際際滷shows by User: SarahAjose / http://www.slideshare.net/images/logo.gif 際際滷shows by User: SarahAjose / Fri, 09 Aug 2024 11:35:56 GMT 際際滷Share feed for 際際滷shows by User: SarahAjose CARDIAC ASSESSMENT, HEART SOUNDS, CARDIAC ENZYME.pptx /slideshow/cardiac-assessment-heart-sounds-cardiac-enzyme-pptx/270894753 cardiacassessmentheartsoundscardiacenzyme-240809113556-8cfb3cb9
Heart is hollow four chamber, muscular pump organ Pericardium outer layer Pericardial sac in between parietal and visceral layer ,containing 5-20cc of fluid, protects myocardium Myocardium makes up the walls of the heart chambers left ventricle is 5-10 times thicker than right side Inner endocardium are the cardiac valves and blood vessels. The intraventricular and intraatrial septa separates the right and left chambers Atrioventricular valves- tricuspid and mitral valves Semilunar valves- pulmonic and aortic valves VASCULATURE Right coronary artery, left coronary artery, great cardiac veins, anterior cardiac veins, besian veins Automaticity ( pace maker ability) Conductivity (Each cell has the ability to conduct impulses to tnext cell) Contractility (ability to contract) Irritability (each cell has the ability to contrct on its own) BP is determined by the cardiac output, the velocity, the resistance of the blood vessels. Systolic- initial force of contraction of heart Diastolic-pressure of blood vessels after initial force Pulse pressure- difference between systolic and diastolic BP Control of HR, CO, blood vessels and the amount of blood volume Sympathetic secretes norepinephrine and innervate cardiac plexus and increase rate of SA node Parasympathetic secretes acetylcholine and innervates cardiac plexus leads to decrease of SA node rate Both regulates normal heart rate and blood pressure Prior history collection the nurse should know the data of the patient Read old charts or summary : previous admission, current and past drugs, reason of admission, social support, allergies, discharge information, chronic medical problems Ask symptoms of present illness Maintain a soothing conversation Dont rush the patient to answer Ask the patient to describe illness finally Record response and can ask more details if necessary Ask for specific cardiac conditions Find out any cardiac drugs patient is taking Assess for any use of alcohol or nicotin Assess the social factors Record the findings INSPECTION Explain the procedure to the patient Provide privacy and undress the patient Sit upright to inspect thorax Inspect posture and symmetry, color of skin, deformities of bone, the neck, face and eyes Breathing pattern to be noted Aware of cyanosis Central cyanosis -lips mouth and conjunctiva indicates heart disease and poor oxygenation Peripheral cyanosis- lips, ear lobes, nail buds PMI (point of maximum intensity): ask to lay on left side and assess skin color of thorax EYES: Arcus senilis- light gray ring surrounding iris common in older patient. If in younger patient indicate lipid metabolism disorder. Xanthelasma- yellowish plaques on skin surrounding the eyes ,also in elbow indicate hypercholesterolemia PALPATION SKIN: frank edema ,puffiness, pitting edema +1,+2,+3,+4.(feet, ankle, face , sacrum, trunk, abdomen) BREATHING: lay hands on chest at different location , feel -respiration pattern , rib elevation, precordial pulses ARTERIES: apical ]]>
Heart is hollow four chamber, muscular pump organ Pericardium outer layer Pericardial sac in between parietal and visceral layer ,containing 5-20cc of fluid, protects myocardium Myocardium makes up the walls of the heart chambers left ventricle is 5-10 times thicker than right side Inner endocardium are the cardiac valves and blood vessels. The intraventricular and intraatrial septa separates the right and left chambers Atrioventricular valves- tricuspid and mitral valves Semilunar valves- pulmonic and aortic valves VASCULATURE Right coronary artery, left coronary artery, great cardiac veins, anterior cardiac veins, besian veins Automaticity ( pace maker ability) Conductivity (Each cell has the ability to conduct impulses to tnext cell) Contractility (ability to contract) Irritability (each cell has the ability to contrct on its own) BP is determined by the cardiac output, the velocity, the resistance of the blood vessels. Systolic- initial force of contraction of heart Diastolic-pressure of blood vessels after initial force Pulse pressure- difference between systolic and diastolic BP Control of HR, CO, blood vessels and the amount of blood volume Sympathetic secretes norepinephrine and innervate cardiac plexus and increase rate of SA node Parasympathetic secretes acetylcholine and innervates cardiac plexus leads to decrease of SA node rate Both regulates normal heart rate and blood pressure Prior history collection the nurse should know the data of the patient Read old charts or summary : previous admission, current and past drugs, reason of admission, social support, allergies, discharge information, chronic medical problems Ask symptoms of present illness Maintain a soothing conversation Dont rush the patient to answer Ask the patient to describe illness finally Record response and can ask more details if necessary Ask for specific cardiac conditions Find out any cardiac drugs patient is taking Assess for any use of alcohol or nicotin Assess the social factors Record the findings INSPECTION Explain the procedure to the patient Provide privacy and undress the patient Sit upright to inspect thorax Inspect posture and symmetry, color of skin, deformities of bone, the neck, face and eyes Breathing pattern to be noted Aware of cyanosis Central cyanosis -lips mouth and conjunctiva indicates heart disease and poor oxygenation Peripheral cyanosis- lips, ear lobes, nail buds PMI (point of maximum intensity): ask to lay on left side and assess skin color of thorax EYES: Arcus senilis- light gray ring surrounding iris common in older patient. If in younger patient indicate lipid metabolism disorder. Xanthelasma- yellowish plaques on skin surrounding the eyes ,also in elbow indicate hypercholesterolemia PALPATION SKIN: frank edema ,puffiness, pitting edema +1,+2,+3,+4.(feet, ankle, face , sacrum, trunk, abdomen) BREATHING: lay hands on chest at different location , feel -respiration pattern , rib elevation, precordial pulses ARTERIES: apical ]]> Fri, 09 Aug 2024 11:35:56 GMT /slideshow/cardiac-assessment-heart-sounds-cardiac-enzyme-pptx/270894753 SarahAjose@slideshare.net(SarahAjose) CARDIAC ASSESSMENT, HEART SOUNDS, CARDIAC ENZYME.pptx SarahAjose Heart is hollow four chamber, muscular pump organ Pericardium outer layer Pericardial sac in between parietal and visceral layer ,containing 5-20cc of fluid, protects myocardium Myocardium makes up the walls of the heart chambers left ventricle is 5-10 times thicker than right side Inner endocardium are the cardiac valves and blood vessels. The intraventricular and intraatrial septa separates the right and left chambers Atrioventricular valves- tricuspid and mitral valves Semilunar valves- pulmonic and aortic valves VASCULATURE Right coronary artery, left coronary artery, great cardiac veins, anterior cardiac veins, besian veins Automaticity ( pace maker ability) Conductivity (Each cell has the ability to conduct impulses to tnext cell) Contractility (ability to contract) Irritability (each cell has the ability to contrct on its own) BP is determined by the cardiac output, the velocity, the resistance of the blood vessels. Systolic- initial force of contraction of heart Diastolic-pressure of blood vessels after initial force Pulse pressure- difference between systolic and diastolic BP Control of HR, CO, blood vessels and the amount of blood volume Sympathetic secretes norepinephrine and innervate cardiac plexus and increase rate of SA node Parasympathetic secretes acetylcholine and innervates cardiac plexus leads to decrease of SA node rate Both regulates normal heart rate and blood pressure Prior history collection the nurse should