ABCDE Approach for Critically Ill Patients

ABCDE Approach for Critically Ill Patients The topic I have chosen for my vignette is a patient with chest pain. The Resuscitation Council (UK 2006) recommends that clinical staff should follow the ABCDE approach when assessing and treating critically ill patients. This will help to identify the deterioration of critically ill patients.With this in mind, it is important that patients presenting with cardiovascular conditions are promptly assessed and treated. Here I am following an ABCDE assessment on a patient with chest pain. The 58-year-old (anonymous) male patient admitted with chest pain, 8hours after the onset of the symptoms. Initially patient was thinking it is heartburn and been taken gaviscon and paracetamol. As I went to see the patient, I introduced myself and checked identity by asking the name.Patient is able to communicate.This incates that the airway is patent. Patient is looking pale and in short of breath. Complaining of heaviness and crushing pain around the chest radiating to left arm. Sat patient upright position and checked breathing. Respiratory rate is 20bpm. (9-14bpm is normal resp rate-bts guidelines). The pattern of the breathing is normal, the movement of the chest wall is equal, and symmetrical.SaO2 checked is, 95% on room air. (Above 94%is normal or 88%-92% for those with resp problem (copd) BTS 2008).I administered 35% oxygen via venturi mask. Supplemental oxygen therapy is important to maintain adequate oxygen levels in the tissues and organs when patients experiencing pain and shortness of breath. (Critical care assessment booklet) Patients peripheries are cold and clammy.this indicates poorly perfused tissues. Pressed on patients finger for 5 seconds to check the capillary refill time.(in health,initial blanching should disappear within 2seconds of releasing pressure(Athern and Philpot 2002).CRT is 4 seconds. delayed CRT indicates poor perfusion(Lima and Bakker 2005). checked radial pulse is tachycardic 114bpm.rate is regular. A manual pulse should always checked, as machines that measure heart rate tend to give an averaged value and therefore do not pickup irregularities or arterial insufficiency (Torrance and Elley, 1997).HR is above systolic blood pressure indicating that patient having cardiac problem. Blood pressure is 101/54 mmhg, Temp 36 deg. Patient was very restless due to pain. Obtained ECG and showing small elevation in the ST segment in standard leads.ST elevation is the first sign of infarction. This happens when myocardium injured. ECG is showing Acute Myocardial infarction. Pain relief is the first priority, as uncontrolled pain increases sympathetic stimulation, which leads to increased myocardial oxygen consumption. This can further aggravate the ischemia (T Moore P Woodrow). Informed doctor about patients condition. Inserted cannula and taken bloods for troponin t and routine investigation fbc, ues, coagulation profile. Doctor arrived and examined the patient, advised to give GTN spray and Diamorphine injection (GTN generates nitric oxide that is Vasoprotective.Nitrovasodilators act primarily to dilate veins and therefore has a major effect on reducing the filling pressures of the heart. This helps to reduce myocardial contraction, wall stress, oxygen demands .It is short acting, and its effects last up to 30 minutes. The sublingual route is preferred as this avoids metabolism by the liver which reduces the drug concentration (H Chummun,KGopaul,A. Lutchman 2009) Diamorphine injection 5mg intravenously given .This is both potent analgesic and has pos itive hemodynamic effects particularly,vasodialatation which reduces the myocardial oxygen demand. Metochlorpromide 10mg intravenously (Antiemetic) given along with opiates to minimize nausea, a side effect of opiates therapy. Aspirin and Clopidogrel 300mg given .These are antiplatelet drugs ,decrease the platelet aggregation and inhibit thrombus formation in the arterial circulation ,because in faster-flowing vessels,throbi are composed mainly of platelets with little fibrin. (BNF 2010) Patient is not thrombolysed with streptokinase injection, because the late presentation and later administration is less effective outcome. Currently most protocols advocate a time window of 6hrs from the onset of pain during which it is appropriate to give thrombolytics.After this time it is usually considered that the risk of the drug outweigh the limited benefit gained(MrBassets and Mr Makins). Reassessed vital signs and pain. The pain is easing off slightly, scoring 2.respiratory rate 16bpm , HR 98bpm BP 112/68,CRT 2. Patients condition is improving. Pain assessment is a priority because continued pain is a symptom of ongoing MI, which places additional risk on myocardial tissue (Urden et al, 2002). Repeat Diamorphine injection given as advised by doctor. Closely observed the patient, monitored breathing and oxygen saturation. Oxygen therapy continued, because it is important to assist the myocardial tissue to continue its pumping activity and to repair the damaged tissue around the site of the infarct (Sole et al, 2001).No shortness of breath at present. Repeat ECG taken in 15 minutes interval for assessment of dysrhythmias and it is noninvasive, well tolerated by patients and provides continuous information about the heart (Docherty and Douglas, 2003). Patients blood sugar checked and it is 6.7mmol.patient has no diabetic history. Patient is very anxious and worried. Anxiety can play a role in acute MI. It may affect the development of further heart disease, further morbidity or prognosis, health care use and rehabilitation. (Crow et al,1996, Januzzi et al 2000).I reassured patient. Anxiety management is assigned a high priority in the early management of Acute MI. Doctor discussed with family about present condition and treatment. Family member who are anxious or upset about the patients condition may heighten patient anxiety, research suggest that family members should provide with information to meet their needs to reduce family anxiety (Quinn et al 1996).Doctor explained to the family about patients diagnosis and treatment. Heart rate monitored continuously by attaching telemetry. This helps to identify cardiac arrhythmias. Vitals signs and pain score recorded regularly. Recognizing the signs of clinical deterioration and taking appropriate timely action can be a vital part of providing optimal patient care. The clinical signs of critical illness usually reflect compromised respiratory, cardiovascular and neurological function.The underlying aim of the initial interventions should be seen as a holding measure to keep the patient alive,and produces some clinical improvement ,in order that definitive treatment may be initiated(Nolan et al,2005).

