...Management of Malignant Hyperthermia in the Operating Room September 21, 2013 Perioperative staff, which includes pre-operative nurses, surgeons, anesthesia providers, operating room staff, and recovery room nurses should know what malignant hyperthermia (MH) is and how to handle it when it arises. “Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stresses such as vigorous exercise and heat” (Rosenberg, Davis, & James, 2007). Almost all patients that are MH susceptible have no characteristics of these changes without anesthesia. It is nearly impossible to diagnose susceptibility without either the exposure to the "trigger" anesthetics or by specific diagnostic testing, such as a muscle biopsy. Examples of key diagnostic features of MH include an unexplained elevation of expired carbon dioxide, muscle rigidity and rhabdomyolysis, hyperthermia, acidosis and hyperkalemia. If the patient is aware of a familial history of MH, and they inform the perioperative staff, they can be better prepared in the event that a crisis does occur. These changes can occur suddenly upon induction of anesthesia or during the surgical procedure, so the staff must be aware of what is happening...
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...Malignant Hyperthermia Malignant Hyperthermia is primarily thought to be an autosomal dominant genetic disorder that causes a hypermetabolic state after administration of volatile anesthetics. When a patient is under anesthesia, the muscles are usually relaxed, but when a patient is experiencing Malignant Hyperthermia crisis, certain IV anesthesia causes the opposite effect. Most inhaled anesthetics other than nitrous oxide, cause or trigger Malignant Hyperthermia. More specifically, the anesthetic agents: Halothane, Chloroform, and Succinylcholine. The genic condition of Malignant Hyperthermia only becomes apparent when a patient is exposed to certain anesthetics such as halothane, which causes muscle rigidity. During the relaxed phase of muscle contraction, adenosine triphosphate and phosphate (ADP and Pi) are bound to the myosin S1 fragment, which is in a strained vertical position. Depolarization to the sarcoplasmic reticulum occurs followed by the depolarization of the triad region which initiates the release of calcium into the cytosol. This calcium then binds to troponin. A conformational change in the actin-tropomyosin interaction is induced by the troponin-calcium complex, which allows myosin to bind to actin. The binding allows the S1 to move to the unstrained position, causing muscle contraction. During this process, ADP and Pi are released. The muscle contraction results from the shortening of every sarcomere in every muscle fiber of the...
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...Management Of Malignant Hyperthermia, Perioperative Services 10929 Source: Clinical Surgery & Procedures I. PURPOSE: To provide guidelines of early recognition and warning signs for Malignant Hyperthermia (MH). Instructions for suggested standard treatment regimen per physician's orders. II. DEFINITIONS: Malignant Hyperthermia (MH) is a potentially lethal, severe hypermetabolic state triggered in genetically predisposed individuals when exposed to certain inhalation agents and depolarizing muscle relaxants. Early recognition of warning signs: A. B. C. D. E. F. G. H. I. J. K. L. M. N. O. P. Q. III. Increase in end-tidal carbon dioxide Muscle rigidity, including masseter spasm (the masseter muscle raises and lowers the jaw) Tachycardia or arrhythmias Fever; rapid rise in temp., sustained rise (to as high as 108 F, 42.2 C or more) Tachyphena (spontaneous hyperventilation) Unstable blood pressure Dark blood in surgical field despite adequate inspired oxygen Cyanotic mottling of skin Profuse sweating Discolored urine Central venous desaturation Central venous and arterial hypercarbia Metabolic acidosis Respiratory acidosis Hyperkalemia Myoglobinuria/Myoglobulinemia Elevated CPK (late) Applies to Facilities: Official (Rev: 7) Applies to Departments: STANDARDS OF PRACTICE: A. B. Performed by: IV. STEPS OF PROCEDURE: A. B. Equipment: Contents of the Malignant Hyperthermia Cart are monitored through the use of the break-away lock system. All locks have a serial number which...
