A heart attack occurs when an artery supplying your heart with blood and oxygen becomes blocked. This loss of blood flow injures your heart muscle. A heart attack generally causes chest pain for more than 15 minutes, but it can also be "silent" and have no symptoms at all.
Many people who suffer a heart attack have warning symptoms hours, days or weeks in advance. The earliest predictor of an attack may be recurrent chest pain that's triggered by exertion and relieved by rest (angina).
Someone having an attack may experience any or all of the following:
Uncomfortable pressure, fullness or squeezing pain in the center of the chest. The pain might last several minutes or come and go. It may be triggered by exertion and relieved by rest.
Prolonged pain in the upper abdomen.
Discomfort or pain spreading beyond the chest to the shoulders, neck, jaw, teeth, or one or both arms.
Shortness of breath.
Lightheadedness, dizziness, fainting.
Sweating.
Nausea.
If you or someone else may be having a heart attack:
Dial 911 or your local emergency medical assistance number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Police or fire-rescue units also may be a source of transportation. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.
Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling 911.
Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.
Begin CPR. If you're with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation (CPR). If you haven't received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and proceeding directly to chest compression. The dispatcher can instruct you in the proper procedures until help arrives.
source:mayoclinic.com
Monday, December 29, 2008
Tuesday, December 23, 2008
TESTICULAR TORSION
Introduction
Background
Testicular torsion is a true urologic emergency and must be differentiated from other complaints of testicular pain because a delay in diagnosis and management can lead to loss of the testicle. Though testicular torsion can occur at any age, including the prenatal and perinatal periods, it most commonly occurs in adolescent males, and testicular torsion is the most frequent cause of testicle loss in that population.
Pathophysiology
The testicle is typically covered by the tunica vaginalis, a potential space that encompasses the anterior two thirds of the testicle and where fluid from a variety of sources may accumulate. The tunica vaginalis attaches to the posterolateral surface of the testicle and allows for little mobility of the testicle within the scrotum.
In patients who have an inappropriately high attachment of the tunica vaginalis, the testicle can rotate freely on the spermatic cord within the tunica vaginalis (intravaginal testicular torsion). This congenital anomaly, called the bell clapper deformity, results in the long axis of the testicle to become oriented transversely rather than cephalocaudal. This congenital abnormality is present in approximately 12% of males, 40% of which have the abnormality in the contralateral testicle as well.1 The bell clapper deformity allows the testicle to twist spontaneously on the spermatic cord, causing venous occlusion and engorgement, with subsequent arterial ischemia causing infarction of the testicle. Experimental evidence indicates that 720° torsion is required to compromise flow through the testicular artery and result in ischemia.
In the neonatal age group, the testicle frequently has not yet descended into the scrotum, where it becomes attached within the tunica vaginalis. This mobility of the testicle predisposes it to torsion (extravaginal testicular torsion). Inadequate fusion of the testicle to the scrotal wall, moreover, typically occurs within the first 7-10 days of life.
Torsion may be categorized as complete, incomplete, or transient.
Frequency
United States
Incidence of torsion in males younger than 25 years is approximately 1 in 4000.2 Torsion more often involves the left testicle.
Of the cases of testicular torsion that occur in the neonatal population, 70% occur prenatally and 30% occur postnatally.
Mortality/Morbidity
This urologic emergency requires prompt diagnosis, immediate urologic consultation, and rapid definitive operative treatment for salvage of the testicle.
A salvage rate of 90-100% is found in patients who undergo detorsion within 6 hours of pain; the viability rate fell to between 20% and 50% after 12 hours; and 0 to 10% viability if detorsion is delayed greater than 24 hours.3, 2
Sex
Testicular torsion affects males only.
Age
Testicular torsion most often is observed in males younger than 30 years, with most aged 12-18 years. The peak age is 14 years, although a smaller peak also occurs during the first year of life.
Clinical
History
History includes a sudden onset of severe unilateral scrotal pain.
As many as 50% of patients have a history of prior episodes of intermittent testicular pain that has resolved spontaneously (intermittent torsion and detorsion).
Onset of pain can occur more slowly, but this is an uncommon presentation of torsion.
Torsion can occur with activity, be related to trauma in 4-8% of cases2, or develop during sleep.
The historical features suggestive of testicular torsion include the following:
Acute onset of unilateral scrotal pain
Scrotal swelling
Nausea and vomiting: In the pediatric population, nausea and vomiting more commonly accompany acute testicular torsion and have a positive predictive value of greater than 96%.4
Abdominal pain (20-30%)
Fever (16%)
Urinary frequency (4%)
Physical
The physical examination may be difficult to perform, particularly in the case of an ill child.
Involved testicle painful to palpation; frequently elevated in position when compared with the other side
Horizontal lie of the testicle
Enlargement and edema of the testicle; edema involving the entire scrotum
Scrotal erythema
Ipsilateral loss of the cremasteric reflex. The cremasteric reflex is almost always absent in patients with testicular torsion, and its presence may help to distinguish other causes of acute scrotal pain from testicular torsion.5, 6
Usually, no relief of pain upon elevation of scrotum (elevation may improve the pain in epididymitis [Prehn sign])
Fever (uncommon)
Causes
Congenital anomaly; bell clapper deformity
Undescended testicle
Sexual arousal and/or activity
Trauma
Exercise
Active cremasteric reflex
Cold weather
source:emedicine
Background
Testicular torsion is a true urologic emergency and must be differentiated from other complaints of testicular pain because a delay in diagnosis and management can lead to loss of the testicle. Though testicular torsion can occur at any age, including the prenatal and perinatal periods, it most commonly occurs in adolescent males, and testicular torsion is the most frequent cause of testicle loss in that population.
Pathophysiology
The testicle is typically covered by the tunica vaginalis, a potential space that encompasses the anterior two thirds of the testicle and where fluid from a variety of sources may accumulate. The tunica vaginalis attaches to the posterolateral surface of the testicle and allows for little mobility of the testicle within the scrotum.
In patients who have an inappropriately high attachment of the tunica vaginalis, the testicle can rotate freely on the spermatic cord within the tunica vaginalis (intravaginal testicular torsion). This congenital anomaly, called the bell clapper deformity, results in the long axis of the testicle to become oriented transversely rather than cephalocaudal. This congenital abnormality is present in approximately 12% of males, 40% of which have the abnormality in the contralateral testicle as well.1 The bell clapper deformity allows the testicle to twist spontaneously on the spermatic cord, causing venous occlusion and engorgement, with subsequent arterial ischemia causing infarction of the testicle. Experimental evidence indicates that 720° torsion is required to compromise flow through the testicular artery and result in ischemia.
In the neonatal age group, the testicle frequently has not yet descended into the scrotum, where it becomes attached within the tunica vaginalis. This mobility of the testicle predisposes it to torsion (extravaginal testicular torsion). Inadequate fusion of the testicle to the scrotal wall, moreover, typically occurs within the first 7-10 days of life.
Torsion may be categorized as complete, incomplete, or transient.
Frequency
United States
Incidence of torsion in males younger than 25 years is approximately 1 in 4000.2 Torsion more often involves the left testicle.
Of the cases of testicular torsion that occur in the neonatal population, 70% occur prenatally and 30% occur postnatally.
Mortality/Morbidity
This urologic emergency requires prompt diagnosis, immediate urologic consultation, and rapid definitive operative treatment for salvage of the testicle.
A salvage rate of 90-100% is found in patients who undergo detorsion within 6 hours of pain; the viability rate fell to between 20% and 50% after 12 hours; and 0 to 10% viability if detorsion is delayed greater than 24 hours.3, 2
Sex
Testicular torsion affects males only.
Age
Testicular torsion most often is observed in males younger than 30 years, with most aged 12-18 years. The peak age is 14 years, although a smaller peak also occurs during the first year of life.
Clinical
History
History includes a sudden onset of severe unilateral scrotal pain.
As many as 50% of patients have a history of prior episodes of intermittent testicular pain that has resolved spontaneously (intermittent torsion and detorsion).
