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Ayur emergincies med-ksr


Published on

CME on Kayachikitsa,
Dr N.R.S. Government Ayurvedic Medical College, Vijayawada
12th Sep 201

Ayur emergincies med-ksr

  1. 1. Ayurveda Atyayika ChikitsaDr. K. Shiva Rama Prasad, at
  2. 2. A Technoayurveda International Presentation In Association with Ayurmitra CME on Kayachikitsa,Dr N.R.S. Government Ayurvedic Medical College, Vijayawada 12th Sep 2011 to 17th Sep 2011. Dr. K. Shiva Rama Prasad, at
  3. 3. • I am looking at the death face of the patient – Silent, Helpless and impatient, to say my last word . . . . . ................ . . . . . . . . . . Sorry !• This presentation is not just to entertain or expecting applaud from the audience, but is a true confession of the Ayurvedic Practitioner Dr. K. Shiva Rama Prasad, at
  4. 4. What made us to be in this situation ?• Improper education• Lack of interest in learning• Or – – Ayurvedic medicines are not competent to combat the emergencies? – Our system is not designed to care the patients of medical emergencies – Why do we are scared of tackling the emergencies and trauma care• Why always Ayurvedic Hospitals are with only death reaching, day counting paralytic patients – who comes after all systems finish their experiments – – If we treat such neurological or respiratory conditions well in advance efficiently – what is the rate of success after Tons of GOLD consumption as medicine Dr. K. Shiva Rama Prasad, at
  5. 5. • A sudden unforeseen crisis (usually involving danger) that requires immediate action • Sudden state of danger etc., requiring immediate action. • A condition requiring immediate treatment, where the patient with this is either conscious or unconscious.Dr. K. Shiva Rama Prasad, at
  6. 6. What a coincidence ! • Speaker on Ayurveda emergencies – not possible to attend the session • So, I am called here to speak on “Ayurveda Emergencies Management” – in emergency short notice • Kindly bear with the presentation & Ideology on Ayurveda Emergencies in Emergency !Dr. K. Shiva Rama Prasad, at
  7. 7. Medical Emergency • A medical emergency is an injury or illness that is acute and poses an immediate risk to a persons life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the victim themselves. K. Shiva Rama Prasad, at
  8. 8. Treatment may require the involvement of multiple levels of care, from a first-aider to an emergency physician through to specialist surgeons. Any response to an emergency medical situation will depend strongly on the situation, the patient involved and availability of resources to help them. It will also vary depending on whether theemergency occurs whilst in hospital under medical care, or outside of medical care (for instance, in the street or alone at home). What is in emergency ? Dr. K. Shiva Rama Prasad, at
  9. 9. Emergency Medicine • Emergency medicine is a medical specialty—a field of practice based on the knowledge and skills required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioral disorders. It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development Dr. K. Shiva Rama Prasad, at
  10. 10. Classification - 1 Disease Emergency True Emergency Procedural Emergency Iatrogenic Emergency (Doctor Made condition) False Emergency Emotional Emergency Anxiety Emergency (Attendees Made condition)Dr. K. Shiva Rama Prasad, at
  11. 11. Typology based on Risk• Patient assessment omission – inappropriate diagnosis - delay may result as life threatening• Patient assessment commission – inappropriate investigations• Treatment omission – failure / delay in giving treatment• Treatment commission - inappropriate treatment given• External disposal omission – Failure to admit• External disposal commission – Not applicable for Emergency• Internal disposal – unable to provide Bed – equipment etc• Equipment – service / machine failure• Documentation (Legal) – inadequate, inaccurate documentation• Patients action – consequences to themselves or others life threatening (insane)• General – failures of any other – such as electricity, etc M Thomas, K Mackway-Jones, N Boreham, Derivation of a typology for the classification of risks in emergency medicine, Emerg Med J 2004;21:464–468. doi: 10.1136/emj.2002.003624 Dr. K. Shiva Rama Prasad, at
  12. 12. Atyayika Typology • Ayurveda emergencies are not away from the problem of patient • The classification includes Tridosha and Srotas specific along with Agni, Ama & Dhatu • We can not neglect the role of the rest in emergency • The life in Ayurveda is dependent upon the “Agni”Dr. K. Shiva Rama Prasad, at
  13. 13. Dosha & Srotas• Out of tridosha, Vata is said as driver and performs all functions & the rest of two are lame – Vata – 5 types, includes different level of body functions and create emergency• Impairment of 13 srotas along with sanjna & chesta vaha srotas may lead to either structural or functional anomalies• Most of the time the structural impairments goes to the surgical emergency management and the functional to the medical emergencies Dr. K. Shiva Rama Prasad, at
