The Death Of The Doctor

The Death Of The Doctor
Lately your heart has been beating so fast you feel like you had just run a marathon. You have gone
to the doctor's since, you have been worried about your pulse and were just informed about your
condition. Now, rest easy, it's not as scary as it might seem. Having a pulse of 150 beats per minute
is scary in its own way and tends to make you worry, but rest assured, 150bpm is not necessarily
normal, but it's nothing you are going to die from. I have been through and have experienced this
and am looking forward to helping you to be informed and relaxed during your discovery and
throughout the procedures of fixing this problem.
The doctor knocks on the door, he/she informs you of your condition "Supraventricular
Tachycardia," but for now let's just abbreviate it as "SVT." You will have to have surgery called an
"SVT ablation "to fix this heart problem, but for the mean time, you are put onto something called
"Beta–Blockers", which prevents the chemical that creates fight or flight, known as adrenaline. Your
doctor has requested you to go to your local hospital, where you will get a certain amount of test
done on you, for example; a stress test, Electric shock management, CAT scan, and a blood test.
These test will give a bases on your condition. Your surgery is going to keep you overnight so be
well prepared for an overnight stay and for a driver to take you home. You will sign in at the post–op
desk and fill out the required information. A little panicky you must be still
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Cardiac Dysrhythmias : Medical Careers
Eduardo Cardenas
Cardiac Dysrhythmias: Supraventricular Tachycardia
N254: Medical Surgical Nursing II
Mr. Decker
Medical Careers Institute
Date of Submission
1/7/2016
Cardiac Dysrhythmias: Supraventricular tachycardia
Supraventricular tachycardia is increase in heart rate over 150 bpm due to do the over firing or
redirected firing of the SA Node conduction above the ventricles. With supraventricular tachycardia
the patient can have an abrupt onset and termination of rhythm, flattened or retrograde conduction P
waves and narrow QRS waves specifically less than 0.08 second (Kyle, 2012).
Clinical Manifestations and Pathophysiology The clinical manifestations of supraventricular
tachycardia are palpitations, dizziness, ... Show more content on Helpwriting.net ...
The nurse should also palpate pulses, noting rate, regularity, amplitude, and symmetry. This is done
to differentiate in equality, rate, and regularity of pulses that are indicative of the effect of altered
cardiac output on systemic or peripheral circulation (Vera, 2013). Another nursing management is to
monitor vital signs. Assess adequacy of cardiac output and tissue perfusion, noting significant
variations in BP/pulse rate equality, respirations, changes in skin color, temperature, and level of
consciousness. The rationale although not all dysrhythmias are life–threatening, immediate
treatment may be required to terminate dysrhythmia in the presence of alterations in cardiac output
and tissue perfusion (Vera, 2013).
The nurse should also administer supplemental oxygen as indicated, Insert and maintain IV access,
reduce patient stimulation, tell the patient to splash cold water on their face, or to do a vagal
movement to help decrease heart rate (Kyle, 2012). Adenosine (Adenocard) is the drug of choice of
to treat supraventricular tachycardia if vagal maneuvers have not worked due to its short half–life
and minimal side effects. Other medications that can be used to suppress supraventricular
tachycardia can be

Familial Cardiomyopathies ( Fc )
Background: Familial Cardiomyopathies (FC) are a collection of cardiac diseases that vary vastly
genetically, and pathologically (1, 2). Hypertrophic cardiomyopathy (HCM) is the most common
form of FC (2). HCM is diagnosed often with left ventricular hypertrophy without a noticeable
increase in external load and smaller ventricular cavity, but with a preserved ejection fraction (3).
That is, the percent of blood leaving the left ventricle (5) does not change. Other pathologies include
interstitial fibrosis, thickening of the media in intramural arteries, and myocytes disarray greater
than 5%; which is a hallmark of HCM (4). HCM shows variability in its penetrance, from a patient
with no symptoms, to having sudden cardiac death (SCD) ... Show more content on Helpwriting.net
...
As a result, many patients that do not fit standard diagnostic criteria may in fact have this form of
HCM (8). This low diagnostic sensitivity can be a contributing factor to the high mortality rate of
TnT related HCM, making understanding its etiology very important. Mutations in TnT mostly seem
to be associated with changes in calcium sensitivity (10). Three mutations seem to be prevalent,
each having varying affects on calcium sensitivity. The TnT–Arg278Cys (R278C) mutation, not
without some debate (15), has been found to have negligible effects on calcium handling, resulting
in a relatively better prognosis for the patient (11). TnT–Phe110Ile (F110I) and Ile79Asn (I79N)
mutations both show a respective increase in calcium sensitivity (10). Their pathologies differ from
most HCM in that very little fibrosis or hypertrophy is seen (12). This is unique, as most HCM has
associated fibrosis, which results in re–entrant tachycardias and possible fibrillation (13). But with
I79N and associated mutations, re–entrant tachycardias have been observed in the absence of any
fibrosis (14). Both the etiology of these mutations and resulting pathology has been researched
extensively in murine and porcine models (14, 15). The I79N, R278C, and F110I mutations were
first identified and characterized by Watkins et al. (16). Families exhibiting HCM had their DNA
sequenced and, using statistical analyses, polymorphisms were

Ventricular Fibrillation
Cardiac Dysrhythmias: Ventricular Fibrillation
According to Brunner et al., the most common dysrhythmia in patients with cardiac arrest is
ventricular fibrillation, which is rapid, disorganized ventricular rhythm that causes ineffective
quivering of the ventricles. No atrial activity is seen on the ECG. The following characteristics that
constitute ventricular fibrillation are, ventricular rate is greater than 300 beats per minute.
Ventricular rhythm is extremely irregular and without a specific pattern. QRS shape and duration are
irregular, undulating waves without recognizable QRS complexes.
Clinical Manifestations and Pathophysiology According to Warnes et. al., Ventricular Fibrillation
occurs in a variety of clinical situations ... Show more content on Helpwriting.net ...
Anxiety is also one of the contributing factors of developing dysrhythmia. Therefore, the nurse must
encouraging to verbalization of feelings and fears, and recognizing the feelings of anxiety, anger, or
sadness is important. Client may also develop a system to identify possible cause, or influential
factors for anxiety, which can be recorded in client's diary or journal. Lastly, the nurse must
establish in the patient education the patient and family action plan, in case of an emergency and,
encourage a family member to obtain CPR training.
Conclusion
Ventricular Fibrillation is life threatening, it is emergency case in which every second of immediate
action is necessary. As you have read in the above paragraphs, the skill of recognizing the signs and
symptoms of ventricular fibrillation, performing CPR and defibrillation is concomitant in survival of
the client. Therefore, advocating for rapid response in the patient teaching is necessary as well as in
health care

History Of Present Illness : 34 Year Old Woman With A...
History of present illness: 34–year–old woman with a history of Wolff Parkinson White Syndrome
complains of intermittent palpitations since 2005. She has had a 24–hour Holter, which was
unremarkable. She came in for a follow–up visit and had an EKG done that revealed the presence of
pre–excitation. The patient reports a daily sensation of palpitations that lasts for several minutes.
The patient reports lightheadedness with the palpitations without syncope. The patient underwent an
exercise treadmill evaluation, which showed no evidence of ischemia. The echocardiography
revealed a structurally normal heart. Delta waves were noted during evaluation but resolved at
higher heart rates. Wolff–Parkinson–White syndrome (WPW) is a conduction disorder of the heart
that is caused by pre accessory pathway resulting in tachyarrhythmias. Kesler & Lahham (2016)
state, "Approximately 0.07% of the population often presents with the chief complaint of
palpitations". A diagnosis of WPW is made in conjunction with certain characteristics.
Characteristics of WPW include: a short PR interval < 0.12 second caused by a faster electrical
conduction through the accessory pathway than the atrioventricular node, upsloping of the QRS and
a delta wave. The delta wave is indicative of rapid ventricular depolarization caused by the rapid
conduction through the accessory pathway (Kesler & Lahham, 2016, p. 469).
CEBM, Level 4
Past Medical History: In addition to her current condition the patient has a