The fellowship of the ring :: essays research papers

The Lord of the Rings: The Fellowship of the Ring The Lord of the Rings: The Fellowship of the Ring, by J.R.R. Tolkien, is the first book in the fantasy-based trilogy of the Lord of the Rings. The book begins with Bilbo Baggins celebrating his one hundred and eleventh birthday. After his party, he then decides to leave everything behind and join a Fellowship, which has a task of destroying the ruling ring, which will give supreme power to whoever has possession of it. Just before he leaves, Gandalf asks Bilbo for this ring. Due to the power in which the ring possesses while it is in his possession, he does not want to give it up. The novel ends with the destruction of the Fellowship due to the power in which the ring contains. One of the prime facts of the Middle Earth is power. Power is not neutral, but is always evil. It gives wicked the chance to dominate. The good is corrupting and inescapable. This is shown repeatedly throughout the novel, from when Bilbo gives up the ring, to when Boromir tries to take the ring, and finally, t o seeing the control that the ring has over Frodo. One incident in the book, which corresponds with how power is evil, would be when Bilbo had to give up the Ring. The ring is very powerful. The power is so enticing that Bilbo is very weary to give up that ring. When Gandalf asks Bilbo if he wishes to give up the ring, Bilbo seems unsure saying yes and no. When it came to having to give it up he didn't like parting with it at all and didn't see why he should have to . Due to the power in which Bilbo feels that the ring had given him, he doesn't want to part with it. By no means does Bilbo want to use the power in an evil manner to dominate all. It is just the thought of power itself that causes this greed to come over him. Although Bilbo in general is a good character, the power of ring corrupts his ways, showing his thirst for power, which he deserves. Another incident, which portrays this corruption of goodness to evil, is when Boromir approaches Frodo and tries to take the ring f rom him. Boromir has authority, which is being heir to the throne of Gondor, but not the supreme power that he desires.

