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Hypothermia Treatment Using adiant Heat
Hypothermia
Critique of Postoperative Hypothermia Treatment Using adiant Heat by Yang et al. (2012)
Critique of Postoperative Hypothermia Treatment Using adiant Heat by Yang et al. (2012)
Perioperative hypothermia has been shown to increase the risk of post-surgery complications, thereby threatening the health of patients and increasing the cost of care (reviewed by Hooper et al., 2009). Guidelines for active warming measures have been suggested by a number of experts, which attempt to address the health risk perioperative hypothermia represents. Should patients arrive in the post-anesthetic care unit (PACU) in a hypothermic state, the conventional approach is to cover patients with pre-warmed hospital blankets; however, forced air-warming has been shown to be more effective across patient populations.
Yang and colleagues (2012) recently published the results of a study examining the relative efficacy of warmed blankets and a radiant heat source for achieving a normothermal state…
References
Brauer, A., English, M.J., Steinmetz, N., Lorenz, N., Perl, T., Weyland, W., and Quintel, M. (2007). Efficacy of forced-air warming systems with full body blankets. Canadian Journal of Anesthesia, 54(1), 34-41.
Giuffre, M., Finnie, J., Lynam, D.A., and Smith, D. (1991). Rewarming postoperative patients: Lights, blankets, or forced warm air. Journal of Post Anesthesia Nursing, 6(6), 387-393.
Hooper, Vallire D., Chard, Robin, Clifford, Theresa, Fetzer, Susan, Fossum, Susan, Godden, Barbara et al. (2009). ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia. Journal of PeriAnesthesia Nursing, 24(5), 271-287.
Pikus, Eugene and Hooper, Vallire D. (2010). Postoperative rewarming: Are there alternaitives to warm hospital blankets. Journal of PeriAnesthesia Nursing, 25(1), 11-23.
Therapeutic Hypothermia in the Treatment of Cardiac rrest
This work has examined the use of hypothermia in treating cardiac arrest, which is an important scientific advance especially for the merican Heart ssociation's goal of reducing mortality rates associated with heart disease by 25%. (Nichols, 2008) The health status of individuals has suffered due to modernization of life in general however, medical advances in the area of cardiac arrests and particularly in the area of neurological functional recovery due to the hypoxic -- ischemic insults developed during and after the cardiac arrest as noted by Bessman (2010)
In addition, only 11% to 48% of surviving patients are noted with positive neuro functional clinical impact upon discharge. Therapeutic hypothermia is stated to result in a gain of 0.66 life years adjusted for quality when compared with normothermia treatment as noted by Merchant (2009). Eligibility is based upon criteria set by The Hypothermia…
As this study has noted the pre-resuscitation period as well as the post-resuscitation period are both related to lipid peroxidation of membrane, DNA fragmentation prior to accelerated programmed cell death "apoptosis. Factors including arrest time, time for resuscitation, severity of reperfusion and core body temperature all are critical in the determination of neuronal functional recovery. Detrimental factors such as arrest time, resuscitation time, reperfusion severity, and core body temperature play vital role in determining neuronal functional recovery. Cooling of the patient's body can mitigation these negative effects in this chain of events and the prevention or minimization of the effects of the size of infarct as well as improvement of myocardial savage, reduction of left ventricular remodeling and more optimized long-term left ventricular function and a decrease in mortality of patients with cardiac arrest as cited by Kelly and Nolan (2010). Hypothermia benefits include neuroprotective protection. The series of steps related to ischemia and reperfusion are temperature dependent. Therefore, if the body is at cooled condition, the deleterious effect of these interlinked events has the potential to be controlled in nature. The goal of treatment of cardiac arrest patients is to prevent or to minimize the effects of infarct size, improve myocardial salvage, reduced left ventricular remodeling and better long-term left ventricular function with overall decreased mortality rates.
The neuroprotective effect of hypothermia includes a decrease in cerebral metabolism, barring the release of excitatory amino acid, reduction of oxygen free radical production and lipid peroxidation, a decrease in CSF platelet activating factor (PAF, and inhibition of cytoskeleton breakdown. Other benefits include enhancement of membrane stabilization, electrolyte redistribution, and normalization of intracellular water concentration and intracellular pH (stabilization of the blood-brain barrier). Further aided is restoring normal intracellular signaling, protein synthesis and gene expression by lower body temperature during cardiac arrest Furthermore, with therapeutic hypothermia can reduce the cardio toxic effect through induction of epicardial reflow, reduction of myocardial metabolic need and maintenance of intracellular high-energy phosphate reserves. (Bessman, 2010)
Induced therapeutic hypothermia are cardioprotective and neuroprotective effect as related to reduction of infarct size, anoxic brain injury and mortality; and reduction in risk of arrhythmias, a decrease in complications. There are risks associated with hypothermia including effects on multiple organ systems however; these risks can be greatly reduced in proper treatment and high-quality intensive care therapy. The use of pharmacological agents is indicated in therapeutic hypothermia and include such as sedatives, analgesics, and neuromuscular blocking agents. (NMBAs) It is evident that therapeutic hypothermia has provided advances in the treatment of cardiac arrest and specifically in terms of the cardioprotective and neuroprotective effect of the use of this method for treatment individuals with cardiac arrest incidents. It is important that hospital nursing staff be educated, trained and prepared to administer therapeutic hypothermia in the care of individuals with cardiac arrest and who are determined to be eligible for such treatment of cardiac arrest.