A Research Study On Cardiac Arrest Management
Cardiac arrest management is an ever evolving system, based on expanding science and technology
that allows for the lay rescuer, or the seasoned paramedic to try and bring back someone whose
heart has stopped. This paper will explore the history and general practices of Advanced Cardiac
Life Support – or ACLS – as well as basic techniques, and how it has helped to improve survival
rates in sudden arrest victims, as well as if there are better ways to tackle issues involving the
correct or incorrect practices of resuscitation.
Before we begin to talk about how to fix a broken heart we must first learn how one functions. The
heart is the powerhouse of the body, its main function is to move the blood that provides oxygen and
other key nutrients to the individual organs in the body. It is a very muscular organ that is regulated
by electrical currents that help to determine the pattern of the heart rate and keep it at a normal rate.
The main reason a heart stops working is because of an interruption in the electricity regulating the
heart. And this is where ACLS comes in, in restarting the heart and reigniting the urge to run. And
this comes via three main routes, CPR, defibrillation and Cardiac medications.
The one and only thing that is the most proven thing in cardiac arrest management is good CPR – or
Cardiopulmonary Resuscitation – this is what everyone can do, from john smith bystander on the
street to emergency medical personnel to the nurses and doctors in the emergency

Cardiac Arrests Of Children, And Opening The Reality Of...
Abstract Almost everyone who works in EMS has this one thing in common, the fear of the pediatric
call. Due to those calls being few and far between, the skills needed for a pediatric call are rarely at
their best. There are also some who don't keep their pediatric skills as sharp as others, because of the
low amount of calls they might run on kids. This paper will be focusing on cardiac arrests in
children, and opening the reality of how common it is becoming. Everything from what causes it,
what is the most common cause, and the unexplainable. The what's, how's and whys are all
questions that we will be expected to know. There is so much that goes into these patients,
physically and mentally. Knowing these things and understanding how to handle these situations is
just as important as knowing the information for a registry test. In almost most of these incidents the
family doesn't care how much you know, they care about how much you care. Cardiac Arrests in
Children We have heard it more than once, the high school football player who has never had a
health issue in his life, playing on a chilly, friday night, collapses in the middle of the game. The
player dies instantly. What was the cause, why did it happen, and how can it be prevented are all
common questions that friends, family and the strangers that share the story on facebook, are all
asking. As an autopsy is finished it is concluded that the young athlete died of a heart abnormality
that was never

The Death Defying Dunk '
The Death–Defying Dunk
Summarize: A 22–year–old male, Joe Hamilton, suffered a cardiac arrest while playing basketball.
Consequently, responders proceeded with cardiopulmonary resuscitation and electrical
defibrillations that lead to a pulse return, however Joe remained in a coma.
Ask: What is a normal ECG and how do you read it?
Access/Generate:
After Joe Hamilton's cardiac arrest, an AED was placed on his chest and proceeded to analyze his
cardiac rhythm (see Figure 1) and returned an inadequate rhythm. Figure 1 In the early 1920 the
development of the electrocardiogram provided objective information about the hearts structure and
function. The evolution of the ECG lead to new inventions that led to the 12–lead electrocardiogram
(1). With this new invention a systematic way of interpreting an Electrocardiograph soon developed.
The layout of the graph is as such: there are 4 columns which correspond to the leads; the first
column – I, II, and III; the second column: aVR, AVL, aVF; the third V1–3; and the fourth V4–6.
Each column is recorded simulation however they are not always displayed on the strip except for
the last rhythm strip which occurs at the bottom of the tracing (lead II and V1).
The labels of the waves indicate a particular action on the heart. P waves represent atrial
depolarization or atrial contraction. The QRS complex indicates ventricular depolarization. While
QRS is normally seen not ever complex has Q (negative deflection), R (positive

A Study On The Cardiac Rhythm
Introduction: The electrocardiogram remains the single most important tool for interpretation of the
cardiac rhythm. 1 It can be used to successfully pick up conduction abnormalities, rhythm
disturbances, possible myocardial ischemia, and a slew of other abnormalities that can be linked to
various cardiac or metabolic diseases. 1,2 ECGs can also be used as a preventive tool to screen for
abnormalities early in the disease process. 3,4 In 1982, Italy passed a law that all individuals who
want to compete in competitive sports undergo a clinical evaluation that included an assessment of
family history, person history, a physical exam, and an electrocardiogram. The bulk of the
evaluation relied heavily on the ECG looking for any abnormalities ... Show more content on
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This program recruited community volunteers to perform the ECGs and were given a standardized
training on how to correctly obtain one. The ECGs were then interpreted by 6 cardiologists
experienced in adolescent ECGs. Among the 32,561 screened, 2.5% had abnormal ECGs. The
importance of this study was to show that mass ECG screenings can be efficiently obtained and still
yield quality results when assessing for risk factors for SCA. This study reported that the cost per
ECG was only $8.67, which is more proof of why ECG screening should become a standardized
preventive modality. ECGs can play an essential role in monitoring the status of a patient and for
recognizing trends in the patients progression. Fesmire et al5 reported that serial ECGs were more
sensitive for evaluating acute myocardial infarctions (AMI) and acute coronary syndrome (ACS)
than an initial ECG. Serial ECGs were 68.1% more sensitive for identifying AMI compared to
55.4% using an initial ECG. For ACS, serial ECGs were 34.2% more sensitive compared to 27.5%
for an initial ECG. The purpose of this ECG workshop is to teach people to be proficient at reading
ECGs. The amount of information that an individual can obtain from an ECG can be extremely
beneficial in helping with diagnosis of patients or determining the proper treatment. This workshop
will include hands on learning, lecture, and worksheets to help individuals develop skills on
recognizing variations on the

Ventricular Tachycardia Lab
Ventricular Tachycardia
An dysrhythmia of the heart is an irregular heartbeat rhythm. Ventricular tachycardia is an
dysrhythmia in which the lower chambers of the heart, the ventricles, beat unusually fast.
The heart rate is measured with an electrocardiogram, or ECG. This is a machine that measures the
electrical impulses from the patient's heart. This is displayed on a monitor or ECG graph paper. The
boxes on the graph paper measure time. Five small boxes are equal to one large box. The large box
represents two–tenths of a second.
The atrial contraction is represented by the P wave. This is an upward, or positive wave of the line
on the graph. The ventricular contraction is displayed by the QRS complex. The QRS ... Show more
content on Helpwriting.net ...
The SA node is the primary pacemaker of the heart. It starts the heartbeat by spontaneously
contracting, causing the rest of the heart to contract in a wave.
The wave spreads through the atria before reaching the atrioventricular node, or AV node, located
just above the right ventricle. The AV node focuses the wave into the ventricles, contracting the
ventricles. Should the SA node fail, the AV node can take over as the primary pacemaker at a rate of
forty to sixty beats per minute.
Should both the SA node and the AV node fail, there is a tertiary pacemaker, the perkinje fibers.
Perkinje fibers are located near the bottom of the ventricles and can stimulate contraction at a rate of
twenty to forty beats per minute.
If the perkinje fibers or the AV node becomes irritated, they can begin contraction of the ventricles
at speeds well above normal. Other causes of ventricular tachycardia include heart disease and
medications.
When the ventricles are contracting at a rate greater than one hundred beats per minute, the heart
becomes inefficient. Blood cannot properly fill the ventricular chambers before it is forced out. This
decreases the amount of oxygenated blood circulating through the body.
The lack of oxygen in the body causes the heart to attempt to pump more blood, forcing the
ventricles to work even harder. Should the