Cultural Assimilation Essay

America is one of the countries that have rich culture. Being a large country, many people are living in it from different origins. Some migrated to this place for work or for other reasons, to experience green pastures. Since America is also in line with the latest fashion, many investors are placing their businesses in this place just to try if they can be successful with their field in this country. America is said to have all sorts of people from all over the world. Europeans, Asians, Russians and other native people are going to America for different reasons. There is a question that arises with the largeness of population of America and the variety of the people there. Is America more of a melting pot or a salad bowl? Melting point, as defined in the scientific manner is the temperature when a substance melts at a certain period of time. In the question given in this assignment, maybe the question is up to the way cultures are being transformed into something new after their migration to the state of America. And the questioning about the salad bowl might ask for the variety of the culture and kinds of people in America. To make the questions easier or in layman’s term, in what I understood about the statement, it asks if America is a place for the transformation of culture or is it a place that consists of variety of things? The site of America, in the viewpoint of other countries, is grand. Since many famous personalities came from this country, I guess it contributes with the fame of the country plus the famous infrastructures and the countries it has given influences. When people learned that life in America is great, that life here is too independent and fresh, green money could be earned, they emerged into going here for the sake of work. Maybe as time passes by, the country has become populated of people from different countries. In m opinion, America is more of a salad bowl since the culture and ideas of the people going here is not melted that nothing will be left. I guess the variety of the culture contributes in making it a salad bowl. As we all know, salad bowls are composed of different foods, fruits or vegetables, plus emulsifying agents like mayonnaise and some extenders. If people reached America, I think it will change the personalities of the people but not enabling them to lose their identities. The other culture of other people will just make it juicier but not change the composition of the culture or personality. It’s like changing a chocolate in syrup for a chocolate cake. We can see that the chocolate already mixed with the cake and it will be difficult for us to distinguish what or where the chocolate is located. Being a salad bowl, the mixture of the cultures and people in America is heterogeneous by which we can still distinguish one identity from the other, unlike with the mixture of powdered coffee and creamer where we will find difficulty of separating the two substances, a homogeneous mixture. My point here is that America really is a more of a salad bowl than a melting pot. In the set up, I guess nothing is lost. There is gain in the mixing of cultures in America since there are many things learned as cultures are being mixed. This is an advantage of it that people might learn the tastes of others and the crafts they are into. All in all, even if their journey or their stay in America changes the people a little, it is still for their better thus making them moving and motile. The personalities will not become stagnant. They will still develop into something new. White privilege might mean something that concerns the power of the white people since if we can look back in our history, white people have conquered a lot of countries in the world and this makes them as a powerful state. People see Americans or white people of high class compared to those with dark or darker skin tones. According from the article I have read, there could be culture cultivation by the time that people step in the land of America, that they will be able to penetrate, learn and apply the things that they will learn from that country thus growth will be evident. The process of cultivation is also the process of acceptance of the new resident in America. He/she should be able to learn to cope with the changes so as to live happily in America. References Cultural Assimilation And Consumption Behaviors: A Methodological Investigation. 2000. Retrieved 11 December 2007 from http://www. entrepreneur. com/tradejournals/article/68876925_3. html

How To Use Neuromarketing To Connect With Your Audience With Roger Dooley

How To Use Neuromarketing To Connect With Your Audience With Roger Dooley What triggers your readers to buy? How can you write better calls to action and get more conversions? Today we’re going to be talking to Roger Dooley, the brains behind the book Brainfluence: 100 Ways to Persuade and Convince Consumers With Neuromarketing. He also writes the Neuromarketing blog and regularly contributes to Entrepreneur and Forbes about neuromarketing. What is neuromarketing, and how can you use it to connect with your audience and get better results? That’s what we’re going to be talking to Roger about today. You won’t want to miss it! How Roger defines neuromarketing, the different types of neuromarketing, and how large and small businesses take advantage of the different types. Some of the principles of why neuromarketing techniques work, including social proof, authority, and reciprocity. Roger’s thoughts on case studies, emotions, and the words that potential customers and marketing professionals use. Why it’s important to understand your target buyer’s unconscious needs as well as their conscious needs. Roger’s best tips on building trust with your audience. How to turn your fans into buyers and how to create effective calls to action. Roger’s advice to a marketer who is just starting out in learning about and implementing some neuromarketing techniques. Links: Brainfluence Neuromarketing blog Roger on Entrepreneur Roger on Forbes Robert Cialdini’s Pre-Suasion The Persuasion Slide Perennial Seller If you liked today’s show, please subscribe on iTunes to The Actionable Content Marketing Podcast! The podcast is also available on SoundCloud, Stitcher, and Google Play. Quotes by Roger: â€Å"Even if you are a small business and you can’t afford to do costly studies, you do have the ability to run different kinds of tests in your app or on your website and see what works best.† â€Å"That person who’s purchasing the product may have certain conscious needs but there are also unconscious needs that the buyer probably is less concerned about.† â€Å"Behavioral psychology, in particular, is important. Those are the things that don’t cost any money to apply.†