Onset of pain can occur more slowly, but this is an uncommon presentation of torsion.
Torsion can occur with activity, be related to trauma in 4-8% of cases2, or develop during sleep.
The historical features suggestive of testicular torsion include the following:
Acute onset of unilateral scrotal pain
Scrotal swelling
Nausea and vomiting: In the pediatric population, nausea and vomiting more commonly accompany acute testicular torsion and have a positive predictive value of greater than 96%.4
Abdominal pain (20-30%)
Fever (16%)
Urinary frequency (4%)
Physical
The physical examination may be difficult to perform, particularly in the case of an ill child.
Involved testicle painful to palpation; frequently elevated in position when compared with the other side
Horizontal lie of the testicle
Enlargement and edema of the testicle; edema involving the entire scrotum
Scrotal erythema
Ipsilateral loss of the cremasteric reflex. The cremasteric reflex is almost always absent in patients with testicular torsion, and its presence may help to distinguish other causes of acute scrotal pain from testicular torsion.5, 6
Usually, no relief of pain upon elevation of scrotum (elevation may improve the pain in epididymitis [Prehn sign])
Fever (uncommon)
Causes
Congenital anomaly; bell clapper deformity
Undescended testicle
Sexual arousal and/or activity
Trauma
Exercise
Active cremasteric reflex
Cold weather
source:emedicine
Monday, December 22, 2008
DYSMENORRHEA
What is dysmenorrhea?
Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary.
primary dysmenorrhea - from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.
secondary dysmenorrhea - due to some physical cause and usually of later onset; painful menstrual periods caused by another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).
What causes dysmenorrhea?
The cause of dysmenorrhea depends on whether the condition is primary or secondary. In general, females with primary dysmenorrhea experience abnormal uterine contractions as a result of a chemical imbalance in the body (particularly prostaglandin and arachidonic acid - both chemicals which control the contractions of the uterus). Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis (a condition in which tissue that looks and acts like endometrial tissue becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity - often resulting in internal bleeding, infection, and pelvic pain). Other possible causes of secondary dysmenorrhea include the following:
pelvic inflammatory disease (PID)
uterine fibroids
abnormal pregnancy (i.e., miscarriage, ectopic)
infection, tumors, or polyps in the pelvic cavity
Who is at risk for dysmenorrhea?
While any female can develop dysmenorrhea, the following females may be at an increased risk for the condition:
females who smoke
females who drink alcohol during menses (alcohol tends to prolong menstrual pain)
females who are overweight
females who started menstruating before the age of 11
Consult your physician for more information.
What are the symptoms of dysmenorrhea?
The following are the most common symptoms ofdysmenorrhea. However, each adolescent may experience symptoms differently. Symptoms may include:
cramping in the lower abdomen
pain in the lower abdomen
low back pain
pain radiating down the legs
nausea
vomiting
diarrhea
fatigue
weakness
fainting
headaches
The symptoms of dysmenorrhea may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How is dysmenorrhea diagnosed?
Diagnosis begins with a gynecologist evaluating a female's medical history and a complete physical examination including a pelvic examination. A diagnosis of dysmenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, diagnostic procedures for dysmenorrhea may include:
ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
laparoscopy - a minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic and abdomen area, the physician can often detect abnormal growths.
hysteroscopy - a visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
Treatment for dysmenorrhea:
Specific treatment for dysmenorrhea will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
cause of the condition (primary or secondary)
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Counseling with your physician regarding symptoms may increase understanding and lead to activities for stress management. Other possible treatment protocols for managing dysmenorrhea symptoms in young women may include the following:
prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications, or NSAIDs, such as aspirin, ibuprofen) - to reduce pain
acetaminophen
oral contraceptives (ovulation inhibitors)
progesterone (hormone treatment)
dietary modifications (to increase protein and decrease sugar and caffeine intake)
vitamin supplements
regular exercise
heating pad across the abdomen
hot bath or shower
abdominal massage
source:healthsystem.viginia.edu
Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary.
primary dysmenorrhea - from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.
secondary dysmenorrhea - due to some physical cause and usually of later onset; painful menstrual periods caused by another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).
What causes dysmenorrhea?
The cause of dysmenorrhea depends on whether the condition is primary or secondary. In general, females with primary dysmenorrhea experience abnormal uterine contractions as a result of a chemical imbalance in the body (particularly prostaglandin and arachidonic acid - both chemicals which control the contractions of the uterus). Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis (a condition in which tissue that looks and acts like endometrial tissue becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity - often resulting in internal bleeding, infection, and pelvic pain). Other possible causes of secondary dysmenorrhea include the following:
pelvic inflammatory disease (PID)
uterine fibroids
abnormal pregnancy (i.e., miscarriage, ectopic)
infection, tumors, or polyps in the pelvic cavity
Who is at risk for dysmenorrhea?
While any female can develop dysmenorrhea, the following females may be at an increased risk for the condition:
females who smoke
females who drink alcohol during menses (alcohol tends to prolong menstrual pain)
females who are overweight
females who started menstruating before the age of 11
Consult your physician for more information.
What are the symptoms of dysmenorrhea?
The following are the most common symptoms ofdysmenorrhea. However, each adolescent may experience symptoms differently. Symptoms may include:
cramping in the lower abdomen
pain in the lower abdomen
low back pain
pain radiating down the legs
nausea
vomiting
diarrhea
fatigue
weakness
fainting
headaches
The symptoms of dysmenorrhea may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How is dysmenorrhea diagnosed?
Diagnosis begins with a gynecologist evaluating a female's medical history and a complete physical examination including a pelvic examination. A diagnosis of dysmenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, diagnostic procedures for dysmenorrhea may include:
ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
laparoscopy - a minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic and abdomen area, the physician can often detect abnormal growths.
hysteroscopy - a visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
Treatment for dysmenorrhea:
Specific treatment for dysmenorrhea will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
cause of the condition (primary or secondary)
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Counseling with your physician regarding symptoms may increase understanding and lead to activities for stress management. Other possible treatment protocols for managing dysmenorrhea symptoms in young women may include the following:
prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications, or NSAIDs, such as aspirin, ibuprofen) - to reduce pain
acetaminophen
oral contraceptives (ovulation inhibitors)
progesterone (hormone treatment)
dietary modifications (to increase protein and decrease sugar and caffeine intake)
vitamin supplements
regular exercise
heating pad across the abdomen
hot bath or shower
abdominal massage
source:healthsystem.viginia.edu
Friday, December 19, 2008
GSTROINTESTINAL BLEEDING SYMPTOMS
(continued)
Acute gastrointestinal bleeding first will appear as vomiting of blood, bloody bowel movements, or black, tarry stools. Blood may look like "coffee grounds." Symptoms associated with blood loss can include the following:
Fatigue
Weakness
Shortness of breath
Abdominal pain
Pale appearance
Vomiting of blood usually originates from an upper GI source. Bright red or maroon stool can be from either a lower GI source or from brisk bleeding at an upper GI source.
Long-term GI bleeding may go unnoticed or may cause fatigue, anemia, black stools, or a positive test for microscopic blood.
When to Seek Medical Care
Any presence of blood in the stool or the upper gastrointestinal tract is significant and needs medical investigation. Black or dark stools may represent slow bleeding into the GI tract and should be investigated by a physician.
Any significant bleeding into the GI tract, either vomited blood or blood through the rectum, should be evaluated in the emergency department.
Exams and Tests
A doctor will perform a complete history and physical exam to evaluate your problem. The physical will include a digital rectal exam, to test for visible or microscopic blood from your rectum.
The doctor may need to insert a tube through your nose into your stomach to help identify the source of the bleeding. The procedure is called endoscopy. An endoscope is a long tube with a tiny camera on the end. It may be passed through the nose into the stomach, or through the rectum into the colon, to directly see the source of bleeding. Endoscopy can be both diagnostic, finding the source of bleeding, and therapeutic, stopping it.