Cardiac Arrest Medical Case Scenarios
CLINICAL PRACTICE GUIDELINES and STANDARD OPERATING PROCEDURE FOR
CARDIAC ARREST IN INPATIENT CARDIAC SURGERY PATIENTS
POLICY and PROCEDURE FOR MANAGEMENT OF CARDIAC ARREST PATIENTS POST–
CARDIAC SURGERY
PURPOSE: To provide guidelines for staff caring for Inpatient Cardiac Surgery population requiring
advanced life support during cardiac arrest events.
SCOPE: All nursing personnel who have been oriented to and/or care for Cardiac Surgery
population. All attending Cardiothoracic Surgery Physicians currently practicing and providing
surgical care within Brooke Army Medical Center. All Trauma Surgery Physicians currently
practicing/providing surgical care to include nightly on–call rotations.
I. POST–CARDIAC SURGERY–CARDIAC ARREST PATIENT ... Show more content on
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Staff should begin setting up for emergent resternotomy once cardiac arrest is noted. Goal is to have
chest opened within 5 minutes. Please verify the physician performing resternotomy is aware of
procedure patient had done (high risk for graft detachment with retractors). Internal cardiac massage
is preferable and more efficient than external cardiac massage (should only be performed by trained
physicians with two–hand technique).
g. If patient paced prior to cardiac arrest with functioning epicardial pacing wires and the rhythm
shows PEA with paced rhythm, the pacing spikes may be masking Ventricular Fibrillation. Detach
pacing wires from pacemaker to assess underlying rhythm.
h. For severe bradycardia, Atropine can be given per AHA protocol.
i. Epinephrine should be witheld unless ordered by Cardiac Surgeon (Severe Hypertension with
Return of Spontaneous Circulation– ROSC).
j. During external cardiac massage with intra–aortic balloon pump (IABP) in place, change trigger
to "pressure." If prolonged period without cardiac massage, change trigger to "internal" at rate of
100 BPM.

V. POST–CARDIAC SURGERY–CARDIAC ARREST GUIDELINES: Intervention– Pulseless
Electrical Activity (PEA)
a. Do not delay external cardiac massage for any more than 1

Ventricular Fibrillation Report
INTRODUCTION: Methods to identify appropriate treatments for the various stages of ventricular
fibrillation (VF) involve differentiating groups of subjects who will respond to defibrillation with
return of spontaneous circulation (ROSC) and those who require other therapies (e.g., CPR, drugs)
prior to defibrillation. The use of quantitative waveform measures (QWM) which measure the
frequency and fractal dimension of the VF electrocardiogram have shown success in predicting
response to defibrillatory shock in animal models. Patients in cardiac arrest are often taking
medications affecting adrenergic activity such as the beta blocker metoprolol and the combined
alpha and beta blocker, labetalol. How this exposure might alter the QWM and ROSC ... Show more
The frequency spectrum in metoprolol treated animals demonstrated a reduction in mean
frequencies from 1 to 3min (electrical phase) and from 3 to 7min (circulatory phase). Labetalol
produced an even greater reduction in frequencies in these intervals. The decline in AMSA was
similar in all three groups over the first 3min. From 3 to 7min the metoprolol group was
significantly lower than the control group (p<0.001 vs compared to control and metoprolol groups).
ROSC was noted in 2/10 in the control group, 7/8 in metoprolol group and 2/7 in the labetalol
group. The frequentist analysis of ROSC showed a relative risk (RR) of ROSC of 4.4 when
comparing control to metoprolol animals and 1.4 comparing control to labetalol

Example Of EKG Interpretation
EKG Interpretation
1. You are a nurse working in the Emergency Department of a hospital. You are asked to admit a
patient who came in with chest pain. When you arrive to assess the patient you find them
unresponsive.
a. Please analyze the rhythm (below). R–R, Regular or Irregular (.1 pt.) irregular Rate: (.1 pt.)
Unmeasurable
PR interval: (.1 pt.) Not measurable QRS: (.1 pt.) none
QT: (.1 pt.) 8 sec Rhythm: (.3 pt.) highly irregular
b. What is the necessary immediate intervention? (.1 point)
The next action for this patient is to defibrillate very soonest to stop the patient from going to
cardiac arrest
c. What are two typical precipitating factors that occur with this rhythm? (.1 pt.)
i. Is having an untreated ventricular tachycardia, electrocution accidents and presents of heart
conditions at birth. ii. Chaotic, rapid and irregular rhythms hence causing ventricular Fibrillation
2. You are a nurse caring for a patient on a telemetry unit. The patient was admitted for hypotension
and tachycardia several days ago. The patient has stabilized and needs to achieve therapeutic levels
for prophylactic treatment prior to discharge.
a. Please analyze their strip (below).
Regular or Irregular (.1 pt.)Regular Rate: (.1 pt.) 101–160 bpm
PR interval: (.1 pt.) 0.12–0.20seconds QRS: (.1 pt.) 0.06–0.12 seconds
QT: (.1 pt.) 6 sec Rhythm: (.3 pt.) Regular The patient has been determined to have this dysrhythmia
chronically and is

Automated External Defibrillator ( Aed )
AED Research 1. How does an AED work? Automated external defibrillator (AED) is a small
computerized device used to analyze heart rhythms and provide an electric shock, if needed, to
restore the normal electrical activity of patients' heart. When a patient is suspected of having a
sudden cardiac arrest CPR is performed until an AED device is available. If the device is available,
when turning the machine on the voice of the device will guide the first responder through the
process. There are adhesive pads with electrodes sensors that are required to stick onto the chest of
the unconscious patient. Once the pads are stick onto the chest, the electrodes then send information
about the person's heart rhythm to the AED. The devices will then analyzes the heart rhythm and
determine if an electric shock is needed. Once the device detect that a shock is needed the device
will warn first responders to stand clear, then the machine will automatically delivered the shock. If
the person is still not breathing, continue on with CPR while the machine recharge. Once the
machine is ready it will again analyze the heart rhythms then provide an electric shock. (U.S.
Department of Health and Human Services [HHS], National Institutes of Health [NIH], National
Heart, Lung, and Blood Institute [NHLBI], 2011). 2. What are the "shockable rhythms" an AED
recognizes and describe each? There are two shockable rhythms an AED is able to recognize. The
first shockable rhythms is ventricular