know the data of the patient Read old charts or summary : previous admission, current and past drugs, reason of admission, social support, allergies, discharge information, chronic medical problems Ask symptoms of present illness Maintain a soothing conversation Dont rush the patient to answer Ask the patient to describe illness finally Record response and can ask more details if necessary Ask for specific cardiac conditions Find out any cardiac drugs patient is taking Assess for any use of alcohol or nicotin Assess the social factors Record the findings INSPECTION Explain the procedure to the patient Provide privacy and undress the patient Sit upright to inspect thorax Inspect posture and symmetry, color of skin, deformities of bone, the neck, face and eyes Breathing pattern to be noted Aware of cyanosis Central cyanosis -lips mouth and conjunctiva indicates heart disease and poor oxygenation Peripheral cyanosis- lips, ear lobes, nail buds PMI (point of maximum intensity): ask to lay on left side and assess skin color of thorax EYES: Arcus senilis- light gray ring surrounding iris common in older patient. If in younger patient indicate lipid metabolism disorder. Xanthelasma- yellowish plaques on skin surrounding the eyes ,also in elbow indicate hypercholesterolemia PALPATION SKIN: frank edema ,puffiness, pitting edema +1,+2,+3,+4.(feet, ankle, face , sacrum, trunk, abdomen) BREATHING: lay hands on chest at different location , feel -respiration pattern , rib elevation, precordial pulses ARTERIES: apical <img style="border:1px solid #C3E6D8;float:right;" alt="" src="https://cdn.slidesharecdn.com/ss_thumbnails/cardiacassessmentheartsoundscardiacenzyme-240809113556-8cfb3cb9-thumbnail.jpg?width=120&amp;height=120&amp;fit=bounds" /><br> Heart is hollow four chamber, muscular pump organ Pericardium outer layer Pericardial sac in between parietal and visceral layer ,containing 5-20cc of fluid, protects myocardium Myocardium makes up the walls of the heart chambers left ventricle is 5-10 times thicker than right side Inner endocardium are the cardiac valves and blood vessels. The intraventricular and intraatrial septa separates the right and left chambers Atrioventricular valves- tricuspid and mitral valves Semilunar valves- pulmonic and aortic valves VASCULATURE Right coronary artery, left coronary artery, great cardiac veins, anterior cardiac veins, besian veins Automaticity ( pace maker ability) Conductivity (Each cell has the ability to conduct impulses to tnext cell) Contractility (ability to contract) Irritability (each cell has the ability to contrct on its own) BP is determined by the cardiac output, the velocity, the resistance of the blood vessels. Systolic- initial force of contraction of heart Diastolic-pressure of blood vessels after initial force Pulse pressure- difference between systolic and diastolic BP Control of HR, CO, blood vessels and the amount of blood volume Sympathetic secretes norepinephrine and innervate cardiac plexus and increase rate of SA node Parasympathetic secretes acetylcholine and innervates cardiac plexus leads to decrease of SA node rate Both regulates normal heart rate and blood pressure Prior history collection the nurse should know the data of the patient Read old charts or summary : previous admission, current and past drugs, reason of admission, social support, allergies, discharge information, chronic medical problems Ask symptoms of present illness Maintain a soothing conversation Dont rush the patient to answer Ask the patient to describe illness finally Record response and can ask more details if necessary Ask for specific cardiac conditions Find out any cardiac drugs patient is taking Assess for any use of alcohol or nicotin Assess the social factors Record the findings INSPECTION Explain the procedure to the patient Provide privacy and undress the patient Sit upright to inspect thorax Inspect posture and symmetry, color of skin, deformities of bone, the neck, face and eyes Breathing pattern to be noted Aware of cyanosis Central cyanosis -lips mouth and conjunctiva indicates heart disease and poor oxygenation Peripheral cyanosis- lips, ear lobes, nail buds PMI (point of maximum intensity): ask to lay on left side and assess skin color of thorax EYES: Arcus senilis- light gray ring surrounding iris common in older patient. If in younger patient indicate lipid metabolism disorder. Xanthelasma- yellowish plaques on skin surrounding the eyes ,also in elbow indicate hypercholesterolemia PALPATION SKIN: frank edema ,puffiness, pitting edema +1,+2,+3,+4.(feet, ankle, face , sacrum, trunk, abdomen) BREATHING: lay hands on chest at different location , feel -respiration pattern , rib elevation, precordial pulses ARTERIES: apical
CARDIAC ASSESSMENT, HEART SOUNDS, CARDIAC ENZYME.pptx from Sarah Ajose
]]> 39 0 https://cdn.slidesharecdn.com/ss_thumbnails/cardiacassessmentheartsoundscardiacenzyme-240809113556-8cfb3cb9-thumbnail.jpg?width=120&height=120&fit=bounds presentation Black http://activitystrea.ms/schema/1.0/post http://activitystrea.ms/schema/1.0/posted 0 CARDIAC ARRYTHMIAS AND ITS NURSING MANAGEMENT /slideshow/cardiac-arrythmias-and-its-nursing-management/270894540 cardiacarrythmias1-240809112342-24b9b1f5
The passage of ions across the myocytes cell membranes is regulated through specific ionic channels that cause cyclic depolarization and repolarization , called as action potential. Voltage dependent fast sodium channels open, causing rapid depolarization mediated by sodium influx When sodium channel influx, allowing calcium to enter through slow calcium channels and potassium to leave through potassium channels, a repolarization Resting sinus heart rate 60 to 100 minute Bradycardia- slower heart rate (in young people, athletes, and during sleep) Tachycardia- faster heart rate (exercise , illness, emotions) Slower heart rate while morning awakening Increase in rate during inspiration and decrease in rate during expiration (respiratory sinus arrythmia) Cardiac arrhythmia is the improper beating of the heart, whether irregular, too fast or too slow. Cardiac arrhythmia occurs when electrical impulses in the heart do not work properly. VENTRICULAR ARRYTHMIAS- lower chambers of the heart (ventricles) SUPRAVENTRICULAR ARRYTHMIAS- upper chambers of the heart(area above ventricles- atria) HR- 100 beats/ minute Fast heart rate begins in ventricles- VT Begins in atria- SVT SA no longer control the ventricles Heart beat quickens Feeling of skipping beats Shortness of breath Dizziness Fainting syncope Uncontrolled irregular beat Instead of one misplaced beat from the ventricles, the patient may have several impulses that begin at the same time from different locationsall telling the heart to beat. HR-> 300 beats/ min Very little blood pumped from heart to brain- fainting Shock delivered for the return of normal rhythm Ventricles contracts too soon Also called as PVB (premature ventricular beat ) Generally not needed treatment Caffeine Tea Soda Chocolate Cough and cold medicines Supraventricular arrhythmias begin in the areas above the hearts lower chambers, such asthe upper chambers (the atria) or the atrial conduction pathways. tobacco alcohol caffeine cough and cold medicines Supraventricular tachycardia (SVT) is a rapid, regular heart rate where the heart beats anywhere from 150-250 times per minute in the atria. Another name for SVT is paroxysmal supraventricular tachycardia (PSVT). The word paroxysmal means occasionally or from time to time. Supraventricular tachycardia or PSVT happens when electrical signals in the hearts upper chambers fire abnormally, which interferes with electrical signals coming from the SA node (the hearts natural pacemaker). The beats in the atria then speed up the heart rate. It is also more likely to occur in women, anxious young people, and people who are extremely tired (fatigued). People who drink a lot of coffee or alcohol or who are heavy smokers also have a greater risk. Atrial fibrillationis a fast, irregular rhythm where s]]>
