...exacerbate the degree of permanent neurological damage following cardiac arrest. Each degree Celsius higher than 37C can cause cerebral destruction through increased metabolic expenditure, excitatory neurotransmitters resulting in calcium cellular reflux and accumulation of oxygen free radicals (Busto et al., 1987). To improve the outcome of patients who survive cardiac arrest requires not only reducing the ischemic process as quickly as possible, caused by cardiac arrest, but also preventing post resuscitation syndrome caused from reperfusion (Safar, 1993). Cerebral reperfusion after successful resuscitation can trigger harmful chemical cascades such as oxygen free radical production which can result in multifocal brain damage. Therapeutic hypothermia (TH) is considered as an effective method for reducing the deleterious neurological outcomes in patients who have out-of-hospital cardiac arrest. Clinical and animal studies have shown that TH following cardiac arrest reduces both the cerebral metabolic rate and oxygen demand and it is thought to attenuate reperfusion injury, global inflammation and endothelial dysfunction, all consequences of cerebral ischemia. Over the...
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...their heart unexpectedly stops beating. The heart’s electrical system suddenly malfunctions and is not able to pump oxygenated blood to the body’s vital organs. Life saving measures are initiated in an attempt to restart the heart’s electrical system. Once return of spontaneous circulation (ROSC) is achieved, efforts to improve neurological recovery may be initiated. Therapeutic hypothermia is one intervention that has been shown to improve neurological outcomes for comatose victims of cardiac arrest (Field, et al., 2010). Hypothermia reduces cerebral oxygen consumption and suppresses the effects of the damaging chemical cascades initiated by reperfusion, the so called...
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...exacerbate the degree of permanent neurological damage following cardiac arrest. Each degree Celsius higher than 37C can cause cerebral destruction through increased metabolic expenditure, excitatory neurotransmitters resulting in calcium cellular reflux and accumulation of oxygen free radicals (Busto et al., 1987). To improve the outcome of patients who survive cardiac arrest requires not only reducing the ischemic process as quickly as possible, caused by cardiac arrest, but also preventing post resuscitation syndrome caused from reperfusion (Safar, 1993). Cerebral reperfusion after successful resuscitation can trigger harmful chemical cascades such as oxygen free radical production which can result in multifocal brain damage. Therapeutic hypothermia (TH) is considered as an effective method for reducing the deleterious neurological outcomes in patients who have out-of-hospital cardiac arrest. Clinical and animal studies have shown that TH following cardiac arrest reduces both the cerebral metabolic rate and oxygen demand and it is thought to attenuate reperfusion injury, global inflammation and endothelial dysfunction, all consequences of cerebral...
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...Chapter 1 1.1 Introduction By synthesizing the data from various studies and research, this dissertation will aim to systematically review the current literature of evidence for therapeutic hypothermia (TH) post cardiac arrest. The research question is as follows: does therapeutic hypothermia treatment present positive neurological outcomes for post cardiac arrest victims? 1.1a Rationale: Whilst working in the Intensive Care Unit, I had the opportunity to witnessed a patient being cooled (therapeutic hypothermia concept) after experiencing out of hospital post cardiac arrest. I was intrigued to learn more about the concept as I had never heard or seen it done before. This prompted me to research further on the evidence based practice pertinent to TH treatment on post cardiac arrest victims. Patients who have suffered post cardiac arrest are usually cared for in a critical care environment such as the intensive care unit (ICU), and the survival rate for in hospital incidents is considered to be poor (Gwinnut et al 2000). Furthermore, according to Becker (1993) and Rea (2004), approximately 0.04% to 0.19% of out of hospital cardiac arrest incidence occur each year in industrial countries. Around 14% to 40% of these victims regain Return of Spontaneous circulation (Giraud 1996, Finn 2001, Fischer 1997), and only 7% to 30% were able to attain good neurological outcomes on discharge (Jennings 2001, Westfal 1996, Weston 1997). By critically reviewing the literature of evidence...
