Impact of Shock on the Body

Impact of Shock on the Body Steve Powell It is important to understand by what is meant by shock. Shock in a physiological is a life threatening condition, and must be taken lightly. Shock as a definition is: â€Å"failure of the circulatory system to maintain adequate perfusion of vital organs†. (1) Mitch Taylor. (2010). Multi-Organ Dysfunction Syndrome Available: http://acls4u.homestead.com/MultOrganDysfunctionSyndromeVoiceOver.pdf. Last accessed 01/06/2014 Shock comes used to be classified as separate types: Cardiogenic Hypovolaemic Anaphylactic Neurogenic Toxic Recently this has been condensed in three types: Cardiogenic Hypovolaemic Distributive The definitions of these types of shock are: Cardiogenic –pump failure resulting in the blood cannot get to where it’s supposed to go i.e. the tissues, hence a low cardiac output. Hypovolaemic –a low volume of blood in the body as a result of major trauma or massive haemorrhage Distributive (Vasogenic) –this type of shock relates to changes in the body’s blood vessels, vascular changes, as a result of Anaphylactic, Neurogenic or toxic insult on the body.(2) Mitch Taylor. (2010). Multi-Organ Dysfunction Syndrome Available: http://acls4u.homestead.com/MultOrganDysfunctionSyndromeVoiceOver.pdf. Last accessed 01/06/2014 In Cardiogenic shock we have ascertained that it is down to pump failure and the bodies in ability to circulate adequate blood around the body to meet its metabolic needs. We have seen that it can be caused by a low cardiac output that is caused by, massive haemorrhage trough trauma or pathophysiological reason (dissected aortic aneurysm). It can also be caused by: a myocardial infarction (heart attack), dysrhythmias, and heart failure. A second cause is obstruction to the pump flow, that is to say conditions such as: valve dysfunction, pulmonary embolism, and tamponade (pericardial effusion that effects the normal action of the heart in pumping). Question 1 cont†¦. Hypovolaemic shock as the name suggests is â€Å"low volume†, causes range from massive haemorrhage through trauma or pathophysiological reasons (triple A). Burns victims are at particular risk as it affects these types of patients at a cellular level, the loss of fluid out of vascular spaces. Technically shock in burns victims a combination of distributive and hypovolaemic shock. In as much as it is seen as volume depletion within the intravascular system, lowered pulmonary artery pressure and an elevated systemic resistance, resulting in a low cardiac output. The low cardiac output is a direct result of an increased after load, a reduced contractility, and a lowered level of plasma volume. (3) Barbara A. Latenser, MD, FACS. (2009). Critical care of the burn patient: The first 48 hours Society of critical and medicine. 37 (10), p2819-p2826 Multiple organ dysfunction syndrome or MODS as it’s also known is a condition where two or more of the body’s systems have failed. MODS can be described as a â€Å"systemic activation of an adaptive host stress response to a catastrophic event†. (4) Sat Sharma and Gregg Eschun (2008) Hypotension and multiple organ dysfunction syndrome Journal of Organ Dysfunction 4 (1), p130-p144 Once a state of prolonged shock has been induced an over the top bodily response takes place. This is known as a â€Å"systemic inflammatory response†. Once this stage has started, the body releases inflammatory mediators that are intrinsic to the pathogenesis of SIRS (systemic inflammatory response syndrome. Where sepsis is not a key trigger, hypotension through hypovolaemic will contribute to the onset of SIRS and eventually MODS. The combination of these three conditions, Sepsis, SIRS, and MODS, combine conditions that have a massive impact on haemodynamic abnormalities, coagulation problems, and systemic issues.(5) Sat Sharma and Gregg Eschun (2008) Hypotension and multiple organ dysfunction syndrome Journal of Organ Dysfunction 4 (1), p130-p144 Any insult to the body and normal function (haemostasis) will initiate a cycle of metabolic chaos that includes an increase for oxygen versus an inadequate supply at a molecular level. Question 1 cont Inadequate blood supply to the tissues and cells in hypovolaemic shock and associated hypotension is the key to MODS in this instance. (6) Mitch Taylor. (2010). Multi-Organ Dysfunction Syndrome Available: http://acls4u.homestead.com/MultOrganDysfunctionSyndromeVoiceOver.pdf. Last accessed 01/06/2014 What we can say about the timeline for MODS is: The event that starts the cascade off, infection, hypoxia, trauma, in our case hypovolaemic shock via traumatic infarct trauma. Increase in levels of cytokines (immune system signalling cells). Leads to a release of ELAM and ICAM that induce leukocyte adhesion. This in turn triggers a multiple release of chemicals and compounds resulting in endothelial damage Resulting oedema eventually leading to organ dysfunction. Word count 611 References Mitch Taylor. (2010). Multi-Organ Dysfunction Syndrome Available: http://acls4u.homestead.com/MultOrganDysfunctionSyndromeVoiceOver.pdf. Last accessed 01/06/2014 Mitch Taylor. (2010). Multi-Organ Dysfunction Syndrome Available: http://acls4u.homestead.com/MultOrganDysfunctionSyndromeVoiceOver.pdf. Last accessed 01/06/2014 Barbara A. Latenser, MD, FACS. (2009). Critical care of the burn patient: The first 48 hours Society of critical and medicine. 