The passage of ions across the myocytes cell membranes is regulated through specific ionic channels that cause cyclic depolarization and repolarization , called as action potential. Voltage dependent fast sodium channels open, causing rapid depolarization mediated by sodium influx When sodium channel influx, allowing calcium to enter through slow calcium channels and potassium to leave through potassium channels, a repolarization Resting sinus heart rate 60 to 100 minute Bradycardia- slower heart rate (in young people, athletes, and during sleep) Tachycardia- faster heart rate (exercise , illness, emotions) Slower heart rate while morning awakening Increase in rate during inspiration and decrease in rate during expiration (respiratory sinus arrythmia) Cardiac arrhythmia is the improper beating of the heart, whether irregular, too fast or too slow. Cardiac arrhythmia occurs when electrical impulses in the heart do not work properly. VENTRICULAR ARRYTHMIAS- lower chambers of the heart (ventricles) SUPRAVENTRICULAR ARRYTHMIAS- upper chambers of the heart(area above ventricles- atria) HR- 100 beats/ minute Fast heart rate begins in ventricles- VT Begins in atria- SVT SA no longer control the ventricles Heart beat quickens Feeling of skipping beats Shortness of breath Dizziness Fainting syncope Uncontrolled irregular beat Instead of one misplaced beat from the ventricles, the patient may have several impulses that begin at the same time from different locationsall telling the heart to beat. HR-> 300 beats/ min Very little blood pumped from heart to brain- fainting Shock delivered for the return of normal rhythm Ventricles contracts too soon Also called as PVB (premature ventricular beat ) Generally not needed treatment Caffeine Tea Soda Chocolate Cough and cold medicines Supraventricular arrhythmias begin in the areas above the hearts lower chambers, such asthe upper chambers (the atria) or the atrial conduction pathways. tobacco alcohol caffeine cough and cold medicines Supraventricular tachycardia (SVT) is a rapid, regular heart rate where the heart beats anywhere from 150-250 times per minute in the atria. Another name for SVT is paroxysmal supraventricular tachycardia (PSVT). The word paroxysmal means occasionally or from time to time. Supraventricular tachycardia or PSVT happens when electrical signals in the hearts upper chambers fire abnormally, which interferes with electrical signals coming from the SA node (the hearts natural pacemaker). The beats in the atria then speed up the heart rate. It is also more likely to occur in women, anxious young people, and people who are extremely tired (fatigued). People who drink a lot of coffee or alcohol or who are heavy smokers also have a greater risk. Atrial fibrillationis a fast, irregular rhythm where s]]> Fri, 09 Aug 2024 11:23:42 GMT /slideshow/cardiac-arrythmias-and-its-nursing-management/270894540 SarahAjose@slideshare.net(SarahAjose) CARDIAC ARRYTHMIAS AND ITS NURSING MANAGEMENT SarahAjose The passage of ions across the myocytes cell membranes is regulated through specific ionic channels that cause cyclic depolarization and repolarization , called as action potential. Voltage dependent fast sodium channels open, causing rapid depolarization mediated by sodium influx When sodium channel influx, allowing calcium to enter through slow calcium channels and potassium to leave through potassium channels, a repolarization Resting sinus heart rate 60 to 100 minute Bradycardia- slower heart rate (in young people, athletes, and during sleep) Tachycardia- faster heart rate (exercise , illness, emotions) Slower heart rate while morning awakening Increase in rate during inspiration and decrease in rate during expiration (respiratory sinus arrythmia) Cardiac arrhythmia is the improper beating of the heart, whether irregular, too fast or too slow. Cardiac arrhythmia occurs when electrical impulses in the heart do not work properly. VENTRICULAR ARRYTHMIAS- lower chambers of the heart (ventricles) SUPRAVENTRICULAR ARRYTHMIAS- upper chambers of the heart(area above ventricles- atria) HR- <60 beats/ minute Because of SA node not sending signals to ventricles Caused by CNS does not send signal due to Aging Congenital defects Antiarrythmic and antihypertensive medicines HR-> 100 beats/ minute Fast heart rate begins in ventricles- VT Begins in atria- SVT SA no longer control the ventricles Heart beat quickens Feeling of skipping beats Shortness of breath Dizziness Fainting syncope Uncontrolled irregular beat Instead of one misplaced beat from the ventricles, the patient may have several impulses that begin at the same time from different locationsall telling the heart to beat. HR-> 300 beats/ min Very little blood pumped from heart to brain- fainting Shock delivered for the return of normal rhythm Ventricles contracts too soon Also called as PVB (premature ventricular beat ) Generally not needed treatment Caffeine Tea Soda Chocolate Cough and cold medicines Supraventricular arrhythmias begin in the areas above the hearts lower chambers, such asthe upper chambers (the atria) or the atrial conduction pathways. tobacco alcohol caffeine cough and cold medicines Supraventricular tachycardia (SVT) is a rapid, regular heart rate where the heart beats anywhere from 150-250 times per minute in the atria. Another name for SVT is paroxysmal supraventricular tachycardia (PSVT). The word paroxysmal means occasionally or from time to time. Supraventricular tachycardia or PSVT happens when electrical signals in the hearts upper chambers fire abnormally, which interferes with electrical signals coming from the SA node (the hearts natural pacemaker). The beats in the atria then speed up the heart rate. It is also more likely to occur in women, anxious young people, and people who are extremely tired (fatigued). People who drink a lot of coffee or alcohol or who are heavy smokers also have a greater risk. Atrial fibrillationis a fast, irregular rhythm where s <img style="border:1px solid #C3E6D8;float:right;" alt="" src="https://cdn.slidesharecdn.com/ss_thumbnails/cardiacarrythmias1-240809112342-24b9b1f5-thumbnail.jpg?width=120&amp;height=120&amp;fit=bounds" /><br> The passage of ions across the myocytes cell membranes is regulated through specific ionic channels that cause cyclic depolarization and repolarization , called as action potential. Voltage dependent fast sodium channels open, causing rapid depolarization mediated by sodium influx When sodium channel influx, allowing calcium to enter through slow calcium channels and potassium to leave through potassium channels, a repolarization Resting sinus heart rate 60 to 100 minute Bradycardia- slower heart rate (in young people, athletes, and during sleep) Tachycardia- faster heart rate (exercise , illness, emotions) Slower heart rate while morning awakening Increase in rate during inspiration and decrease in rate during expiration (respiratory sinus arrythmia) Cardiac arrhythmia is the improper beating of the heart, whether irregular, too fast or too slow. Cardiac arrhythmia occurs when electrical impulses in the heart do not work properly. VENTRICULAR ARRYTHMIAS- lower chambers of the heart (ventricles) SUPRAVENTRICULAR ARRYTHMIAS- upper chambers of the heart(area above ventricles- atria) HR- 100 beats/ minute Fast heart rate begins in ventricles- VT Begins in atria- SVT SA no longer control the ventricles Heart beat quickens Feeling of skipping beats Shortness of breath Dizziness Fainting syncope Uncontrolled irregular beat Instead of one misplaced beat from the ventricles, the patient may have several impulses that begin at the same time from different locationsall telling the heart to beat. HR-&gt; 300 beats/ min Very little blood pumped from heart to brain- fainting Shock delivered for the return of normal rhythm Ventricles contracts too soon Also called as PVB (premature ventricular beat ) Generally not needed treatment Caffeine Tea Soda Chocolate Cough and cold medicines Supraventricular arrhythmias begin in the areas above the hearts lower chambers, such asthe upper chambers (the atria) or the atrial conduction pathways. tobacco alcohol caffeine cough and cold medicines Supraventricular tachycardia (SVT) is a rapid, regular heart rate where the heart beats anywhere from 150-250 times per minute in the atria. Another name for SVT is paroxysmal supraventricular tachycardia (PSVT). The word paroxysmal means occasionally or from time to time. Supraventricular tachycardia or PSVT happens when electrical signals in the hearts upper chambers fire abnormally, which interferes with electrical signals coming from the SA node (the hearts natural pacemaker). The beats in the atria then speed up the heart rate. It is also more likely to occur in women, anxious young people, and people who are extremely tired (fatigued). People who drink a lot of coffee or alcohol or who are heavy smokers also have a greater risk. Atrial fibrillationis a fast, irregular rhythm where s
