...Cardiac arrest algorithms are simplified and redesigned to emphasize the importance of hig h-quality CPR Key changes from the 2005 ACLS Guidelines Atropine is no longer recommended for routine use in the management of PEA/asystole There is an increased emphasis on physiologic monitoring to optimize CPR quality and detec t ROSC Key changes from the 2005 ACLS Guidelines Chronotropic drug infusions are recommended as an alternative to pacing in symptomatic and unstable bradycardia Adenosine is recommended as a safe and potentially effective therapy in the initial mana gement of stable undifferentiated regular mono morphic wide-complex tachycardia Topic in ACLS 2010 Management Management of Cardiac Arrest of Symptomatic Bradycardia and Tachycardia Management of Cardiac Arrest Management of Cardiac Arrest Early CPR and rapid defibrillation can significantly increase the chance for survival to hospital discharge Management of Cardiac Arrest Medications and advanced airways associated with an increased rate of ROSC • But have not been shown to increase the rate of survival to hospital discharge Higher quality CPR and post– cardiac arrest interventions...
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...If the QRS is present and the pattern is sever, it is a sign of atrial flutter. Also, a sine wave shows ventricular flutter, and the absence of P waves with wide QRS complexes is ventricular tachycardia. Therefore, it is very important to consider the rate and rhythm of the heart beat in ECG recording. Moreover, axis is another factor that we can study from the ECG recording for clinical diagnosis. The QRS axis shows the direction of the ventricular depolarization in heart beat. A normal QRS axis should be in the range of −30° to 105°. If this value is more than +105°, right axis deviation, it shows right ventricular hypertrophy or left posterior fascicular block. If this value is less than −30°, left axis deviation, it shows a left ventricular hypertrophy or left anterior fascicular block. Also, the waves and the distance between them have a normal range of time duration and the amplitudes (voltages). P wave larger than 80ms represents atrial enlargement, PR wave larger than 200ms indicates first degree atrioventricular...
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...Atrial Fibrillation Pathophysiology March 20, 2016 Introduction Atrial Fibrillation, commonly known as A-Fib or AF, is the most common type of persistent cardiac arrhythmia. AF effects only 2% of the population under the age of 65, but 9% of those over the age of 65 (Centers for Disease Control and Prevention [CDC], 2015). Many other cardiac diseases are seen with AF, either as a cause, or as a result of the atrial fibrillation. Left untreated, AF can result in tachycardia that causes ventricular dysfunction and/or heart failure, along with a significantly increased risk of thromboembolic stroke. I recently conducted an interview with my father who has had AF for nearly 20 years and I compared my findings in the literature against his experiences with the disease. Pathophysiology Atrial Fibrillation is a supraventricular tachyarrthymia. In the heart, ventricular rate is controlled by the conduction and refractory properties of the AV node and the progression of wave fronts entering the AV node. Calcium channels are accountable for the major depolarizing current in AV nodal cells. Beta-adrenergic receptor stimulation boosts AV nodal conduction, whereas vagal stimulation impedes AV nodal conduction. Sympathetic activation and vagal withdrawal, as with illness or exertion, speeds up the ventricular rate. After each atrial excitation wave that depolarizes AV nodal tissue, those cells become refractory for a time, preventing subsequent impulses from propagating...
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...Multi-Parameter Patient Monitoring Platform Santosh N Vasist Abstract: This project measures pulse rate, temperature and records ECG signal of a patient. It predicts the risk of a disorder related to the heart using Artificial Neural Networks (ANN) in the absence of a doctor. This project uses an ECG sensor to measure the electrical activity of the heart using a three electrode system, a heartbeat sensor to measure the heart rate by analyzing the blood flow in index finger, and a temperature sensor to measure the body temperature. Additional parameters such as age, gender, height, weight along with the QRS interval from the recorded ECG is used to predict the risk of a disorder using Artificial Neural Networks (ANN). I. INTRODUCTION Human heart generates small electrical signals which travel through the muscles of the heart and results in the contraction and relaxation of the heart thus in turn resulting in the pumping action. These electrical impulses can be detected by Electrocardiography. An Electrocardiograph is the record of the electrical activities occurring in the heart. Electrodes set on distinctive parts of the body distinguish electrical signs originating from diverse regions inside of the heart. Effectively almost all the diseases related to the heart can be detected by the ECG. An ECG is a quick and easy method for the doctor to determine the condition of the heart. The ECG readings are almost immediate and reliable, which means the findings of the test...