Lab tests also can be helpful to determine the rate or severity of bleeding and to determine factors that may contribute to the problem.
Gastrointestinal Bleeding Treatment
Self-Care at Home
There is no home care for heavy gastrointestinal bleeding. Go to a hospital's emergency department. For hemorrhoids or anal fissures, eat a diet high in fiber and fluids to keep stools soft.
Medical Treatment
Serious gastrointestinal bleeding can destabilize your vital signs. For instance, your blood pressure may fall sharply and your heart rate will increase.
The physician may need to resuscitate you with IV fluids and possibly a blood transfusion.
In some cases, you may need surgery.
Next Steps Follow-up
Maintain a proper diet and take the medications prescribed to you as your doctor directs.
Follow up with your physician on a regular basis to monitor progress, so that your doctor can prevent further progression and complications of your gastrointestinal bleeding.
Prevention
You can prevent some causes of gastrointestinal bleeding.
Avoid foods and factors, such as alcohol and smoking, that increase gastric secretions.
Eat a high-fiber diet to increase the bulk of the stool, which helps prevent diverticulosis and hemorrhoids.
source:webmd.com
Acute gastrointestinal bleeding first will appear as vomiting of blood, bloody bowel movements, or black, tarry stools. Blood may look like "coffee grounds." Symptoms associated with blood loss can include the following:
Fatigue
Weakness
Shortness of breath
Abdominal pain
Pale appearance
Vomiting of blood usually originates from an upper GI source. Bright red or maroon stool can be from either a lower GI source or from brisk bleeding at an upper GI source.
Long-term GI bleeding may go unnoticed or may cause fatigue, anemia, black stools, or a positive test for microscopic blood.
When to Seek Medical Care
Any presence of blood in the stool or the upper gastrointestinal tract is significant and needs medical investigation. Black or dark stools may represent slow bleeding into the GI tract and should be investigated by a physician.
Any significant bleeding into the GI tract, either vomited blood or blood through the rectum, should be evaluated in the emergency department.
Exams and Tests
A doctor will perform a complete history and physical exam to evaluate your problem. The physical will include a digital rectal exam, to test for visible or microscopic blood from your rectum.
The doctor may need to insert a tube through your nose into your stomach to help identify the source of the bleeding. The procedure is called endoscopy. An endoscope is a long tube with a tiny camera on the end. It may be passed through the nose into the stomach, or through the rectum into the colon, to directly see the source of bleeding. Endoscopy can be both diagnostic, finding the source of bleeding, and therapeutic, stopping it.
Lab tests also can be helpful to determine the rate or severity of bleeding and to determine factors that may contribute to the problem.
Gastrointestinal Bleeding Treatment
Self-Care at Home
There is no home care for heavy gastrointestinal bleeding. Go to a hospital's emergency department. For hemorrhoids or anal fissures, eat a diet high in fiber and fluids to keep stools soft.
Medical Treatment
Serious gastrointestinal bleeding can destabilize your vital signs. For instance, your blood pressure may fall sharply and your heart rate will increase.
The physician may need to resuscitate you with IV fluids and possibly a blood transfusion.
In some cases, you may need surgery.
Next Steps Follow-up
Maintain a proper diet and take the medications prescribed to you as your doctor directs.
Follow up with your physician on a regular basis to monitor progress, so that your doctor can prevent further progression and complications of your gastrointestinal bleeding.
Prevention
You can prevent some causes of gastrointestinal bleeding.
Avoid foods and factors, such as alcohol and smoking, that increase gastric secretions.
Eat a high-fiber diet to increase the bulk of the stool, which helps prevent diverticulosis and hemorrhoids.
source:webmd.com
Thursday, December 18, 2008
GASTROINTESTINAL BLEEDING OVERVIEW
The many causes of gastrointestinal (GI) bleeding are classified into upper or lower, depending on their location in the GI tract.
Upper gastrointestinal bleeding: Upper GI bleeding originates in the first part of the GI tract-the esophagus, stomach, or duodenum (first part of the intestine). Bleeding can come from ingestion of caustic poisons or stomach cancer. Most often, upper GI bleeding is caused by one of the following:
Peptic ulcers
Gastritis
Esophageal varices
Mallory-Weiss tears
Lower gastrointestinal bleeding: Lower GI bleeding originates in the portions of the GI tract farther down the digestive system-the segment of the small intestine farther from the stomach, large intestine, rectum, and anus. Diverticular disease, angiodysplasia, polyps, hemorrhoids, and anal fissures most commonly cause the bleeding. Blood in the stool can result from cancers, inflammatory bowel disease, and infectious diarrhea.
Gastrointestinal Bleeding Causes
The many causes of gastrointestinal bleeding are classified into upper or lower, depending on their location in the GI tract.
Upper GI bleeding
Peptic ulcer disease: Peptic ulcers are localized erosions of the wall of the digestive tract. Ulcers usually occur in the stomach or duodenum. Breakdown of the walls results in damage to blood vessels, causing bleeding. When the mucous membranes break down, they are unable to counteract the harsh effects of stomach acid. Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, and cigarette smoking promote gastric ulcer formation. Helicobacter pylori are a type of bacteria that also promote formation of ulcers.
Gastritis: General inflammation of the stomach wall, which can result in bleeding. Gastritis also results from an inability of the gastric lining to protect itself from the acid it produces. NSAIDs, steroids, alcohol, burns, and trauma can cause gastritis.
Esophageal varices: Swellings in veins of your esophagus or stomach usually result from liver disease. Varices most commonly result from alcoholic liver cirrhosis. When varices bleed, the bleeding can be massive and catastrophic and occur without warning.
Mallory-Weiss tear: A tear in the esophageal or stomach wall, often as a result of vomiting or retching. Tears also can occur after seizures, forceful coughing or laughing, lifting, straining, or childbirth. Physicians often find tears in people who have recently binged on alcohol.
Lower GI bleeding
Diverticulosis: One of the most common causes of lower GI bleeding. Small out-pockets, or diverticula, form on part of the wall of your colon (large intestine), usually in a weakened area of the bowel wall. You may develop several pockets, which are more common in people who have constipation and strain at stool.
Angiodysplasia: Along with diverticulosis, this is one of the most common causes of lower GI bleeding. Angiodysplasia is a malformation in the blood vessels in the wall of the GI tract. The sores are most common in the large intestine and often bleed. The elderly and people with chronic kidney failure develop the disease most often.
Polyps: Intestinal polyps are noncancerous tumors of the GI tract, occurring mostly in people older than 40 years. A small proportion of these polyps may transform into cancer. Colonic polyps may bleed rapidly, or they may bleed slowly and go undetected.
Hemorrhoids and fissures: Hemorrhoids are swellings of veins in and around your rectum. Repeated stretching from straining at stool causes them to bleed. Bleeding from hemorrhoids is usually mild, intermittent, and bright red. Massive bleeding is rare. Anal fissures, or tears in the anal wall, also may trigger small amounts of bright red bleeding from the anus. Forceful straining during passage of hard stool usually causes such tears, which can be very painful.
source:webmd.com
Upper gastrointestinal bleeding: Upper GI bleeding originates in the first part of the GI tract-the esophagus, stomach, or duodenum (first part of the intestine). Bleeding can come from ingestion of caustic poisons or stomach cancer. Most often, upper GI bleeding is caused by one of the following:
Peptic ulcers
Gastritis
Esophageal varices
Mallory-Weiss tears
Lower gastrointestinal bleeding: Lower GI bleeding originates in the portions of the GI tract farther down the digestive system-the segment of the small intestine farther from the stomach, large intestine, rectum, and anus. Diverticular disease, angiodysplasia, polyps, hemorrhoids, and anal fissures most commonly cause the bleeding. Blood in the stool can result from cancers, inflammatory bowel disease, and infectious diarrhea.
Gastrointestinal Bleeding Causes
The many causes of gastrointestinal bleeding are classified into upper or lower, depending on their location in the GI tract.