A Patient With A Suspected Dvt
What is an appropriate focused assessment and care to provide a patient with a suspected DVT? A
focused assessment is an assessment that centers directly on the chief complaint that a patient
presents with when they arrive to seek out care. In this case, our assessment is focused on a potential
deep vein thrombosis (DVT). A DVT is a essentially a ball of blood cells that are clumped together
impeding blood flow which can cause irritation to the vein and potentially more dangerous
problems. If the thrombus moves, it can travel through the body and into the lungs and impeded
breathing which is not good. Therefore, it is essential to catch DVT's right away and treat them to
prevent them from moving. The first thing that needs to be assessed when a patient presents with a
suspected DVT is their level of consciousness and their vital signs including the heart rate, blood
pressure, respirations, temperature and oxygen saturation. Next, assess the site of the expected DVT,
and perform a neurovascular assessment which comparing to the same site on the opposite side of
the patients body. Check for adequate circulation by assessing for pink color distal to the site. While
performing this assessment, you want the area distal to the site to be pink to ensure there is adequate
blood flow. If it is whitish in color, this is a sign of a DVT and needs to be documented. While
assessing color, also assess the site directly for any color deviation from the clients natural skin
color. If the

Athletes With Abnormal Av Conduction Characterized By An...
Athletes with abnormal AV conduction characterized by an HV interval >90 ms or a His–Purkinje
block should have pacemaker implantation. Supraventricular Tachycardia (SVT): SVTs are not more
common in athletes than in the general population of a similar age distribution, with the possible
exception of atrial fibrillation (AF). Treatment of these SVTs with catheter ablation is likely to
achieve a permanent cure and, in general, is preferable to lifelong therapy with pharmacological
agents. Atrial Fibrillation: Athletes with AF should undergo a work–up that includes thyroid
function tests, queries for drug use, ECG, and echocardiogram. Athletes with low–risk AF that is
well tolerated and self–terminating may participate in all competitive sports without therapy. In
athletes with AF, when antithrombotic therapy, other than aspirin, is indicated, it is reasonable to
consider the bleeding risk in the context of the specific sport before clearance. Catheter ablation for
AF could obviate the need for rate control or antiarrhythmic drugs and should be considered.
Syncope: Athletes with exercise–induced syncope should be restricted from all competitive athletics
until evaluated by a qualified medical professional. Athletes with syncope should be evaluated with
a history, physical examination, ECG, and selective use of other diagnostic tests when there is
suspicion of structural heart disease or primary electrical abnormalities that may predispose to
recurrent syncope or sudden

Ineffective Communication In Nursing
Ineffective Communication My patient, C.R., came into the hospital due to chronic renal failure
(CRF). He was scheduled to have his second round of dialysis done on the intensive care unit (ICU).
Dialysis nurse was present in the room, setting up the machine for continuous renal replacement
therapy (CRRT) and noticed that the patient went into symptomatic supraventricular tachycardia
(SVT). Being thrown into SVT causes the heart rate to speed up over 150 and can cause the patient
to have pain in their chest, feeling lightheaded and fatigued, and have shortness of breath. At the
same time, C.R.'s nurse walked into the room and the patient's rhythm converted into ventricular
tachycardia (VT). At the time the patient converted to VT, he became ... Show more content on
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This situation is just a good example of poor communication and lack of patient knowledge. The
nurse received report from the off going nurse and was not told a code status of the patient. She then
did not attempt to learn of the patient's code status after receiving report, going about her daily tasks
and med passes. Since she was uneducated about the patient's status, she was unable to be a proper
patient advocate and inform the code team that this patient did not want life saving measures

Cardiac Arrest : The Side Effects Of Saving Lives
Cardiac Arrest – The Side Effects of Saving Lives
Antje Dangel
University of South Florida
Cardiac Arrest – Drugs Administered during Advanced Cardiac Life Support and Associated
Complications
In 2014, heart disease remains the leading cause of death while cardiac arrest is one of the most
devastating conditions patients and their families have to face. Despite all efforts to elucidate
management of cardiac arrest and implementation of advanced cardiovascular life support (ACLS)
survival rates post cardiac arrest remains at 23.9 % in adults and 40.2% in children, respectively
(AHA, 2012). Nurses undergo extensive ACLS training every two years and while algorithms,
administration of emergency drugs, and procedures seem to be followed appropriately, rationales are
often not well understood. While some studies show evidence of short–term outcome advantage,
insufficient evidence exists regarding administration of ACLS drugs and improved long–term
outcome. In this paper pharmacokinetics and pharmacodynamics, adverse effects of ACLS drugs,
and anticipated long–term adverse effects of intervention drugs post cardiac arrest are being
discussed. Lastly, drug–drug interaction of ACLS drugs with commonly used cardiac medications
will be discussed. In the case study of JG, the patient went into cardiac arrest on the way to the
hospital and he was pronounced after a full code had been performed for three hours. The cause of
cardiac arrest in regards to heart rhythm is

Running Head : Cardiac Arrest
Running head: Cardiac Arrest
Cardiac Arrest
Dylan Noble
Utah Valley University
Captain Steve Allred
Paramedic 3110 Intro
"Each year, 326,200 people in the U.S. experience EMS–assessed out–of–hospital non–traumatic
sudden cardiac arrest, and nine out of ten victims die." (www.sca–aware.org 1) This number may
seem quite low, but in the end one out of ten lives saved is still better than none.
This paper will be going over a scenario involving a real patient and what things could have been
different with EMS care. It will also be covering what exactly cardiac arrest is and what rhythms
produce it. And for every cardiac rhythm in cardiac arrest, there is a specific treatment plan
paramedics can follow.
Scenario
The day started off normally. I got to the station early at 0645 and started to talk to some of the guys
working. There were a couple guys I just met that day. Then I started to get all my stuff ready for the
day. I put all my gear on the ambulance and started on the daily checks for our rig. The daily checks
consist of checking the lights and sirens, fluids, and making sure all our supplies are in the
compartments and in the bags. As I started going through the monitor bag with the
electrocardiogram (EKG), we get a call to a male in his 40's unresponsive and not breathing.
Everyone jumped into the rigs and we rushed off to the scene code three. We were en route to a
residence to the south. When we arrived we looked for the address but it did not

Digoxin Case Study Essay
Question 1:
Digoxin toxicity. Digoxin has a narrow therapeutic index and chronic toxicity is more likely in the
elderly and those with renal impairment. Since Mr Buchanan is 75 years old, he may already have
some form of renal impairment and therefore is at a higher risk of developing toxic serums levels if
continually taking Digoxin (Australian Medicines Handbook, 2016 and Nickson, 2014). Digoxin
toxicity can be caused by prolonged use, an overdose or a general increase in the current dose
(Australian Medicines Handbook, 2016). If Mr Buchanan is taking digoxin for an extended amount
of time, he may build up a tolerance to its effects due to being consistently exposed to the drug
(Australian Medicines Handbook, 2016). This is significant risk ... Show more content on
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Document any abnormal results (lower or higher than normal levels) in the nursing progress notes.
Encourage regular oral fluids to keep his kidneys and renal tract hydrated. Monitor Mr Buchanan's
fluid intake and output through a Fluid Balance Chart (FBC) and/or daily weighs. This is important
in Mr Buchanan's case as Digoxin is renally excreted and if his ability to excrete fluid decreases,
digoxin levels may build–up and increase (Nickson, 2014) Consider a fluid restriction to prevent
possible fluid overloading due to his decreased renal function (Vera, 2011). Perform a urinalysis
when possible to find levels of Specific Gravity (how concentrated the urine is), pH, Protein, Blood,
Nitrites, Leukocytes, Ketones, Glucose and Bilirubin. The results of this test can help identify any
possible impairment in renal function and identify the presence of an infection (Vera, 2011).
Risk 3 – Arrhythmias due to drug induced QT prolongation Educate Mr Buchanan on the signs and
symptoms of arrhythmias such as: A fluttering in his chest. Chest pain. Shortness of breath. Light–
headedness or dizziness.