  14. 14. Tagged Typology of Emergency• Surgical Emergency – Usually all traumatic / accident cases – Organ related pathology - Appendicitis, Acute abdomen, etc• Medical Emergency – Internal - Any functional impairments – External - Snake bite, scorpion sting, etc Dr. K. Shiva Rama Prasad, at
  15. 15. Vata & Emergency• Why the Vata? – As it is minute and penetrable in all channels and tissues – Avrutavata symptoms mimic emergency• Pranavata – shiras as seat – corresponds intellectual, cognitive, motor functions• Udanavata – uras as seat – corresponds pulmonary, acid base & fluid regulation• Samanavata – digestive functions & movements in abdomen• Vyanavata – heart as seat – cardio-vascular, Hemodynamics, etc• Apanavata – pelvic floor, excretory and expulsive functions Dr. K. Shiva Rama Prasad, at
  16. 16. Emergency Resuscitation Vata• उदानं योजयेदध्वर्मपानं चानुलोमयेत ् ||२१९|| ू समानं शमयेच्चैव िऽधा व्यानं तु योजयेत ् | ूाणो रआयश्चतुभ्योर्ऽिप ःथाने ह्यःय िःथितीुवा ||२२०|| र् ःवं ःथानं गमयेदेवंऽवृतानेतान ् िवमागर्गान ् |२२१| • Udana to be brought to up (Chest)= Respiratory Resuscitation • Apana is sent to down = active peristalsis created • Samana is subsided = kindling fire, regulated digestion • Vyanna is by all three methods (regulated, spread & excreted) • Prana Protected well = ??? Dosha shamana Dr. K. Shiva Rama Prasad, at
  17. 17. Emergency measures• Airway maintenance• Life line introduction – fluid and electrolytes maintenance• Blood Pressure / Pulse regulation• Consciousness recall• Stomach wash if necessary• Call another Doctor ! If not possible !• Or send the patient to better Hospital ! Dr. K. Shiva Rama Prasad, at
  18. 18. What to do in Ayurveda ?• Ayurveda suggest few routes of drug administration that bypass the digestion and act in Emergency – eg: Vasti, Nasya, Lepa, etc.• All the Rasa-Aushadha used in sub-lingual route are meant for Emergency Medical Practice• Ayurveda Injections – 25 years back experimentally prepared and marketed with success and withdrawn because of the Govt. policy – are best and quick tools in tackling emergency Dr. K. Shiva Rama Prasad, at
  19. 19. Tackling Jwara as Emergency • I witness hyperpyrexia of 106.6 degrees F for a child aged 5 years • Cold sponging along with Mrutyunjaya ras made the fever to control very fast • Along with what I have considered is – soap water enema – which made the temperature to drop in 15 – 30 minutes graduallyDr. K. Shiva Rama Prasad, at
  20. 20. Tackling Atisara as Emergency• Loose motions are not such emergency – unless the person goes in dehydration• Along with the measures of controlling diarrhea –• Triphla Churna is mixed Ice-water along with ORH solution made the person to recover faster and sooner Dr. K. Shiva Rama Prasad, at
  21. 21. Tackling Pakshaghata as Emergency • A female patient aged 45 years approached with right side paralytic stroke where both upper & lower limbs are included along with facial paralysis • I prescribed 1 tab Brihatvata chintamani along with Ekangaveer Ras for every 4th hourly for 24 hours resulted in to the normalcy and regulated the dose to 6th hourly on second day and 3rd day it was perfectly normal walk made me to continue the same medicines twice daily – for that patient I continued same medicine daily once for another 21 days – please note - nothing more then these two medicinesDr. K. Shiva Rama Prasad, at
  22. 22. Tackling Tamaka swasa as Emergency• Status asthmatics is bad situation for patient & Doctor• Swasakasachintamani + Malla sindhura with tmala patra swarasa sub-lingual makes instantaneous relief• 25 ml of Dashamoola taila or Dhanwantara taila Salwana sukhoshna Matra vasti – makes the patient to get relief immediate Dr. K. Shiva Rama Prasad, at
  23. 23. Conclusion • There are many more situations drive physician in to emergency • All situations can not be recorded • We have to follow the needs of patient demands the situation with the equipment we have with us • With out deviating the Ayurveda principles – what ever it suggest we follow with situational dosage and intake methods – we can tackle the emergencies through Ayurveda medicines. • We require the parental route Ayurveda medicines to bring in to and practice Ayurveda in tradition and in scientificDr. K. Shiva Rama Prasad, at
  24. 24. • It is right time to start . . .. Ayurveda Emergency MedicineDr. K. Shiva Rama Prasad, at
  25. 25. I strongly recommend to startDo you feel this Critical& Emergency Doctor? Suchiveda (Ayurveda Injection Therapy) and a Committee to study Ayurveda practice inYes ! I am short of20,000 for my new CAR ! Medical emergencies Now you Ask & Answer Dr. K. Shiva Rama Prasad, at