. A persons GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score used to guide immediate medical care after a brain injury (such as car accident) and also to monitor hospitalized patients and track their level of consciousness.
The Glasgow coma scale was first published in 1974 at the university of Glasgow by neurosurgery professors Graham Teasdale & Bryan Jennett. The Glasgow coma scale is used to objectively describe the extent of impaired consciousness in all type of acute medical and trauma patients.
The Glasgow coma scale (GCS) is a clinical scale used to reliably measure a persons level of consciousness after a brain injury.
Or
The GCS is the summation of scores for eye, verbal, & motor responses. The minimum score is 3 which indicates deep coma or a brain dead state. The maximum is 15 which indicates a fully awake patients.
It's a presentation on GCS 2023.
care of unconscious patient Med surg pptNehaNupur8
detailed information about care of unconscious patient in the hospital , neurological ward, contain introduction, definition, levels of unconsciousness , causes, clinical manifestations, pathophysiology diagnostic evaluation, assessment of patient, medical magement, nursing management, surgical care, emergency care ,complications, summary ,research.
Status epilepticus (SE) is a medical emergency that starts when a seizure hits the 5-minute mark (or if there’s more than one seizure within 5 minutes).
Convulsive Status epilepticus-
The convulsive type is more common and more dangerous.
It involves tonic- clonic seizures (grand mal seizures)
In the tonic phase ( lasts less than 1 minute), body becomes stiff and person lose consciousness. Eyes roll back into head, muscles contract, back arches, and trouble breathing.
As the clonic phase starts, body spasms and jerks occur. Neck and limbs flex and relax rapidly but slow down over a few minutes.
Once the clonic phase ends, patient might stay unconscious for a few more minutes. This is the postictal period.Non-convulsive Status epilepticus-
Patient lose consciousness but is in an “epileptic twilight” state.
There might not able any shaking or seizing at all, so it can be very hard for someone observing patient to figure out what’s happening.
A non-convulsive seizure can turn into a convulsive episode.
Poorly controlled epilepsy
Low blood sugar
Stroke
Kidney failure
Liver failure
Encephalitis
HIV
Alcohol or drug abuse
Genetic diseases such as Fragile X syndrome and Angelman syndrome
Head injuries
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.
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.
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
- 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
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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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.
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.
1. UNCONSCIOUSNESS
rd
3 Lec. 18 Mar. 2009
Dr. Adel I. Abdelhady
BDS, MsC, (Tanta, Egypt.), PhD (Egypt, USA)
Oral and maxillofacial Surgery Dept.
College of Dentistry, King Faisal university, KSA
2.
3. UNCONSCIOUSNESS
GENERAL CONSIDERATION
General Causes of unconsciousness
Predesposing factors in dental settings
General Prevention:
Clinical manifestation:
Management of unconsciousness
VASODEPRESSOR SYNCOPE
Postural hypotension
ACUTE ADRENAL INSUFFICIENCY
Differential diagnosis
4. GENERAL CONSIDERATION
Definition
Consciousness….awareness of surroundings…
respond to questions & commands
Unconsciousness is a lack of response to
sensory stimulation
ie Unconscious patient is a patient :
incapable of responding to
sensory stimuli with loss of the protective
mechanisms especially which maintain patent
airway
Syncope……….sudden…transient loss of consc
coma …prolonged loss of consc,,,as.deep sleep…..
can not be aroused by simple measurements.
5. GENERAL CONSIDERATIONS
Terms
Confusion
intermingling of ideas
Delirium illusions,
delusions
Dizziness
a
disturbed sense of
relationship to space
unsteadiness-
Causes
drug
overdose…..alcohol……
local anesthesia, sedat…
Hyperventilation
Hypoglycemia
Hyperglycemia
Hypothyroidism
Hyperthyroidism
cerebr vasc
6. Predisposing Factors
These factors includes:
1-Stress ( Vasodepressor syncope)
2- Impaired physical status( ASA III or IV)
3- Administration or ingestion of drugs( LA,
analgesics, antianxiety agents, CNS depressant
leading to alterations in consciousness
When a patient with impaired physical status is
exposed to undue physiologic or psychological
stress, the chance are even greater that this
patient may react adversely to the situation.
7. Individuals with underlying cardiovascular
disease may respond to the stress with
sudden death secondary to cardiac
dysrhythmias, which are precipitated by
the same physiologic stress that can
cause vasodepressor syncope in healthy
individual
8.
9. ASA I
Healthy, normal patient
Physiologically able to tolerate the stress
Without psychological problems
No treatment modifications are indicated
10. ASA II
Mild systemic disease
Can perform normal activity without
experiencing distress
Healthy patient with more extreme anxiety
May need modification in treatment
11. ASA III
Severe systemic disease
Limited activity but not incapacitated
Need stress reduction method during dental
treatment
May need to alter treatment
12. ASA IV
Has an incapacitating disease that is life
threatening
Patient is in distress at rest
No elective dental therapy
Emergency treatment should be in hospital
setting
15. Prevention
Loss of consciousness can be prevented
in many, if not most, by thorough
pretreatment medical and dental
evaluation.
Recognition
Termination
Activate ER team
Position
A, B, C, D.
16. General Causes of unconsciousness :
1-Neurogenic & Psychogenic :
e.g. stress, injections in dental
office
vasodepressor ----> syncope..
2-Vascular
3-Cardiogenic
4-Failed Oxygenation
5-Drugs
6-Endocrine
17. Predesposing factors for uncon in
dental settings:
1.
Stress:
2.
Impaired physical status.
3.
Drug : as
analgesics
anti anxiety
antibiotics
18. Clinical manifestation:
-
Unconscious patient is:
incapable of responding to
sensory stimuli.
- with Loss of protective
mechanisms especially which maintain
patent airway.