Ventricular Tachycardia Case Summary
A 65–year–old man with ischemic cardiomyopathy (left ventricular ejection fraction <20%) and
ventricular tachycardia was treated with a left ventricular assist device (LVAD) (HeartWare,
Framingham, MA) as a bridge to transplant and biventricular implantable cardioverter/defibrillator
(ICD; Boston Scientific, Natick, MA). The patient was admitted after he experienced multiple
discharges of his ICD. A review of the ICD's memory showed multiple occurrences of symptomatic
non–sustained ventricular tachycardia (NSVT). The patient was started on mexiletene, but continued
to have symptomatic episodes of VT. Ultimately, the patient required a continuous infusion of
amiodarone to control the arrhythmia. The patient was discharged after being transitioned to an oral
regimen of amiodarone and mexiletene. He was readmitted two days later with complaints of
burning ... Show more content on Helpwriting.net ...
Up to 62% of ventricular arrhythmias may not be detected during the typical monitoring period of
48 hours 3. Implantable cardiac monitors offer a longer monitoring period and may offer a greater
yield of significant arrhythmias than external monitors e.g. Holter, however, they require invasive
implantation and explantation procedures that carry their own risks. To address these short falls
non–invasive adhesive patch monitors such as the iRhythm Zio® XT Patch (San Francisco, CA)
have been developed. These devices are low profile, moisture proof, single lead monitors that can be
worn by patients for up to 14 days. The Zio XT Patch has been shown to increase diagnostic yield
when compared with external monitors, partly due to an extended monitoring window 4. There are
no published reports, however, comparing the diagnostic yield of Zio® XT Patch with implantable
cardiac monitors. Here we present a patient with heart failure treated with an ICD and VAD, and
monitored using a Zio® XT

Research Paper On Ventricular Tachycardia
Supraventricular tachycardia (SVT) is an abnormally rapid heart rhythm originating above the
ventricles, > 100 and usually >150 bpm. A rapid heart rate will significantly reduce the time which
the ventricles must fill. The filling time results in a smaller amount of blood ejected from the heart
during systole. The result is a drop in cardiac output and the patient may experience symptoms such
as, shortness of breath, palpitations, dizziness, rapid breathing, chest pain, or even loss of
consciousness. It may last from a few seconds or hours to several days. SVT is one of the most
frequently occurring arrhythmia in children with an incidence of 1 in 100 to 250. The treatment of
choice in acute management is IV adenosine, except for people with

Symptoms And Treatment Of Cystic Retrochiasmatic...
Abstract:
Cystic retrochiasmatic craniopharyngiomas may reach enormous size by expanding into the
posterior fossa along the retroclival area, which is very unusual finding. A 5–year–old boy presented
with headache for 2 month. On the neurological examination, it was normal. Initial magnetic
resonance (MR) images revealed a huge, thin–capsuled multi–cystic mass, which extended around
brain stem & extending bilaterally along the base of the middle and posterior cranial fossa. Subtotal
excision of the cystic wall was done followed by applying of a catheter within the cyst attached to a
reservoir with a favorable outcome.
KEY WORDS: Endoscopic drainage, Cystic, Craniopharyngioma,
Introduction
Craniopharyngiomas usually emerge in the infundibulo–hypophyseal axis of the sella and
suprasellar region occupies the suprasellar cisterns, however may extend in any direction. The
horizontal extension of the tumor may be anteriorly into the pre–chiasmatic cistern and sub–frontal
space, may extend laterally into the sub–temporal space, or may extend posteriorly into the
prepontine and interpeduncular cisterns, cerebellopontine angle and then to the foramen magnum. 7
However, rarely extensive tumors may extend anteriorly in the pre–chiasmatic cistern and
posteriorly into the 3rd ventricle and down along the clivus. Approximately 4 % of the cases have
posterior fossa extension. 2,6
Case Report
A 5–year–old boy was admitted to our department with severe headache, which aggravated over 3

Ecg Basics Essay
Contents Page Page Abstract 1 Section 1– Correct lead placement 2 Section 2 – Incorrect lead
placement 5 Section 3 – Conclusion and recommendations 7 References Appendices Abstract
Recording an electrocardiogram or ECG, is a procedure which is performed daily all over the United
Kingdom by thousands of healthcare workers and in particular nurses (Jacobson, 2000). The way in
which this procedure is performed varies from geographical location to location and occasionally
even more so, between staff on the same ward (Amos, 2000). This reason stated by Amos (2000),
formed the basis of my decision to choose this topic. The recording of an ECG is often seen as a
fairly mundane, routine ... Show more content on Helpwriting.net ...
The patient's ankles also need to be exposed at this point. In addition it is suggested that Nurses need
also to remember to keep the patient's lower half covered as much as possible and treat the patient
with the utmost respect at all times (Dougherty and Mallet, 2000). If using a machine equipped with
metallic stickers, it is important that the nurse wipes the patient's skin with an alcoholic swab before
applying, to ensure good electrical contact is made as this according to Ford (2002) will save time in
the long run. If the machine is supplied with the suction cups, then electrode spray must be applied
to the areas of skin and where electrodes will be placed. Men with very hairy chests may require a
gel based electrodes for adhesion, or in extreme cases, shaving may be needed. Lewes (1965)
publish an paper stating that ketchup, mayonnaise and K–Y jelly all were as good as hospital
adhesion gels, based on performance, however as Cowley (2002) points out, it is considered
somewhat strange and not seen as best practice to cover your patient in ketchup or mayonnaise prior
to recording an ECG. Finally, ensure that the patient is supine on a bed, comfortable and relaxed.
Cowley (2002) describes how accurate chest lead placement is essential for ensuring quality ECG
output, as any misplaced leads may result in a change in ECG waveform, in turn this may cause the
ECG trace to be misinterpreted. The full pictorial description

Syncope Research Paper
Syncope Syncope is when you lose consciousness and drop to the ground. Syncope may also be
called fainting or passing out. It is caused by a sudden drop in blood flow to the brain. While most
causes of syncope are not dangerous, syncope can be a sign of a serious medical problem. Signs that
you may be about to faint include: Feeling dizzy or light–headed. Feeling nauseous. Seeing all white
or all black in your field of vision. Having cold, clammy skin. If you fainted, get medical help right
away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.
HOME CARE INSTRUCTIONS Have someone stay with you until you feel stable. Do not drive,
use machinery, or play sports until

