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- A crash cart is a cabinet containing equipment that physicians and nurses need when a cardiac arrest occurs. This is obviously a grave situation and requires immediate life-saving steps.
- The items found on a crash cart include a defibrillator, endotracheal intubation equipment, central vein catheters, and cardiac drugs. These items are essential for treating cardiac arrest and maintaining vital functions.
- In addition to cardiac arrest treatment, the emergency department also uses other equipment such as the chest-tube tray and the ear, nose, and throat tray for specific procedures.
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A crash cart is a cabinet containing equipment that physicians and nurses need when a cardiac arrest occurs (the heart stops beating). This is obviously a grave situation and requires immediate life-saving steps. These are some of the items found on a crash cart: Defibrillator - This is an electrical device with two paddles that are placed on your chest. It discharges electricity through your heart when a lethal rhythm is present. The goal is to shock the heart back to normal. "Lethal rhythms" include ventricular fibrillation (rapid, unsynchronized, uncoordinated heartbeat) and ventricular tachycardia (rapid heartbeat that prevents the heart from pumping properly). It can also be used in less dangerous rhythms to return the heart to a normal rhythm. Endotracheal intubation equipment - Endotracheal intubation is the procedure of placing a tube into someone's trachea (windpipe) when that person stops breathing or is not breathing adequately. The tube allows artificial respiration equipment to take over the job of breathing for the patient. The package includes tubes of different sizes and a laryngoscope -- a special light with a flat metal piece to lift the tongue out of the way so that a tube can be placed into the trachea. Central vein catheters - These are catheters (small tubes) placed in the large central veins (near the heart) so that medications and fluids can reach the heart and important organs quickly. •Cardiac drugs - During a cardiac arrest, certain potent drugs are required to restart the heart or return it to a more stable rhythm. The most common lethal arrhythmias present during a cardiac arrest are: •Ventricular fibrillation - Twitching of the ventricle (main chamber of the heart), as opposed to an effective contraction that pumps blood out of the heart •Ventricular Tachycardia - Rapid contraction of the ventricle, producing insufficient blood flow out of the heart •Asystole - Total absence of electrical activity and therefore no contraction of the heart •Pulseless electrical activity (PEA) - Electrical activity of the heart but inadequate contraction of the heart •Bradycardia - Various rhythms that cause the heart to beat so slowly that not enough blood is pumped out of the heart Some of the drugs that are used to treat these arrhythmias are: •Epinephrine - Used in ventricular fibrillation, pulseless ventricular tachycardia, asystole, PEA, and sometimes bradycardia •Atropine - Used in asystole, bradycardia and sometimes PEA •Lidocaine - Used in ventricular fibrillation and ventricular tachycardia There are many other pieces of equipment that are used in an emergency department, including the chest-tube tray, which holds the equipment needed to put in a chest tube (a tube placed between the ribs and the lung to re-expand a collapsed lung), and an ear, nose and throat tray, which holds specialized equipment used most commonly for nosebleeds and to remove foreign bodies from the ear, nose, or throat.
