Guide, the Following Widths Are Recommended
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Paramedic National EMS Education Standard
NORTHWEST COMMUNITY EMERGENCY MEDICAL SERVICES SYSTEM CCCooonnntttiiinnnuuuiiinnnggg EEEddduuucccaaatttiiiooonnn SSSeeepppttteeemmmbbbeeerrr 222000111222 EEyyee && EEaarr DDiissoorrddeerrss && TTrraauummaa Questions/comments are welcome. Please direct to Jen Dyer, RN, EMT-P EMS Educator NWC EMSS Con-Ed Eye and Ear Disorders and Trauma September 2012 – page 1 Paramedic National EMS Education Standard Integrates assessment findings with principles of pathophysiology to formulate a field impression and implement a treatment/disposition plan for patients with eye and ear disorders/trauma. Objectives: Upon completion of the class and review of the independent study materials and post-test question bank, each participant will do the following with a degree of accuracy that meets or exceeds the standards established for their scope of practice: 1. Identify the anatomical structures of the eye and describe the corresponding physiologic function of each. (C) 2. Explain the physiology of normal vision. (C) 3. Identify the anatomic structures of the ear and describe the corresponding physiologic function of each. (C) 4. Explain the physiology of normal hearing. (C) 5. Explain the physiology of equilibrium. (C) 6. Select and discuss maneuvers for assessing eye structures and functions (C) and demonstrate a thorough EMS assessment of ocular structures, visual acuity, pupils and ocular movements. (P) 7. Distinguish abnormal assessment findings/conditions of the eye: blurred vision, diplopia, photophobia, changes in vision, flashing, pupil exam, Adie’s pupil, oculomotor nerve paralysis, Horner’s Syndrome, blindness, deviation/paralytic strabismus, orbit fracture, cataracts, conjunctivitis, color blindness, near sightedness, farsightedness, astigmatism, amblyopia, burns of the eye, corneal abrasions, foreign body, inflammation of the eyelid, glaucoma, hyphema, iritis, orbital cellulitis, macular degeneration and trauma. -
5 Minute EMS Clinic-The First Five Minutes V2
EMS Basics: The First 5 Minutes For fire departments who offer both fire and OPQRST EMS services, approximately 75-80% of all ONSET-What was patient doing calls are medically-based. Not every fire de- when the symptoms started? partment is fortunate enough to have EMT’s or PROVOKES/PALLIATES- paramedics on their fire trucks. Regardless of Does anything make the pain your crew’s level of medical training, there are worse/better? several goals that MUST be accomplished QUALITY-Describe the pain within the first five minutes of patient contact. (sharp, dull, throbbing, etc.). Accomplishing these goals will directly im- prove patient outcomes. RADIATES-Does the pain radi- ate somewhere else? GOAL #1—-PROTECT YOURSELF: SEVERITY-On a scale from 1- Wear proper PPE (gloves, etc.) and ensure that the scene is safe prior to entry. 10 with 10 being the worst pain, rate your pain level. GOAL #2—-FOR CRITICAL PATIENTS, PERFORM IMMEDIATE INTERVENTIONS: TIME-When did the symptoms UNCONSCIOUS PATIENT = Open & protect airway start? CARDIAC ARREST = Perform CPR UNCONTROLLED BLEEDING = Direct pressure, bandage, elevate, & treat for shock SEVERE SHORTNESS OF BREATH = Administer high-flow oxygen GOAL #3—-OBTAIN THE FOLLOWING: Vital Signs = Blood Pressure, Pulse (rate/quality), Respiratory Rate, Lung Sounds, Blood Glucose, etc. OPQRST/SAMPLE History of current illness (see right column) GOAL #4—-DOCUMENT PATIENT’S DEMOGRAPHIC INFORMATION: Write down patient’s name, date of birth, social security number, phone number, etc. This information will be very helpful for the incoming ambulance crew. FOR THE OFFICER SAMPLE Make sure that your crew knows your expectations and their roles PRIOR to the alarm. -
Blockage of Neddylation Modification Stimulates Tumor Sphere Formation