37 (10), p2819-p2826 Sat Sharma and Gregg Eschun (2008) Hypotension and multiple organ dysfunction syndrome Journal of Organ Dysfunction 4 (1), p130-p144 Sat Sharma and Gregg Eschun (2008) Hypotension and multiple organ dysfunction syndrome Journal of Organ Dysfunction 4 (1), p130-p144 Mitch Taylor. (2010). Multi-Organ Dysfunction Syndrome Available: http://acls4u.homestead.com/MultOrganDysfunctionSyndromeVoiceOver.pdf. Last accessed 01/06/2014 Reflection As far as a reflective piece of work goes, I find myself having to reflect on skills that I learnt 10 years ago and have been employing on a regular basis. Although reflection should take place on a regular basis, it is never too late to reflect on things. Even though the skills were learnt 10 years ago there is 10 years scope to develop bad habits if not identified and rectified. The four skills in question inspection, auscultation, percussion, and palpation form part of the primary and secondary surveys for healthcare professionals worldwide. The initial primary survey should take seconds. I can remember when I first started doing patient inspections/assessments, it would be very text book orientated, not a bad thing you would have thought. However when you’ve exhausted all the text book questions you suddenly come to stand still and there is a period of silence then between yourself and the patient and sometimes the relatives. What I started to do, on the advice of a colleague, was, as i approached the patient I would assess their â€Å"colour posture and behaviour†. These three things would give me an idea of the state of the patient. If the patient answered the door and looked well and was ambulatory (as happens) then I would be off to a fairly good start. The patient had spoken to me (airway was clear); they looked well perfused and were mobile, no obvious life threatening conditions. If for instance the patient answered the door and was pale, sweaty, breathless and complained of chest pain then that would put a completely different slant on the primary survey. The patient would then have to be sat down immediately and further cardiac assessment undertaken. So by employing this little method (colour, posture, and behaviour) I was able, at a glance to do a quick assessment of the patient. Other aspects, such as scene safety etc†¦. soon became second nature as was the ability to do rapid risk assessments at the scene’s of RTC’s and other scene’s where there may be hazardous. There is a lot to take into consideration when carrying out an assessment, it is however a rolling concept where you question as you asses or treat. For non life threatening conditions then there no need to rush and miss your history taking, if you stick to the AMPLE model of: Allergies Medicine Past medical history Last meal/oral intake Events that lead to calling 999. These questions are limited and can take 1-2 minutes to ask and be answered. This is where you can expand on the history take and delve further in to the patient’s medical, social, familial history. When I first qualified I was encouraged by work colleagues to use all my extended skills. The auscultation side of the assessment was a little difficult at first because I just didn’t know what I was listening for; it wasn’t long before we started getting quite a few patients with respiratory problems. This enabled me to match the condition with what I was listening to. I remember also listening to chest sounds on the internet, a useful exercise, but not like the real thing. One thing that stick s out, and is still relevant o this day, is that its well and good listening to chest sounds on the computer and in the back of a relatively quiet ambulance, that it is at the side of a road with traffic rushing by and the sound of the fire services generators going at full tilt. Auscultation is a tool that I use frequently in my patient assessment. The percussion side of my assessment, I have to be honest and say that I do it for respiratory cases and trauma cases, but not for every patient that I see. It’s probably an area where i could do with more practise if I’m being hypercritical. Would I know a hyper/hypo-resonant chest? I believe so, however if I were to do a SWOT analysis then this would probably be in my weak box. Palpation I tend to use a lot more, whether it is because I get far more abdominal calls than critical chest’s I don’t know. The fact remains that I use palpation far more than percussion. Palpation is an extremely useful tool in the ballpark when it comes to abdominal complaints. However what I have learnt about abdominal related problems over the years, is that, as well as not being in my scope of practise to diagnose and discharge (without referring to a gp first), more analytical tools are needed. Tools such a doctor, ultrasound and bloods to name (various other scans can be utilised at DGH). Looking back or reflecting over the past 10 years, I feel i took on board the training that I received both EMT and Paramedic, and have built on them to a point where I more than comfortable treating an 80 year old gentleman in his living room with chronic emphysema to a road traffic collision where it’s quite a challenging environment. I have however identified a possible weakness in my practise that I will be address at the soonest opportunity.