CARDIAC ARRYTHMIAS AND ITS NURSING MANAGEMENT from Sarah Ajose
]]> 77 0 https://cdn.slidesharecdn.com/ss_thumbnails/cardiacarrythmias1-240809112342-24b9b1f5-thumbnail.jpg?width=120&height=120&fit=bounds presentation Black http://activitystrea.ms/schema/1.0/post http://activitystrea.ms/schema/1.0/posted 0 CANCER OF LARYNX AND ITS DETAILED MANAGEMENT /slideshow/cancer-of-larynx-and-its-detailed-management/270864631 cancerlarynx-240808092941-5f500380
Cancer of the larynx is a malignant tumour in and around the larynx (voice box). Squamous centre carcinoma is the most common form of cancer of the larynx (95%). Cancer of the larynx occurs more frequently in men than in women, and it is most common in people between the ages of 50 to 70 years of age. It accounts for approximately half of all head and neck cancers. Almost of all malignant tumours of the larynx arise from the surface epithelium and are classified as squamous cell carcinoma. It is an organ that provides a protective sphincter at the inlet of the air passage and is responsible for voice production. It extends from the tongue to the trachea (from the level of the upper border of the epiglottis to the level of the 6th vertebra). Above :- Continous with pharynx Below :- Continous with trachea Anteriorly :- Covered by skin, superficial facia, deep fascia and infrahyoid muscles. On each side :- to the thyroid lobe. Maintain an open passageway for air movement (thyroid and cricoid cartilages) Epiglotis and vestibular folds prevent swallowed material from moving into larynx. vocal folds are primary source of sound production.Greater amplitude of vibration. The Pseudostratified ciliated columnar epithelium traps debris, preventing their entry into the lower respiratory tract. Respiration fixation of chest Helps in promoting venous return Aspiration on swallowing Sore throat Foreign body sansation Dysphagia Neck mass Dyspnea Pain in the throat reffered to the ear Hoarseness of voice Persistent cough Sore throat Thorat pain Throat burning (when consuming hot liquids or citrus fruits juices) Lump fekt in the neck Dysphagia Dyspnea Unilateral nasal obstruction Nasal discharge Foul breathing MEDICAL MANAGEMENT Chemotherapy - For patients with more advanced disease - Cisplatin based chemo with radation is used. - 5 flurouresil also used Radiation therapy - Goal of radiation is destroy cancer cells and preserve the function of the larynx - It can be used pre operatively and post operatively - It is combined with surgery in advanced conditions as adjuvant therapy. Vocal cord strapping Stripping of vocal cord is used to treat dysphagia, hyperkerotosis and leukoplagia. the procedure involves removal of the mucosa of the edge of the vocal cord, is by using an operating microscope. surgical removal of the vocal cord, is usually performed via transoral laser. Laser surgery When the tumour size is of small tumour are eradicated with the used of uaser. Microelectrodes of small tuours of the lungs. Partial laryngectomy A partial laryngectomy is often used smaller cancers of larynx. It is recommended in the early stage of cancer in thr glotis area when only one vocal cord is involved. In this prition is removed along with the vocal cord and the tumor, all other structure remain. In total laryngectomy, the laryngeal structure are removed, including the hyoid bone, epiglotis, cricoids ca]]>
Cancer of the larynx is a malignant tumour in and around the larynx (voice box). Squamous centre carcinoma is the most common form of cancer of the larynx (95%). Cancer of the larynx occurs more frequently in men than in women, and it is most common in people between the ages of 50 to 70 years of age. It accounts for approximately half of all head and neck cancers. Almost of all malignant tumours of the larynx arise from the surface epithelium and are classified as squamous cell carcinoma. It is an organ that provides a protective sphincter at the inlet of the air passage and is responsible for voice production. It extends from the tongue to the trachea (from the level of the upper border of the epiglottis to the level of the 6th vertebra). Above :- Continous with pharynx Below :- Continous with trachea Anteriorly :- Covered by skin, superficial facia, deep fascia and infrahyoid muscles. On each side :- to the thyroid lobe. Maintain an open passageway for air movement (thyroid and cricoid cartilages) Epiglotis and vestibular folds prevent swallowed material from moving into larynx. vocal folds are primary source of sound production.Greater amplitude of vibration. The Pseudostratified ciliated columnar epithelium traps debris, preventing their entry into the lower respiratory tract. Respiration fixation of chest Helps in promoting venous return Aspiration on swallowing Sore throat Foreign body sansation Dysphagia Neck mass Dyspnea Pain in the throat reffered to the ear Hoarseness of voice Persistent cough Sore throat Thorat pain Throat burning (when consuming hot liquids or citrus fruits juices) Lump fekt in the neck Dysphagia Dyspnea Unilateral nasal obstruction Nasal discharge Foul breathing MEDICAL MANAGEMENT Chemotherapy - For patients with more advanced disease - Cisplatin based chemo with radation is used. - 5 flurouresil also used Radiation therapy - Goal of radiation is destroy cancer cells and preserve the function of the larynx - It can be used pre operatively and post operatively - It is combined with surgery in advanced conditions as adjuvant therapy. Vocal cord strapping Stripping of vocal cord is used to treat dysphagia, hyperkerotosis and leukoplagia. the procedure involves removal of the mucosa of the edge of the vocal cord, is by using an operating microscope. surgical removal of the vocal cord, is usually performed via transoral laser. Laser surgery When the tumour size is of small tumour are eradicated with the used of uaser. Microelectrodes of small tuours of the lungs. Partial laryngectomy A partial laryngectomy is often used smaller cancers of larynx. It is recommended in the early stage of cancer in thr glotis area when only one vocal cord is involved. In this prition is removed along with the vocal cord and the tumor, all other structure remain. In total laryngectomy, the laryngeal structure are removed, including the hyoid bone, epiglotis, cricoids ca]]> Thu, 08 Aug 2024 09:29:41 GMT /slideshow/cancer-of-larynx-and-its-detailed-management/270864631 SarahAjose@slideshare.net(SarahAjose) CANCER OF LARYNX AND ITS DETAILED MANAGEMENT SarahAjose Cancer of the larynx is a malignant tumour in and around the larynx (voice box). Squamous centre carcinoma is the most common form of cancer of the larynx (95%). Cancer of the larynx occurs more frequently in men than in women, and it is most common in people between the ages of 50 to 70 years of age. It accounts for approximately half of all head and neck cancers. Almost of all malignant tumours of the larynx arise from the surface epithelium and are classified as squamous cell carcinoma. It