Introduction
Within the neonatal time period, hypothermia is really a significant, life-damaging health problem. Adverse delivery location surroundings and transport complications frequently lead to reduced body heat in neonates. Regulating body heat, especially for the initial 12 hour-period right after delivery, is very important in lessening the death and morbidity levels of preterm babies. This document by Çaglar, Gözen And Ince (2014), examines the results of utilizing vinyl fabric isolation bags or perhaps polyethylene wrap for preventing postnatal hypothermia within preterm babies at = 32 weeks pregnancy.
Review
Early newborn babies (NB) lose several weeks of activation inside the uterus and conditions of thermoregulation are among the primary problems associated with prematurity. Due to the restricted capability for personal-safety of the thermoregulation system, NB can simply lose warmth as well as body temperature, and give in to the serious physical effects of hypothermia. Along with the immaturity from the defense…
References
Ça?lar, S., Gözen, D., & ?nce, Z. (2014). Heat loss prevention (help) after birth in preterm infants using vinyl isolation bag or polyethylene wrap. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 43(2), 216-223.
Li, S., Guo, P., Zou, Q., He, F., Xu, F., & Tan, L. (2016). Efficacy and safety of plastic wrap for prevention of hypothermia after birth and during NICU in preterm infants: a systematic review and meta-analysis. PloS one, 11(6), e0156960.
Oatley, H. K., Blencowe, H., & Lawn, J. E. (2016). The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates. Journal of Perinatology, 36(Suppl 1), S83–S89. doi. 10.1038/jp.2016.35
Rolim, K. M. C., Freitas, L. C., Lima, A. D. H. G., Magalhães, F. J., & Gurgel, E. D. P. P. (2015). Polyethylene wrap for maintaining the body temperature of the newborn. Revista de Enfermagem Referência, 9-16.
Therapeutic Hypothermia Review
Annotated Bibliography
Lucero, Catherine (2010) Therapeutic Hypothermia. Clinical Correlations. Retrieved from: http://www.clinicalcorrelations.org/?p=2032
Lucero (2010) writes of therapeutic hypothermia "resumption of spontaneous circulation after prolonged ischemia due to cardiac arrest carries significant morbidity and mortality and much effort has been directed toward reducing the debilitating consequences." Lucero reviews the studies that demonstrate an association between therapeutic hypothermia in post-cardiac arrest patients and improved neurological outcomes.
Tran, Bau P., et al. (2010) Use of Mild Therapeutic Hypothermia to Treat Cardiac Arrest. Journal of the American Academy of Physician Assistants. 1 Mar 2010. Retrieved from: http://www.jaapa.com/use-of-mild-therapeutic-hypothermia-to-treat-cardiac-arrest/article/164767/
Tran, et al. (2010) reviews the key findings of research studies on the usefulness of therapeutic hypothermia following cardiac arrest.
3. Lutes, Michael and Larsen, Nathan (2007) Focus on: Therapeutic Hypothermia. Clinical Practice and Management March 2007. Retrieved from: http://www.acep.org/content.aspx?id=26776
Lutes and Larsen (2007) reviews recent studies that examine the use of therapeutic hypothermia,…
All in all, frostbite is much easier to prevent than it is to cure. The old adage that an once of prevention is worth a pound of cure certainly holds true in this instance. Remembering to keep yourself covered up and monitoring the way your fingers and toes fell is the most important step in keeping yourself safe from frostbite. Simple awareness is usually the first step in preventing accidents and injuries, and playing with the cold is no exception. If your fingers begin to feel stiff or numb, you should go inside and warm them immediately. It might not be fun lose a snowball fight, but it's better than losing your fingers.
orks Cited
Carline, Jan D., Lentz, Martha J. & Steven C. MacDonald. Mountaineering First Aid. Seattle: The Mountaineers Books, 2004.
Dealing with Frostbite." Holiday City. 30 November 2005. Accesed 12 January 2009. http://www.holidaycityflash.com/article/dealing_frostbite.html
Frostbite." eMedicineHealth: A Practical…
Works Cited
Carline, Jan D., Lentz, Martha J. & Steven C. MacDonald. Mountaineering First Aid. Seattle: The Mountaineers Books, 2004.
Dealing with Frostbite." Holiday City. 30 November 2005. Accesed 12 January 2009. http://www.holidaycityflash.com/article/dealing_frostbite.html
Frostbite." eMedicineHealth: A Practical Guide to Health. 2009. Accessed 12 January 2009. http://www.emedicinehealth.com/frostbite/page2_em.htm
Frostbite." Healthscout Health Encyclopedia. 2001-2009. Accessed 12 January 2009. http://www.healthscout.com/ency/68/453/main.html
Veterinary Nursing Anesthesia and Analgesia Case Journal
The objective of this study is to address anesthesia needs in two specific cases with the first being a 12-week-old Jack Russell puppy and the second being a 12-year-old geriatric cat.