Upper GI bleeding
Peptic ulcer disease: Peptic ulcers are localized erosions of the wall of the digestive tract. Ulcers usually occur in the stomach or duodenum. Breakdown of the walls results in damage to blood vessels, causing bleeding. When the mucous membranes break down, they are unable to counteract the harsh effects of stomach acid. Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, and cigarette smoking promote gastric ulcer formation. Helicobacter pylori are a type of bacteria that also promote formation of ulcers.
Gastritis: General inflammation of the stomach wall, which can result in bleeding. Gastritis also results from an inability of the gastric lining to protect itself from the acid it produces. NSAIDs, steroids, alcohol, burns, and trauma can cause gastritis.
Esophageal varices: Swellings in veins of your esophagus or stomach usually result from liver disease. Varices most commonly result from alcoholic liver cirrhosis. When varices bleed, the bleeding can be massive and catastrophic and occur without warning.
Mallory-Weiss tear: A tear in the esophageal or stomach wall, often as a result of vomiting or retching. Tears also can occur after seizures, forceful coughing or laughing, lifting, straining, or childbirth. Physicians often find tears in people who have recently binged on alcohol.
Lower GI bleeding
Diverticulosis: One of the most common causes of lower GI bleeding. Small out-pockets, or diverticula, form on part of the wall of your colon (large intestine), usually in a weakened area of the bowel wall. You may develop several pockets, which are more common in people who have constipation and strain at stool.
Angiodysplasia: Along with diverticulosis, this is one of the most common causes of lower GI bleeding. Angiodysplasia is a malformation in the blood vessels in the wall of the GI tract. The sores are most common in the large intestine and often bleed. The elderly and people with chronic kidney failure develop the disease most often.
Polyps: Intestinal polyps are noncancerous tumors of the GI tract, occurring mostly in people older than 40 years. A small proportion of these polyps may transform into cancer. Colonic polyps may bleed rapidly, or they may bleed slowly and go undetected.
Hemorrhoids and fissures: Hemorrhoids are swellings of veins in and around your rectum. Repeated stretching from straining at stool causes them to bleed. Bleeding from hemorrhoids is usually mild, intermittent, and bright red. Massive bleeding is rare. Anal fissures, or tears in the anal wall, also may trigger small amounts of bright red bleeding from the anus. Forceful straining during passage of hard stool usually causes such tears, which can be very painful.
source:webmd.com
Wednesday, December 17, 2008
FIRST AID TIPS
Section 1: How to react responsibly
KEEP CALM. Remaining calm while helping the victim will help him/her to keep calm and cooperate with the rescuer. It will also help prevent any further injury.
PLAN QUICKLY WHAT YOU NEED TO DO. Learn basic procedures, or have your first aid manual available, so you can care for the victim.
SEND FOR PROFESSIONAL HELP. Reaching help quickly could save a life. Know your local emergency telephone numbers.
BE AN ENCOURAGEMENT TO THE INJURED PERSON. Let the victim know that help is on the way and try to make them as comfortable as possible. Showing care and concern for the victim can give them hope during their circumstances.
Section 2: Assessing the Situation
When arriving at a scene, assess the situation immediately. Be aware of any situation which may put your life at risk. Avoid all dangerous situations and do not put yourself into a situation where you may also become a victim. If the scene is dangerous, wait for professional help to arrive at which time you may be asked to assist.
When you are faced with multiple casualties and you are the only rescuer follow these rules:
DO NOT MOVE A VICTIM UNLESS HE/SHE IS IN IMMEDIATE DANGER (e.g. An unsafe building, burning car, etc.)
CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY. Ask an onlooker to call Emergency Medical Services. If you are alone, asses the situation, attend to life threatening situations and then call the Emergency Medical Services.
Assess all victims:
a. Check to see if the victim is breathing.
b. Check to see if the victim has a pulse.
c. Check to see whether the victim is bleeding.
Attend the victims in the following priority:
a. Those who are not breathing and do not have a pulse. BEGIN CPR IMMEDIATELY
b. Those who are not breathing and have profound bleeding. CHECK AIRWAY and try to resume breathing. Start artificial respiration if necessary. Be aware that the victim may go into cardiac arrest if you do not stop the bleeding.
c. Those who are breathing and have profound bleeding. Remember that the victim may go into cardiac arrest if you do not stop the bleeding.
Reassess the situation frequently.
Once you have attended to a victim and restored cardiac functions, breathing and stopped bleeding MOVE ON to the next victim. Remember to always reassess the situation.
KEEP CALM. Remaining calm while helping the victim will help him/her to keep calm and cooperate with the rescuer. It will also help prevent any further injury.
PLAN QUICKLY WHAT YOU NEED TO DO. Learn basic procedures, or have your first aid manual available, so you can care for the victim.
SEND FOR PROFESSIONAL HELP. Reaching help quickly could save a life. Know your local emergency telephone numbers.
BE AN ENCOURAGEMENT TO THE INJURED PERSON. Let the victim know that help is on the way and try to make them as comfortable as possible. Showing care and concern for the victim can give them hope during their circumstances.
Section 2: Assessing the Situation
When arriving at a scene, assess the situation immediately. Be aware of any situation which may put your life at risk. Avoid all dangerous situations and do not put yourself into a situation where you may also become a victim. If the scene is dangerous, wait for professional help to arrive at which time you may be asked to assist.
When you are faced with multiple casualties and you are the only rescuer follow these rules:
DO NOT MOVE A VICTIM UNLESS HE/SHE IS IN IMMEDIATE DANGER (e.g. An unsafe building, burning car, etc.)
CALL THE EMERGENCY MEDICAL SERVICES IMMEDIATELY. Ask an onlooker to call Emergency Medical Services. If you are alone, asses the situation, attend to life threatening situations and then call the Emergency Medical Services.
Assess all victims:
a. Check to see if the victim is breathing.
b. Check to see if the victim has a pulse.
c. Check to see whether the victim is bleeding.
Attend the victims in the following priority:
a. Those who are not breathing and do not have a pulse. BEGIN CPR IMMEDIATELY
b. Those who are not breathing and have profound bleeding. CHECK AIRWAY and try to resume breathing. Start artificial respiration if necessary. Be aware that the victim may go into cardiac arrest if you do not stop the bleeding.
c. Those who are breathing and have profound bleeding. Remember that the victim may go into cardiac arrest if you do not stop the bleeding.
Reassess the situation frequently.
Once you have attended to a victim and restored cardiac functions, breathing and stopped bleeding MOVE ON to the next victim. Remember to always reassess the situation.
Saturday, December 13, 2008
NEAR DROWNING
Near-drowning is when a person is in danger of drowning. Each year, almost 8,000 people die from drowning. Seventy percent of all near-drowning victims recover; 25% die, and 5% have brain damage.
A toddler can drown in as little as 2 inches of water in a bathtub, sink, etc. Toilet bowls are unsafe, too, if a small child falls into one head-first.
Signs & Symptoms
A person is in the water with signs of distress. He or she can't stay above water, swims unevenly, signals for help, etc.
Blue lips or ears. The skin is cold and pale.
Bloated abdomen. Vomiting. Choking.
Confusion. Lethargy.
The person does not respond or can't breathe.
Causes
Not being able to swim. Being in water too deep and too rough for one's ability to swim.
Water sport and other accidents. Not following water safety rules. Not wearing a life preserver, etc. Unsupervised swimming.
Falling through ice while fishing, skating, etc.
Injury or problems that occur while swimming, boating, etc. Examples are leg or stomach cramps, fatigue, and alcohol or drug use. A heart attack, stroke, seizure, and a marine animal bite or sting may have occurred.
Treatment
Immediate medical care is needed for near-drowning.
source:healthy.net
A toddler can drown in as little as 2 inches of water in a bathtub, sink, etc. Toilet bowls are unsafe, too, if a small child falls into one head-first.
Signs & Symptoms
A person is in the water with signs of distress. He or she can't stay above water, swims unevenly, signals for help, etc.
Blue lips or ears. The skin is cold and pale.
Bloated abdomen. Vomiting. Choking.
Confusion. Lethargy.