Treatment For Inappropriate Sinus Tachycardia
ABSTRACT
Inappropriate Sinus Tachycardia is a chronic medical condition with a wide variety of clinical
presentations making it, sometimes, very insidious at the time of the diagnosis. Several therapeutic
options including, pharmacotherapy, cardiac rehabilitation and modification or ablation of the sinus
node have been proposed for the management of Inappropriate Sinus Tachycardia. But due to the
complexity and not well understood pathophysiology, it can be difficult to manage despite the
numerous treatment options currently available. The purpose of this review is to analyze the
treatment for Inappropriate Sinus Tachycardia focusing on the role of newer therapy and the
potential benefits in the management of this cardiac rhythm ... Show more content on
Helpwriting.net ...
[4]
The clinical presentation of patients with IST can vary due to the diversity of its multiple symptoms
including: intermittent palpitations, dyspnea, dizziness, lightheadedness, pre–syncope, syncope,
chest pain, myalgia, and fatigue. [12] Associated psychological and emotional problems can also be
seen, but no relationship with IST has been identified. [8]
Using a criteria of a resting heart rate >100 bpm and an average heart rate of >90 bpm on 24–hour
Holter monitoring, Still et al., estimated the prevalence of IST in a middle–aged population of men
and women. The IST prevalence was 1.2% (7 of 604 patients) [2], including both symptomatic and
asymptomatic patients. IST has also been reported in older population. [5] Although, IST is believed
to be a chronic condition, long–term complications are few. IST has been associated with
tachycardia–induced cardiomyopathy in isolated cases [6][7] and no mortality has been yet reported.
IST is a medical entity that should be diagnosed by exclusion, medical history and physical
examination and should be assessed thoroughly, aiming to the potential causes of sinus tachycardia,
thus, thyroid disease, medications, hypovolemia, panic attacks, anxiety and substance abuse should
be ruled out. A 12–lead EKG is useful for recording tachycardia and defining sinus rhythm, which
helps differentiate IST from

A Multi System Disease Of Unknown Etiology
Sarcoidosis is a multi–system disease of unknown etiology. The diagnosis is confirmed when non–
caseating granulomas are identified in tissue biopsies, predominantly from the lung parenchyma or
the mediastinal lymph nodes and is supported by compatible clinical and radiological features. [1]
Cardiac manifestations may occur in isolation or may precede, follow or occur concurrently with the
involvement of the lungs and other organs. All components of the heart may potentially be involved.
The most common are conduction abnormalities leading to bradyarrhythmias and syncope,
ventricular tachycardias and the development of congestive heart failure. [2, 3]
The location and extent of granulomatous infiltration accounts for variations in cardiac ... Show
more content on Helpwriting.net ...
[5, 6] Japanese Ministry of Health (JMH) published criteria are the current established method for
non–invasive clinical diagnosis. [2, 5] Imaging modalities suggested by the JMH criteria include
gallium–67 scintigraphy and late gadolinium–enhanced cardiovascular magnetic resonance (LGE–
CMR). [2] However, only 5–10% of patients with sarcoidosis present with clinical evidence of
myocardial involvement based on the above criteria while autopsy studies indicate that cardiac
involvement is present in up to 25–50% of cases implying that there is a significant proportion of
sub–clinical cardiac sarcoidosis not detected with the existing criteria. [1, 7] Nuclear imaging
modalities have shown significant advances and rapid growth in the field of the diagnosis and
monitoring of cardiac involvement in sarcoidosis. Promising results show high sensitivity for
identifying pathophysiological activity at an early stage before structural changes have occurred as
well as value of reproducible activity quantification when emphasizing in therapy monitoring.
Although gallium–67 scintigraphy has traditionally been used in sarcoidosis patients, cardiac
positron emission tomography (PET) along with myocardial perfusion scans have shown superiority
that mostly includes higher sensitivity in detecting active

What Is the Path of the Cerebrospinal Fluid from Its...
What is the path of the cerebrospinal fluid from its formation site? Cerebrospinal fluid is a clear,
colorless fluid that acts as a cushion to protect and support the brain inside of the skull, while also
playing an essential role in the removal of waste products from the brain. It can be found
surrounding both the brain and spinal cord. I was motivated to do research on the path that the
cerebrospinal fluid takes from its formation site because of its importance in protecting the brain.
Cerebrospinal Fluid. (n.d.). Retrieved from http://www.upright–health.com/cerebrospinal–fluid.html
The first resource I utilized was Upright–Health. On this website I found an article titled
"Cerebrospinal Fluid" that gave an overview on where the cerebrospinal fluid is made and how it
moves from the production site to the rest of the body. It stated that the cerebrospinal fluid, also
called CSF, flows throughout the body by its differences in pressure. This cerebrospinal fluid flow is
sometimes known as the third circulation of the brain. Normally, the fluid has a very low pressure
that is only moderately higher than the pressure in the veins and the brain. The flow begins where
the cerebrospinal fluid is produced, which is the highest point of pressure. The CSF is produced in
the chambers of the brain, called the ventricles, through use of both an active and a passive process.
The active process requires energy causing the cells lining the ventricles to secrete salt into the

Get On That Bike
Studying for a final. Researching in a lab. Getting my EMT certification. Volunteering. Getting heart
disease. I know what you're thinking. How are these things all related to each other and wanting to
go to medical school? Admittedly, it took me some time to figure that out myself. As I started each
of the things above I didn't necessarily begin with the thought that this experience would some how
better prepare me for life as a medical student and physician. Even though being a doctor has always
been my dream, I began each (albeit one of them with no choice) for a unique reason. I studied
because I wanted to learn. I did research because I wanted to further my studies by using them in a
practical capacity. I got an EMT ... Show more content on Helpwriting.net ...
This was a very sobering and difficult thought process. After all the studying, the time, the
research...I didn't feel like I could do this. These doubts lingered and troubled me for many months.
Like any college student with strong ambitions for his future, these worries weighed heavily upon
me. However, it all paled in comparison to what happened next. Suddenly these thoughts seemed
utterly insignificant. That spring, I got diagnosed with heart disease.
Ventricular Tachycardia. It is strange to think that somebody 21 years old could get such a
complicated sounding disease. Initially I felt confused and a bit doubtful. I asked the doctor over and
over again to make sure it was the correct diagnosis. Eventually I came to accept the fact that I have
Ventricular Tachycardia. Eventually, I was able to see that having this disease didn't have to be such
a negative thing; that it could help me on my path. I went back to volunteering and shadowing with
a new understanding. I was finally able to feel what the patients were going through, because I had
gone through something similar. The confusion, fear, doubt, anger. I finally felt like I had the
capacity to show empathy and understanding to patients and that medical school would help me to
advance this ability
From my utter ignorance on the first day of University, to the dark cloud of despair that hovered
above me, and finally through to my diagnosis

Ventricular Tachycardia
Knowledge and practices of nurses concerning intravenous potassium administration in a Turkish
hospital
Lisa Doty
Gateway Technical College
Knowledge and practices of nurses concerning intravenous potassium administration in a Turkish
hospital
Safety is the number one concern during treatment and care of patients in the hospital. When
patients receive the electrolyte potassium intravenously is potentially toxic and has been responsible
for many deaths in hospitals. If the electrolyte potassium is given incorrectly intravenously, it can
cause ectopic heartbeats, ventricular fibrillation and ventricular tachycardia. When the physician
orders to the potassium intravenously, it is the responsibility of the nurse to be knowledgeable about
the potential risks.
A study was done in a Turkish university hospital to determine the lack of knowledge and practices
of administering potassium intravenously. There were 105 nurses that volunteered to participate in
the study who worked in the surgical intensive care unit and surgical clinics. During the shift the
nurses were given a questionnaire that consisted of two parts: part 1 collected data on the nurses'
demographics and characteristics, the second part consisted of close–ended questions on the
administration of ... Show more content on Helpwriting.net ...
Because nurses are more involved with the distribution of medications, especially potassium
intravenously, it is important to understand and can identify the risks of administering this
medication. With proper training, protocols and knowledge of safety precautions, administration of
potassium intravenously will be less fatal to the patient. According to the study, the nurses'
knowledge and understanding of administering the potassium intravenously was slightly above the
medium level. It is recommended that those who distribute this medication have proper training and
knowledge about it before