12-Week-old Jack Russell Puppy
This 12-week-old Jack Russell Puppy has eaten a babies dummy. This case study will highlight the anesthesia requirements and protocol and highlight the relevance of effect on renal function, speed of recovery, analgesia, emphasis on knowledge and understanding. Even at 12-weeks of age, this puppy is considered a pediatric patient according to the work of Gleed and Seymour (1991). This means that the patient has a higher oxygen requirement that the adult. The tongue of this patient due to his age is large and the airway is small in diameter. As well, there is a lower functional renal capacity in this age patient all of which make the…
Bibliography
Bennett, RC, et al. (2008) Comparison of sevoflurane and isoflurane in dogs anaesthetized for clinical surgical or diagnostic procedures. Journal of Small Animal Practice. 49, 392-397.
Gleed, R and Seymour C (Eds) (1991) Manual of Small Animal Anesthesia and Hall, LW Clarke KW Trim CM 2001 Veterinary Anesthesia 10th edition Myerscough College 2011 Drugs used for Premedication
HEDip CVN VN 2020 Veterinary Anesthesia: Anesthesia for Specific Scenarios. Session Introduction Myerscough College 2011.
Hollingshead KW & Mckelvey D (2000) Veterinary Anesthesia and Analgesia 3rd Edn Mosby Missouri
The picture to the left depicts the various elements that are responsible for thermoregulation in human skin. The illustrations shows the various layers of skin along with the veins, arteries and capillaries of the circulatory system that assist in insuring that the thermoregulatory system works properly. The sweat glands are responsible for selectively removing materials from the blood the sweat glands then concentrates or alters these toxins, and secretes them for elimination from the body. The perspiration or sweat is then removed through the sweat pore. This has a twofold purpose: to remove toxins and thermoregulation (in this case cooling the body).
Thermoregulation involving perspiration is brought about by both internal and environmental heat and exercise. As it relates to the latter, there have been many studies related to exercise and thermoregulation. According to Marino (2004)
"thermoregulatory effector responses of humans and concluded that temperature regulation during exercise is dissimilar…
Works Cited
Caterina MJ, Schumacher MA, Tominaga M, Rosen TA, Levine JD, Julius D. The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature. 1997;389:816-824.
Dugan SA, Powell LH, Kravitz HM, Everson Rose SA, Karavolos K, Luborsky J (2006)
Musculoskeletal pain and menopausal tatus. Clin J. Pain 22: 325 -- 331
Deecher, D.C.K. Dorries (2007)Understanding the pathophysiology of vasomotor symptoms
altenative appoach to Computeized Tomogaphy in foensic pathology.
Thomsen, A.H., Juik, A.G., Uhenholt, A.G., Vesteby, A. (2009).
Jounal: Foensic Science Intenational.
Publication Infomation: 2008, 183, 87-90.
Publishe Infomation:
The main pupose of this aticle is to see whethe o not CT scans ae necessay as a means of augmenting autopsies. The eseach question is: do the benefits of CT scans match the effot equied to implement this technology? Thee is no hypothesis fo this aticle; the authos wee cetainly non-patisan in thei appoach and assumptions. The sample was 20 dead bodies (including 15 males) with CT scans pefomed by the Depatment of Radiology at Aahus Univesity Hospital. I eviewed this aticle to ascetain the elevance of CT scans to foensic pathology.
Abstact: This aticle denotes the boons and the detiments associated with using CT scans as compaed to, and augmenting the usage of conventional autopsies fo foensic pathology. Oiginal eseach…
references to certain applications dating back to the 1980s. In this respect the article was extremely comprehensive in its scope, although perhaps it may have been better suited focusing on more contemporary applications. Still, for the variety of knowledge it covered and the degree of insight it shed, it is certainly an excellent starting point for research into this field, and helps to synthesize the various points of relevance of the other articles explicated within this assignment.
Bruised witness: Bernard Spilsbury and the performance of early twentieth-century English forensic pathology
Author(s): Burney, I., Pemberton, N.
Journal: Medical History
Publication Information: 2011, 55, 41-60.
The accident occurred while the actress was taking a skiing lesson. She initial experienced no symptoms from her fall, but later complained of a headache and was taken to a local hospital. Reports indicate that her fall was not very spectacular and occurred at a low speed on a beginner run. She was not wearing a helmet at the time of the accident. (Quinn, 2009)
However, while it is true that sometimes there are no immediately obvious signs of a severe brain injury, at other times there are.
Severe Traumatic Brain njury
The symptoms of a severe traumatic brain injury (which can result in permanent neurological damage) include a number of cognitive problems including inability to concentrate, problems with memory, problems in focusing and paying attention, ability to process new information at a normal rate, a high level of confusion, and perseveration, which is the action of doing something over…
In describing the course of their patients, experienced clinicians who use HBOT to treat patients with brain injury, cerebral palsy, and stroke refer to improvements that may be ignored in standardized measures of motor and neuro-cognitive dysfunction. These measures do not seem to capture the impact of the changes that clinicians and parents perceive. Caregivers' perceptions should be given more weight in evaluating the significance of objective improvements in a patient's function. Unfortunately, studies have not consistently measured caregiver burden, or have assessed it only by self-report. Studies in which the caregivers' burden was directly observed would provide much stronger evidence than is currently available about treatment outcome. (AHRQ Publication Number 03-E049, 2003)
In other words, this somewhat alternative treatment produces results that are more meaningful to the injured person and his or her caregivers.
