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LA GRAMMATICA DI ENGLISH GRATIS IN VERSIONE MOBILE   INFORMATIVA PRIVACY

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WIKIBOOKS
DISPONIBILI
?????????

ART
- Great Painters
BUSINESS&LAW
- Accounting
- Fundamentals of Law
- Marketing
- Shorthand
CARS
- Concept Cars
GAMES&SPORT
- Videogames
- The World of Sports

COMPUTER TECHNOLOGY
- Blogs
- Free Software
- Google
- My Computer

- PHP Language and Applications
- Wikipedia
- Windows Vista

EDUCATION
- Education
LITERATURE
- Masterpieces of English Literature
LINGUISTICS
- American English

- English Dictionaries
- The English Language

MEDICINE
- Medical Emergencies
- The Theory of Memory
MUSIC&DANCE
- The Beatles
- Dances
- Microphones
- Musical Notation
- Music Instruments
SCIENCE
- Batteries
- Nanotechnology
LIFESTYLE
- Cosmetics
- Diets
- Vegetarianism and Veganism
TRADITIONS
- Christmas Traditions
NATURE
- Animals

- Fruits And Vegetables



ARTICLES IN THE BOOK

  1. Acute abdomen
  2. Acute coronary syndrome
  3. Acute pancreatitis
  4. Acute renal failure
  5. Agonal respiration
  6. Air embolism
  7. Ambulance
  8. Amnesic shellfish poisoning
  9. Anaphylaxis
  10. Angioedema
  11. Aortic dissection
  12. Appendicitis
  13. Artificial respiration
  14. Asphyxia
  15. Asystole
  16. Autonomic dysreflexia
  17. Bacterial meningitis
  18. Barotrauma
  19. Blast injury
  20. Bleeding
  21. Bowel obstruction
  22. Burn
  23. Carbon monoxide poisoning
  24. Cardiac arrest
  25. Cardiac arrhythmia
  26. Cardiac tamponade
  27. Cardiogenic shock
  28. Cardiopulmonary arrest
  29. Cardiopulmonary resuscitation
  30. Catamenial pneumothorax
  31. Cerebral hemorrhage
  32. Chemical burn
  33. Choking
  34. Chronic pancreatitis
  35. Cincinnati Stroke Scale
  36. Clinical depression
  37. Cord prolapse
  38. Decompression sickness
  39. Dental emergency
  40. Diabetic coma
  41. Diabetic ketoacidosis
  42. Distributive shock
  43. Drowning
  44. Drug overdose
  45. Eclampsia
  46. Ectopic pregnancy
  47. Electric shock
  48. Emergency medical services
  49. Emergency medical technician
  50. Emergency medicine
  51. Emergency room
  52. Emergency telephone number
  53. Epiglottitis
  54. Epilepsia partialis continua
  55. Frostbite
  56. Gastrointestinal perforation
  57. Gynecologic hemorrhage
  58. Heat syncope
  59. HELLP syndrome
  60. Hereditary pancreatitis
  61. Hospital
  62. Hydrocephalus
  63. Hypercapnia
  64. Hyperemesis gravidarum
  65. Hyperkalemia
  66. Hypertensive emergency
  67. Hyperthermia
  68. Hypoglycemia
  69. Hypothermia
  70. Hypovolemia
  71. Internal bleeding
  72. Ketoacidosis
  73. Lactic acidosis
  74. Lethal dose
  75. List of medical emergencies
  76. Malaria
  77. Malignant hypertension
  78. Medical emergency
  79. Meningitis
  80. Neuroglycopenia
  81. Neuroleptic malignant syndrome
  82. Nonketotic hyperosmolar coma
  83. Obstetrical hemorrhage
  84. Outdoor Emergency Care
  85. Overwhelming post-splenectomy infection
  86. Paralytic shellfish poisoning
  87. Paramedic
  88. Paraphimosis
  89. Peritonitis
  90. Physical trauma
  91. Placenta accreta
  92. Pneumothorax
  93. Positional asphyxia
  94. Pre-eclampsia
  95. Priapism
  96. Psychotic depression
  97. Respiratory arrest
  98. Respiratory failure
  99. Retinal detachment
  100. Revised Trauma Score
  101. Sepsis
  102. Septic arthritis
  103. Septic shock
  104. Sexual assault
  105. Shock
  106. Simple triage and rapid treatment
  107. Soy allergy
  108. Spinal cord compression
  109. Status epilepticus
  110. Stroke
  111. Temporal arteritis
  112. Testicular torsion
  113. Toxic epidermal necrolysis
  114. Toxidrome
  115. Triage
  116. Triage tag
  117. Upper gastrointestinal bleeding
  118. Uterine rupture
  119. Ventricular fibrillation
  120. Walking wounded
  121. Watershed stroke
  122. Wilderness first aid
  123. Wound

 