The person does not respond or can't breathe.
Causes
Not being able to swim. Being in water too deep and too rough for one's ability to swim.
Water sport and other accidents. Not following water safety rules. Not wearing a life preserver, etc. Unsupervised swimming.
Falling through ice while fishing, skating, etc.
Injury or problems that occur while swimming, boating, etc. Examples are leg or stomach cramps, fatigue, and alcohol or drug use. A heart attack, stroke, seizure, and a marine animal bite or sting may have occurred.
Treatment
Immediate medical care is needed for near-drowning.
source:healthy.net
Friday, December 12, 2008
DISLOCATION FIRST AID
A dislocation is an injury in which the ends of your bones are forced from their normal positions. The cause is usually trauma, such as a blow or fall, but dislocation can be caused by an underlying disease, such as rheumatoid arthritis.
Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball. Dislocations may occur in major joints, such as your shoulder, hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb or toe.
The injury will temporarily deform and immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions.
If you believe you have dislocated a joint:
Don't delay medical care. Get medical help immediately.
Don't move the joint. Until you receive help, splint the affected joint into its fixed position. Don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels.
Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
Regardless of where the joint dislocation is on the injured person's body, these are the basic steps you should take to provide first aid. The key to providing first aid in any situation is to remain calm while you help the injured person. Take the following steps to give first aid to someone with a dislocated joint.
Step1
Call 911. Do this before you begin any other type of first aid on the joint dislocation. Follow any instructions you are given.
Step2
Make sure to check the injured person's breathing. Make sure nothing is obstructing their airway. Administer CPR or rescue breathing if necessary. Also take any necessary steps to staunch bleeding before beginning first aid for a joint dislocation.
Step3
Keep the injured person still. Don't attempt to move him unless absolutely necessary. If you must move him, grab his clothes, not his body.
Step4
Cover any open wounds to prevent infection. If sterile bandages aren't available, cut up a clean article of clothing.
Step5
Do not try to move the bone and/or joint. Splint it or immobilize it just as it is. If you try to move a dislocated joint, you risk further injury and more pain to the injured person.
Step6
Check that the wounded area is getting enough blood flow. Press near the injury. The skin should turn white, then immediately get its color back.
Step7
Keep the victim calm until emergency help arrives. Cover him with a blanket to keep him warm. Be observant for the signs of shock that may set in several minutes after the injury occurs. Apply an ice bag to the dislocated joint to provide some relief from the pain.
source:Myoclinic.com
Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball. Dislocations may occur in major joints, such as your shoulder, hip, knee, elbow or ankle or in smaller joints, such as your finger, thumb or toe.
The injury will temporarily deform and immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions.
If you believe you have dislocated a joint:
Don't delay medical care. Get medical help immediately.
Don't move the joint. Until you receive help, splint the affected joint into its fixed position. Don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels.
Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
Regardless of where the joint dislocation is on the injured person's body, these are the basic steps you should take to provide first aid. The key to providing first aid in any situation is to remain calm while you help the injured person. Take the following steps to give first aid to someone with a dislocated joint.
Step1
Call 911. Do this before you begin any other type of first aid on the joint dislocation. Follow any instructions you are given.
Step2
Make sure to check the injured person's breathing. Make sure nothing is obstructing their airway. Administer CPR or rescue breathing if necessary. Also take any necessary steps to staunch bleeding before beginning first aid for a joint dislocation.
Step3
Keep the injured person still. Don't attempt to move him unless absolutely necessary. If you must move him, grab his clothes, not his body.
Step4
Cover any open wounds to prevent infection. If sterile bandages aren't available, cut up a clean article of clothing.
Step5
Do not try to move the bone and/or joint. Splint it or immobilize it just as it is. If you try to move a dislocated joint, you risk further injury and more pain to the injured person.
Step6
Check that the wounded area is getting enough blood flow. Press near the injury. The skin should turn white, then immediately get its color back.
Step7
Keep the victim calm until emergency help arrives. Cover him with a blanket to keep him warm. Be observant for the signs of shock that may set in several minutes after the injury occurs. Apply an ice bag to the dislocated joint to provide some relief from the pain.
source:Myoclinic.com
Thursday, December 11, 2008
MUSCLE CRAMPS
Muscle cramps are common discomforts that everyone has had to deal with at one time or another. Here are some signs of a muscle cramp :
A sharp, sudden, painful spasm, or tightening of a muscle, (especially common in the legs).
Muscle hardness
Twitching of the muscle
Persistent cramping pains in lower abdominal muscles
Sometimes occurring when a muscle contracts with great intensity and stays contracted, refusing to stretch out again.
Causes
Imbalances in certain minerals, body fluids, hormones, and chemicals which allow the lengthening and contracting of our muscles to occur can prompt spasms and cramps. As well as this, malfunctions in the nervous system itself can also cause problems. Excessive physical activity and hormonal imbalances causes us to sweat , which brings about the loss of many essential minerals (such as potassium) our muscles need.
Traditional Treatment
For everyday muscle cramps, there really isn’t any medication specifically for them. Try to stretch the muscle and massage out the cramp it you can.
Muscle cramps can also be caused by a lack of potassium and vitamin E, so eating something like bananas or pineapple can help to replenish the minerals you’ve lost. Calcium is also thought to help prevent muscle cramps, so drink your milk!
If you take vitamin E supplements it will help prevent nighttime muscle cramps, which can be quite an annoyance.
Prevention
Drink 6 to 8 cups of water every day.
Be sure to get enough potassium, vitamin E, and calcium into your system.
Be sure to warm up before exercising.
When to seek further professional advice
If you suffer from frequent or severe cramps, see your doctor. And severe cramps in your chest, shoulders, or arms can be symptoms of a heart attack; call immediately for medical help.
Your muscle cramp lasts more than an hour.
Your cramp is in your chest or arms.
*** Before administering any first aid to anyone outside your family, be aware of your rights and responsibilities: The Good Samaritan Law. ***
source:firstaidguide.net
A sharp, sudden, painful spasm, or tightening of a muscle, (especially common in the legs).
Muscle hardness
Twitching of the muscle
Persistent cramping pains in lower abdominal muscles
Sometimes occurring when a muscle contracts with great intensity and stays contracted, refusing to stretch out again.
Causes
Imbalances in certain minerals, body fluids, hormones, and chemicals which allow the lengthening and contracting of our muscles to occur can prompt spasms and cramps. As well as this, malfunctions in the nervous system itself can also cause problems. Excessive physical activity and hormonal imbalances causes us to sweat , which brings about the loss of many essential minerals (such as potassium) our muscles need.
Traditional Treatment
For everyday muscle cramps, there really isn’t any medication specifically for them. Try to stretch the muscle and massage out the cramp it you can.
Muscle cramps can also be caused by a lack of potassium and vitamin E, so eating something like bananas or pineapple can help to replenish the minerals you’ve lost. Calcium is also thought to help prevent muscle cramps, so drink your milk!
If you take vitamin E supplements it will help prevent nighttime muscle cramps, which can be quite an annoyance.
Prevention
Drink 6 to 8 cups of water every day.
Be sure to get enough potassium, vitamin E, and calcium into your system.
Be sure to warm up before exercising.
When to seek further professional advice
If you suffer from frequent or severe cramps, see your doctor. And severe cramps in your chest, shoulders, or arms can be symptoms of a heart attack; call immediately for medical help.
Your muscle cramp lasts more than an hour.
Your cramp is in your chest or arms.