From Fashion Producer to Fashion Retailer

From Fashion Producer to Fashion Retailer For both the retailers and manufacturers, the goal of fashion merchandising and marketing is to ensure that the merchandise is sold at a profit (Steele 295). To achieve this, one needs careful coordination and execution of the business strategies. The success of the fashion business hinges on fashion merchandising and fashion marketing. Advertising We will write a custom essay sample on From Fashion Producer to Fashion Retailer specifically for you for only $16.05 $11/page Learn More Owing to the advances in information technology, customers all over the world have become more knowledgeable and inquisitive, due to information on the fashion industry that is readily available on the internet. It is thus important for those involved in fashion retailing to ensure that the needs and wants of their target customers have been met. In an effort to overcome this challenge, fashion manufacturers are now producing specific fashion merchandise to suit the needs of sp ecific customers (Kotler and Armstrong 81). Since fashion retailers are constantly in contact with the final customers, they are more likely to know the needs and wants of their target market. This is important in a highly competitive business environment. If fashion manufactures are not updated with the needs and wants of the end-consumer, they may lose their share of the market. In order to safeguard their market share, some fashion producers may contemplate shifting from the manufacture of fashion merchandises to retailing fashion merchandise. The research paper endeavors to examine the advantages and disadvantages associated with such a move. For a long time, fashion producers have primarily concentrated in the production of their merchandise in an easy and economical manner. A lot of money and time would be spent on consumers in an attempt to convince them that their merchandise suits the needs and wants of the consumers. However, as packaged foods, automobiles and healthy pr oducts recorded successful growth through marketing, fashion businesses also adopted this concept (Steele 296). When fashion producers switches to fashion retailers they are in close contact with their clients and as a result, this enhances the relationship that they share with their clients. This is a positive sign for good business. Principles of marketing therefore become vital for the business. Owing to the constant contact with the end-consumers, they are also likely to know the needs and wants of the customers. Consequently, they have to ensure that they provide merchandise that has been customized to suit the requirements of the market.Advertising Looking for essay on art and design? Let's see if we can help you! Get your first paper with 15% OFF Learn More Fashion producers are also likely to have an enhanced access to the market. They are therefore better placed to study the retail market well, thereby improving their competitiveness. Retail fashioni ng also enables one to provide branded merchandise to the market. Customers would be willing to offer premium prices for such merchandise, and this incenses the profit earnings of a fashion retailer. There is also the issue of consumer loyalty, because they are able to get what they want. Consequently, the fashion retailer is more likely to have repeat business with such customers (Steele 297). Brand orientation brings with it the dimensions of functionality, distinctiveness, symbolism, and value addition (Bridson Evans 404). As such, when a fashion retailer become more brand- oriented, he/she is likely of offer customers a greater retail offer, relative to the competition. Fashion retailers should therefore endeavor to differentiate their merchandise in such a manner as to afford them a competitive advantage in the market. On the other hand, there are also a number of disadvantages that accompanies the decision by a fashion producer to also become a fashion retailer. To start wi th, there is a shift from the core activity, in this case the production of the fashion merchandise, to retailing. A firm is more likely to success when it concentrates on its core activity, as opposed to undertaking various activities. When a firm is only concerned with its core activity, it is more likely to invest more in research and development in an attempt to ensure that its merchandises meet the needs of the consumers (McColl and Moore 97). Another disadvantage of such a move would be the added cost of advertising and undertaking numerous market surveys and research, in an effort to capture the needs and wants of the customer so that the merchandise can be produced to suit these needs. The fashion retailer now has to project sales with regard to the unit of merchandise that they want to sell. In the case of a fashion producer, he/she is required to anticipate the retailers’ needs. In the same way, we may also expect that the fashion retailer shall also have to envis ion the needs of his/her consumers (Stone 59). Advertising We will write a custom essay sample on From Fashion Producer to Fashion Retailer specifically for you for only $16.05 $11/page Learn More However, we need to realize that the number of consumers of fashion merchandise by far outstrips the number of fashion retailers. Accordingly, this means that a fashion retailer shall have to sue more financial and human resources in an attempt to ensure that they deliver the needs of the market. There are various reasons why a fashion producer may decide to become a fashion retailer. They include the need for brad recognition, gaining a competitive advantage, and increased consumer loyalty, among others. Fashion retailing affords one constant interaction with the end-consumers, thereby enhancing the consumer-retailer relationship. However, even as a fashion retailer contemplates on becoming a fashion retailer, he/she should also be careful to ensure that they re tain the quality of their merchandise. In addition, fashion retailing may mean that one now has to deal with a specific brand. Many fashion brands are a fad that loses popularity with time. Therefore, Fashion producers should therefore not abandon the core activity of manufacturing because they may need to fall back on it. Bridson, Kerrie, and Evans, Jody. The secret of fashion advantage in brand orientation. International Journal of retail Distribution Management, 32.8(2004): 403-411 Kotler, Philip, and Gary Armstrong. Principles of Marketing. 9th ed. Upper Saddle River, N.J.: Prentice Hall, 2001. Print.Advertising Looking for essay on art and design? Let's see if we can help you! Get your first paper with 15% OFF Learn More McColl, Julie, and Moore, Christopher. An exploration of fashion retailer own brand strategies. Journal of Fashion Marketing and Management, 15.1(2011): 91-107 Steele, Valerie. The Berg Companion to Fashion. Oxford: Berg Publishers, 2010. Print. Stone, Elaine. The Dynamics of Fashion. New York: Fairchild Publications, 2004. Print.