is an organ that provides a protective sphincter at the inlet of the air passage and is responsible for voice production. It extends from the tongue to the trachea (from the level of the upper border of the epiglottis to the level of the 6th vertebra). Above :- Continous with pharynx Below :- Continous with trachea Anteriorly :- Covered by skin, superficial facia, deep fascia and infrahyoid muscles. On each side :- to the thyroid lobe. Maintain an open passageway for air movement (thyroid and cricoid cartilages) Epiglotis and vestibular folds prevent swallowed material from moving into larynx. vocal folds are primary source of sound production.Greater amplitude of vibration. The Pseudostratified ciliated columnar epithelium traps debris, preventing their entry into the lower respiratory tract. Respiration fixation of chest Helps in promoting venous return Aspiration on swallowing Sore throat Foreign body sansation Dysphagia Neck mass Dyspnea Pain in the throat reffered to the ear Hoarseness of voice Persistent cough Sore throat Thorat pain Throat burning (when consuming hot liquids or citrus fruits juices) Lump fekt in the neck Dysphagia Dyspnea Unilateral nasal obstruction Nasal discharge Foul breathing MEDICAL MANAGEMENT Chemotherapy - For patients with more advanced disease - Cisplatin based chemo with radation is used. - 5 flurouresil also used Radiation therapy - Goal of radiation is destroy cancer cells and preserve the function of the larynx - It can be used pre operatively and post operatively - It is combined with surgery in advanced conditions as adjuvant therapy. Vocal cord strapping Stripping of vocal cord is used to treat dysphagia, hyperkerotosis and leukoplagia. the procedure involves removal of the mucosa of the edge of the vocal cord, is by using an operating microscope. surgical removal of the vocal cord, is usually performed via transoral laser. Laser surgery When the tumour size is of small tumour are eradicated with the used of uaser. Microelectrodes of small tuours of the lungs. Partial laryngectomy A partial laryngectomy is often used smaller cancers of larynx. It is recommended in the early stage of cancer in thr glotis area when only one vocal cord is involved. In this prition is removed along with the vocal cord and the tumor, all other structure remain. In total laryngectomy, the laryngeal structure are removed, including the hyoid bone, epiglotis, cricoids ca <img style="border:1px solid #C3E6D8;float:right;" alt="" src="https://cdn.slidesharecdn.com/ss_thumbnails/cancerlarynx-240808092941-5f500380-thumbnail.jpg?width=120&amp;height=120&amp;fit=bounds" /><br> Cancer of the larynx is a malignant tumour in and around the larynx (voice box). Squamous centre carcinoma is the most common form of cancer of the larynx (95%). Cancer of the larynx occurs more frequently in men than in women, and it is most common in people between the ages of 50 to 70 years of age. It accounts for approximately half of all head and neck cancers. Almost of all malignant tumours of the larynx arise from the surface epithelium and are classified as squamous cell carcinoma. It is an organ that provides a protective sphincter at the inlet of the air passage and is responsible for voice production. It extends from the tongue to the trachea (from the level of the upper border of the epiglottis to the level of the 6th vertebra). Above :- Continous with pharynx Below :- Continous with trachea Anteriorly :- Covered by skin, superficial facia, deep fascia and infrahyoid muscles. On each side :- to the thyroid lobe. Maintain an open passageway for air movement (thyroid and cricoid cartilages) Epiglotis and vestibular folds prevent swallowed material from moving into larynx. vocal folds are primary source of sound production.Greater amplitude of vibration. The Pseudostratified ciliated columnar epithelium traps debris, preventing their entry into the lower respiratory tract. Respiration fixation of chest Helps in promoting venous return Aspiration on swallowing Sore throat Foreign body sansation Dysphagia Neck mass Dyspnea Pain in the throat reffered to the ear Hoarseness of voice Persistent cough Sore throat Thorat pain Throat burning (when consuming hot liquids or citrus fruits juices) Lump fekt in the neck Dysphagia Dyspnea Unilateral nasal obstruction Nasal discharge Foul breathing MEDICAL MANAGEMENT Chemotherapy - For patients with more advanced disease - Cisplatin based chemo with radation is used. - 5 flurouresil also used Radiation therapy - Goal of radiation is destroy cancer cells and preserve the function of the larynx - It can be used pre operatively and post operatively - It is combined with surgery in advanced conditions as adjuvant therapy. Vocal cord strapping Stripping of vocal cord is used to treat dysphagia, hyperkerotosis and leukoplagia. the procedure involves removal of the mucosa of the edge of the vocal cord, is by using an operating microscope. surgical removal of the vocal cord, is usually performed via transoral laser. Laser surgery When the tumour size is of small tumour are eradicated with the used of uaser. Microelectrodes of small tuours of the lungs. Partial laryngectomy A partial laryngectomy is often used smaller cancers of larynx. It is recommended in the early stage of cancer in thr glotis area when only one vocal cord is involved. In this prition is removed along with the vocal cord and the tumor, all other structure remain. In total laryngectomy, the laryngeal structure are removed, including the hyoid bone, epiglotis, cricoids ca
CANCER OF LARYNX AND ITS DETAILED MANAGEMENT from Sarah Ajose
]]> 163 0 https://cdn.slidesharecdn.com/ss_thumbnails/cancerlarynx-240808092941-5f500380-thumbnail.jpg?width=120&height=120&fit=bounds presentation Black http://activitystrea.ms/schema/1.0/post http://activitystrea.ms/schema/1.0/posted 0 Addisons disease PPT for nursing students /slideshow/addisons-disease-ppt-for-nursing-students/270805901 addisonsdisease-240806112713-eac2ddb3
Introduction:The adrenal glands are developed from two separate embryological tissue. The nerve crest ectoderm and the intermediate mesoderm. The medulla originate from neural crest cells. The Two adrenal glands are situated on the upper pole of each kidney enclosed with in the renal fascia. Definition: A disease characterized by progressive anemic, low blood pressure, great weakness and bronze discoloration of the skin. It is caused by inadequate secretion of hormones by the adrenal gland ( glucocorticoids, mineralocorticoids). Incidence: 80 90 % of all cases are auto immune or ideopathic in nature. 1 in 100,000 people in US have addisons disease Prevalence is estimated to be between 40 and 60 million people of the general poppulation. All age groups are affected. Can be life threatening. Both sex are affected equally Risk factors: Cancer Anticoagulants ( resulting in adrenal hemorrhage) Have chronic infections like tuberculosis with antibiotics Had surgical removal of adrenal glands. Auto immune disease like type- 1 diabetes or graves disease. Signs and symptoms: Fatique Muscle weakness, Muscle / joint pain Increased insulin sensitivity Nausea, vomitting Anorexia ( decreased appetite) Irritability, Depression Dehydration, hypotension Hyperpigmentaion Abdominal pain Hyponatremia, hypoglycemia Hyperkalemia, hypovolemia Treatment medical: Hormone replacement is used to correct the insufficient levels of steroids the adrenal glands cannot produce. Increase sodium intake Life long drug maintenance is required. Pharmacological mgt: Hydrocortisone pills to replace cortisol. If patient also lacking aldosterone, fludrocortisone acetate pills will be provided. If the patient is taking fludrocortisone, need to increase salt intake, especially in hot and humid whether and after exercise. In emergencies and during surgery, the medicine is given intravenously. Patient education: Advise the patient to take more salt during hot whether and heavy exercise. Never skip a dose- this could lead to addisons crisis. Learns to recogise the symptoms of an addisons disease. Eg- pain in the lower back, severe vomitting,extreme weakness, fainting, contact physician immediately. Wear medic allert card. Frequently monitor weight. Reframe from stressful activities. education about self care of patient: Advice the patient for regular medications. 1oo mg- hydrocortisone 4 mg dexamethasone Availability of medications should be known by the patient. Always wear the medic allert card and carry medic bag. Nursing magt: ASSESSMENT OF THE PATIENT Health history & physical examination focus on the presence of fluid imbalance and patients level of stress. Monitor vital signs ( blood pressure) Patient is assessed for changes in weight, muscle weakness, fatique and any illness or stress Monitoring and managing crisis:Monitoring vital signs include, shock, hypotension, rapid weak pulse, rapid respiratory rate, pallor & extreme weakness. Patient with crisis requires immediate]]>