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以下のとおりお答えします。 クラッシュカートというのは、心停止（心臓の脈動が止まること）が発生した時に医師と看護婦が必要とする機器を載せたキャビネットである。これは明らかに重要な状況であり、即時の生命救助の段取りを必要とする。これには、クラッシュカートにある器具の幾つかが必要になる： 除細動器－これは、胸に置かれる2つのパドルを持つ電気機器である。致命的な脈動状況が現れた時に用いて、放電で電気が心臓を通るようにする。目標は、心臓に衝撃を与えて正常に戻すことである。「致命的な脈動」は、心室の繊維攣縮（急速で、同調せず、組織立っていない心拍）および心室の頻脈（心臓が適切な血液汲み上げを妨害するような急速な心拍）を含む。それはまた、心臓を正常な脈動に戻すために、さほど危険ではない脈動でも使用できる。 気管内への挿管機器－気管内の挿管とは、当人が呼吸を停止するか、または適正に呼吸しない時に、管を気道（気管）に設置する手続である。管は、人工呼吸機器が患者のために呼吸という作業を引き継ぐことを可能にする。パッケージには、種々のサイズの管と喉頭鏡－管が気道内に設置できるように、邪魔にならないところに舌を持ち上げる平らな金属断片がついている特別なライト－が含まれる。 中心的静脈カテーテル－太い中心的静脈（心臓近くの静脈）に設置されるカテーテル（細い管）で、医薬品や注入液が心臓や重要な器官へ迅速に到達できるようにするためのものである。 ・強心剤－心臓停止の間は、心臓を再スタートさせるか、より安定した拍動に戻すために一定の強力な薬が必要になる。 心臓停止時間内の、最も一般的な致命的不整脈の露見は下記のとおりである： ・心室の繊維攣縮－血液を心臓から送り出す効果的な収縮と対立するような、心室（心臓の主要な隔壁室）のひきつり・痙攣。 ・心室頻脈－心室の急速な収縮で、心臓外への血流不足を来たす。 ・不全収縮－全体的な電気活動の不在、およびそれによる心臓の無収縮。 ・無拍動電気活動(PEA)－心臓の電気活動はあるが、心臓の収縮が不十分。 ・徐脈－脈拍が遅すぎて十分な血液が心臓から送り出されない状況を来たす脈拍で、速度差に幅がある。 これらの不整脈を治療するために使用される薬のうちの幾つかが下記のとおりである： ・エピネフリン（アドレナリン）－心室の繊維攣縮、無拍動の心室頻脈、不全収縮、PEA、および時々徐脈に使われる。 ・アトロピン－不全収縮徐脈、および時々PEAに使われる。 ・リドカイン－心室の繊維攣縮および頻脈に使われる。 そのほかに、緊急事態部門で使われる多くの機器があるが、それには胸管トレイも含まれる。これは、胸管（崩壊した肺を再拡張するために肋骨と肺の間に設置される管）を挿入するために必要な機器である。また、耳、鼻、および咽喉用のトレイも保持するが、これは最も一般的には鼻血のために使われる専門的な機器で、ほかに、耳、先端、または咽喉から異物を取り除くためにも用いられる。 以上、ご回答まで。
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An automated external defibrillator (AED) is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm. With simple audio and visual commands, AEDs are designed to be simple to use for the layperson, and the use of AEDs is taught in many first aid, certified first responder, and basic life support (BLS) level cardiopulmonary resuscitation (CPR) classes. An automated external defibrillator is used in cases of life-threatening cardiac arrhythmias which lead to cardiac arrest. The rhythms that the device will treat are usually limited to: 1.Pulseless Ventricular tachycardia (shortened to VT or V-Tach) 2.Ventricular fibrillation (shortened to VF or V-Fib) In each of these two types of shockable cardiac arrhythmia, the heart is electrically active, but in a dysfunctional pattern that does not allow it to pump and circulate blood. In ventricular tachycardia, the heart beats too fast to effectively pump blood. Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole. AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator. Uncorrected, these cardiac conditions (ventricular tachycardia, ventricular fibrillation, asystole) rapidly lead to irreversible brain damage and death, once cardiac arrest takes place. After approximately three to five minutes in cardiac arrest, irreversible brain/tissue damage may begin to occur. For every minute that a person in cardiac arrest goes without being successfully treated (by defibrillation), the chance of survival decreases by 7 percent per minute in the first 3 minutes, and decreases by 10 percent per minute as time advances beyond ~3 minutes. AEDs are designed to be used by laypersons who ideally should have received AED training. However, sixth-grade students have been reported to begin defibrillation within 90 seconds, as opposed to a trained operator beginning within 67 seconds. This is in contrast to more sophisticated manual and semi-automatic defibrillators used by health professionals, which can act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator able to read electrocardiograms. Bras with a metal underwire and piercings on the torso must be removed before using the AED on someone to avoid interference. American TV show Mythbusters found evidence that use of a defibrillator on a woman wearing an underwire bra can lead to arcing or fire but only in unusual and unlikely circumstances. A study analyzed the effects of having AEDs immediately present during Chicago's Heart Start program over a two-year period. Of 22 individuals 18 were in a cardiac arrhythmia which AEDs can treat (Vfib or Vtach). Of these 18, 11 survived. Of these 11 patients, 6 were treated by bystanders with absolutely no previous training in AED use.