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...said to be infarcted. The term myocardial infarction (MI) means damaged heart muscle. If a main coronary arteries is blocked, a large part of the heart muscle is affected. If a smaller branch artery is blocked, a smaller amount of heart muscle is affected. After an MI, if part of the heart muscle has died, it is replaced by scar tissue over the next few weeks. What happens in dysrhythmias- A cardiac dysrhythmia is an abnormal heart beat: the rhythm may be irregular in its pacing or the heart rate may be low or high. Some dysrhythmias are potentially life threatening while other dysrhythmias (such as sinus arrhythmia) and normal. Tachycardia is a fast (over 100 beats per minute) heart rhythm. Tachycardias can originate in the atria or ventricles. * Dysrhythmias that originate in the atria are termed supraventricular dysrhythmias (supraventricular means above the ventricles). These...
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...Humans in technology environment are not very free from natural selection. According to Charles Darwin, natural selection acts only for the good of each organism, so since our very first human ancestors had no natural defenses, they would die from what is considered today an insignificant disease. It was throughout millions of years, that the human body started to build an immunization to certain diseases and only the stronger humans were the ones to survive and carry on that trait. Likewise, having no fur on their bodies to survive in the cold weather, they learned how to use other animals’ skins and how to build some weapons, in order to chase wild animals. Nowadays, humans have made incredible discoveries; we have created a wonderful world of technology, which leads us to make some enormous progress in the field of medicine; especially in how to treat diseases which were, at some time, considered incurable. My point is, that since we have made such progress in technology, I am scared that we are keeping too many people alive, including some that might not fit the environment in which they live. In addition, we are allowing some infertile people to reproduce through in-vitro fertilization, when apparently they were not capable naturally. We are also letting babies survive by saving their lives at their birth even though they might not be perfectly healthy or other traits which could bedetrimental for the human species. But through science and the new technology, we have...
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...Case Study 5—Coronary Artery Disease It is midmorning on the cardiac unit where you work, and you are getting a new patient. G.P., a 60- year-old retired businessman, is married and has 3 grown children. As you take his health history, he tells you that he began feeling changes in his heart rhythm about 10 days ago. He has hypertension and a 5-year history of angina pectoris. During the past week he has had more frequent episodes of midchest discomfort. The chest pain has awakened him from sleep but does respond to NTG, which he has taken sublingually about 8 to 10 times over the past week. During the week he has also experienced increased fatigue. He states, “I just feel crappy all the time anymore.” A cardiac catheterization done several years ago revealed 50% occlusion of the right coronary artery (RCA) and 50% occlusion of the left anterior descending (LAD) coronary artery. He tells you that both his mother and father had CAD. He is taking amlodipine, metoprolol, lipitor, and baby ASA qd. Setting: Hospital, outpatient cardiac rehabilitation Index Words: coronary artery disease (CAD), hypertension, angina, lifestyle modification, medications, laboratory values, assessment, risk factors, pacemaker 1. What other information are you going to ask about his episodes of chest pain? [k] Use the following memory aid to obtain information from the patient who has chest pain. FACTOR QUESTIONS TO ASK PATIENT P Precipitating events What events or activities precipitated...
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...014CRNA Interview Preparation Q: Tell me about a time when you had to manage a difficult clinical situation. Q: Tell me about a time when you were working with someone who wasn't pulling their weight, and they had a different value system than yours. How did you deal with this person? Q: Tell me about a time when you failed. What happened, and how did you recover? Q: Tell me about a time when you had an ethical dilemma at work. What did you do? Q: Tell me about a time when you felt it was you against everyone else. You thought you were right and that everyone else was wrong. What did you do? Q: Why do you want to be a CRNA?** Q: What would make you a successful CRNA?** Q: How do you handle stress? Q: What kind of patients do you take care of? Your favorite and why?** Q: Tell us about your work experience.** Q: How do you describe success? Q: Do you foresee any barriers to your education? (finances, time commitments) Q: What does a CRNA do? How do you think your role as a CVICU nurse relates to the role and responsibilities of a CRNA?** Q: Where do you want to be in 5 years?**. Q: Why our program? Q: What questions do you have for us?** A: What do you look for in potential students? How does your program facilitate student research? I am very interested in teaching and education, how does your program prepare me to be an educator? What do you see as your school's strong points? On avg. how many intubations, art lines...