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...A Report On Malignant Hyperthermia August 2014 A Report On Malignant Hyperthermia Imagine a “hidden disease” that is usually inherited with no clear signs of symptoms until it’s suddenly triggered by drugs, or the right environmental factor or stressor. Then, once triggered, this disease induces a drastic and uncontrolled increase in skeletal muscle oxidative metabolism which overwhelms the body’s capacity to supply oxygen, regulate body temperature, and remove carbon dioxide. When this occurs, you may observe muscle rigidity, rapid heartbeat, high body temperature, muscular breakdown, and an increase in acid content (MHAUS, 2014). If not treated in a quick manner, Malignant Hyperthermia will kill. What makes this disease into a horror story is the fact that it arises upon certain triggers that are either environmental or certain types of drugs administrated from the veterinarians orders. The most common triggering agents are anesthetic gases like sevoflurane, halothane, enflurane, desflurane, and isoflurane. Certain types of muscle relaxants that are commonly added to anesthetic gases have also been known to trigger the disease as well as catecholamines, phenothiazines, and monoamine oxidase inhibitors which inhibits the activity of the monoamine oxidase enzyme family and is usually used to treat depression. That’s right! People can get Malignant Hyperthermia as well as are little furry friends. It’s not all bad news though, Some local anesthetics have...
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...Malignant Hyperthermia Malignant hyperthermia is a rare genetic condition. It causes sudden, life-threatening problems such as a high fever and a rapid, irregular heart rate. The condition happens when a person is in a sleep-like state of non-feeling (general anesthesia) or right after. CAUSES This condition is caused by a sudden increase in metabolism. Metabolism is the body's breakdown and use of food and energy. This condition is almost always triggered by either an inhaled medicine that makes you sleep (general anesthetic) or by a medicine that relaxes your muscles (muscle relaxant). RISK FACTORS This condition is more likely to develop in people with a family history of problems while under general anesthesia. Tests can show if a person...
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...chapter 1 Health Care chapter 2 chapter 3 The World's Best fighting with Disease Saved from Certain death Selling Medicine Felix Hoffmann wanted to help his father. What followed was one of the biggest success stories in business. A doctor in a farming Community made a discovery that has saved millions of lives. Everyone expected Jeanna Giese to die, but one doctor did not give up. B write the word from Part A next to its definition 1The feeling when something hurts you. pain 2The person who controls a business or the workers manager 3 To help someone who is sick ; treat 4 A medical condition with higher than normal body temperature; fever 5. Available for sale; on the marker 6. An organization that sells goods or services to make money; Company 7. Medicine that is not liquid, you can pick it up and take it with water; pill 8. To stop something from happening; prevent 9, Almost the same; similar 10. Someone who goes to see a doctor; patient 11. 12. To make or create spmething ; produce A person who does a study to learn more about something ; researcher. A Felix Hoffmann's father was in a lot of pain, so Hoffmann did research and developed a mixture with salicylic acid. It worked well. Hoffmann told his manager at Bayer about this. The Company developed a drug called aspirin. It helped stop pain and lower fevers. They tested the new drug and found that it worked well. At first, Bayer...
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...Table of Contents Page 1. Introduction …………………………………………………... 2 2. Background …………………………………………………….. 2 2.1 Why technology has become important in sport performance? 3 2.2 A brief history of technology used to improve performance. 3 3. Technology used to aid sport performance …...... 3 4.1 Footbounaut ……………………………………………………... 3 4.2 Ingestible Pills ……………………................................................ 5 4.3 Sensors ……………………………………………………...…..... 6 4.4 Fitmodo …………………………………………………………... 7 4. Future of sport performance technology ……… 9 5. Conclusion ………………………………………………………. 11 6. References ……………………………………………………… 13 Student’s name Tutor Course Date of submission Technology Used to Improve Performance in Sports Introduction As the world's sport keeps on changing, so does the use of technology keep improving. In the modern day sports, there has been tremendous development in the field of sport with new technology being unveiled in every sport. The use of technological improvement to enhance the game, for example, the hawk-eye technology while others are meant to help the players in their exercises, training, injury treatment and nutrition. There is some computer software designed for fitness and nutrition professional and they are used to organize data and produce reports. Some of this software includes; teams beep test and body byte. In this paper, I will focus on new sports technology such as Footbounaut...
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...HEAT STRESS Heat stress can be a serious problem in hot working environments. The body temperature for a human must be maintained all the time, regardless of work load or adverse environmental conditions. A drastic increase in body temperature can result in death. The body initially responds to heat by sweating and by circulating blood closer to the skin's surface to lower the main body temperature. High temperatures, high humidity, sunlight, and heavy workloads increase the heat stress. Too much heat can also make workers lose their concentration or become fatigued and thus increases the chance of accidents and injuries. This heat stress may lead to the following: Heat Rash: Is an early signal of potential heat stress. It is commonly associated with hot, humid conditions in which skin and clothing remain humid. Heat rash may involve small areas of the skin or the entire upper body Heat syncope: Is characterized by dizziness or fainting while standing still in the heat for an extended period. Heat Cramps: Symptoms include painful cramps or spasms in the legs, arms, or abdomen. Heat cramps are often caused by a temporary fluid and salt imbalance during hard physical work in hot environments. Heat Exhaustion which results from the reduction of body water content or blood volume. The condition occurs when the amount of water lost as sweat exceeds the volume of water drunk during the heat exposure. The victim of heat exhaustion may have some or all of the signs or symptoms:...