Blockage of neddylation modification stimulates tumor PNAS PLUS sphere formation in vitro and stem cell differentiation and wound healing in vivo Xiaochen Zhoua,b,1, Mingjia Tanb,1, Mukesh K. Nyatib, Yongchao Zhaoc,d, Gongxian Wanga,2, and Yi Sunb,c,e,2 aDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China; bDivision of Radiation and Cancer Biology, Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109; cInstitute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310029, China; dKey Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; and eCollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou 310058, China Edited by Vishva M. Dixit, Genentech, San Francisco, CA, and approved March 10, 2016 (received for review November 13, 2015) MLN4924, also known as pevonedistat, is the first-in-class inhibitor acting alone or in combination with current chemotherapy of NEDD8-activating enzyme, which blocks the entire neddylation and/or radiation (6, 11). One of the seven clinical trials of MLN4924 modification of proteins. Previous preclinical studies and current (NCT00911066) was published recently, concluding a modest effect clinical trials have been exclusively focused on its anticancer property. of MLN4924 against acute myeloid leukemia (AML) (12). Unexpectedly, we show here, to our knowledge for the first time, To further elucidate the role of blocking neddylation in cancer that MLN4924, when applied at nanomolar concentrations, signif- treatment, we thought to study the effect of MLN4924 on cancer icantly stimulates in vitro tumor sphere formation and in vivo stem cells (CSCs) or tumor-initiating cells (TICs), a small group tumorigenesis and differentiation of human cancer cells and mouse of tumor cells with stem cell properties that have been claimed to embryonic stem cells. -
Medicare 2019 Part C & D Star Ratings Cut Point Trends
Trends in Part C & D Star Rating Measure Cut Points Updated – 12/19/2018 (Last Updated 12/19/2018) Page 1 Document Change Log Previous Revision Version Description of Change Date - Final release of the 2019 Star Ratings Cut Point Trend document 12/19/2018 (Last Updated 12/19/2018) Page i Table of Contents DOCUMENT CHANGE LOG .............................................................................................................................. I TABLE OF CONTENTS .................................................................................................................................... II INTRODUCTION ............................................................................................................................................... 1 PART C MEASURES ........................................................................................................................................ 2 Measure: C01 - Breast Cancer Screening ........................................................................................................................ 2 Measure: C02 - Colorectal Cancer Screening .................................................................................................................. 3 Measure: C03 - Annual Flu Vaccine .................................................................................................................................. 4 Measure: C04 - Improving or Maintaining Physical Health ........................................................................................... -
Thermo-Responsive Poly(N-Isopropylacrylamide)- Cellulose Nanocrystals Hybrid Hydrogels for Wound Dressing
Article Thermo-Responsive Poly(N-Isopropylacrylamide)- Cellulose Nanocrystals Hybrid Hydrogels for Wound Dressing Katarzyna Zubik 1, Pratyawadee Singhsa 1,2, Yinan Wang 1, Hathaikarn Manuspiya 2 and Ravin Narain 1,* 1 Department of Chemical and Materials Engineering, Donadeo Innovation Centre in Engineering, 116 Street and 85 Avenue, Edmonton, AB T6G 2G6, Canada; [email protected] (K.Z.); [email protected] (P.S.); [email protected] (Y.W.) 2 The Petroleum and Petrochemical College, Center of Excellence on Petrochemical and Materials Technology, Chulalongkorn University, Soi Chulalongkorn 12, Pathumwan, Bangkok 10330, Thailand; [email protected] * Correspondence: [email protected]; Tel.: +1-780-492-1736 Academic Editor: Shiyong Liu Received: 29 January 2017; Accepted: 21 March 2017; Published: 24 March 2017 Abstract: Thermo-responsive hydrogels containing poly(N-isopropylacrylamide) (PNIPAAm), reinforced both with covalent and non-covalent interactions with cellulose nanocrystals (CNC), were synthesized via free-radical polymerization in the absence of any additional cross-linkers. The properties of PNIPAAm-CNC hybrid hydrogels were dependent on the amounts of incorporated CNC. The thermal stability of the hydrogels decreased with increasing CNC content. The rheological measurement indicated that the elastic and viscous moduli of hydrogels increased with the higher amounts of CNC addition, representing stronger mechanical properties of the hydrogels. Moreover, the hydrogel injection also supported the hypothesis that CNC reinforced the hydrogels; the increased CNC content exhibited higher structural integrity upon injection. The PNIPAAm- CNC hybrid hydrogels exhibited clear thermo-responsive behavior; the volume phase transition temperature (VPTT) was in the range of 36 to 39 °C, which is close to normal human body temperature. -