*** Before administering any first aid to anyone outside your family, be aware of your rights and responsibilities: The Good Samaritan Law. ***
source:firstaidguide.net
Tuesday, December 9, 2008
HEAT CRAMPS
Overview
Heat cramps are involuntary muscle spasms
They are caused by deficiency of water and sodium
Heat cramps are painful, may be severe and prolonged
Heavy exercising in hot weather causes excessive sweating
This causes electrolyte deficiency resulting in muscle cramps
Muscles most affected are the voluntary muscles of-
a. Calves
b. Arms
c. Thighs
d. Back
e. Abdomen
Heat cramps are the least serious of all heat injuries
It is a warning sign for heat exhaustion
Risk factors
Negative sodium balance
Diuretic medications
Absence of acclimatization / adaptation
Causes
Heat
Dehydration
Excessive sweating
Loss of body salts
Muscle stress
Poor body condition
Symptoms
Some of the most common symptoms are:
Dizzy feeling
Fainting
Exhaustion
Nausea
Vomiting
Rapid heartbeat
Hot/sweaty skin
Treatment
Rest briefly and cool down
Manual pressure / massage must be applied to the affected muscle
Drink one quart of water with one teaspoon of salt
Drink some clear juice / electrolyte-containing sports drink
Practice gentle stretching exercise of the affected muscle
Seek medical help if the cramps remain after 1 hour
Prognosis
Heat cramps usually improves with
An electrolyte drink
Cool shade
Rest
Prevention
Adequate fluids must be taken periodically
Fluids must be taken before feeling thirsty
Avoid heavy sweaty exercises in humid conditions
Make sure to drink fluids while exercising
source:Medindia.net
Heat cramps are involuntary muscle spasms
They are caused by deficiency of water and sodium
Heat cramps are painful, may be severe and prolonged
Heavy exercising in hot weather causes excessive sweating
This causes electrolyte deficiency resulting in muscle cramps
Muscles most affected are the voluntary muscles of-
a. Calves
b. Arms
c. Thighs
d. Back
e. Abdomen
Heat cramps are the least serious of all heat injuries
It is a warning sign for heat exhaustion
Risk factors
Negative sodium balance
Diuretic medications
Absence of acclimatization / adaptation
Causes
Heat
Dehydration
Excessive sweating
Loss of body salts
Muscle stress
Poor body condition
Symptoms
Some of the most common symptoms are:
Dizzy feeling
Fainting
Exhaustion
Nausea
Vomiting
Rapid heartbeat
Hot/sweaty skin
Treatment
Rest briefly and cool down
Manual pressure / massage must be applied to the affected muscle
Drink one quart of water with one teaspoon of salt
Drink some clear juice / electrolyte-containing sports drink
Practice gentle stretching exercise of the affected muscle
Seek medical help if the cramps remain after 1 hour
Prognosis
Heat cramps usually improves with
An electrolyte drink
Cool shade
Rest
Prevention
Adequate fluids must be taken periodically
Fluids must be taken before feeling thirsty
Avoid heavy sweaty exercises in humid conditions
Make sure to drink fluids while exercising
source:Medindia.net
Friday, December 5, 2008
CHILD BIRTH GUIDE
Due date is an estimate
What you think of as your due date is actually in medcial terms referred to as EDD--estimated due date. It is better to think of a due month than a due date. Try not to focus too much on your "due" date coming and going. Only 5% of babies are born on their due dates.
How do I know I´m in labor?
Signs that indicate that this is likely "real" labor:
*contractions become progressively more regular, intense and last longer.
*intensified by walking.
*don´t stop when lying down or changing activity.
*contractions are accompanied by a "show" of blood-tinged mucus.
*accompanied by effacement and/or dilation.
Remember that labor may start and stop before finally continuing all the way to birth...don´t be discouraged. Any work done at this time is work that doesn´t have to be done later!
Prelabor signs
Some signs that labor may begin in the next few days or weeks include:
*baby drops lower into the pelvis.
*low backache, different from the normal late-pregnancy tiredness.
*increased urination and bowel movements, perhaps accompanied by abdominal cramps and diarrhea.
*sudden burst of energy (nesting instinct).
*increased vaginal discharge of egg-white consistency.
Changing Positions During Labor
Changing positions during labor is very important. Even if you are confined to the bed - moving around - changing sides you lay on - or sitting up will help to dilate and efface the cervix. Gravity will also aid in bringing the birth about quicker. If you can walk around or sit in a chair this will greatly help. If not, moving around in the bed - even if you have to use a bed-pan can help to bring about the birth quicker.
Sleep on your side
During the last half of pregnancy, side-lying is the most comfortable for mom and healthiest for baby. Use pillows behind your back and under your stomach to help balance comfortably.
Labor Inductions
There are several methods of labor inductions both medically and naturally. Medically speaking there are the application of prostaglandin gel to the cervix, Pitocin IV drip, stripping of the membranes and breaking of the bag of waters. Naturally speaking there are herbs to help bring labor on, nipple stimulation, intercourse and exercise. If labor needs to be augmented (induced) find out all you can about the above mentioned methods.
Due Date
Technically speaking, the due date is calculated by subtracting 3 months from the 1st day of your last period and then adding 7 days.
Let people know how you are doing
Don´t just assume that all pain in childbirth is unavoidable. Be sure to let your caregivers know what is going on with you. They may well have suggestions for you that can ease your discomforts without medication. If you let them know you are having pain in your back, for example, they can help you change positions so as to minimize that. It might also give them clues as to baby´s position that will be helpful to know to allow you to work with your body most efficiently.
True Contractions
True contractions will grow stronger and closer together. They will increase in intensity when changing positions. Braxton Hicks contractions will go away when changing positions and will not be regular. True contractions may be accompanied by lower back pain that radiates to the lower abdomen and possibly down the legs. Diarrhea may accompany the contractions as well as bloody show.
Signs of True Labor
True labor usually begins with contractions that intensify rather than ease up - more than 4 an hour. When you change positions or move around and the contraction gets stronger - it is the real thing. Pain, if any, starts in the lower back and can radiate down the groin and into the legs and feels like you need to have a bowel movement. The contractions will become more frequent and will increase in duration, though they may not be "text" book - i.e. - every 5 minutes. They may be 5 minutes, 8 minutes, 10 minutes, 4 minutes, etc. Bloody show or blood-tinged mucus will start during true labor. Membranes may rupture, though this only happens in about 15% of labors. The rupture may be a gush or a trickle.
Things To Pack In The Hospital Bag
Giving birth in a hospital requires at least a one night stay. Items needed are: gown (if you prefer to wear your own), underwear, pads, nursing bra and pads, slippers, socks, outfit to wear home (keeping in mind that you´ll still have a lot of that pregnancy weight on), baby´s going home outfit, at least 2 receiving blankets, diapers, wipes, toiletries, camera and film, clothes for the coach, snacks for you and coach, change for vending machines, money for coach to eat with, lollipops for laboring, lotion for massaging away labor pains, pillow (hospial pillows are uncomfortable) and any item you feel you cannot live without during labor and birth. Most hospitals do provide enough diapers, wipes and gowns for you and baby, pads and pants for you after birth and some toiletry items. Check with your hospital to find out what they provide and pack accordingly.
Epidural Block
Epidurals are used for pain relief in laboring moms. A needle is placed in the lower back in the epidural space between the spinal cord and the outer membrane. The epidural numbs the pelvic area and most of the times the legs too. The medication can be given and stopped easily - to allow the laboring mom to push more effectively. Blood pressure has to be monitored and IV fluids given in conjunction with the epidural. It takes about 2 hours after the epidural has been removed to regain all feeling in the lower half of the body.
When to go to the hospital
For most women the best bet is to stay at home for as long as possible. Early arrival at the hospital may cause labor to slow, opening the door for questionable interventions.
Ask your doctor at a prenatal visit when he or she would like you to go in, but for most women a good rule of thumb for first-time mothers is to go when contractions are 5 minutes or less apart, last at least one minute, and are strong enough that you need to focus solely on them.
Touch your baby
The skin is the largest organ of the human body! Stroking stimulates the newborn to regulate his breathing.
Are you a candidate for home birth?
Home birth is something you should consider if:
*You truly believe that you should birth at home.
*You have no known complications that make your delivery high risk.
*You feel prepared to handle the work of labor through natural means, and your history supports this.
*You live no more than 10-15 minutes from a hospital.