19. General Prevention
1.
Preliminary patient evaluation to
recognize fearful patients and if there is
dental fear—use sedation technique.
2. Sit down dentistry:
i.e, treat patient while lies in a supine
or slightly recumbent position.
20.
21. Pathophysiology:
the most important factor in pathogeneses of
unconsciousness is Hypotension.
O2 deprivation: is a major pathophysiologic
factor in unconsciousness
ie Air way obstruction -->
permanent brain damage in 4 – 5 mint.
& cardiac arrest in 5-10 mint.
General , local metabolic & C.N.S. changes
also occur .
22. NB
Psychic mechanisms: are the most
important mechanism involved in
transient loss of consciousness or
syncope
23.
24.
25. Inadequate Cerebral Circulation
The most common mechanism of syncope is sudden decrease in
the delivery of blood to the brain:
1-Dilation of peripheral arterioles
2-Failure of normal peripheral vasoconstrictor activity
( orthostatic hypotension)
3-A sharp drop in COP heart diseases
4-Constriction of cerebral vessels as carbon dioxide is lost in
hyperventilation
5-Occlusion or narrowing of internal carotid or other arteries to the
brain
6-Life-threatening ventricular dysrhythmias
The first four cause no harm if the patient is in supine position
26. Recognition of Unconsciousness
Step1: Assessment of consciousness :
*Lack of response to sensory stimulation
*Loss of protective reflexes
*Inability to maintain a patent airway
Step2:Terminate dental procedure.
Step3: Summoning of help, rescuer
should call for assistance immediately by
activating the dental office emergency
system
34. Causes of Partial Airway Obstruction
Sound
Probable cause
Management
Snoring
Hypopharyngeal
obstruction by the
tongue
Repeat head tilt,
jaw thrust
Gurgling
Foreign bodies (blood,
vomits) in airway
Suction airway
Wheezing
Bronchial
obstruction
Asthma
Laryngospasm
Administer
Bronchodilator
Crowing
Suction airway;
positive-pressure
35.
36.
37.
38. Determination of Airway Patency and Breathing
Clinical Signs
Diagnosis
Can feel and hear air
at nose and mouth and
see chest and
abdominal movement
Can feel and hear air
at nose and mouth but
no chest and
abdominal movement
Cannot feel or hear air
at mouth and nose and
chest and abdominal
movements heaving
and erratic
Cannot feel or hear air
at mouth and nose and
no chest and
abdominal movements
Airway patent ;
patient breathing
Management
Maintain airway
Airway patent ;
patient breathing
Maintain airway
Patient attempting to
breath, but airway
obstruction still present
Repeat head tilt, if
necessary use jaw
thrust technique
Respiratory
arrest
Artificial
ventilation
39.
40. The basic steps in
the management of
unconsciousness are: R.t.p.- A B C D:
-R: recognition of case
-t : terminate dental
procedure
-p: position,
- A: air way,
- B: breathing,
- C: circulation
41.
42.
43. Management of unconsciousness
R-recognition of unconsciousness
ie :assessment of consciousness :
You should diagnose unconsciousness by
A- no response to sensory stimulation : eg.
are you all right ?
response to painful stimuli
or B- no protective reflexes
or C- inability to maintain a patent airway.
T
:Terminate dental procedure .
:summoning [call] of help .
53. Head tilt- chin lift technique will elevate the tongue &
ensure patent air way
54.
B : Breathing Care
*** do – look-listen & feel technique
*** if the rescuer thinks a foreign material in
the airway
he should tilt the patient back
turn the head to one side
remove any thing in oral Cavity by
fingers
or by high volume suction technique
*** then Give O2 by artificial ventilation
77. Clinical manifestation
Depend on cause
in Hyperventilation: rapid respir rate
in Hypoglycemia : cold wet skin
in Hyperglycemia : hot dry skin
in Hypothyroidism: weakness fatigue
in Hyperthyroidism : restlessness
in cerebr
vasc acc: sudden loss of consc
78. Management
1-Recognize
2- terminate dental procedure
3-P-----depend on cause
supine position is accepitable…….
in diabetic & thyroid dis--- upright
in cerebrovasc acc---- can upright to dec bl
pr
3- A,B,C
4-definitive care
m- monitor vital signs
m- manage signs & symptom
d-defin tt depend on cause
81. Prevention
1-avoid the predisposing factors:
2-Proper position: supine posit……
Never treat in upright posit
3-relief anxiety : by sedations
82. Management
Pre syncope : R T
Syncope
P…. A B C D
: R T P…. A B C D
Post syncope : R
T P…. A B C D
83.
84. Postural hypotension
The Second common cause
of uncon in
dentistry
Definition :
a disorder of autonomic nerv syst in
which syncope occurs when the patient
assumes an upright position
or a drop of systolic bl pr ---20 mg or
more on standing
94. Management of ACUTE ADRENAL
INSUFFICIENCY
General Dental considerations :
consult a physician
give glucocorticoids
before
during
after stress
????????????????????
95. Manag :A- consc patient
1-R
2-T- terminate dental procedure
3-P
4- A
B
C
7-definitive care
m- monitor vital signs
m- medical assistance
o- emergency O
d-drugs glucocorticoids
97. Manag :B- unconsc patient
1-R…. recognize unconsc
2-T ….
3-P…..
4- A
B
C
7-definitive care
m- no time for monitor vital signs
m- no time medical assistance
o- emergency O
d-drugs glucocorticoids
e-emergency fluid therapy
99. CLINICAL ITEMS HELP TO ESTABLISH
THE CAUSE OF UNCONSCIOUSNESS
AGE
0—14 H E
hypoglycemia
epilepsy
14—40 : S H E
Syncope psychogenic
hypoglycemia
epilepsy