High-Dose Chemotherapy Less Frequent Catheter Dressing Changes
Bone Marrow Transplantation (2002) 29, 653–658 2002 Nature Publishing Group All rights reserved 0268–3369/02 $25.00 www.nature.com/bmt High-dose chemotherapy Less frequent catheter dressing changes decrease local cutaneous toxicity of high-dose chemotherapy in children, without increasing the rate of catheter-related infections: results of a randomised trial E Benhamou1, E Fessard2, C Com-Nougue´1,3, PS Beaussier2, G Nitenberg4, C Tancre`de5, S Dodeman2 and O Hartmann2 1Department of Biostatistics and Epidemiology, Institut Gustave Roussy, Villejuif, France; 2Department of Pediatrics, Institut Gustave Roussy, Villejuif, France; 3Pierre et Marie Curie University, Paris, France; 4Intensive Care Unit, Institut Gustave Roussy, Villejuif, France; and 5Department of Microbiology, Institut Gustave Roussy, Villejuif, France Summary: In our hospital, patients treated with high-dose chemo/radiotherapy (HDC) regimens followed by bone Cutaneous lesions caused by catheter dressing changes marrow transplantation (BMT) are fitted with a central can be serious and generate local pain in children venous catheter which is usually inserted a few days before undergoing high-dose chemotherapy followed by bone hospitalisation in the transplantation unit. Usually, central marrow transplantation. One hundred and thirteen venous catheter dressings are changed, empirically, every children entered a randomised trial to compare two 3 or 4 days,1,2 whatever the state of the dressing and mostly catheter dressing change frequencies (15 days vs 4 days). because less frequent changes are suspected of promoting Skin toxicity was classified according to the following local infections likely to give rise to bacteraemia in granul- scale: grade 0: healthy skin, to grade 4: severe skin tox- ocytopenic patients. -
2012 2013 First Aid Contest Rules
2016 FIRST AID CONTEST RULES INDEX Section II Title Page Rules Governing the 2016 First Aid Contest ........................................................................ 1 Scorecard A Discounts ............................................................................................................ 8 Interpretations of Scorecard B (Artificial Ventilation/Cardiopulmonary Resuscitation). ........................................................................................................................ 12 Skill Sheets Initial Assessment .................................................................................................................. 15 Patient Assessment ................................................................................................................ 16 Automated External Defibrillator ........................................................................................ 19 One-Person CPR (Manikin Only) ........................................................................................ 18 Two-Rescuer CPR (Manikin Only) ...................................................................................... 20 Mouth-to-Mask Resuscitation .............................................................................................. 24 Airway Obstruction ............................................................................................................... 25 Sucking Chest Wound .......................................................................................................... -
When Doing TRIAGE, You MUST Protect Yourself and Your Buddy