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...Background Hypothermia (hi-po-THUR-me-uh) is a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. The term “hypo” refers to less, and “thermia” refers to temperature. Normally, the core body temperature is 98.6 degrees F. Hypothermia occurs as your body temperature passes below 95 F (35 C). When your body temperature drops, your heart, nervous system and other organs cannot work correctly. Left untreated, hypothermia can eventually lead to severe heart and respiratory failure, and in some cases, death. Hypothermia is most often caused by long term exposure to cold weather or or and unexpected immersion into in the face of a cold stressor. Hypothermia, though, is not always the result of exposure to extremely cold outdoor temperatures. History Hypothermia has been applied therapeutically since antiquity. The Greek physician Hippocrates, the namesake of the Hippocratic Oath and arguably the world’s first modern doctor, advocated the packing of wounded soldiers in snow and ice.[3] Napoleonic surgeon, Baron Dominque Larrey recorded that officers who were kept closer to the fire survived less often than the minimally pampered infantrymen using snow and ice.[3] In modern times the first medical article concerning hypothermia was published in 1945.[3] This article focused on the effects of hypothermia on patients suffering from severe head injury. In the 1950s hypothermia established its first medical...
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...America accentuating increased opportunities for hypo/hyperthermia cases. Hypothermia and cold stress on transport is a preventable condition that can have a significant impact on mortality and morbidity, especially in pre-term infants. Proper thermoregulation and management should always be a top priority whether the newborn is well or sick. It is important for the transport team to understand infants at increased risk for hypothermia, normal & abnormal core temperatures, normal response to cold stress, mechanisms of heat gain and loss, physiologic response to hypothermia, what methods are used to rewarm hypothermic infants, how to monitor infants during rewarming, and how to handle the hyperthermic infant. Team members need to diligently consider all risk factors that may place these delicate patients at risk and effectively maintain a normal body temperature throughout the entire transport. Infants have a difficult time balancing heat loss with heat production. At birth, the term infant has a surface area-to-volume ratio four times that of its parents and a heat production only one and one-half times as high. In addition, the infants ability to increase heat production in the face of cold stress is only about one-third that of the parents. Other factors contributing include decreased amounts of insulating fat, thinner immature skin, and if any brown fat. Infants at the highest risk for hypothermia consist of: • Premature, low-birth weight infants, especially those with...
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...System Admin Max Points: 15.0 What do you look forward to, as you begin this educational experience and your personal search for purpose? What is your greatest fear? How can you overcome it? Write about one specific educational experience from your past where you addressed a fear and overcame it and how you succeeded in this process. I certainly look forward to completing the RN to BSN program on schedule. As an experienced and competent RN of 12 years, my management has given me an opportunity to serve as an intermittent Charge Nurse and a Preceptor on a 24-bed surgical unit. I serve as a Charge RN to my colleagues as well as a preceptor to new hires with BSN degree. I have a good rapport and a good working relationships with my colleagues. Assuming roles a leader with ADN, gave the drive and the motivation to advance my education by obtaining my BSN degree. My employment has offered a scholarship program to any diploma and ADN who have ambitions to advance their education through the NNEI (National Nursing Education Initiatives). I took the opportunity and applied for the program which is now being processed. My biggest fear would be a failure to complete the BSN program on schedule. I want to be a good role model and an inspiration to my 12-year old who is a 7th grader. I want to prove and set examples not just to my daughter, but to my employment, colleague and friends that failure is never an option. I’m also under a contract agreement from the NNEI who will be funding...
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...Medical, Inc. Case Analysis Company Background In July 1987, Dr. Scott Augustine, an anesthesiologist, founded Augustine Medical, Inc. (AM) in Minnesota. Their goal was to develop and market products for hospital operating rooms and postoperative recovery rooms. Through experience, he discovered that hospitals needed an innovative approach to warming post-surgery patients. Dr. Augustine developed the Bair Hugger® Patient Warming System. Company executives were occupied with finalizing the Bair Hugger® Patient Warming System in early 1988. Original two products: (1) produce and sell patented warming system used to treat hypothermia and postoperative patents, (2) tracheal intubation guide for crisis situations and in the surgical room. Core Competencies Providing the most innovative and safe way to warm postoperative patients and those with hypothermia. Augustine Medical, Inc.’s products are also more effective, less likely to leak water onto expensive equipment, and easier to operate than other competitors methods of hearing patients. The Hospital Market Approximately 21 million surgical operations are performed annually in the US. That’s 84,000 operations per average 8-hour workday. Approximately 5,500 hospitals have operating rooms and postoperative recovery rooms. Research commissioned by AM indicated that there are 31,365 postoperative recovery beds and 28,514 operating rooms in hospitals in the US. 60 – 80 percent of all postoperative patients are rendered...
