The Conduction System in the Heart


INTRODUCTION  
The conduction system in the heart is an intrinsic system whereby the cardiac muscle is automatically stimulated to contract, without the need for external stimulation (Waugh & Grant, 2007). It comprises specialised cardiac cells, which initiate and conduct impulses, providing a stimulus for myocardial contraction. It is controlled by the autonomic nervous system; the sympathetic nerves increase heart rate, contractility, automaticity and atrioventricular (AV) conduction, while the parasympathetic nerves have an opposite effect.

Blood Transfusion and Its Components




E. Celis-Rodriguez, K. Reinhart, Y. Sakr
Introduction

tRANSFUSSION
Transfusion of blood products in the critical care setting is a common practice that has been performed for many years. Since the 19th century, when James Blundell reported the clinical application of the treatment of hemorrhage for the first time in the Lancet [1], blood transfusion has been the cornerstone in the treatment of severe hemorrhage, not only as a means of improving oxygen transport capacity, but also to maintain homeostasis and reduce mortality rates [1]. The 10/30 rule was the standard of care for decades [2], but the first report of this appeared in the 1940s, when Lundy et al. [3] stated that “It is a clever idea to provide blood before surgery,” referring to patients whose hemoglobin levels were between 8 and 10 g/dL. With the more restrictive use of blood transfusion since the 1980s, there have been attempts to define specific indications for transfusion, minimal hemoglobin levels for critically ill patients, and the benefits and potential risks of transfusion [4].

The Neuroendocrine Response to Sepsis


Introduction
Acute response to LPS includes the release of a number of proinflammatory mediators that reach the brain in areas free of blood-brain barrier, or via specific transport systems. The hypothalamic-pituitary axis is also activated via neural routes. Then, infection is characterized by high circulating levels of adrenocorticotrope hormone (ACTH), and cortisol which remain in plateau as long as the stressful condition is maintained. Circulating vasopressin levels follow a biphasic response with high concentrations, followed by relative vasopressin insufficiency in about one third of cases.

nursing care plan for STATUS ASTHMATICUS



Status asthmaticus is a critical emergency that requires prompt intervention to avoid acute and possibly fatal, respiratory failure. In this condition, the asthmatic attacks are unresponsive to medical therapeutics, with severe bronchospasms creating decreased oxygenation and perfusion. During an acute asthmatic attack, the individual may demonstrate varying degrees of respiratory distress depending on the duration of the attack, and the severity of spasm.

Critical Nursing Care Plan For: PNEUMOTHORAX



A pneumothorax occurs when free air accumulates in the pleural cavity between the visceral and parietal areas, and causes a portion or the complete lung to collapse. Pressure in the pleural space is normally less than that of atmospheric pressure but following a penetration injury, air can enter the cavity from the outside changing the pressure within the lung cavity and causing it to collapse.

CRITICAL NURSING CARE PLAN FOR: Pneumonia



Pneumonia is an acute infection of the lung's terminal alveolar spaces and/or the interstitial tissues which results in gas exchange problems. The major challenge is identification of the source of the infection. Pneumonia ranks as the sixth most common cause of death in the United States.

CRITICAL NURSING CARE PLAN FOR PULMONARY EMBOLISM



A pulmonary embolus (PE) usually results after a deep vein thrombus partially or totally dislodges from the pelvis, thigh, or calf. The clot then lodges in one or more of the pulmonary arteries and obstructs forward blood flow and oxygen supply to the lung parenchyma.

PULMONARY

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CARDIOLOGY

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FALL

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