CERT Unit 3– DMO #1 Spring 2018 Assumptions Disaster Medical Operations ● Need for CERT members to learn disaster medical operations is based on two — Part 1 assumptions: ! Number of victims could exceed local capacity for treatment ! Survivors will assist others ‒ They will do whatever they know how to do CERT Basic Training ‒ They need to know lifesaving first aid or post- Unit 3 disaster survival techniques Spring 2018 90% of disaster victims are rescued by other victims! Importance of Quick Action Unit Objectives – Learn how to: ● Phase 1: Death within minutes, result of ● Identify “killers” severe trauma ● Conduct TRIAGE under ● Phase 2: Death within several hours, simulated disaster result of excessive bleeding conditions ● Phase 3: Death in several days or weeks, ● Open airway, control result of infection bleeding, and treat for shock Rescuer Safety During Triage TRIAGE AND PPE’s ● If hazmat or terrorist event is suspected, CERT members DO NOT respond When doing TRIAGE, ! Evacuate as safely as possible ● ALWAYS wear PPE: you MUST protect ! Helmet ! Goggles yourself ! N95 mask ! Work gloves and your buddy ! Sturdy shoes or boots ! Non-latex exam gloves must do the same 1 CERT Unit 3– DMO #1 Spring 2018 Personal Protective Equipment - PPE Personal Protective Equipment - PPE ● Personal protective equipment, commonly ● How to put on and take off Non-Latex referred to as "PPE", is equipment worn to Gloves minimize exposure to serious workplace ● Practice! injuries and illnesses. ● New gloves for every victim ● Wash or sanitize hands Goggles Masks after de-gloving Gloves Personal Protective Equipment - PPE IF IT’S WET AND NOT YOURS DON’T TOUCH IT! Three “Killers” - ABS CERT Sizeup ● Emergency medicine “killers” 1. -
Local Anesthetics in Cosmetic Dermatology
COSMETIC DERMATOLOGY Local Anesthetics in Cosmetic Dermatology Peter W. Hashim, MD, MHS; John K. Nia, MD; Mark Taliercio, BS; Gary Goldenberg, MD PRACTICE POINTS • The proper delivery of local anesthesia is integral to successful cosmetic interventions. • Regional nerve blocks can provide effective analgesia while reducing the number of injections and preserving the architecture of the cosmetic field. copy Local anesthetics play an important role in cos- LOCAL ANESTHETICS metic dermatology. Techniques using topical and The sensation of pain is carried to the central ner- regional anesthesia provide numerous pain man- vousnot system by unmyelinated C nerve fibers. Local agement options for laser and injection treatments. anesthetics (LAs) act by blocking fast voltage-gated In this article, we review strategies to maximize sodium channels in the cell membrane of the nerve, patient comfort during cosmetic interventions. thereby inhibiting downstream propagation of an Cutis. 2017;99:393-397.Doaction potential and the transmission of painful stimuli.1 The chemical structure of LAs is funda- mental to their mechanism of action and metabo- ocal anesthesia is a central component of suc- lism. Local anesthetics contain a lipophilic aromatic cessful interventions in cosmetic dermatol- group, an intermediate chain, and a hydrophilic Logy. The number of anesthetic medications amine group. Broadly, agents are classified as amides and administration techniques has grown in recent or esters depending on the chemical group attached years as outpatient cosmetic procedures continue to the intermediate chain.2 Amides (eg, lidocaine, to expand. Pain is a commonCUTIS barrier to cosmetic bupivacaine, articaine, mepivacaine, prilocaine, procedures, and alleviating the fear of painful inter- levobupivacaine) are metabolized by the hepatic sys- ventions is critical to patient satisfaction and future tem; esters (eg, procaine, proparacaine, benzocaine, visits. -
EMA/CVMP/508559/2019 Committee for Medicinal Products for Veterinary Use
28 August 2020 EMA/CVMP/508559/2019 Committee for Medicinal Products for Veterinary Use Advice on implementing measures under Article 106 (6) of Regulation (EU) 2019/6 on veterinary medicinal products – scientific problem analysis and recommendations to ensure a safe and efficient administration of oral veterinary medicinal products via routes other than medicated feed Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2020. Reproduction is authorised provided the source is acknowledged. Introduction On 1 July 2019 the European Commission requested the European Medicines Agency to provide a scientific problem analysis and recommendations to ensure the safe and efficient oral administration of veterinary medicinal products via routes other than medicated feed, by taking into account: - the effective and safe use of veterinary medicinal products authorised and prescribed for oral administration via routes other than medicated feed, such as mixing of water for drinking with a veterinary medicinal product, mixing of a veterinary medicinal product into the ordinary feed by the farmer or by use of top-dressing of the feed offered to the animal in a feeding device with a veterinary medicinal product (solid or as an emulsion); this issue should address the borderline between medication with medicated feed -