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...CNE V Continuing Nursing Education Objectives and instructions for completing the evaluation and statements of disclosure can be found on page 224. What Is Normal?' Evaluating Vital Signs Dehra Van Kuiken, Myra Martz Huth ital signs (VS) are indicators of physiological functioning and include temperature, respiratory rate, fieart rate (pulse), and blood pressure (BP). Health care professionals measure VS to assess, monitor, evaluate, and document an individual's physiological status or change in condition (Royal College of Nursing, 2011). Depending on the individual's condition, VS are monitored and recorded routinely by policy, tradition, or expert opinion, whether needed or not (Evans, Hodgkinson, & Berry, 2001; Zeitz & McCutcheon, 2006). Five years ago, pédiatrie nurse leaders and evidencebased practice (EBP) experts from children's hospitals across the country voiced concerns about the frequency of VS at a National Summit for Pédiatrie and Adolescent EvidenceBased Practice (Melnyk et al., 2007). This summit resulted in our team formulating a clinical question, searching for the evidence, critically appraising the evidence, and formulating conclusions on normal parameters. Before the question on the frequency of ys could be addressed, two fundamental questions needed exploration, and thus, became the focus of our work. The questions are: • Among pédiatrie patient ages 1 through 5 years, what are "normal" VS parameters? • Among pédiatrie patient ages 1 through 5 years...
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...diomyopathy Topic presentation on Cardiomyopathy Topic presentation on Cardiomyopathy INDEX S.N | CONTENT | PG.NO | 1 | Introduction | 5 | 2 | Definition Cardiomyopathy | 5 | 3 | Classification | 6 | 4 | Risk Factors | 7 | 5 | Clinical Manifestations | 7 | 6 | Diagnostic Evaluation | 7-9 | 7 | Dilated CardiomyopathyDefinition,Charecteristics,Types , Causes,Diagnostic Evaluation,Pathophysiology,Clinical Manifestations,Medical Management | 10-17 | 8 | Hypertrophic CardiomyopathyIncidence,Causes,Charecteristics,Clinical Manifestations,Medical And Nursing Management | 18-21 | 9 | Restrictive Cardiomyopathy-Other Names,Causes,Pathophysiology,Clinical Manifestations,Diagnostic Evaluation,Medical Management | 23-26 | 10 | Surgical management | 27-32 | 11 | Prevention | | 12 | Nursing Management,Home Care Management | 32-40 | 13 | Complications | 40-42 | 14 | Conclusion | 42 | 15 | Research Abstract | 42-43 | 16 | References | 44 | GENERAL OBJECTIVE: On completion of the course the students aquires indepth knowledge regarding cardiomyopathy and able to apply this knowledge with a positive attitude. SPECIFIC OBJECTIVE: On completion of the course the students are able to ...
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...NRSG240 Final Test note CARDIAC NURSING 4 AMI 4 Definition (3marks)- very detailed needed. 4 Clinical manifestations of AMI. (5marks) 4 Nursing Interventions and Rationale for Managing a patient with Acute Chest pain(6marks) 4 and Ineffective Tissue perfusion (6marks) 5 Acute chest Pain 오류! 책갈피가 정의되어 있지 않습니다. 1. PQRST questions to evaluate MI- intensity, location, radiation, duration, precipitation & alleviating factors, in order to accurately evaluate, treat and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 2. Semi-Fowler’s position & O2 therapy 2L via Hudson Mask in order to increase oxygenation of myocardial tissue & prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Administer medications- Morphin (normally 2.5-5mg) & anginine 600mcg (given every five minutes; maximum 3 tablets in order to relieve/prevent pain & ischemia to decrease anxiety & cardiac workload. 오류! 책갈피가 정의되어 있지 않습니다. 4. 12-lead ECG & monitor in order to check hypotension & bradycardia, which may lead to hypoperfusion. 오류! 책갈피가 정의되어 있지 않습니다. Ineffective tissue perfusion 오류! 책갈피가 정의되어 있지 않습니다. 1. Monitor vital signs (Hourly) and saturation oxygen to determine baseline and ongoing change. 오류! 책갈피가 정의되어 있지 않습니다. 2. Administer oxygen by Hudson’s mask (6-10L/min) and monitor the effectiveness to increase oxygenation of myocardial tissue and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Monitor respiratory status for sysptoms of heart failure to maintain appropriate levels of oxygenation...
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...Courtesy of L E K A R SPECIAL EDITION Authors: Marino, Paul L. Title: ICU Book, The, 3rd Edition Copyright ©2007 Lippincott Williams & Wilkins ISBN: 0-7817-4802-X Authors Dedication Quote Preface to Third Edition Preface to First Edition Acknowledgments Table of Contents Section I - Basic Science Review Basic Science Review Chapter 1 - Circulatory Blood Flow Chapter 2 - Oxygen and Carbon Dioxide Transport Section II - Preventive Practices in the Critically Ill Preventive Practices in the Critically Ill Chapter 3 - Infection Control in the ICU Chapter 4 - Alimentary Prophylaxis Chapter 5 - Venous Thromboembolism Section III - Vascular Access Vascular Access Chapter 6 - Establishing Venous Access Chapter 7 - The Indwelling Vascular Catheter Section IV - Hemodynamic Monitoring Hemodynamic Monitoring Chapter 8 - Arterial Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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