Choosing A Birthing Position
There are several birthing positions. What you choose is entirely up to you and your care provider and whether or not you are giving birth in a hospital, birthing center or at home. The choices consist of back lying (most hospitals use this), side-lying, all fours (crawling position), sitting, squatting, and standing. Whatever position you choose, you may have to practice - such as squatting - because it requires the use of strong arms and legs. Also, depending upon your health and the health of the baby, you may be limited with your choices. If you have a strong preference - talk with your doctor or midwife well in advance of your due date.
Be Prepared EARLY
Yes, I believe it is very necessary to have everything in order before baby arrives. Speaking from experience - I had preterm labor at 30 weeks and was on bedrest and panicked because I didn´t have things in order. Try to have all that you think baby will need - ready at the beginning of the third trimester. Have the crib, bassinet, clothes, carseat, blankets, etc. all set up and ready for the birth. Even though it may sit out for 3 months - at the very least should something happen earlier than anticipated - you´ll have everything in order and ready for your little one.
Methods of Childbirth Classes
There are 4 main childbirth classes. Bradley Method, Lamaze, Grantly Dick-Read and "prepared" childbirth classes. The methods vary in breathing and relaxation excercises. Choosing a class depends upon your preferences and expectations of your childbirth experience and the availability of an instructor in your area.
Midwife and Doctor
If you are planning a home birth - it is a good idea to have a midwife - be it certified or direct-entry. It´s also a good idea to have a doctor that you have seen for emergencies. This is part of your emergency back up plan.
Pain Relief During Childbirth
There are varying degrees of pain relief management for childbirth. Medically there is the epidural, spinal, intrathecal injection of narcotics, narcotics given through an IV and the pudendal block. Naturally there are childbirth classes that teach methods of breathing exercises, relaxation techniques and focusing to alleviate the pain during labor and birth.
Circumcision Debate
Circumcision is a decision that should be made prior to the baby´s birth. Be sure to weigh all the options, if you are unsure of which way to go. There are benefits either way to circumcise or to not circumcise.
Choosing a childbirth class
To best prepare yourself, you should take a private childbirth education class--one not affiliated with a hospital. These type of classes have the advantage of describing all your choices to you; the hospital will only tell you what they are willing to offer. The more complete information allows you to be a better consumer.
Childbirth Classes
I think every woman should take a childbirth class. These classes help to answer questions, educate and prepare you for the best possible experience in childbirth. There are a number of childbirth classes offered from prepared childbirth classes - which teach about hospital procedures - to specialized classes that teach different labor coping means. All teach the mechanics about the birth process and the choices you may have to make. Ask your physican or midwife about the classes offered in your area. Be sure to call soon, most classes fill up fairly quick.
Education Makes The Best Birth Experience Possible
Preparing for childbirth should be number one once you find out you are pregnant. Knowledge melts away fear - ignorance only leads to fear. Read all you can about childbirth and speak with your doctor or midwife in depth about any concerns or questions you may have. Take childbirth classes, subscribe to pregnancy magazines - many are free, and read through quality websites. You may even want to join with a pregnancy discussion board - as I´ve had very positive and educational experiences with these. All in all, education about pregnancy and birth is the best possible plan for a woman facing a pregnancy and the end result - birth. Especially for first-time moms, there is no substitute for what educating yourself can do for a positive experience from conception to birth.
Dehydration
Dehydration is the number one reason preterm labor starts. It is possible to naturally induce labor by withholding water - however it is strongly advisable not to do this without the care of your doctor.
Home Vs. Hospital Birth
Whether you choose to give birth at home or in a hospital depends upon a few things. If your pregnancy has progressed normally, if the baby is doing good and if you have quick access to a hospital in an emergency are good canidates for homebirth. If you desire pain relief during labor and delivery, the hospital may be a better choice. Utlimately it depends upon your preferences. Most doctors will not delivery a home birth - however midwives will. And in some states, having a home birth is against the law.
Active Birth: The New Approach to Giving Birth Naturally
"Active Birth: The New Approach to Giving Birth Naturally" by Janet Balaskas. This book teaches mothers to follow their insticts and use their bodies actively in labor. My personal favorite for practical advice on coping with labor.
Coping With Pre-Term Labor
Pre-term labor is labor that occurs before the 37th week of pregnancy. Most of the time bedrest and plenty of fluids will help to halt pre-term labor. If labor starts to dilate and efface the cervix - drugs are given to relax the uterus. The main thing is to keep stress at bay - and relax. The number one goal in dealing with pre-term labor is keeping that baby inside for as long as possible. Follow doctor´s orders and accept all the help you can with taking care of your household.
Relaxation Methods
Relaxation and breathing techniques can help a laboring mom to better cope with the pain of childbirth. Breathing exercises learned from natural childbirth classes helps to calm and relax the laboring mom - helping her to focus without the use of medications. Usually a coach (husband) plays a big role in helping mom to relax as taught in the natural childbirth classes.
Back Lying
Back lying has long been the favorite position of hospital births in the United States in the 20th century. Lying on your back - feet in stir-ups has been a favorite of physicans because of the ease at which they can assist the delivery. This position is still used in a lot of hospitals if an epidural or spinal anesthesia has been administered or if there is concern for uterine rupture.
What you think of as your due date is actually in medcial terms referred to as EDD--estimated due date. It is better to think of a due month than a due date. Try not to focus too much on your "due" date coming and going. Only 5% of babies are born on their due dates.
How do I know I´m in labor?
Signs that indicate that this is likely "real" labor:
*contractions become progressively more regular, intense and last longer.
*intensified by walking.
*don´t stop when lying down or changing activity.
*contractions are accompanied by a "show" of blood-tinged mucus.
*accompanied by effacement and/or dilation.
Remember that labor may start and stop before finally continuing all the way to birth...don´t be discouraged. Any work done at this time is work that doesn´t have to be done later!
Prelabor signs
Some signs that labor may begin in the next few days or weeks include:
*baby drops lower into the pelvis.
*low backache, different from the normal late-pregnancy tiredness.
*increased urination and bowel movements, perhaps accompanied by abdominal cramps and diarrhea.
*sudden burst of energy (nesting instinct).
*increased vaginal discharge of egg-white consistency.
Changing Positions During Labor
Changing positions during labor is very important. Even if you are confined to the bed - moving around - changing sides you lay on - or sitting up will help to dilate and efface the cervix. Gravity will also aid in bringing the birth about quicker. If you can walk around or sit in a chair this will greatly help. If not, moving around in the bed - even if you have to use a bed-pan can help to bring about the birth quicker.
Sleep on your side
During the last half of pregnancy, side-lying is the most comfortable for mom and healthiest for baby. Use pillows behind your back and under your stomach to help balance comfortably.
Labor Inductions
There are several methods of labor inductions both medically and naturally. Medically speaking there are the application of prostaglandin gel to the cervix, Pitocin IV drip, stripping of the membranes and breaking of the bag of waters. Naturally speaking there are herbs to help bring labor on, nipple stimulation, intercourse and exercise. If labor needs to be augmented (induced) find out all you can about the above mentioned methods.
Due Date
Technically speaking, the due date is calculated by subtracting 3 months from the 1st day of your last period and then adding 7 days.
Let people know how you are doing
Don´t just assume that all pain in childbirth is unavoidable. Be sure to let your caregivers know what is going on with you. They may well have suggestions for you that can ease your discomforts without medication. If you let them know you are having pain in your back, for example, they can help you change positions so as to minimize that. It might also give them clues as to baby´s position that will be helpful to know to allow you to work with your body most efficiently.
True Contractions
True contractions will grow stronger and closer together. They will increase in intensity when changing positions. Braxton Hicks contractions will go away when changing positions and will not be regular. True contractions may be accompanied by lower back pain that radiates to the lower abdomen and possibly down the legs. Diarrhea may accompany the contractions as well as bloody show.