Emergency Drill Triage Kit Instruction Guide
Emergency Drill Triage Kit Instruction Guide During major emergencies schools must be prepared to be self-reliant This kit does not require because it is universally understood that local first responders will advanced training or be overwhelmed. Schools will need to be ready to rescue and treat equipment. The skills injured victims using only the skills and training of the school staff. This that this kit will review Emergency Drill Triage Kit was created in collaboration with the Pediatric are the same skills Disaster Resource and Training Center at Childrens Hospital Los Angeles. taught in Basic First Aid It is intended to support school personnel as they practice identifying, and CPR classes. reporting, transporting and treating injured victims. This kit is designed to help school personnel review their Basic First Aid training and practice those skills. m num ti b ic e v r Objects fell onto patient. 9 VISUAL CUES A key component of this kit is the 40 mock victim tags. These victim Cut on Non-bleeding scalp laceration; head and right foot swollen tags were created based on historical data of earthquake-related VICTIM INFORMATION and tender. rightEmergency Triage Drillfoot injuries. Experts from Childrens Hospital Los Angeles and Los Angeles pain. City Fire reviewed the mock victim scenarios and outlined first aid and medical responses. These victim tags represent the kinds of Mock Victim Tags injuries sustained by school aged children during an earthquake and 40 cards in clip pouches they are designed to review the First Aid procedures that could be Victim Checklist used during any traumatic emergency. -
View/Download
Backcountry First Aid: Prevention,Triage and Treatment Peter Heidmann DVM MPH Specialist: Equine Internal Medicine Montana Equine Equine Medicine and Surgery Board-certified Experts 406-388-8323 Dedicated to the highest quality care of horses Preparation = Prevention • Paperwork – Health Certificate, Coggins – Contact Information – Maps • Know your country • Tack – Well-fitted, well-suited • Fitness – Fatigue promotes injury – Lameness and myopathy – Colic and lacerations Triage: Lameness • Heat? Swelling? • Flexion Tests – Arthritis – Ligament Sprain • (Connects bone to bone) – Tendon Strain • (Connects muscle to bone) • 85% of lameness originates at/below fetlock – Digital Pulses • Stone Bruises • Sole Abscess • Fractured Coffin Bone (P3) Treatment: Lameness • Thermal Therapy – Ice Early -- Heat Late • Anti-inflammatory Medications – Phenylbutazone – Surpass • Limb Wraps – Minimize Swelling – Supports Soft Tissues – Extensive Padding is CRITICAL • Other Salves? Poultices? Sweats? Triage: Wounds • Location location location • Which wound is more serious? Triage: Wounds • Infection Control – Each round removes contamination: • Dirty water is better than mud • Clean water is better than dirty water • Sterile water is better than clean water – A clean wound is considered infected after 6 hours • 2 - 4 - 16 - 256 - 65,536 - 4,294,967,296!! – Antiseptic Solutions – Vaccinations – Antibiotics • Oral, Injectable, Topical • Ask your veterinarian… Triage: Eye Trauma • Use caution with “hi-line” • Eyelid Trauma • Corneal Trauma – Signs: • Squinting • Severe Tearing • Head-shyness Treatment: - Clean any wounds w/ Saline - Opthalmic Antibiotics - NO STEROID OINTMENTS! Triage: Hemorrhage Blood Loss: How Much is TOO Much?? Blood Volume is 8 - 10 % of Body Weight Eg 1000# horse = 450 Kg = 36-45 L Total Total loss of 1/10 is typically well-tolerated = 3.6 - 4.5 Liters = More than 1GALLON! Triage: Hemorrhage Treatment • Most Wounds stop bleeding spontaneously • Arterial vs.