I have focused here primarily on the biochemical end of treatments for those with traumatic brain injury because it is this level of treatment that offers the long-term possibility of the greatest level of treatment. Such treatments as are described here have the chance to cure traumatic brain injury. But until these are perfected, every other kind of treatment and therapy -- from drug treatments to speech therapy to the love of friends -- will remain priceless.
Myxedema is a potentially deadly endocrine regulation disease that usually arises in connection with pre-existing hypothyroidism, when the normal homeostatic mechanisms for responding to hypothyroidism are overwhelmed. It occurs most often in elderly women, and is usually characterized by swelling of the skin and other soft tissues (Wall, 2000).
The thyroid gland is central to homeostatic metabolic functions, and operates as part of a complex feedback loop involving both the pituitary and hypothalamus to control essential elements of fluid and electrolyte balance and thermoregulation. Under normal conditions, the hypothalamus influences pituitary hormonal output of thyroid stimulating hormone (TSH) via the secretion of thyrotropin releasing hormone (TH). Virtually any disruption of the precise functioning of these individual glands, or their complex interrelationships can precipitate conditions of hyperthyroidism and Grave's Disease or hypothyroidism and myxedema (MedicineNet, 2002).
Classic symptoms of myxedema include facial puffiness caused by subcutaneous accumulation of mucoploysaccharide, coarsening or…
References
Information on Hypothyroidism. (MedicineNet.com website)
Accessed July 25, 2004, at http://www.medicinenet.com/hyperthyroidism/page1.htm
Last updated: July 2, 2002
Manifold, C.A. Hypothyroidism and Myxedema Coma. (E-medicine.com website)
Evidence-Based Protocol Implementation
Influencing Multiple Systems Through Evidence-Based Change as advance practice nurse, work informed factors direct reach, influence extends context labor. Likewise, propose a nurse leader influenced multiple systems, turn, impact groups.
Nurses are encouraged to utilize and incorporate in their daily practice evident-based practice. The Evidence-based practice (EBP) is considered to be a scientific standard that determines and guides on the best clinical measure (LoBiondo-Wood and Haber). EBP has grown in its relevance to clinical decision making and support to the nursing profession since it facilitates efficiency in provision of care and quick recovery to patients. Successful implementation of EBP calls for monitoring of existing practices, documentation of relevant procedures and evaluation of possible change practices in clinical and nursing care (LoBiondo-Wood and Haber).
Possible adjustments needful for patient's care protocol
Immediate care for patients coming from SICU is critical to their recovery from the procedure they undergo.…
References
Grossman, S., C. Bautista, and L. Sullivan. "Using Evidence-Based Practice to Develop a Protocol for Postoperative Surgical Intensive Care Unit Patients." Dimensions Of Critical Care Nursing 21.5 (2002): 206-14. Print.
LoBiondo-Wood, G., and J. Haber. Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. St. Louis: Mosby Elsevier, 2006. Print.
Melnyk, B., and E. Fineout-Overholt. Evidence-Based Practice in Nursing and Healthcare. Philadelphia: Lippincott, Williams and Wilkins 2005. Print.
Schmidt, N.A., and J.M. Brown. Evidence-Based Practice for Nurses: Appraisal and Application of Research. (Eds.) United States: Laureate Education, Inc. custom ed., 2012. Print.
As they share a common bond in the underlying struggles and challenges that they are wrestling with. This is significant, because it shows how the ice age would force people to work together, to overcome the various weather related issues that are having an impact upon their lives. ("Paleolithic")
The use of various types of tools / technology would change the way humans would live their lives. This is because, the ice age would force everyone to utilize new survival techniques that were often not focused on. Prior to the ice age, most humans were considered to be hunter and gathers. This meant that they would often rely on killing various types of animals, as their way of providing food and clothing for themselves. At the same time, humans would often gather various fruits and berries to consume. Once the ice age began this would all change, as the total…
Bibliography
"Amblin to Alaska." Why Files, n.d. Web. 16 Nov. 2010
"Ice Ages." Science Clarified, 2010. Web. 16 Nov. 2010
"Paleotlithic." Wikipedia, n.d. Web. 16 Nov. 2010
Frith, Naill. "Humans Survived the Ice Age by Sheltering. Daily Mail, 2010. Web. 16 Nov. 2010.
Being able to merge the resources of a variety of different specialists is one strength of the Memorial Herman approach. In the future, as the interrelationship between the body and the brain, and psychological disorders and overall functioning has become an accepted part of mainstream science: studies such as these will be even more important for research institutes. Memorial Herman is clearly on the cutting-edge of the field in this regard.