Weber's and Marx Capitalism Essay Example | Topics and Well Written Essays - 1500 words

Weber's and Marx Capitalism - Essay Example This so-called Protestant ethic was the primary impulse for an almost accidental massive social phenomenon that led to the emergence of capitalism. Weber postulates that the unique characteristics of Protestantism and Calvinism were responsible for enabling society to absorb and embrace the capitalistic economic model. In his introduction he writes, A glance at the occupational statistics of any country of mixed religious composition brings to light with remarkable frequency a situation which has several times provoked discussion in the Catholic press and literature, and in Catholic congresses in Germany, namely, the fact that business leaders and owners of capital, as well as the higher grades of skilled labor, and even more the higher technically and commercially trained personnel of modern enterprises, are overwhelmingly Protestant. This is true not only in cases where the difference in religion coincides with one of nationality, and thus of cultural development, as in Eastern Germany between Germans and Poles. The same thing is shown in the figures of religious affiliation almost wherever capitalism, at t he time of its great expansion, has had a free hand to alter the social distribution of the population in accordance with its needs, and to determine its occupational structure. The more freedom it has had, the more clearly is the effect shown. It is true that the greater relative participation of Protestants in the ownership of capital, in management, and the upper ranks of labor in great modern industrial and commercial enterprises, may in part be explained in terms of historical circumstances, which extend far back into the past, and in which religious affiliation is not a cause of the economic conditions, but to a certain extent appears to be a result of them. Participation in the above economic functions usually involves some previous ownership of capital, and generally an expensive education; often both (1). This thesis (convincingly dubbed 'The Weber Thesis'), based on observations as to the distribution of Protestants in the capitalist world, essentially submits the enterprising and comparatively risky Protestant nature (perhaps a product of the then-fresh Protestant revolution) translated from the religious to the economic world, responsible for the development of the capitalistic economic model. This analysis has met with criticism from a number of academic minds. R. H. Tawney, one distinctive and well-known critic, agreed that capitalism and Protestantism were linked; however, in Religion and the Rise of Capitalism Tawney writes that Protestantism adopted the risk-taking, profit-making model from capitalism, and not that capitalism adopted these traits from Protestantism (Tawney, 1926). Sandra Pierotti continues, "The strongest connection that Tawney saw between capitalism and Protestantism was rationality. Protestantism was a revolt against traditionalism and as such advocated rationality as an approach to life and business. Tawney proposed that the rationality inherent in capitalism became a tenet of Protestantism because rationality was diametrically opposed to the traditionalism of Catholicism. Early Protestant leaders recognized that hard work and rational organization of time were capitalist virtues which fit very nicely into the concept of living one's life in the service of God. Tawney saw the capitalist concepts of division of labor and planned accumulation as being reflected in the dogma of Protestantism which urged its followers to use one's calling on earth for the greater glory of God.

Informal Class Assessment Essay Example | Topics and Well Written Essays - 500 words

Informal Class Assessment - Essay Example Likewise, in the employment information, not one shares similar work. On the other hand, in terms of interests, there were three who are fond of sports; one is into hiking; two loves reading (but on different facets); one loves travelling; two are into volunteer work, and one is into art, as well as modeling. Even other noted information was vastly diverse. Due to the diversity of the group in educational background, line of employment, and interests, the topics that could be of interest to the batch could be current events, especially one that is controversial in nature; or a general topic that could appeal to all: food, health, love, or relationships, to name a few. These suggested topics could be tackled with enough authoritative research and by establishing a thesis statement to determine which point of view or contention one would propose. For instance, a current controversial topic on gun ban or gun control could be a subject of discussion based on the amount of current news articles written on the subject. One could even solicit their respective views on the subject regarding their preference for gun ban or gun control and signify one’s stance. The topic of food could also be interesting in terms of arguing whether American society has manifested a food dilemma in terms of exhibiting increasing trends on obesity despite being health conscious on nutritional contents of the food Americans regularly eat. This topic could also lead to health concerns, especially trying to determine whether advertisements pose more threats for the children in promoting food items that endanger their health. As such, despite the disparities in educational backgrounds, employment experiences, interests or hobbies, and plans for the future, there are different interesting topics that one have thought of which could spur the interest of the class as the potential