Positive And Negative Effects Of Gaming

Video games are frowned upon by parents as time-wasters, and worse, some education experts think that these games corrupt the brain. Violent video games are easily blamed by the media and some experts as the reason why some young people become violent or commit extreme anti-social behavior. But many scientists and psychologists find that video games can actually have many benefits – the main one is making kids smart. Video games may actually teach kids high-level thinking skills that they will need in the future.Positive Effects of Video Games:†¢When you play video games, it gives the brain a real workout. In many video games, the skills required to win involve abstract and high level thinking. These skills are not even taught at school. Some of the mental skills enhanced by video games include: o Following instructionso Problem solving and logic o Hand-eye coordination, fine motor and spatial skills. o Planning, resource management and logistics. o Multitasking o Quick t hinking, making fast analysis and decisions. o Accuracyo Pattern recognition o Estimating skillso Memory . o Concentration o Improved ability to rapidly and accurately recognize visual information o Teamwork and cooperation when played with others o Management†¢Video games increase your self-confidence and self-esteem as you master the games. In many games, the levels of difficulty are adjustable.As a beginner, you begin at the easy level and by constant practicing and slowly  building skills, you become confident in handling more difficult challenges. Since the cost of failure is lower, you don’t fear making mistakes. You take more risks and explore more. You can transfer this attitude to the real life.Negative Effects of Video Games:†¢Most of the bad effects of video games are blamed on the violence they contain. Children who play more violent video games are more likely to have increased aggressive thoughts, feelings, and behaviors, and decreased prosocial help ing, according to a scientific study (Anderson & Bushman, 2001). The effect of video game violence in kids is worsened by the games’ interactive nature. In many games, kids are rewarded for being more violent. The act of violence is done repeatedly. The child is in control of the violence and experiences the violence in his own eyes (killings, kicking, stabbing and shooting).This active participation, repetition and reward are effective tools for learning behavior. Indeed, many studies seem to indicate that violent video games may be related to aggressive behavior (such as Anderson & Dill, 2000; Gentile, Lynch & Walsh, 2004). However, the evidence is not consistent and this issue is far from settled. Many experts including Henry Jenkins of Massachusetts Institute of Technology have noted that there is a decreased rate of juvenile crime whch coincides with the popularity of games such as Death Race, Mortal Kombat, Doom and Grand Theft auto.He concludes that teenage players are able to leave the emotional effects of the game behind when the game is over. Indeed there are cases of teenagers who commit violent crimes who also spend great amount of time playing video games such as those involved in the Columbine and Newport cases. It appears that there will always be violent people, and it just so happen that many of them also enjoy playing violent video games. †¢Too much video game playing makes your kid socially isolated. Also, he may spend less time in other activities such as doing homework, reading, sports, and interacting with the family and friends.†¢Some video games teach kids the wrong values. Violent behavior, vengeance and aggression are rewarded. Negotiating and other nonviolent solutions are often not options. Women are often portrayed as weaker characters that are helpless or  sexually provocative.†¢Games can confuse reality and fantasy.†¢Academic achievement may be negatively related to over-all time spent playing video g ames. Studies have shown that the more time a kid spends playing video games, the poorer is his performance in school. (Anderson & Dill, 2000; Gentile, Lynch & Walsh, 2004). A study by Argosy University's Minnesota School on Professional Psychology found that video game addicts argue a lot with their teachers, fight a lot with their friends, and score lower grades than others who play video games less often. Other studies show that many game players routinely skip their homework to play games, and many students admitted that their video game habits are often responsible for poor school grades.†¢Although some studies suggest that playing video games enhances a child’s concentration, other studies, such as a 2012 paper published in Psychology of Popular Media Culture, have found that games can hurt and help children's attention issues — improving the ability to concentrate in short bursts but damaging long-term concentration. †¢Video games may also have bad eff ects on some children’s health, including obesity, video-induced seizures. and postural, muscular and skeletal disorders, such as tendonitis, nerve compression, carpal tunnel syndrome. †¢When playing online, your kid can pick up bad language and behavior from other people, and may make your kid vulnerable to online dangers.†¢A study by the Minneapolis-based National Institute for Media and the Family suggests that video games can be addictive for kids, and that the kids' addiction to video games increases their depression and anxiety levels. Addicted kids also exhibit social phobias. Not surprisingly, kids addicted to video games see their school performance suffer. †¢Kids spending too much time playing video games may exhibit impulsive behavior and have attention problems. This is according to a new study published in the February 2012 issue of the Journal of Psychology and Popular Media Culture. For the study, attention problems were defined as difficulty eng aging in or sustaining behavior to reach a goal.