Because of its impressive outreach, the hospital is also able to draw upon a wide array of specific populations, as in the case of studies such as the "Evaluation of cardiovascular effects of smoking cessation in HIV-infected patients" (Bell 2009). Few other hospitals would be able to draw from a large amount of HIV-positive patients who were smokers and willing to participate in research studies. The study may prove beneficial to the research subjects as well as to the…
References
About us. (2009). Memorial Hermann. Retrieved November 12, 2009 at http://www.memorialhermann.org/aboutus/
Bell, Tanvir. (2009). Evaluation of cardiovascular effects of smoking cessation in HIV-infected patients. Memorial Herman. Retrieved November 12, 2009 at http://www.memorialhermann.org/locations/texasmedicalcenter/heartandvascularinstitute/content.aspx?id=5772
Frazier, Lorraine. (2009). Interactions among depressive symptoms and genetic influences on cardiac outcomes. Memorial Herman. Retrieved November 12, 2009
The first is $995 for the unit and $12 for the blankets. The second is $1,499 for the unit and $20 for the blankets. The third is $3,995 for the unit and $22 for the blankets. The fourth is $5,000 for the unit and $25 for the blankets. Fixed costs are $500,000. The contribution margin is expected to be 70% on the units and 60% on the blankets on the delivered price.
Our demand estimates are derived based on the price relative to the main competitors, and take into consideration the impact of having to gain formal approval beyond the $1,500 price point. We have also assumed that wherever we set our price point, we will need to offer a discount. Buyers expect to receive a discount, so we believe that even if we offer a low price point there will be a psychological need on the part of the…
However, "although not as critical as going without water, missing even a few meals can cause a host of undesirable complications," such as lethargy, confusion and disorientation, poor judgment, a weakened immune system and the "inability to maintain body temperature which can lead to hypothermia, heat exhaustion and heat stroke." Much like studies done on surviving without water, exactly how long a person can go without food varies tremendously, yet it is dependent on several important factors, such as a person's overall state of health, the amount of muscle on the body which is "broken down by a starving body and used for both fuel and nutrients," the amount of body fat (an overweight person will normally survive longer than a thin or underweight person), a person's metabolism and the temperature of the environment in which a person finds himself; that is, a cold environment expends additional calories to stay…
Bibliography
Autrotrophic Humans Survive With No Food or Water." Unexplainable.net. Internet. 2007. Retrieved at http://www.unexplainable.net/artman/publish/article_1333.shtml .
Glanze, Walter D., Ed. Mosby's Medical, Nursing and Allied Health Dictionary. St. Louis: C.V. Mosby Company, 2003.
How Long Can You Live Without Food?" Survival Topics. Internet. 2007. Retrieved at http://www.survivaltopics.com/survival/how-long-can-you-live-without-food .
Myers, Harold M. The Human Body and Survival Techniques. New York: G.H. Patterson, 2004.
This entity follows the California Clean Air Act and the Federal Clean Air Act so that it is responsible for air monitoring, permitting, enforcement, long-range air quality planning, regulatory development, and education and public information activities with regard to air pollution.
A more recent concern has developed as the first cruise ship to enter Monterey ay since 1966 caused environmental groups to demand increased protection for marine sanctuaries and to increase regulation of the cruise ship industry. The water around Monterey ay has also been affected by sewage spills at local beaches, leading to viral and bacterial contamination. In 2000, four Monterey County beaches were closed because of sewage spills, and twenty-five warning advisories were issued. In 2001, there was one beach closure and eleven advisories. It has also been found that there is inadequate storm pipe maintenance in cities on the Monterey peninsula.
The California Ground Squirrel is a…
Bibliography
Burde, John H. And George a. Feldhamer. Mammals of the National Parks. Baltimore: Johns Hopkins University Press, 2005.
Environmental Impact Analysis." San Benito County 2005 RTP EIR (2005).
Castillo, Edward D. A Short Overview of California Indian History (1998). http://www.nahc.ca.gov/califindian.html .
Cato, Paisley. "Spermophilus beecheyi." San Diego Natural History Museum (2007), http://www.sdnhm.org/fieldguide/mammals/sper-bee.html .
Mass Casuality Decontamination
Mass Causality Decontamination
Throughout the past era, worries about possible terrorist acts concerning weapons of mass destruction (WMD) directed Congress and the President to obtain a complete counteract terrorism strategy that was aimed at stopping a chemical, biological, or nuclear attack and improving domestic attentiveness. The organization of choice for national significance management has been the Department of Defense. Of the $1.2 billion taken in the FY 2000 business plan purposely for WMD reply, most of it went to DOW Overreliance on the military for domestic (Wynd, C. 2006) WMD defense, nevertheless, may reduce the military's war combating capacity and holds the potential for breach of individual rights. Given that these attacks are confronting to avoid and may take place anywhere and at any time, mass decontamination is one of the significant factors to controlling the distresses of such an occurrence, saving lives, and limiting the number…
References:
10th european congress of trauma and emergency surgery. (2010). European Journal of Trauma and Emergency Surgery, 35, 1-1-188. doi:10.1007/s00068-009-8001-z
Cabrera, Suzanne Lobaton, R.N., M.N., & Beaton, Randal D, PhD., E.M.T. (2009). The role of occupational health nurses in terrorist attacks employing radiological dispersal devices. AAOHN Journal, 57(3), 112-112-9; quiz 120-1.
DA-az, G. (2005). Different approaches to the difficult relationship between intelligence and policy: A case study of the cuban missile crisis of 1962 vs. The 2003 war in iraq. UNISCI Discussion Papers, (9), 93-93-126.
Disaster Response: Principles of Preparation and Coordination. (1989). St. Louis: Center of Excellence and Disaster Management.
Legislation on liability and compensation is needed.
The United States should ratify the International Maritime Organization (IMO) 1984 Protocols.