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An Automated External Defibrillator is a simple to use device that uses computer technology to help a person whose heart has stopped heating. It analyzes the heart rhythm of a victim, and then advises the user whether a shock is required. AEDs are designed to be used by common people, who require little training to operate the devices correctly. AEDs are usually limited to just delivering shocks for VF(ventricular fibrillation) and VT(ventricular tachycardia) rhythms. There are 2 types of AEDs : Fully Automated and Semi Automated. Most AEDs are semi automated. A semi automated AED automatically diagnoses heart rhythms and determines if a shock is necessary. If a shock is advised, the person using the device must then push a button to give the shock. A fully automated AED automatically diagnoses the heart rhythm and advises the user to stand back while the shock is automatically given. Also, some types of AEDs come with advanced features, such as a manual override or an ECG display. In order to make them highly visible, public access AEDs are often brightly colored, and are mounted in protective cases near the entrance of buildings. When these protective cases are opened, and the defibrillator is removed, it might make an alarm sound to alert nearby staff that it has been removed. All trained AED operators should phone for an ambulance when sending for or using an AED. Because the patient will be unconscious, this always requires an ambulance to come.
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英語の医学書を訳しながら見ているのですがよくわからないところがあったのでどんなことが書いてるのか和訳していただけないでしょうか？ cardiac glycoside may be withhold until patient's symptomatic response to the ACE inhibitor or B-blocker has been defined and then used only in those patients who remain symptomatic while receiving ACE inhibitor or β-blocker agents therapy . In patients with congestive heart failure who are receiving a cardiac glycoside without an ACE inhibitor or β-blocker , the cardiac glycoside should not be withdrawn , but appropriate therapy with an ACE inhibitor and a β-blocker should be initiated . the beneficial effects of cardiac glycoside have been shown to be additive with those of ACE inhibitors and diuretics ; symptomatic and functional deterioration can occur when cardiac glycoside are withdrawn from patients whose failure was stabilized on a regimen of combined therapy. 少々長いですがよろしくお願いします。
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Positive inotrope infusions, e.g. the B1 agonist, dobutamine, are used in cardiogenic shock. The use of digoxin, which is a mild positive inotrope, is controversial in heart failure unless there is a concurrent supraventricular tachycardia. Vasodilators, such as glyceryl trinitrate, reduce pre‐load by venodilation and reduce after‐load by arterial vasodilation. Tolerance develops, so nitrates are used acutely, for ongoing ischaemia, acute heart failure or when ACE inhibitors are contraindiscated. 上記の英文を和訳してください。 よろしくお願いします。
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The term spike refers to the shape of the peaks that are seen on the oscillograph records when the membrane potential is measured by a fine electrode placed in the vicinity, or in the interior of the neuron. (The more interpretable records of the membrane potential are obtained by means of one electrode inside the cell and one outside, which may be placed at some distance and is then called “indifferent electrode”.) この文章の和訳お願いします。
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Regrettably, the notion of rights of ownership of capital and other income-earning assets remains conflicted, especially in societies that still believe that profit seeking is not quite moral. A key purpose of property rights, after all, is to protect assets in order to use them to profit or personally benefit. Such rights are not supportable in a society that holds any significant remnant of the view of property as “theft.” That notion embraced by Karl Marx rests on the presumption that gained wide acceptance in the first half of the twentieth century that wealth created under a division of labor is produced jointly, and hence should be owned collectively.
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There are certain things in life that are so obvious as to be beyond question. At the enjoyable end of the victory spectrum is the sheer excitement of crossing the ribbon first, coming top of the class or spraying champagne from the podium at the other end lies that depressing ache of being a straggler, an also-ran and, yes, a loser. But some people, it seems, are perfectly happy to be losers. Psychologists at the University of Michigan have discovered that while some people become stressed after losing out to a rival in a laboratory task, others become stressed out after Winning. The research challenges the widely held belief that the will to Win is a universal human desire. _ “This runs counter to the idea that everybody likes coming out at the top of the heap,” says Oliver Schultheiés, professor of psychology at the University of Michigan, who oversaw the study. "That’s a really surprising finding for us." Professor Schultheiss concludes that people can be split into wolves, who are utterly driven to win and devastated at losing out, and sheep, whose triumphs over others bring distress rather than heart-pumping joy. Lance Armstrong, the record-breaking Tour de France winner, is the embodiment of a wolf; Estelle Morris, who quit her position as Education Secretary because she did not feel up , could be suspected of ovine tendencies. How to separate the wolves from the sheep? Professor Schultheiss and his colleagues first used a test to assess the motivations of 108 college students. They were asked to look at various photographs _ such as a picture of two cyclists racing next to each other 4 and write a description of what they saw. The resulting script was used to deduce the participant’s “ implicit power motivation,” which is defined as a hidden desire to dominate others. ( A ) are more likely to have Written a scenario in which the cyclists were competing aggressively; ( B ) might have perceived a gentler relationship between the riders. Those with the highest scores - the greatést need to be top dog - were considered ( C ), and those at the low end were termed ( D ). A～Dにはwolvesとsheepが入ります