Barack Obama s A More Perfect Union - 1460 Words

Harsh Kumar Mr. Dowlen 3rd period Barack Obama’s â€Å"A More Perfect Union† Biweekly Journal Summary: President Obama’s, â€Å"A More Perfect Union†, speech conveyed many of his beliefs concerning racism. Obama is the son of a white woman and a Kenyan man, and just because of his race people are either with or against him. He begins his speech by talking about the founding fathers and the Declaration of Independence by saying that ‘all men are created equal’. His former pastor, Reverend Jeremiah Wright brought up some of his observations about racism which caused some unease. He continues his speech by saying that the solution to ending this unease of racism is to come together and forgive each other for all the wrongs they have done in the past. He ends his speech by saying that both races need to become united in order for a more perfect union. Barack Obama buttresses his argument about slavery and unification by using ethos, pathos, allusion, as well as repetition. Vocabulary: †¢ Hue- color or shade †¢ Unequivocal – leaving no doubt; unambiguous. †¢ stalwart – loyal, reliable, and hardworking †¢ emanating- originate from; be produced by †¢ Perverse- showing a deliberate and obstinate desire to behave in a way that is unreasonable or unacceptable, often in spite of theShow MoreRelatedBarack Obama s A More Perfect Union 999 Words   |  4 Pagesâ€Å"We the people, in order to form a more perfect union.† Barack Obama begins his moving speech with this message, trusting that new and renewed ethnic views will form in our nation’s voters. In March of 2008, Barack Obama was in the depths of his campaign to become President of the United States. The preaching given at that time, called â€Å"A More Perfect Union† revealed his thoughts about racism and equality in America. Throughout the time since that speech, many voters and politicians have given theirRead MoreBarack Obama s A More Perfect Union1580 Words   |  7 Pagesdoors can be opened. Not only can that result in the idea of change but actually show evidence of it. But this act cannot be done alone. It requires more than one to stand to gether to complete this challenge. With voices heard and actions done, Senator Barack Obama believes that this can be accomplished while giving his speech â€Å"A More Perfect Union†. Obama argues that the problems we have today are from the past. He states they still remain because we allow them to control us and the world we live. InRead MoreLetter From A Birmingham Jail And Barack Obama s A More Perfect Union1304 Words   |  6 PagesIn Martin Luther King Jr. s Letter from a Birmingham Jail and Barack Obama s A More Perfect Union, both leaders discussed many of the same issues. 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Snippets of the reverend s speech sparked controversy in 2008 due to the fact that President Obama was still running for the democratic nominee for the Presidential Election. Doubts about Obama began to form due to his association with Wright. Can the country trust a man who associates with a person that hate the country? As a response to the reverend s statement, Obama gave his speech A More Perfect Union to addressRead MoreRhetorical Analysis of Obama Speech Essay2690 Words   |  11 PagesLiteratures and Foreign Languages Let Us Learn and Resource Together 23 November 2008 Rhetorical Analysis of â€Å"A More Perfect Union† Speech The speech titled â€Å"A More Perfect Union† was delivered by Senator Barack Obama on March 18, 2008 near the historical site of the signing of the U.S. Constitution in Philadelphia, Pennsylvania. The speech responds to the video clip of Barack Obama’s pastor, Reverend Jeremiah Wright, making racially charged comments against America and Israel. 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Should College Sports Be Paid - 1680 Words

Capitalism, a system dealing with both political and economical aspects in which a country’s trade and industry are controlled by an individual for profit, rather than by the state. One of the largest â€Å"money-making† industries in the nation is known as the National Collegiate Athletic Association (â€Å"NCAA†) (Gregory). College sports have become more popular than ever before, especially with the help of television and modern technology. Making over $700 million a year, this industry has been introduced numerous times over the years to the debate of prohibiting payments to athletes other than athletic scholarships (Goldman). Currently, in order to meet the demand of sports, especially at a Division I University, high school athletes are recruited, and make a decision to play for their team of choice, while giving the schools national exposure. However, many consumers are wondering if athletes in college sports are being properly compensated for the money they bring into the university, for the show they put on for the general public (Johnson). In 2013, the SEC signed a contract with CBS and ESPN for the rights to broadcast all football games with a payment of $3.1 billion. Each school in the conference receives an annual stipend of $20.9 million, which is said to go directly to each school’s football program (Johnson). According to Lee Goldman, graduate of Stanford University School of Law and one of many author’s of Notre Dame Law Review, the money is dispersed throughoutShow MoreRelatedShould College Sports Be Paid?1732 Words   |  7 Pagesplayers were paid, you wouldn’t see players like Michael Jordan, Hakeem Olajuwon, or Ralph