Introduction:The adrenal glands are developed from two separate embryological tissue. The nerve crest ectoderm and the intermediate mesoderm. The medulla originate from neural crest cells. The Two adrenal glands are situated on the upper pole of each kidney enclosed with in the renal fascia. Definition: A disease characterized by progressive anemic, low blood pressure, great weakness and bronze discoloration of the skin. It is caused by inadequate secretion of hormones by the adrenal gland ( glucocorticoids, mineralocorticoids). Incidence: 80 90 % of all cases are auto immune or ideopathic in nature. 1 in 100,000 people in US have addisons disease Prevalence is estimated to be between 40 and 60 million people of the general poppulation. All age groups are affected. Can be life threatening. Both sex are affected equally Risk factors: Cancer Anticoagulants ( resulting in adrenal hemorrhage) Have chronic infections like tuberculosis with antibiotics Had surgical removal of adrenal glands. Auto immune disease like type- 1 diabetes or graves disease. Signs and symptoms: Fatique Muscle weakness, Muscle / joint pain Increased insulin sensitivity Nausea, vomitting Anorexia ( decreased appetite) Irritability, Depression Dehydration, hypotension Hyperpigmentaion Abdominal pain Hyponatremia, hypoglycemia Hyperkalemia, hypovolemia Treatment medical: Hormone replacement is used to correct the insufficient levels of steroids the adrenal glands cannot produce. Increase sodium intake Life long drug maintenance is required. Pharmacological mgt: Hydrocortisone pills to replace cortisol. If patient also lacking aldosterone, fludrocortisone acetate pills will be provided. If the patient is taking fludrocortisone, need to increase salt intake, especially in hot and humid whether and after exercise. In emergencies and during surgery, the medicine is given intravenously. Patient education: Advise the patient to take more salt during hot whether and heavy exercise. Never skip a dose- this could lead to addisons crisis. Learns to recogise the symptoms of an addisons disease. Eg- pain in the lower back, severe vomitting,extreme weakness, fainting, contact physician immediately. Wear medic allert card. Frequently monitor weight. Reframe from stressful activities. education about self care of patient: Advice the patient for regular medications. 1oo mg- hydrocortisone 4 mg dexamethasone Availability of medications should be known by the patient. Always wear the medic allert card and carry medic bag. Nursing magt: ASSESSMENT OF THE PATIENT Health history & physical examination focus on the presence of fluid imbalance and patients level of stress. Monitor vital signs ( blood pressure) Patient is assessed for changes in weight, muscle weakness, fatique and any illness or stress Monitoring and managing crisis:Monitoring vital signs include, shock, hypotension, rapid weak pulse, rapid respiratory rate, pallor & extreme weakness. Patient with crisis requires immediate]]> Tue, 06 Aug 2024 11:27:13 GMT /slideshow/addisons-disease-ppt-for-nursing-students/270805901 SarahAjose@slideshare.net(SarahAjose) Addisons disease PPT for nursing students SarahAjose Introduction:The adrenal glands are developed from two separate embryological tissue. The nerve crest ectoderm and the intermediate mesoderm. The medulla originate from neural crest cells. The Two adrenal glands are situated on the upper pole of each kidney enclosed with in the renal fascia. Definition: A disease characterized by progressive anemic, low blood pressure, great weakness and bronze discoloration of the skin. It is caused by inadequate secretion of hormones by the adrenal gland ( glucocorticoids, mineralocorticoids). Incidence: 80 90 % of all cases are auto immune or ideopathic in nature. 1 in 100,000 people in US have addisons disease Prevalence is estimated to be between 40 and 60 million people of the general poppulation. All age groups are affected. Can be life threatening. Both sex are affected equally Risk factors: Cancer Anticoagulants ( resulting in adrenal hemorrhage) Have chronic infections like tuberculosis with antibiotics Had surgical removal of adrenal glands. Auto immune disease like type- 1 diabetes or graves disease. Signs and symptoms: Fatique Muscle weakness, Muscle / joint pain Increased insulin sensitivity Nausea, vomitting Anorexia ( decreased appetite) Irritability, Depression Dehydration, hypotension Hyperpigmentaion Abdominal pain Hyponatremia, hypoglycemia Hyperkalemia, hypovolemia Treatment medical: Hormone replacement is used to correct the insufficient levels of steroids the adrenal glands cannot produce. Increase sodium intake Life long drug maintenance is required. Pharmacological mgt: Hydrocortisone pills to replace cortisol. If patient also lacking aldosterone, fludrocortisone acetate pills will be provided. If the patient is taking fludrocortisone, need to increase salt intake, especially in hot and humid whether and after exercise. In emergencies and during surgery, the medicine is given intravenously. Patient education: Advise the patient to take more salt during hot whether and heavy exercise. Never skip a dose- this could lead to addisons crisis. Learns to recogise the symptoms of an addisons disease. Eg- pain in the lower back, severe vomitting,extreme weakness, fainting, contact physician immediately. Wear medic allert card. Frequently monitor weight. Reframe from stressful activities. education about self care of patient: Advice the patient for regular medications. 1oo mg- hydrocortisone 4 mg dexamethasone Availability of medications should be known by the patient. Always wear the medic allert card and carry medic bag. Nursing magt: ASSESSMENT OF THE PATIENT Health history & physical examination focus on the presence of fluid imbalance and patients level of stress. Monitor vital signs ( blood pressure) Patient is assessed for changes in weight, muscle weakness, fatique and any illness or stress Monitoring and managing crisis:Monitoring vital signs include, shock, hypotension, rapid weak pulse, rapid respiratory rate, pallor & extreme weakness. Patient with crisis requires immediate <img style="border:1px solid #C3E6D8;float:right;" alt="" src="https://cdn.slidesharecdn.com/ss_thumbnails/addisonsdisease-240806112713-eac2ddb3-thumbnail.jpg?width=120&amp;height=120&amp;fit=bounds" /><br> Introduction:The adrenal glands are developed from two separate embryological tissue. The nerve crest ectoderm and the intermediate mesoderm. The medulla originate from neural crest cells. The Two adrenal glands are situated on the upper pole of each kidney enclosed with in the renal fascia. Definition: A disease characterized by progressive anemic, low blood pressure, great weakness and bronze discoloration of the skin. It is caused by inadequate secretion of hormones by the adrenal gland ( glucocorticoids, mineralocorticoids). Incidence: 80 90 % of all cases are auto immune or ideopathic in nature. 