Federal planning for oil spills must be improved.
Studies of the long-term environmental and health effects must be undertaken expeditiously and carefully.
How NOAA responds to spills?
NOAA is a 24/7 service that monitors and waits for a help if there is a spill. They help protect and conserve the natural resources. As soon as they got call they go to the scene as fast as possible. They inspect the vessel, and study the spill, damage and spread in the affected area. We determine the success of their operation through the response of NOAA. NOAA Office of Response and Restoration has a mission based on the online source, http://www.noaanews.noaa.gov/stories2004/s2353.htm:
OR& R. is currently assisting with trajectory modeling, oil fate forecasting, weather, and information management and participating in over flights and resource…
Bibliography:
"Clean-Up Techniques" [Online] Available at:
"Containment and Recovery of Floating Oil" [Online] Available at:
Etkin, D.S. 1997. Oil Spills from Vessels (1960-1995): An International Historical Perspective.
For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings.
The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane based inhalation "may be a suitable technique for thoracic surgery in achalasia due to sclerodermic patients." The reason for this conclusion is that the study found that this procedure "can provide a smooth anesthesia course and a rapid recovery, with hemodynamic stability, and also having pain-free postoperatively." More so, the study found that providing anesthesia without neuromuscular blockade and non-intravenous opioids has "provided a shorter recovery time."
Clearly this specific case study has important and practical implications to the practice…
Bibliography
Erol, Demet Dogan, M.D. (2006): "Thoracic Epidural Blockade in an Elderly with Achalasia Due to Scleroderma for Thoractomy, Esophageal Myotomy and Cystotomy-Capitonnage. The Internet Journal of Anesthesiology. Vol. 11, Number 1.
The above equation can also be utilized to calculate conduction loss from a human body to ambient air. For example, for a 1.5 tall man wearing dry, insulating clothing, the rate of conductive heat loss on a cold day (ambient temperature at 0oC, normal skin temperature at 37oC) can be calculated as 178W. For the same person wearing wet clothing, however, the equivalent rate is 2,565W. This significant difference in heat losses explains the onset of hypothermia when someone is exposed to ice-cold water or rain (Forinash, 2010). Conduction takes place on a microscopic level as particles of kinetic energy are transferred between two different systems (Abbott, et al., 2005). When atoms and/or molecules heat up, vibrate, or move rapidly, some of their energy gets transferred to other atoms and molecules that are in close proximity. In other words, heat is transferred to the surrounding particles and away from the…
The first is the actors in the setting. The researcher will collect variables such as age and gender so as not to interfere with the natural setting of the revelers. The second category is the behaviors being carried out by these actors. These will be recorded as acts which are small units of behavior, activities which are a set of related acts and events which are a set of related acts in a sequence. The third category is the space that is occupied by these actors. This will essentially be an understanding of the setting of the underground rave. Information on ventilation, lighting, cleanliness, and setting of the underground rave will be collected. The fourth category is the arrangement of objects in the space. This will seek to collect information regarding the arrangement of tables, chairs, bars, and other items in the underground rave. The next category is the time…
References
Anderson, Tammy L. "Understanding the Alteration and Decline of a Music Scene: Observations from Rave Culture." Sociological Forum 24.2 (2009): 307-36. Print.
Aronson, E., T.D. Wilson, and M. Brewer. "Experimental Methods." The Handbook of Social Psychology. Eds. Gilbert, D., S. Fiske and G. Lindzey. 4th ed. Vol. 1. New York: Random House, 1998. 99-142. Print.
Creswell, J.W. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Thousand Oaks, California: SAGE Publications, 2002. Print.
Demers, Joanna. "Dancing Machines: 'Dance Revolution', Cybernetic Dance, and Musical Taste." Popular Music 25.3 (2006): 401-14. Print.
Child and Elder Abuse
Many children and frail elderly people are at risk of being abused largely because their ability to defend themselves is impaired. In the recent past, the media has been awash with many cases of abuse and neglect involving children and the elderly. In this text, I conduct an online research in an attempt to identify and analyze two recent cases of child and elder abuse.
Case
ecently, Alyssia Skinner - a resident of Hernando, was according to ojas (2013) "charged with child neglect, aggravated child abuse with great bodily harm, and torturing and caging a child." This severe case of child neglect and abuse was discovered after detectives visited her home and found a 17-month-old baby living in deplorable conditions. The said baby had been living in a small room which was largely disorganized and had no toys. Further, the room in question had several soiled…
References
Hollingsworth, H. (2013, February 12). David and Pamela Martin Charged With Child Abuse for Allegedly Handcuffing Teen to Pole. Retrieved February 15, 2013, from the Huffington Post website: http://www.huffingtonpost.com/2013/02/12/david-pamela-martin-child-abuse-handcuff-teen-pole_n_2670898.html
Rojas, J. (2013, February 15). Citrus County Woman Charged With Severely Abusing Toddler. Retrieved February 15, 2013, from Bay News website: http://www.baynews9.com/content/news/baynews9/news/article.html/content/news/articles/bn9/2013/2/15/citrus_county_woman_.html
Starr, R. & Wolfe, D.A. (Eds.). (1991). The Effects of Child Abuse and Neglect: Issues and Research. New York, NY: Guilford Press.