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...Heat Stroke and Heat Exhaustion University of Phoenix Susie Hughes HCS 245 August 29, 2011 Mr. Carmon Heat Stroke and Heat Exhaustion In Dallas of this year, a football coach with a heart condition from a heat stroke. He was practicing with his team in heat that was more than 100 degrees. Two days later, two South Georgia football players, died from heat exhaustion, both were 16 years of age. For the past two months, the country has been under the threat of hot and humid temperatures. Heat advisors in most countries across the United States, are broadcast publicly to ensure that people are taking serious precautions during the months of extreme humid temperatures. In this essay, the writer will discuss: (1) definition and short history of heat strokes and heat exhaustion conditions, (2) the symptoms and the signs of each illness, (3) how is heat strokes/heat exhaustion acquired, (4) the diagnosis and treatments, (5) alternative treatments, and (6) the statistics. Definition and Short History of Heat Strokes and heat exhaustion Heat stokes and heat exhaustion are heat-related illnesses. The Center of Disease Control and Prevention (2011) states that, “historically from 1979-2003, excessive heat exposure caused 8,015 deaths in the United Stated, which 300 deaths were accounted for during 2001.” Heat exhaustion, is an insignificant nature of heat-related illnesses, and occurs when a person is working, children are...
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...three months or as long as two years (or up to one year if you're under 18). Generally, the lower your risk of dental problems, the longer you can wait before your next check-up. So people with good oral health will probably need to attend only once every 12 to 24 months, but those with more problems will need check-ups more often. Inflammation and body temperature (a) Normothermia, where set-point and actual body temperature coincide. This condition occurs during most of the time. (b) Hypothermia, where set-point may or may not be normal, but actual body temperature is below this set-point. Hypothennia can occur as a response to a drug, disease or exposure to the cold. (c) Hyperthermia, where set-point may or may not be normal, but actual body temperature is higher than this set-point. Hyperthermia can occur as a response to a drug, disease or exposure to a warm environment. (d) Fever, where set-point is raised and deep body temperature may or may not be raised to the same level. Inflammation and the Pathophysiology of Fever The inflammatory response is a generic response no matter what is...
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...Presentation Rationale Purpose: The purpose of this speech is to educate and inform my audience of the risks inherent from unintended hypothermia. I’m eager to alert perioperative staff of the potential dangers as well as the preventative measures that can be taken in order to avoid complications associated with unintended hypothermia. My central idea is hypothermia management saves lives. Intended Audience: My ideal audience for this speech would be those medical professionals working in the perioperative area. Significance: This topic is very significant to my audience because our patients’ outcomes are directly related to our competency in this area. Knowledge of what measures are to be implemented to avoid unintended hypothermia in the perioperative setting will greatly decrease our infection rates and shorten length of stay. Presentation Plan I. Introduction a. Audience hook: Did you know hypothermia is associated with a threefold increase in SSIs and it is estimated that SSIs increase postoperative hospitalization by an average of 4 days? (Hart et al., 2011) b. Thesis statement: Research suggests that intraoperative temperature management should be closely monitored because unintended hypothermia leads to increased risk for infection and increased length of stay. c. Preview of Main points: i. Unintended hypothermia leads to increased risk for infection. ii. Unintended hypothermia leads to increased length of stay. II. ...