Sampson on different teams. It would be the college with the most money, could pay the best student-athletes, the most money and Cinderella stories for the most part would disappear. Dynasties of college sports would be made. Money would ruin college sports more than it already has. It has already stripped championships, ruined players images and futures, and tarnished reputations of colleges. The Fab 5Read MoreShould College Sports Be Paid?2868 Words   |  12 PagesDivision I college athletics have come a very long way since its original erection in the late 1800s as only something that occurred at the Ivy Leagues. Today, there is now a side which advocates for paid compensations for college athletes (this is mostly focused in football and basketball). According to the NCAA s current policy on intercollegiate compensation the athlete first must be considered an amateur. This rule that is in place is extremely redundant because in order for a student toRead More Should College Athletes be Paid? Essay1510 Words   |  7 Pagescontroversies with sports is, should student athletes be be paid a salary? Some people believe that they should be paid and others would completely disagree. Even though they technically are being paid, they really are not. The only type of way the athletes would be paid is through financial aid or if they have a job. Only their education is being paid by the school. Although some people believe that they should be paid, it would not be a good idea at all. So college athletes should not be paid at all becauseRead MoreThe National Collegiate Athletic Association1227 Words   |  5 Pagesthat college athletics is a $10-billion marketplace† (Suggs). With huge sums of revenue generated from college sports teams, players for the successful teams appear to be very marketable. â€Å"The National Collegiate Athletic Association, the largest collegiate sports organization in the United States, oversees much of the business of American college sports. For 2011-12, the NCAA reported $871.6 million in revenue-- 81 percent of which came from a broadcast rights agreement with Turner/CBS Sports. AnotherRead MoreShould College Athletes Get Paid?1742 Words   |  7 PagesShould College Athletes Get Paid? Should college athletes be paid? This has been a controversial topic ever since college sports started. Many people argue that they should. Many people argue that they should not. College athletes should get paid because they work extremely hard playing their sport. The people that say they should be paid argue that the amount of time athletes dedicate is equivalent to a full-time job, and maybe even more. The people that say they should not get paid argue that collegeRead MoreWhy College Athletes Should Not Be Paid1301 Words   |  6 PagesNovember 2015 Why College Athletes Should Not Be Paid What amount of money should college athletes be paid? This has been a controversial question for many years.Some lower level Division One NCAA athletes think that their scholarships do not pay them enough as it is, and instead they want cash rather than the scholarship. These situations have been taken to court and arbitrated in NCAA hearings. The NCAA, or the National College Athletics Association, has declined for the athletes to be paid a salary everyRead MoreNCAA aAhletes and Pay 1142 Words   |  5 PagesShould college student-athletes be paid has become a much debated topic. The incentive for a student-athlete to play a college sport should not be for money, but for the love of the game. It has been argued that colleges are making money and therefore the student-athlete should be compensated. When contemplating college income from sporting events and memorabilia from popular sports, such as football and basketball, it must not be forgotten that colleges do incur tremendous ex pense for all theirRead MoreShould College Athletes Be Paid?1713 Words   |  7 PagesCollege sports are one of the largest and fastest growing markets in today’s culture. With some college sports games attracting more viewers than their professional counterparts, the NCAA is one of the most profiting organizations in America. Recently there has been controversy in the world of college sports as to whether the college athletes that are making their universities and the NCAA money should receive payment while they are playing their respective sport. Many believe that these athletesRead MoreShould College Athletes Be Paid?1364 Words   |  6 PagesHave you paid attention to all of the news that has been surfacing about collegiate sports lately? It is a big topic now days in the world of sports on weather college athletes should be getting paid to play sports. College athletics have gained great popularity of the past few decades, and have brought schools lots of revenue. A lo t of college athletes think they should be getting paid for their services they do for their school. College sports like basketball and football generate over six billionRead MoreStudent Athletes Being Paid or Not700 Words   |  3 PagesStudent Athletes Being Paid or Not College athletics today are enormous compared to the size that it was many years ago, especially in the region that I live in which is SEC country, should student athletes that have contributed to this growth be compensated for their contributions or not. With many big television deals and high ticket pricing this has been a topic that has become a constant in the minds of many. This topic is beginning to gather legs and making a move to the forefront of the NCAA