1 in 100,000 people in US have addisons disease Prevalence is estimated to be between 40 and 60 million people of the general poppulation. All age groups are affected. Can be life threatening. Both sex are affected equally Risk factors: Cancer Anticoagulants ( resulting in adrenal hemorrhage) Have chronic infections like tuberculosis with antibiotics Had surgical removal of adrenal glands. Auto immune disease like type- 1 diabetes or graves disease. Signs and symptoms: Fatique Muscle weakness, Muscle / joint pain Increased insulin sensitivity Nausea, vomitting Anorexia ( decreased appetite) Irritability, Depression Dehydration, hypotension Hyperpigmentaion Abdominal pain Hyponatremia, hypoglycemia Hyperkalemia, hypovolemia Treatment medical: Hormone replacement is used to correct the insufficient levels of steroids the adrenal glands cannot produce. Increase sodium intake Life long drug maintenance is required. Pharmacological mgt: Hydrocortisone pills to replace cortisol. If patient also lacking aldosterone, fludrocortisone acetate pills will be provided. If the patient is taking fludrocortisone, need to increase salt intake, especially in hot and humid whether and after exercise. In emergencies and during surgery, the medicine is given intravenously. Patient education: Advise the patient to take more salt during hot whether and heavy exercise. Never skip a dose- this could lead to addisons crisis. Learns to recogise the symptoms of an addisons disease. Eg- pain in the lower back, severe vomitting,extreme weakness, fainting, contact physician immediately. Wear medic allert card. Frequently monitor weight. Reframe from stressful activities. education about self care of patient: Advice the patient for regular medications. 1oo mg- hydrocortisone 4 mg dexamethasone Availability of medications should be known by the patient. Always wear the medic allert card and carry medic bag. Nursing magt: ASSESSMENT OF THE PATIENT Health history &amp; physical examination focus on the presence of fluid imbalance and patients level of stress. Monitor vital signs ( blood pressure) Patient is assessed for changes in weight, muscle weakness, fatique and any illness or stress Monitoring and managing crisis:Monitoring vital signs include, shock, hypotension, rapid weak pulse, rapid respiratory rate, pallor &amp; extreme weakness. Patient with crisis requires immediate
Addisons disease PPT for nursing students from Sarah Ajose
]]> 80 0 https://cdn.slidesharecdn.com/ss_thumbnails/addisonsdisease-240806112713-eac2ddb3-thumbnail.jpg?width=120&height=120&fit=bounds presentation Black http://activitystrea.ms/schema/1.0/post http://activitystrea.ms/schema/1.0/posted 0 Advanced cardiac life support at emergency department /slideshow/advanced-cardiac-life-support-at-emergency-department/270805521 acls-240806111043-5b0fbdf1
Introduction:Advanced cardiac life support(ACLS) or advanced cardiovascular life support refers to a set of clinical interventions for urgent treatment of cardiac arrest and other life- threadening medical emergencies,as well as the knowledge and skills to deploy those interventions. American heart association ( AHA) protocols are considered to be gold standard ACLS protocols, and it gets reviewed every 5 years. ACLS is build heavily upon the foundation of BLS ( Basic life support ). Definition:Advanced cardiac life support, advanced cardiovascular life support refers to a set of clinical guidelines for the urgent and emergent treatment of life- threating cardiovascular conditions that will cause or have caused cardiac medicatios, and techniques. AHA adult chain of survival:Immediate recognition of cardiac arrest and condition of the emergency response system. Early CPR with emphasis on chest compressions. Rapid defibrillation. Effective advanced life support. Integrated post- cardiac arrest care. Components of high quality CPR in BLS:SCENE SAFETY Make sure the environment is safe for rescuers and victim. RECOGNITION OF CARDIAC ARREST Check for responsiveness No breathing or only gasping ( no normal breathing ) No definitive pulse left with in 10 secs ( cartoid or femoral pulse ) Breathing and pulse check can be performed with in 10 secs Activation of emergency activation system: If done with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR. Otherwise, send someone and begin CPR immediately, use the AED as soon as it is available. Chest compression 30 : 2 Compression rate 100 - 120 / min Compression depth -- at least 5 cm or 2 inches Hand placement - 2 hands on the half of the sternum Chest recoil- allow full chest recoil Minimize interruptions - < 30 secs ( Early defibrillation and early CPR for treatable arrhythmias remains the corner stone of ACLS) CPR quality: Push hard ( at least 2 inches (5 cm) and fast (100- 120/min) and allow complete chest recoil. Minimize interruptions in compressions. Avoid excessive ventilation. Change compressor every 2 minutes, or sooner if fatigued. If no advanced airway, 30:2 compression : ventilation ratio. Quantitative waveform capnography. If PETCO2 is low of decreasing reassess CPR quality Defibrillation:Biphasic:- Manufacturer recommendations (eg: initial dose of ( 20 -200 j); if unknown, use maximum available. Second and subsequent doses should be equivalent and higher doses may be considered. Mono phasic: 360 j DRUG THERAPY: Epinephrine IV/IO Dose: 1mg every 3-5 minutes Amiodarone IV/IO Dosew : First dose 300mg bolus, second dose 150 mg. Lidocaine IV/IO dose : First dose 1-1.5 mg/kg, second dose 0.5-0.75 mg/kg. Advanced airway: Endotracheal intubation or supraglottic advanced airway Waveform capnography or capnometry to confirm and monitor ET tube/ Placement. Once advanced airway in place, give 1 breath every 6 seconds ( 10 breaths]]>
Introduction:Advanced cardiac life support(ACLS) or advanced cardiovascular life support refers to a set of clinical interventions for urgent treatment of cardiac arrest and other life- threadening medical emergencies,as well as the knowledge and skills to deploy those interventions. American heart association ( AHA) protocols are considered to be gold standard ACLS protocols, and it gets reviewed every 5 years. ACLS is build heavily upon the foundation of BLS ( Basic life support ). Definition:Advanced cardiac life support, advanced cardiovascular life support refers to a set of clinical guidelines for the urgent and emergent treatment of life- threating cardiovascular conditions that will cause or have caused cardiac medicatios, and techniques. AHA adult chain of survival:Immediate recognition of cardiac arrest and condition of the emergency response system. Early CPR with emphasis on chest compressions. Rapid defibrillation. Effective advanced life support. Integrated post- cardiac arrest care. Components of high quality CPR in BLS:SCENE SAFETY Make sure the environment is safe for rescuers and victim. RECOGNITION OF CARDIAC ARREST Check for responsiveness No breathing or only gasping ( no normal breathing ) No definitive pulse left with in 10 secs ( cartoid or femoral pulse ) Breathing and pulse check can be performed with in 10 secs Activation of emergency activation system: If done with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR. Otherwise, send someone and begin CPR immediately, use the AED as soon as it is available. Chest compression 30 : 2 Compression rate 100 - 120 / min Compression depth -- at least 5 cm or 2 inches Hand placement - 2 hands on the half of the sternum Chest recoil- allow full chest recoil Minimize interruptions - < 30 secs ( Early defibrillation and early CPR for treatable arrhythmias remains the corner stone of ACLS) CPR quality: Push hard ( at least 2 inches (5 cm) and fast (100- 120/min) and allow complete chest recoil. Minimize interruptions in compressions. Avoid excessive ventilation. Change compressor every 2 minutes, or sooner if fatigued. If no advanced airway, 30:2 compression : ventilation ratio. Quantitative waveform capnography. If PETCO2 is low of decreasing reassess CPR quality