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...1. Ethically, is brain death not as final as cardiac death? Why or why not? Brain death is final; there is no coming back from it, ever. Neurons die, and the brain ceases to function permanently. With cardiac death, we can sometimes use medication or electricity to resume heart functions. Asystole (no electrical activity in the heart) can sometimes be reversed if the underlying cause of the problem can be treated (such as severe electrolyte abnormalities, or severe hypothermia). 2. How does the Prudent Person Rule apply in this case? Yes the Prudent Person Rule does apply in this case. It applies because the young girl came in for a simple routine surgery and was fine. Then shortly after the routine surgery she started to bleed profusely then went into cardiac arrest and was determined to be brain dead afterwards. 3. In your opinion, could this tragedy have been prevented? If so, how? In my opinion there was something wrong with this young girl to where she needed surgery. But even though the outcome is very sad, there is no real way for me to say yes or no if this tragedy could have been prevented because there so many missing pieces. I am not given any information on what happened during the pre-op and post-op and if there were any measures that could have been done to prevent this tragedy. In any surgery the patient and family should be completely informed of the risk of surgery during and after surgery and informed to the ramifications of a situation before making...
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...1. A person having a heart attack may have an uncomfortable feeling, such as pain or pressure in the chest or other areas of the upper body. true 2. What sudden illness is usually caused by a blockage of blood flow to the brain? stroke 3. If someone faints, the first thing you should do is: Drink cool water on face 4. What is the best way of opening the airway to check for breathing? Head tilt chin lift 5. Which statement best outlines the steps of proper use of an epinephrine pen? (1 point) fist 6. If a known diabetic appears has missed their lunch and appears confused and vague, you should do what immediately? Sugary drink 7. If an adult is eating and suddenly coughs and cannot breathe, talk, or make any sounds, you should ask the adult if she is choking. If she nods "yes", tell her you are going to help and give abdominal thrusts. true 8. How should you care for a person with a possible head, neck or back injury? minimize 9. What are the signs of shock? Cold and moist skin - all the above 10. A flail chest is where Several ribs 11. In stroke recognition, F.A.S.T. means: Face arm speech time 12. Which of the following sequences is correct for using an AED? Turn on, pads, analyze, shock 13. If a victim falls from a height and then becomes sleepy or confused, vomits or complains of a headache, the victim may have a head injury. false 14. Which form of hyperthermia (high body temperature) is more severe? Heat...
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...Biology Paper, CSE Style (Martin) Hypothermia, the Diving Reflex, and Survival Full title, writer’s name, name of course, instructor’s name, and date (all centered). Briana Martin Biology 281 Professor McMillan April 17, XXXX Marginal annotations indicate CSE-style formatting and effective writing. Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007). Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006). This paper follows the style guidelines in Scientific Style and Format: The CSE Manual for Authors, Editors, and Publishers, 7th ed. (2006). Page header contains abbreviated title and the page number. Headings, centered, help readers follow the organization. Hypothermia and Diving Reflex 2 ABSTRACT This paper reviews the contributions of hypothermia and the mammalian diving reflex (MDR) to human survival of cold-water immersion incidents. It also examines the relationship between the victim's age and MDR and considers the protective role played by hypothermia. Hypothermia is the result of a reduced metabolic rate and lowered oxygen consumption by body tissues. Although hypothermia may produce fatal cardiac arrhythmias such as ventricular fibrillation, it is also associated with bradycardia and peripheral vasoconstriction, both of which enhance oxygen supply to the heart and brain. The MDR also causes bradycardia and reduced peripheral blood flow as well as laryngospasm, which protects victims against rapid inhalation of water. Studies of drowning...