Cardiopulmonary bypass entails the techniques through which perfusionists replace some major functions of the lungs and heart with a mechanical system to support a patient during surgical interventions on the pulmonary or cardiovascular system (Ghosh & Cook, 2009). It involves bypass of the lungs and heart in an open-heart surgery where perfusionists redirect blood getting to the heart via a heart-lung machine before it gets into the arterial circulation. Cardiopulmonary bypass takes the role of the lungs and heart during surgery.
Reasons for Application
Cardiothoracic surgeons conduct cardiopulmonary bypass while repairing cardiac defects. he surgeons need a bloodless and motionless heart to work on, and to attain this, the surgeons stop the motion of the lungs and the heart. While the lungs and the heart remain motionless, there must be a way for blood to flow throughout the body to deliver oxygen and nutrients essential in life. Perfusionists together with…
The patient receives heparin to avoid clotting besides protamine sulfate to overturn heparin effects. In the course of the procedure, the surgeons maintain hypothermia, and body temperature remains at 8°C to 32°C (McCann, 2005). The surgeons and perfusionists cool the blood during cardiopulmonary bypass and return it to the body. The cooled blood lowers the basal metabolic rate of the body, lowering its oxygen demand. Cooled blood holds an increased viscosity, while the crystalloid solution utilized to guide the bypass tubing water-down the blood. The cardiopulmonary bypass comprises of two major elements, which include the oxygenator and the pump. The oxygenator removes deoxygenated blood from the body replacing it with oxygenated blood via numerous hoses. The elements cardiopulmonary bypass circulates and interconnect through a chain of tubes formed of PVC or silicon rubber while the pump console consists of numerous rotating motor-compelled pumps that massage tubing peristaltically.
Risk Linked to CPB
During open-heart surgery, surgeons temporarily stop the pounding of the heart and maintain life via CPB. Surgeons stop the functioning of the heart through lowering its temperature or through a preservative injection to allow CPB to pump blood throughout the patient's body. Although
Alberta Tar Sands Issues
The tar sands oil reserves in Alberta, Canada, represent the second largest proven petroleum reserve in the world -- right behind the reserves in Saudi Arabia. The Alberta tar sands are located in the vast boreal forest of Canada, just north of Montana, and it is estimated that nearly 179 billion barrels of oil are in the tar sands, according to Bridget Mintz Testa, writing in the peer-reviewed journal Mechanical Engineering (Testa, 2008). The great volume of crude oil is seen as a positive, reliable source of energy for Canada and other countries that will be importing this oil. The extraction, production, and transportation of tar sands oil also represents a number of serious environmental impacts, which will be reviewed in this paper.
The Science Involved in Tar Sands Oil Production
Notwithstanding the fact that tar sands oil is in plentiful supply, one of the down…
Works Cited
American Petroleum Institute "Keystone XL Pipeline." Retrieved February 26, 2013, from http://www.api.org.
Austen, Ian. "Oil Sands Industry in Canada Tied to Higher Carcinogen Level." The New York
Times. Retrieved February 26, 2013, from http://www.nytimes.com .
Chemical Engineering. "Solvent extraction method shows promise for recovering bitumen from tar sands." 118.9 (2011): p. 12.
Parable of the Sadhu
In the story "The Parable of Sadhu," author Bowen H. McCoy explores the question of ethics while his narrator hikes in Nepal. McCoy himself was the managing director of Morgan Stanley. He was also president of Morgan Stanley Realty, Inc. Bowen McCoy then is a figure who embodies the idea of business and financial gain. hat then could he gain from a trek in the Himalayas but a vacation from the stress of his money-centered world? This is the conflict that makes up the story of "The Parable of Sadhu." It is not only a cultural clash, but a moral and ethical one, which McCoy makes evident through the use of literary devices to make the reader feel the clash as much as he did.
By using a first-person narrator, the author adds authority to the words of the narrator. henever this perspective is utilized by…
Works Cited:
McCoy, Bowen H. "The Parable of the Sadhu." Harvard Business Review. Sept-Oct 1983. 103-
108. Print.
Transurethral Resection Syndrome
Since 1930, transurethral resection of the prostrate (TURP) has been the customary treatment for both moderate as well as severe prostatic hypertrophy. But there are many complications that can occur because of TURP. Transurethral Resection Syndrome is one such complication that occurs due to water intoxication of the body resulting in various acid-base imbalances including hyponatremia. Though the developments in TURP surgical procedures has made the occurrence of this syndrome less frequent, with the complication occurring in only about 2% of all patients undergoing these procedures but if occurs the syndrome has pretty serious consequences including cellular edema, increased intervascular volume and hyponatremia. Therefore, it becomes mandatory for the nurses to have a basic knowledge of the syndrome (including how and why), ability to identify the early signs of the syndrome and the ways to take care of the patients with this syndrome. The paper stresses on…
Staffing shortages in nursing are a consequence of poor nurse retention and nurse satisfaction. Being a nurse requires a lot of dedication, patience, and ability to keep updated in a constantly evolving world. When hospitals and other medical facilities have staffing shortages or shortages in qualified nurses, the healthcare delivery of that particular place dwindles. Nurses are the backbone of any healthcare facility.