Advantages And Disadvantages Of Defibrillators
Section 1
Section 3
3.1 Side Effects
3.1.1 Implantable defibrillators
Despite their widespread and successful usage, both internal and external defibrillators have several
drawbacks. Internal defibrillators have limited autonomic responsiveness and electrochemical
reactions at the electrode–tissue interface limit current amplitude and duration [30] [31].
Complications can arise during device implantation, such as infections or during extraction [32]
[33]. Incorrect ventricular excitation can result in an asynchronous activation of the cardiac muscle
[34], which is a poor substitute for the normal sinus rhythm, which could lead to increased incidence
of AF and heart failure in the future [35]. Lead dislodgement and malfunction can also be a ... Show
more content on Helpwriting.net ...
The most promising at the moment is optogenetic defibrillation. Optogenetics is the combined use
of genetic and optical techniques for functional sensing and control in biological tissue [41]. Using
genetically introduced light–gated ion channels and pumps, optogenetics offers alternatives to
traditional method of excitation and suppression. In particular, Channelrodopsin–2 (ChR2), a light
sensitive protein, and its variants have widespread application as optical actuators in neuroscience
and now are being used in experimental cardiac research.
Optogenetic defibrillators would allow modulation of electrical function of cells containing the light
sensitive proteins, in the case of defibrillators they would be located throughout the cardiac muscle.
Defibrillation using this method has been achieved with mice hearts [42]. The great advantage of
optogenetic defibrillation is that this would be, in contrast to electrical shocks pain–free. This would
greatly improve the life of people requiring ICDs.
Also unlike electrical shocks, sequential light pulses can be applied repetitively, as these do not
require the charging of a capacitator to generate high–voltage fields. Experimental results in mice
hearts showed that 4 consecutive light pulses instead of 1 increased the termination rate of VT from
85% to

The Importance Of Ecg And An Ecg
In regards to this week's assignment on written instructions, I have chosen to write the topic on the
steps to take in obtaining electrocardiogram, most commonly called ECG. An ECG is very
important equipment not only in a hospital environment but also to outside facility because it can
detect any abnormalities in a person's heart status in the shortest time making it very efficient to start
treatment as soon as possible. The audience that my instructions aims for are not only to those that
have some medical background but also to some individuals who may have a basic understanding of
some medical terms. They do not necessarily need to have some special skills in order to obtain an
ECG. However, if they are to interpret the result of the recorded ECG, then additional learning and
training is needed. These instructions are designed to be easily understood not only to healthcare
professional as a form of refresher, but is also targeted to potential reader who would want to learn
in obtaining an ECG. The written instructions are designed to be very informational and details in
regards to the given task. Along the step–by–step structure, I have also incorporated some terms
such as electrodes that the reader may not know about and have included a brief definition of them
in the introduction. There are also visuals to help guide the reader along in completing the given
task. Some of the basic design principles that I have applied in my instructions are repetition,
alignment, and

Atrial Relaxation
Moreover, atrial stimulation close to the AV BT insertion site results in maximal preexcitation.
Failure of atrial stimulation to increase the amount of preexcitation can occur because of markedly
enhanced AVN conduction, the presence of another AV BT, or pacing–induced block in the AV BT
due to the long ERP of the BT (Kuo et al, 1996). FIGURE 4: Effect of atrial extrastimulation on
preexcitation. A: Manifest preexcitation during normal sinus rhythm (NSR) with HV interval value
of –11 msec. Atrial extrastimulation (AES) increased the degree of preexcitation (HV interval value
of –64 msec). B: An earlier coupled AES produced more pronounced preexcitation with HV interval
value of –93 msec. C: A more premature AES produced full preexcitation with the His bundle
activated retrogradely , with VA conduction over the AVN & an echo beat (atrioventricular reentry)
(Issa et al, 2012). Atrioventricular echo beats (Figure 5) occur secondary to: anterograde conduction
of the atrial stimulus over the AVN–HPS & retrograde conduction over an AV BT (concealed or ...
Show more content on Helpwriting.net ...
A: Each of the atrial paced impulses (S1) conducts anterogradely over the slow AVN pathway. The
last paced impulse also conducts retrogradely up the fast AVN initiate typical AVNRT with RBBB.
B: Each of the atrial paced impulses conducts anterogradely over the slow AVN pathway with a long
PR interval resulting in crossing over, which can mimic a 1:2 AV. Following anterograde conduction
down the slow pathway, the last paced impulse also conducts retrogradely over the fast pathway,
initiating typical AVNRT. C: Atrial pacing from the coronary sinus ostium (CS os) induces typical
AVNRT. The last paced impulse conducts over both the fast and slow AVN pathways resulting in a
1:2 response (i.e., 2 ventricular responses); this is followed by induction of typical AVNRT with
RBBB (Issa et al,

Early Repolarization Pattern (ERP) Essay
Introduction
Early repolarization pattern (ERP) is an enigmatic common electrocardiographic (ECG)
finding,occurring in 1% to 2% of the general population (1). ERP prevalence is decreasing with
advancing age (2) This ECG pattern is frequently observed in healthy persons,particularly
young,male (3,4,5), athletic (6,7), and of African–American origin (4,5,6,7,8).On the 12–lead ECG
the ERP is characterized as "notching" or "slurring" of the terminal portion of the R wave and
beginning of the ST–segment that produces a positive hump known as J wave. The J wave is a
deflection with a dome that appears immediately after the end of QRS complex followed by ST–
segment elevation ≥ 0.1 mV (or 1 mm, varying from 1 to 4 mm) above isoelectric line ... Show more
These authors proposed three subtypes:
Type 1: ERS observed predominantly in the lateral precordial leads, prevalent among healthy male
athletes and rarely seen in IVF survivors; Type 2: ERS predominantly in the inferior or inferolateral
leads and associated with a higher level of risk; Type 3: ERS globally in the inferior, lateral, and
right precordial leads and associated with the highest level of risk for development of malignant
arrhythmias.Type 3 is often associated with IVF storms.
(21)
Short–QT syndrome is described as a disorder characterized by abbreviated QT interval, ventricular
and atrial arrhythmias,and sudden cardiac death (22)
Recent studies supported an association between short QT syndrome and early repolarization. The
aim of this study was to study the prevalence of ER and its relationship with the QTc interval in
healthy subjects
Methods
Study Population
This study included 80 healthy participants with early repolarization ECG (n=40) and normal ECG
(n=40) . Study population matched one–to–one according to age and gender. Briefly, in addition to
undergoing Standard resting 12–lead electrocardiography, the subjects completed a questionnaire
regarding their health habits, known diseases, and medications. None of the participants were using
medications. All patients

Schizophrenia Is A Heterogeneous Illness
Schizophrenia is a heterogeneous illness that may involve several pathophysiological gender
differences. For men and women incidence risk peaks between 20–29 years of age, and women also
have a second risk peak between 30–39 years of age. Negative symptoms including low motivation
and withdrawal are more frequent in men and appear up to six years before diagnosis (Hafner, 2005;
Hafner et al., 1993; Morgan et al., 2008). Women exhibit greater levels of depression and positive
symptoms including sexual inappropriateness, impulsivity and delusions (Mendrek et al., 2015; Van
der Werf et al., 2014). Sex differences in either age of onset or prevalence of negative symptoms are
not as evident in patients that have a family history of schizophrenia (Bergen et al., 2014; Hafner et
al., 1998).
Estrogen has been proposed to have a possible protective role that may account for a later age of
disease onset in women, when levels are lowest during post–response rates to antipsychotic drugs
are also higher in women menopause (Allen et al., 2013; Hafner, 2005; Leung M.D. & Chue M. R.
C. Psych., 2000; Ochoa et al., 2012). Obstetric complications have also been connected with an
increased risk of developing schizophrenia, an earlier age of disease onset, poorer outcomes and
ventricular enlargement. Such complications appear to be more frequent and severe in males than
females. (Allen et al., 2013; Dalman et al., 1999; Kelly et al., 2004). Prenatal exposure to influenza
5 months before birth