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...Safety Smarts ‘SPECIAL EDITION’ HEAT SAFETY REMINDER Heat Related Injuries Are YOUR Responsibility The past few summers have shown that the risk of heat illness from high temperatures is one of the most serious challenges to the safety and health of employees across America. With the current heat wave it is important that management understand that we support the Zero-Incident-Mindset by protecting our workers from heat related injuries. To date this year, we have had a few incidents as a result of heat illness. HEAT ILLNESS CAN BE DEADLY. Every year, thousands of workers become sick from exposure to heat, and some even die. These illnesses and deaths are preventable. Workers exposed to hot and humid conditions are at risk of heat illness, especially those doing heavy work tasks or using bulky protective clothing and equipment. Some workers might be at greater risk than others if they have not built up a tolerance to hot conditions. What is heat illness? The body normally cools itself by sweating. During hot weather, especially with high humidity, sweating isn't enough. Body temperature can rise to dangerous levels if precautions are not taken. Heat illnesses range from heat rash and heat cramps to heat exhaustion and heat stroke. Heat stroke requires immediate medical attention and can result in death. How can heat illness be prevented? Remember three simple words: Water, Rest, and Cool. Employers should educate their workers on how drinking water often, taking breaks...
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...Temperature Regulation A normal, healthy human is able to maintain a constant body temperature of approximately 98.6F despite the temperature of the environment. In a hot environment, the body sends a signal to the brain via the spinal cord to say the body is overheating, the brain then sends a signal back down the spinal cord and tells the body to cool itself by perspiration which evaporates and cools the skin. In cold weather, the body senses the lower temperature and our brain tells us to put more clothes on to warm ourselves up. Temperature Regulation of the Human Body The human body has the remarkable capacity for regulating its core temperature somewhere between 98°F and 100°F when the ambient temperature is between approximately 68°F and 130°F according to Guyton. This presumes a nude body and dry air. The external heat transfer mechanisms are radiation, conduction and convection and evaporation of perspiration. The process is far more than the passive operation of these heat transfer mechanisms, however. The body takes a very active role in temperature regulation. The temperature of the body is regulated by neural feedback mechanisms which operate primarily through the hypothalmus. The hypothalmus contains not only the control mechanisms, but also the key temperature sensors. Under control of these mechanisms, sweating begins almost precisely at a skin temperature of 37°C and increases rapidly as the skin temperature rises above this value. The heat production...
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...Water is essential to maintain blood volume, regulate body temperature and allow muscle contractions to take place. During exercise, the main way the body maintains optimal body temperature is by sweating. Heat is removed from the body when beads of sweat on the skin evaporate, resulting in a loss of body fluid. Sweat production, and therefore fluid loss, increases with a rise in ambient temperature and humidity, as well as with an increase in exercise intensity. Drinking fluid during exercise is necessary to replace fluids lost in sweat. This will reduce the risk of heat stress, maintain normal muscle function, and prevent performance decreases due to dehydration. In most cases during exercise, the rates of sweat loss are higher than the rate you can drink, so most athletes get into fluid deficit. Therefore, fluid guidelines promote drinking more fluid to reduce the deficit and potential performance detriments associated with dehydration. However, it is also important to acknowledge that it is possible to over-drink during exercise. Drinking more fluid than is comfortable, in any conditions, has the potential to interfere with your performance. In cool weather or when the exercise pace is gentle, the rate of sweat loss may be quite low. It is unnecessary and potentially dangerous to drink at rates that are far greater than sweat losses. Knowing your sweat rate can give you an indication of how much you should be drinking during exercise. Dehydration and Performance...
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...WRITING AN ESSAY RELATED TO ARTICLE (The Malay Mail, 16th March 2016) Nowadays, Malaysian weather is a polemic issue that been discussed everywhere. The temperature could arise to 40 degree Celsius. Based on article that I choose, the writers’ reports about the effects of overheat temperature in Malaysia. They are heat exhaustion, heatstroke and hyperthermia. Firstly, heat exhaustion is a warning that the body is getting too hot. The person may be thirsty, giddy, weak, uncoordinated, nauseous, and sweating too much. The body temperature is usually normal and the pulse is normal or raised. The skin is cold and sticky. Although heat exhaustion often is caused by the body's loss of water and salt, salt supplements should only be taken with advice from a doctor. Heat exhaustion is the body's response to an excessive loss of water and salt contained in sweat. Those most prone to heat exhaustion are elderly people, people with high blood preset and people working or exercising in a hot environment. In the articles, there were 11 cases heat exhaustion in nationwide, which five instances reported at Banting Hospital, two at Langkawi, and one each at Pahang Seremban, and two cases at Kuala Lumpur. Secondly, heat exhaustion is a condition whose symptoms may include heavy sweating and a rapid pulse, a result of your body overheating. It's one of three heat-related syndromes, with heat cramps being the mildest and heatstroke being the most severe. Causes of heat exhaustion include...
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