Especially in recent times, nurses provide prescriptions, treatment protocols, and diagnosis when doctors are away or busy. This literature review is meant to explain such a phenomena and how it relates directly to nurse satisfaction and nursing retention. From here, the connection crosses over to nursing care and healthcare delivery as standards of practice. Things like arrhythmias will be viewed to understand how nursing shortages attribute to lower quality of care. Utilizing Polk's theory of esilience, this review will allow a look into performance improvement concerns and…
References
Bosch, R., Kirch, W., Theuer, J., Pittrow, D., Kohlhaussen, A., Willich, S., & Bonnemeier, H. (2013). Atrial fibrillation management, outcomes and predictors of stable disease in daily practice: Prospective non-interventional study. International Journal Of Cardiology, 167(3), 750-756. doi:10.1016/j.ijcard.2012.03.053
GIANFERMI, R., & BUCHHOLZ, S. (2011). Exploring the relationship between job satisfaction and nursing group outcome attainment capability in nurse administrators. Journal Of Nursing Management, 19(8), 1012-1019. doi:10.1111/j.1365-2834.2011.01328.x
Hudgins, T. (2015). Resilience, job satisfaction and anticipated turnover in nurse leaders. Journal Of Nursing Management, n/a-n/a. doi:10.1111/jonm.12289
Minhas, R., Vogelaar, G., Wang, D., Almansoori, W., Lang, E., & Blanchard, I. et al. (2015). A prehospital treat-and-release protocol for supraventricular tachycardia. CJEM, 1-8. doi:10.1017/cem.2014.53
ole of ALS in EMS
ALS (Advanced Life Support) represents a complex collection of rules and procedures extending beyond elementary life support, for further aiding ailing or injured individuals in clearing their windpipe, breathing and ensuring air circulates throughout their body, thus supporting blood circulation under emergency circumstances (Advanced Life Support (Definition and Explanation), 2016). The following individuals commonly need ALS transport (Lifeline: Basic and Advanced Life Support, 2016):
A surgical or medical patient with ongoing intravenous medicine but not requiring any egistered Nurse, in keeping with state regulation.
Individuals with Cardiac Monitor attached
Urgent care center patients
Patients suffering from a possible compromise of the airway
Obstetrical Patients
Patients regarded as having a possible complication in the course of transport, as indicated by a report forwarded by the sending healthcare facility.
Whiteman, C., Shaver, E., Doerr, ., Davis, S., Blum, F., Davidov, D., & Lander, O. (2014). Trauma patient…
References
Advanced Life Support (Definition And Explanation). (2016, February 19). Retrieved from Nurse Frontier: http://www.nursefrontier.com/advanced-life-support/
Al-Shaqsi, S. (2010). Models of International Emergency Medical Service (EMS) Systems. Oman Medical Journal, 320-323.
Anest, T., Ramirez, S., Balhara, K., Hodkinson, P., Wallis, L., & Hansoti, B. (2016). Defining and improving the role of emergency medical services in Cape Town, South Africa. Emergency Medical Journal.
Gordon, E., & Ornato, J. (2000). Emergency cardiac care: introduction. Journal of the American College of Cardiology.
The Rationale for and the Efficacy of Torture during Interrogation
Although information from interrogational torture is unreliable, it is likely to be used frequently and harshly. ==John W. Schiemann, 2012
Introduction
The epigraph above is indicative of the growing consensus concerning the lack of efficacy of torture in providing interrogators with reliable concealed information Concealed information is the foundation of the majority of security issues. In most cases, concealed information is a situation wherein one individual knows something that someone else does not know. Consequently, the majority of security issues could be resolved if there was a dependable method of determining those cases in which an individual was concealing information and extracting that information effectively. To date, though, there has not been a dependable method developed.1 For instance, polygraph research has been unable to achieve an accuracy level that would make the results acceptable in courtrooms in the United States…
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique
Cardiac surgery by nature elicits a powerful stress response resulting from activation of stress hormones including epinephrine, norpinephine and cortisol hormones among others. Surgical trauma and blood loss may contribute to this stress response. Some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that results in a stress reaction.
The role of the anesthesiologist in cardiac surgery is to as much extent as possible, to reduce the stress response that results form cardiac surgery. Stress response can be mitigated by a variety of anesthetic technique, including use of opioids and epidural anesthesia. These ideas are explored in greater detail below.
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique
INTRODUCTION stress response may…
Bibliography
Cook, Richard I. "Adapting to New Technology in the Operating Room." Human Factors, Vol. 38, 1996.
Cook, R.I., Woods, D.D., Howie, M.B., Horrow, J.C. & Gaba, D.M. (1992). "Unintentional delivery of vasoactive drugs with an electromechanical infusion device." Journal of Cardiothoracic and Vascular Anesthesia, 6, 238-244.
Cuschieri, R.J., Morran, C.G., Howie, J.C., & McArdle, C.S. (1985). "Postoperative pain a dpulmonary complications: comparison of three analgesic regimens." British Journal of Surgery, 72, 495-499.
Glaser, J., Kiecolt-Glaser, MacCallum P., Marucha, P., & Page, G. "Psychological Influences on Surgical Recovery: Perspectives from Psychoneuroimmunology." American Psychologists, Vol. 53, 1998.