 
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    ENGLISHGRATIS.COM è un sito personale di
    Roberto Casiraghi e Crystal Jones
    email: robertocasiraghi at iol punto it

    Roberto Casiraghi           
    INFORMATIVA SULLA PRIVACY              Crystal Jones


    Siti amici:  Lonweb Daisy Stories English4Life Scuolitalia
    Sito segnalato da INGLESE.IT

 
 



THE BOOK OF MEDICAL EMERGENCIES
This article is from:
http://en.wikipedia.org/wiki/Cardiac_tamponade

All text is available under the terms of the GNU Free Documentation License: http://en.wikipedia.org/wiki/Wikipedia:Text_of_the_GNU_Free_Documentation_License 

Cardiac tamponade

From Wikipedia, the free encyclopedia

 

Cardiac tamponade, also known as pericardial tamponade, is a medical emergency condition where liquid accumulates in the pericardium in a relatively short time. The elevated pericardial pressure prevents proper filling of heart cavities. Instead of reducing the filling of both ventricles equally, the septum of the heart will bend into either the left or right ventricle. The end result is low stroke volume, shock and often death.

Causes

Cardiac tamponade occurs when the pericardial space fills up with fluid faster than the pericardial sac can stretch. If the amount of fluid increases slowly (such as in hypothyroidism) the pericardial sac can expand to contain a liter or more of fluid prior to tamponade occurring. If the fluid occurs rapidly (as may occur after trauma or myocardial rupture) as little as 100 ml can cause tamponade.

Causes of increased pericardial effusion include hypothyroidism, trauma (either penetrating trauma involving the pericardium or blunt chest trauma), pericarditis (inflammation of the pericardium), iatrogenic trauma (during an invasive procedure), and myocardial rupture.

Myocardial rupture is a somewhat uncommon cause of pericardial tamponade. It typically happens in the subacute setting after a myocardial infarction (heart attack), in which the infarcted muscle of the heart thins out and tears. Myocardial rupture is more likely to happen in elderly individuals without any previous cardiac history who suffer from their first heart attack and are not revascularized either with thrombolytic therapy or with percutaneous coronary intervention or with coronary artery bypass graft surgery.

Diagnosis

Signs and symptoms of cardiac tamponade can appear very similar to congestive heart failure. Usually, however, the differential diagnosis can be made via a history of sudden onset attributable to trauma, particularly in younger patients.

Identification of cardiac tamponade relies upon Beck's triad: hypotension, jugular vein distension, and muffled heart sounds resulting from accumulated fluid dampening sound transmission through the chest wall. In pre-hospital settings, identification of the quiet heart sounds can be difficult. It is important to note the baseline condition during the primary survey and recognize a downward trend.

Tension pneumothorax is the major differential diagnosis of cardiac tamponade. A tension pneumothorax will present with a deviated trachea and unequal breath sounds. Cardiac tamponade presents with a midline trachea and equal breath sounds, unless comorbid with either hemothorax or pneumothorax. A paradoxical pulse may also present in cardiac tamponade.

First Aid

If recognized, call for help and arrange for immediate transport to advanced medical care. MEDEVAC in wilderness first aid situations is indicated. If the patient's heart stops, CPR should be initiated immediately, although patient outcomes for out-of-hospital, tamponade-related arrest are extremely low.

Pre-hospital care (for EMTs and Paramedics)

Definitive care requires in-hospital interventions. Prehospital interventions, even with Advanced Life Support-trained crews, cannot sufficiently treat the condition. Management of cardiac tamponade includes:

  • High flow oxygen either by non-rebreather mask or bag valve mask.
  • Timely identification of symptoms followed by rapid transport.
  • IV administration of electrolyte fluids (normal saline) to maintain a systolic blood pressure of between 90 and 100 mmHg
  • Monitoring oxygen saturation and blood pressure levels
  • Early activation of an Aeromedical Evacuation team or rapid transport to a designated trauma center

There is little care that can be provided prehospitally except management of the shock condition. Definitive care requires piercing the pericardial membrane with a needle permitting the fluid evacuation. Piercing the pericardial membrane with a needle (which was a skill taught in the early days of EMS to all Paramedics) is generally not advised in the back of a bouncing ambulance. In most states, Paramedics working in a ground-based ambulance may not legally perform this procedure. However many flight medics and flight nurses are trained to perform needle pericardiocentesis. Military Medics are also trained to perform this procedure.

Clinical treatment

Pericardiocentesis, needle evacuation of the fluid and lowering of the pericardial pressure, and then treatment of the underlying cause, is life-saving. Often, a pericardial drain is left in situ to prevent short-term recurrence. Surgery to repair the damage to the heart is often required.

See also

  • Tamponade
  • emergency medicine

External links

  • MedlinePlus Encyclopedia 000194
Retrieved from "http://en.wikipedia.org/wiki/Cardiac_tamponade"