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...my audience of the risks inherent from unintended hypothermia. I’m eager to alert perioperative staff of the potential dangers as well as the preventative measures that can be taken in order to avoid complications associated with unintended hypothermia. My central idea is hypothermia management saves lives. Intended Audience: My ideal audience for this speech would be those medical professionals working in the perioperative area. Significance: This topic is very significant to my audience because our patients’ outcomes are directly related to our competency in this area. Knowledge of what measures are to be implemented to avoid unintended hypothermia in the perioperative setting will greatly decrease our infection rates and shorten length of stay. Presentation Plan I. Introduction a. Audience hook: Did you know hypothermia is associated with a threefold increase in SSIs and it is estimated that SSIs increase postoperative hospitalization by an average of 4 days? (Hart et al., 2011) b. Thesis statement: Research suggests that intraoperative temperature management should be closely monitored because unintended hypothermia leads to increased risk for infection and increased length of stay. c. Preview of Main points: i. Unintended hypothermia leads to increased risk for infection. ii. Unintended hypothermia leads to increased length of stay. II. Main Point 1: Unintended hypothermia leads to increased risk for infection. a. ...
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...Background | Since medical law and ethics are often interrelated, you need to have a clear understanding of both in order to protect yourselves, your employer, and the patient. Even though only a small number of malpractice cases actually end up in court, it is nevertheless important for you to understand how the law impacts physicians and employers. In this assignment, you will examine two scenarios surrounding healthcare personnel in their work environment. | Part 1: Legal Responsibility | 30 points | Adam Green is an orderly in the Midwest Nursing Home. His supervisor, Nora Malone, has asked him to supervise the dining room while 20 residents eat their evening meal. Bill Heckler is an 80-year-old resident who is very alert and ambulatory. He tells Adam that he doesn't like the meal that's being served, and he wants to leave the dining room and go back to his own room. Adam is quite busy since he has to watch the behavior of several patients who are confused. He's concerned that patients might choke on their food or otherwise harm themselves. Adam becomes impatient with Bill and tells him that he cannot leave the room until everyone is finished eating. Adam then locks the dining room door. Bill complains to the nursing home administrator that he was unlawfully detained. He then hires an attorney who brings forth a charge of false imprisonment. For each question below, provide an answer in 2 to 3 sentences, using proper grammer and spelling. | A. Was Adam's action...
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...HEAT STRESS Heat stress can be a serious problem in hot working environments. The body temperature for a human must be maintained all the time, regardless of work load or adverse environmental conditions. A drastic increase in body temperature can result in death. The body initially responds to heat by sweating and by circulating blood closer to the skin's surface to lower the main body temperature. High temperatures, high humidity, sunlight, and heavy workloads increase the heat stress. Too much heat can also make workers lose their concentration or become fatigued and thus increases the chance of accidents and injuries. This heat stress may lead to the following: Heat Rash: Is an early signal of potential heat stress. It is commonly associated with hot, humid conditions in which skin and clothing remain humid. Heat rash may involve small areas of the skin or the entire upper body Heat syncope: Is characterized by dizziness or fainting while standing still in the heat for an extended period. Heat Cramps: Symptoms include painful cramps or spasms in the legs, arms, or abdomen. Heat cramps are often caused by a temporary fluid and salt imbalance during hard physical work in hot environments. Heat Exhaustion which results from the reduction of body water content or blood volume. The condition occurs when the amount of water lost as sweat exceeds the volume of water drunk during the heat exposure. The victim of heat exhaustion may have some or all of the signs or symptoms:...
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...of why acknowledging your own biases may be helpful when working with clients. As a future mental health professional being in the position of a client, that is seeing a therapist whose background is different from mine whether by ethnicity, linguistics or even sexuality I would crave for them to be understanding, non-judgmental and respectful of my beliefs and values. In reflecting an understanding attitude, it would be very important for me that the therapist displays keen listening skills; as these attitudes of listening can either assist in promoting a free flowing dialogue between myself and the therapist or build a wall which may prevent me from expressing my feelings on the challenges and issues I am currently facing. In the therapeutic relationship, it is important that the client feels that the therapist is not critical and judgmental towards them and displays a high level of "caring and compassion toward the client even if they have confessed their deepest secrets and hidden desires" (Brew and Kottler, 2008; p.115). Another aspect of being understanding on the part of the therapist is the therapist's body language. Especially with the therapist's cultural differences certain actions in relation to body language may have differing meaning and thus depending on the action may be construed as being offensive. With body language being so important Ivey, Ivey and Zalaquett (2010) noted that if the therapist faces the client squarely, leans forward slightly, has a positively...
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