Ventricular Fibrillation And Its Effects On The Heart
Ventricular fibrillation (VF) is a life–threatening condition in which the signaling in the ventricles of
the hearts is no longer coordinated. The loss of this coordinated signaling causes rapid, random and
chaotic signaling leading to spasms of the ventricular walls. During VF, blood is not being circulated
to the brains and the rest of the body and is therefore deprived of oxygen. This condition can be
reversed by using a defibrillator, which sends an electric discharge of direct current to the victim (1).
Improper signaling of electrical activity in the heart can also lead to a rapid heart rate. This type of
tachycardia is called ventricular tachycardia (VT) and may lead to VF (Figure 1). Pulseless VT is
also with defibrillation and VF and VT are both considered shockable heart rhythms (2,3).
A large and increasing proportion of patients presents with non–shockable rhythms in out–of–
hospital cardiac arrest (OHCA). These non–shockable rhythms are pulseless electrical activity
(PEA) and asystole. During PEA, a normal heart rhythm is observed on the electrocardiogram
(ECG), but without cardiac output. Asystole is a condition without ventricular complexes. The heart
muscles fail to contract due to the lack of cardiac electrical activity. Both PEA and asystole are
treated with cardiopulmonary resuscitation (CPR) without defibrillation, combined with epinephrine
administered intravenously (4). Non–shockable rhythms are associated with high mortality. The
survival rates of PEA

Defibrillation Research Paper
Defibrillators are devices that deliver a dose of electrical energy (electrical shock) to an afflicted
heart in order to carry out defibrillation. Defibrillation is achieved through an electric shock to the
heart which helps to re–establish normal rhythms in a heart having dangerous arrhythmia (abnormal
heart rhythm), ventricular fibrillation (heart beats with rapid, erratic electrical impulses) or in
cardiac arrest. The most used type of defibrillator in the recent world is AEDs. Automated external
defibrillators (AEDs) are small portable, lightweight devices that use electrodes (sticky pads with
sensors) attached to the chest of a patient to deliver the electric shock needed to revive normal heart
rhythm.
Defibrillators have evolved greatly from ... Show more content on Helpwriting.net ...
John Erichsen in 1842 first discovered defibrillation and he found this through a dog whose heart
went into fibrillation when its coronary artery was closed off (Boston Scientific, 2016). In
Switzerland, 1899, Prevost and Battelli uncovered that in dogs, small electric shocks could prompt
ventricular fibrillation and found that larger charges would reverse the condition (Hugo Delgado,
2013). In the 1920s devices called electrocardiograms were invented by Dr Carl J to measure the
electrical activity of the heart and help identify the different stages of ventricular fibrillation (Boston
Scientific, 2016). A new technique was discovered after that to overcome fibrillation in humans in
1930s by Claude Schaeffer Beck (Boston Scientific, 2016). The new technique would assist in
treating heart failure in which piece of chest muscle was implanted into the sac that surrounds the
heart (pericardium) but this technique is no longer used (Boston Scientific, 2016). A procedure
called cardio pericardial pexy was also created by Claude Beck in 1935 in which a

Mobile Technology Essay
Abstract–The increase in popularity for wearable technologies has opened the door for an Internet of
Things (IoT) solution to healthcare. One of the most prevalent healthcare problems today is the poor
survival rate of out–of–hospital sudden cardiac arrests. The objective of this paper is to present a
noval way of solving such a big problem by using Mobile IoT devices,
Cloud computing technology and Machine learning. Mobile IoT that can collect physical activity
such as heart rates and body temperature and store the data on a cloud. Machine learning algorithm
uses this heap of data and predicts and detects heart attack. Embedded sensory system with a Low
Energy
(LE) Bluetooth communication module is used to collect ECG and body temperature ... Show more
What is the use of a big heap of data if you can't get some knowledge out of it? and writing codes
which get some knowledge out of such big heaps of distinct data is nearly impossible. So, now
comes the question of how to deal with such data complexity monsters?. Well, the answer is quite
simple "Machine learning". It is hear to rescue us from the data complexity monsters.
What is machine learning?
Machine learning is a type of artificial intelligence (AI) that provides computers with the ability to
learn without being explicitly programmed.You may not know it, but machine learning is all around
you. When you type a query into a search engine, its how the engine figures out which results to
show you (and which ads, as well). When you read your email, you dont see most of the spam,
because machine learning filtered it out. Go to Amazon.com to buy a book or Netflix to watch a
video, and a machine–learning system helpfully recommends some you might like. Facebook uses
machine learning to decide which updates to show you, and Twitter does the same for tweets.
Whenever you use a computer, chances are machine learning is involved somewhere.
Machine learning along with IoT can help us solve really big problems which mankind is currently
facing. One such problem I want to address and provide a solution to is predict and monitor heart
attacks.
The healthcare represents one of the top

Wolff-Parkinson White Syndrome Essay
Wolff–Parkinson White Syndrome Wolff–Parkinson White syndrome is a heart condition where
there is an extra electrical pathway or circuit in the heart. The condition can lead to episodes of rapid
heart also known as tachycardia. Wolff–Parkinson White syndrome, also known as WPW, is present
at birth. People of all ages, even infants, can experience the symptoms related to WPW. Episodes of
tachycardia often occur when people are in their teens or early twenties. Most of the time, a fast
heart beat are not life threatening, but serious heart problems can occur. Treatments for Wolff–
Parkinson White syndrome can stop or prevent episodes of fast heart beats. A catheter–based
procedure, known as ablation can permanently correct the heart ... Show more content on
Helpwriting.net ...
"Wolf–Parkinson–White syndrome is associated with some forms of congenital heart disease, such
as Ebstein's anomaly." (Mayo Clinic Staff). The heart is made up of four chambers. The two upper
chambers known as the atria, and the two lower chambers known as the ventricles. The rhythm of
your heart is controlled by the sinus node. The sinus node is almost like a natural pacemaker which
is located in the atrium. The sinus node gives off electrical impulses that start every heartbeat.
"Electrical impulses travel across the atria causing the atria muscles to contract and pump blood in
the ventricles." (Mayo Clinic Staff). The electrical impulses eventually arrive at a cluster of cells
known as the atrioventricular node or the AV node. The AV node slows down the signal before
sending it to the ventricles. By this delay, it allows the ventricles to fill with blood causing the
electrical impulses to reach the muscles of the ventricles so they can contract and pump blood to the
lungs and the rest of the body. When a person has WPW syndrome an extra electrical pathway
connects the atria and the ventricles. This means that an electrical signal can bypass the AV node.
When the impulses use this alternative route through the heart, the ventricles are activated to early.
Looped electrical impulses and disorganized electrical impulses are two major types of rhythm
disturbances. A looped electrical impulse is when electrical

The Death Of The Doctor

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