Defibrillation:Biphasic:- Manufacturer recommendations (eg: initial dose of ( 20 -200 j); if unknown, use maximum available. Second and subsequent doses should be equivalent and higher doses may be considered. Mono phasic: 360 j DRUG THERAPY: Epinephrine IV/IO Dose: 1mg every 3-5 minutes Amiodarone IV/IO Dosew : First dose 300mg bolus, second dose 150 mg. Lidocaine IV/IO dose : First dose 1-1.5 mg/kg, second dose 0.5-0.75 mg/kg. Advanced airway: Endotracheal intubation or supraglottic advanced airway Waveform capnography or capnometry to confirm and monitor ET tube/ Placement. Once advanced airway in place, give 1 breath every 6 seconds ( 10 breaths]]> Tue, 06 Aug 2024 11:10:43 GMT /slideshow/advanced-cardiac-life-support-at-emergency-department/270805521 SarahAjose@slideshare.net(SarahAjose) Advanced cardiac life support at emergency department SarahAjose Introduction:Advanced cardiac life support(ACLS) or advanced cardiovascular life support refers to a set of clinical interventions for urgent treatment of cardiac arrest and other life- threadening medical emergencies,as well as the knowledge and skills to deploy those interventions. American heart association ( AHA) protocols are considered to be gold standard ACLS protocols, and it gets reviewed every 5 years. ACLS is build heavily upon the foundation of BLS ( Basic life support ). Definition:Advanced cardiac life support, advanced cardiovascular life support refers to a set of clinical guidelines for the urgent and emergent treatment of life- threating cardiovascular conditions that will cause or have caused cardiac medicatios, and techniques. AHA adult chain of survival:Immediate recognition of cardiac arrest and condition of the emergency response system. Early CPR with emphasis on chest compressions. Rapid defibrillation. Effective advanced life support. Integrated post- cardiac arrest care. Components of high quality CPR in BLS:SCENE SAFETY Make sure the environment is safe for rescuers and victim. RECOGNITION OF CARDIAC ARREST Check for responsiveness No breathing or only gasping ( no normal breathing ) No definitive pulse left with in 10 secs ( cartoid or femoral pulse ) Breathing and pulse check can be performed with in 10 secs Activation of emergency activation system: If done with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR. Otherwise, send someone and begin CPR immediately, use the AED as soon as it is available. Chest compression 30 : 2 Compression rate 100 - 120 / min Compression depth -- at least 5 cm or 2 inches Hand placement - 2 hands on the half of the sternum Chest recoil- allow full chest recoil Minimize interruptions - < 30 secs ( Early defibrillation and early CPR for treatable arrhythmias remains the corner stone of ACLS) CPR quality: Push hard ( at least 2 inches (5 cm) and fast (100- 120/min) and allow complete chest recoil. Minimize interruptions in compressions. Avoid excessive ventilation. Change compressor every 2 minutes, or sooner if fatigued. If no advanced airway, 30:2 compression : ventilation ratio. Quantitative waveform capnography. If PETCO2 is low of decreasing reassess CPR quality Defibrillation:Biphasic:- Manufacturer recommendations (eg: initial dose of ( 20 -200 j); if unknown, use maximum available. Second and subsequent doses should be equivalent and higher doses may be considered. Mono phasic: 360 j DRUG THERAPY: Epinephrine IV/IO Dose: 1mg every 3-5 minutes Amiodarone IV/IO Dosew : First dose 300mg bolus, second dose 150 mg. Lidocaine IV/IO dose : First dose 1-1.5 mg/kg, second dose 0.5-0.75 mg/kg. Advanced airway: Endotracheal intubation or supraglottic advanced airway Waveform capnography or capnometry to confirm and monitor ET tube/ Placement. Once advanced airway in place, give 1 breath every 6 seconds ( 10 breaths <img style="border:1px solid #C3E6D8;float:right;" alt="" src="https://cdn.slidesharecdn.com/ss_thumbnails/acls-240806111043-5b0fbdf1-thumbnail.jpg?width=120&amp;height=120&amp;fit=bounds" /><br> Introduction:Advanced cardiac life support(ACLS) or advanced cardiovascular life support refers to a set of clinical interventions for urgent treatment of cardiac arrest and other life- threadening medical emergencies,as well as the knowledge and skills to deploy those interventions. American heart association ( AHA) protocols are considered to be gold standard ACLS protocols, and it gets reviewed every 5 years. ACLS is build heavily upon the foundation of BLS ( Basic life support ). Definition:Advanced cardiac life support, advanced cardiovascular life support refers to a set of clinical guidelines for the urgent and emergent treatment of life- threating cardiovascular conditions that will cause or have caused cardiac medicatios, and techniques. AHA adult chain of survival:Immediate recognition of cardiac arrest and condition of the emergency response system. Early CPR with emphasis on chest compressions. Rapid defibrillation. Effective advanced life support. Integrated post- cardiac arrest care. Components of high quality CPR in BLS:SCENE SAFETY Make sure the environment is safe for rescuers and victim. RECOGNITION OF CARDIAC ARREST Check for responsiveness No breathing or only gasping ( no normal breathing ) No definitive pulse left with in 10 secs ( cartoid or femoral pulse ) Breathing and pulse check can be performed with in 10 secs Activation of emergency activation system: If done with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR. Otherwise, send someone and begin CPR immediately, use the AED as soon as it is available. Chest compression 30 : 2 Compression rate 100 - 120 / min Compression depth -- at least 5 cm or 2 inches Hand placement - 2 hands on the half of the sternum Chest recoil- allow full chest recoil Minimize interruptions - &lt; 30 secs ( Early defibrillation and early CPR for treatable arrhythmias remains the corner stone of ACLS) CPR quality: Push hard ( at least 2 inches (5 cm) and fast (100- 120/min) and allow complete chest recoil. Minimize interruptions in compressions. Avoid excessive ventilation. Change compressor every 2 minutes, or sooner if fatigued. If no advanced airway, 30:2 compression : ventilation ratio. Quantitative waveform capnography. If PETCO2 is low of decreasing reassess CPR quality Defibrillation:Biphasic:- Manufacturer recommendations (eg: initial dose of ( 20 -200 j); if unknown, use maximum available. Second and subsequent doses should be equivalent and higher doses may be considered. Mono phasic: 360 j DRUG THERAPY: Epinephrine IV/IO Dose: 1mg every 3-5 minutes Amiodarone IV/IO Dosew : First dose 300mg bolus, second dose 150 mg. Lidocaine IV/IO dose : First dose 1-1.5 mg/kg, second dose 0.5-0.75 mg/kg. Advanced airway: Endotracheal intubation or supraglottic advanced airway Waveform capnography or capnometry to confirm and monitor ET tube/ Placement. Once advanced airway in place, give 1 breath every 6 seconds ( 10 breaths
Advanced cardiac life support at emergency department from Sarah Ajose
]]> 143 0 https://cdn.slidesharecdn.com/ss_thumbnails/acls-240806111043-5b0fbdf1-thumbnail.jpg?width=120&height=120&fit=bounds presentation Black http://activitystrea.ms/schema/1.0/post http://activitystrea.ms/schema/1.0/posted 0 https://public.slidesharecdn.com/v2/images/profile-picture.png I am a student. Doing my second year msc nursing. https://cdn.slidesharecdn.com/ss_thumbnails/cardiacassessmentheartsoundscardiacenzyme-240809113556-8cfb3cb9-thumbnail.jpg?width=320&height=320&fit=bounds slideshow/cardiac-assessment-heart-sounds-cardiac-enzyme-pptx/270894753 CARDIAC ASSESSMENT, HE... https://cdn.slidesharecdn.com/ss_thumbnails/cardiacarrythmias1-240809112342-24b9b1f5-thumbnail.jpg?width=320&height=320&fit=bounds slideshow/cardiac-arrythmias-and-its-nursing-management/270894540 CARDIAC ARRYTHMIAS AND... https://cdn.slidesharecdn.com/ss_thumbnails/cancerlarynx-240808092941-5f500380-thumbnail.jpg?width=320&height=320&fit=bounds slideshow/cancer-of-larynx-and-its-detailed-management/270864631 CANCER OF LARYNX AND I...