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There is some evidence that these improvements in the characteristics of elders have resulted in more positive views of aging. Tibbitts claimed that during the past 30 to 40 years, U.S. society has moved from holding negative stereotypes of old people to holding positive views in which elders are seen as being able to contribute to the quality of life for themselves, their communities, and society as a whole. Schonfield even argued that the assumption of negative attitudes toward old people is a "social myth" perpetuated by the gerontological literature. We will be examining these attitudes in derail in Chapter 2, but there does appear to be a substantial shift from negative to positive attitudes. The improvements in the physical, mental,social, and economic characteristics of elders have been so marked, and there have been so many programs and services developed for elders only, that many have begun to criticize these programs as discrimination in favor of the aged, or positive ageism. We will be discussing examples of positive ageism throughout this book; but the ones that have drawn most criticism so far are the Medicare program and some features of the Social Security System, such as the automatic cost of living increases in benefits and the tax-exemption of Social Security benefits for most elders. Perhaps these programs have been criticized the most because they involve the most money. Critics are beginning to argue that since elders are no longer deprived economically and since they are now much better off mentally, physically, and socially than they were in the past, it is no longer necessary or fair to continue the enormous expense of these special supports and programs available only to elders. Some argue that the way to reduce positive ageism is to make these supports and programs available to all ages on the basis of need. For example, they recommend that the national health insurance, which only elders now enjoy, be extended to all ages. It is clear that positive ageism is becoming an important issue and promises to become even more important as we are faced with more older people and more expensive programs for "seniors only."
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Lattice type and systematic absences In indexing the powder patterns it has been assumed that all the possible reflections are observed, that is, scattering from each of the different lattice planes is sufficiently intense to contribute to the diffraction profile. This is normally so for a primitive lattice, but for body centred and face centred lattices restrictions occur on the values that h, k and I may take if the reflections are to have any intensity. This results in certain reflections not being observed in the powder diffraction pattern and these are known as systematic absences. The origin of these absences can be illustrated with regard to Fig.2.3. という文章です。できれば翻訳サイト丸々ってのは控えてほしいです。
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Gerontology is defined as the science of aging. Actually it is made up of the knowledge about aging derived from many sciences, including biology, pｓychology, and sociology. Ｇｅｒｏｎｔｏｌｏｇｉｓｔｓ are the scientists who study aging. Gerontologists have been accused of focusing only on the declines of aging, and of assuming that the characteristics of the aged are the primary causes of the problems of elders. Such a focus on declines is a subtle form of ageism because it ignores the possibilities of growth and improvement with age. The assumption that the characteristics of elders are the cause of the problems of elders is another subtle from of ageism, because it ignores the extent to which the ageism embedded in our social structure and culture contribute to the problems of elders. The extent to which various theories in gerontology may contribute to ageism is discussed in Chapter 6. Geriatrics is the study of the medical aspects of old age, and the application of gerontology to the prevention, diagnosis, and treatment of illness among older persons. Thus, while gerontology deals with all aspects of aging, geriatrics is limited to the medical aspects. Physicians may be subject to several kinds of ageism. Because they focus on illness and disability, they may forget that health and ability is normal among elders. They may be tempted to blame any difficult or obscure illness on old age and assume that nothing can be done about it. Geriatricians and other providers of service to elders may exaggerate age differences and needs of elders in order to promote their own service roles. Several gerontologists charge that gerontology is becoming increasingly "biomedicalized" and that this produces a negative view of aging. Kalish suggested that there is a "new ageism" found especially among advocates and service providers for the aged. It stereotypes the "elderly" in terms of the characteristics of the least capable, least healthy, and least alert of the elderly. It perceives the older person as, in effect, a relatively helpless and dependent individual who requires the support services of agencies and other organizations. It encourages the development of services without adequate concern as to whether the outcome of these services contributes to reduction of freedom for the participants to make decisions controlling their own lives. It produces an unrelenting stream of criticism against society in general and certain individuals in society for the mistreatment of the elderly, emphasizing the unpleasant existence faced by the elderly.
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