Signs of True Labor
True labor usually begins with contractions that intensify rather than ease up - more than 4 an hour. When you change positions or move around and the contraction gets stronger - it is the real thing. Pain, if any, starts in the lower back and can radiate down the groin and into the legs and feels like you need to have a bowel movement. The contractions will become more frequent and will increase in duration, though they may not be "text" book - i.e. - every 5 minutes. They may be 5 minutes, 8 minutes, 10 minutes, 4 minutes, etc. Bloody show or blood-tinged mucus will start during true labor. Membranes may rupture, though this only happens in about 15% of labors. The rupture may be a gush or a trickle.
Things To Pack In The Hospital Bag
Giving birth in a hospital requires at least a one night stay. Items needed are: gown (if you prefer to wear your own), underwear, pads, nursing bra and pads, slippers, socks, outfit to wear home (keeping in mind that you´ll still have a lot of that pregnancy weight on), baby´s going home outfit, at least 2 receiving blankets, diapers, wipes, toiletries, camera and film, clothes for the coach, snacks for you and coach, change for vending machines, money for coach to eat with, lollipops for laboring, lotion for massaging away labor pains, pillow (hospial pillows are uncomfortable) and any item you feel you cannot live without during labor and birth. Most hospitals do provide enough diapers, wipes and gowns for you and baby, pads and pants for you after birth and some toiletry items. Check with your hospital to find out what they provide and pack accordingly.
Epidural Block
Epidurals are used for pain relief in laboring moms. A needle is placed in the lower back in the epidural space between the spinal cord and the outer membrane. The epidural numbs the pelvic area and most of the times the legs too. The medication can be given and stopped easily - to allow the laboring mom to push more effectively. Blood pressure has to be monitored and IV fluids given in conjunction with the epidural. It takes about 2 hours after the epidural has been removed to regain all feeling in the lower half of the body.
When to go to the hospital
For most women the best bet is to stay at home for as long as possible. Early arrival at the hospital may cause labor to slow, opening the door for questionable interventions.
Ask your doctor at a prenatal visit when he or she would like you to go in, but for most women a good rule of thumb for first-time mothers is to go when contractions are 5 minutes or less apart, last at least one minute, and are strong enough that you need to focus solely on them.
Touch your baby
The skin is the largest organ of the human body! Stroking stimulates the newborn to regulate his breathing.
Are you a candidate for home birth?
Home birth is something you should consider if:
*You truly believe that you should birth at home.
*You have no known complications that make your delivery high risk.
*You feel prepared to handle the work of labor through natural means, and your history supports this.
*You live no more than 10-15 minutes from a hospital.
Choosing A Birthing Position
There are several birthing positions. What you choose is entirely up to you and your care provider and whether or not you are giving birth in a hospital, birthing center or at home. The choices consist of back lying (most hospitals use this), side-lying, all fours (crawling position), sitting, squatting, and standing. Whatever position you choose, you may have to practice - such as squatting - because it requires the use of strong arms and legs. Also, depending upon your health and the health of the baby, you may be limited with your choices. If you have a strong preference - talk with your doctor or midwife well in advance of your due date.
Be Prepared EARLY
Yes, I believe it is very necessary to have everything in order before baby arrives. Speaking from experience - I had preterm labor at 30 weeks and was on bedrest and panicked because I didn´t have things in order. Try to have all that you think baby will need - ready at the beginning of the third trimester. Have the crib, bassinet, clothes, carseat, blankets, etc. all set up and ready for the birth. Even though it may sit out for 3 months - at the very least should something happen earlier than anticipated - you´ll have everything in order and ready for your little one.
Methods of Childbirth Classes
There are 4 main childbirth classes. Bradley Method, Lamaze, Grantly Dick-Read and "prepared" childbirth classes. The methods vary in breathing and relaxation excercises. Choosing a class depends upon your preferences and expectations of your childbirth experience and the availability of an instructor in your area.
Midwife and Doctor
If you are planning a home birth - it is a good idea to have a midwife - be it certified or direct-entry. It´s also a good idea to have a doctor that you have seen for emergencies. This is part of your emergency back up plan.
Pain Relief During Childbirth
There are varying degrees of pain relief management for childbirth. Medically there is the epidural, spinal, intrathecal injection of narcotics, narcotics given through an IV and the pudendal block. Naturally there are childbirth classes that teach methods of breathing exercises, relaxation techniques and focusing to alleviate the pain during labor and birth.
Circumcision Debate
Circumcision is a decision that should be made prior to the baby´s birth. Be sure to weigh all the options, if you are unsure of which way to go. There are benefits either way to circumcise or to not circumcise.
Choosing a childbirth class
To best prepare yourself, you should take a private childbirth education class--one not affiliated with a hospital. These type of classes have the advantage of describing all your choices to you; the hospital will only tell you what they are willing to offer. The more complete information allows you to be a better consumer.
Childbirth Classes
I think every woman should take a childbirth class. These classes help to answer questions, educate and prepare you for the best possible experience in childbirth. There are a number of childbirth classes offered from prepared childbirth classes - which teach about hospital procedures - to specialized classes that teach different labor coping means. All teach the mechanics about the birth process and the choices you may have to make. Ask your physican or midwife about the classes offered in your area. Be sure to call soon, most classes fill up fairly quick.
Education Makes The Best Birth Experience Possible
Preparing for childbirth should be number one once you find out you are pregnant. Knowledge melts away fear - ignorance only leads to fear. Read all you can about childbirth and speak with your doctor or midwife in depth about any concerns or questions you may have. Take childbirth classes, subscribe to pregnancy magazines - many are free, and read through quality websites. You may even want to join with a pregnancy discussion board - as I´ve had very positive and educational experiences with these. All in all, education about pregnancy and birth is the best possible plan for a woman facing a pregnancy and the end result - birth. Especially for first-time moms, there is no substitute for what educating yourself can do for a positive experience from conception to birth.
Dehydration
Dehydration is the number one reason preterm labor starts. It is possible to naturally induce labor by withholding water - however it is strongly advisable not to do this without the care of your doctor.
Home Vs. Hospital Birth
Whether you choose to give birth at home or in a hospital depends upon a few things. If your pregnancy has progressed normally, if the baby is doing good and if you have quick access to a hospital in an emergency are good canidates for homebirth. If you desire pain relief during labor and delivery, the hospital may be a better choice. Utlimately it depends upon your preferences. Most doctors will not delivery a home birth - however midwives will. And in some states, having a home birth is against the law.
Active Birth: The New Approach to Giving Birth Naturally
"Active Birth: The New Approach to Giving Birth Naturally" by Janet Balaskas. This book teaches mothers to follow their insticts and use their bodies actively in labor. My personal favorite for practical advice on coping with labor.
Coping With Pre-Term Labor
Pre-term labor is labor that occurs before the 37th week of pregnancy. Most of the time bedrest and plenty of fluids will help to halt pre-term labor. If labor starts to dilate and efface the cervix - drugs are given to relax the uterus. The main thing is to keep stress at bay - and relax. The number one goal in dealing with pre-term labor is keeping that baby inside for as long as possible. Follow doctor´s orders and accept all the help you can with taking care of your household.
Relaxation Methods
Relaxation and breathing techniques can help a laboring mom to better cope with the pain of childbirth. Breathing exercises learned from natural childbirth classes helps to calm and relax the laboring mom - helping her to focus without the use of medications. Usually a coach (husband) plays a big role in helping mom to relax as taught in the natural childbirth classes.
Back Lying
Back lying has long been the favorite position of hospital births in the United States in the 20th century. Lying on your back - feet in stir-ups has been a favorite of physicans because of the ease at which they can assist the delivery. This position is still used in a lot of hospitals if an epidural or spinal anesthesia has been administered or if there is concern for uterine rupture.
Tuesday, December 2, 2008
CHOKING FIRST AID
Maneuvers to relieve choking are frequently life saving. Adults most often choke on a piece of food, such as a large piece of meat. Infants do not have well-developed swallowing reflexes and may choke if given small, rounded foods such as peanuts or hard candies. Children, especially toddlers, also may choke on balloons, toys, coins, other inedible objects that they place in their mouth, and foods (particularly rounded, smooth foods, such as hot dogs, round candies, nuts, and grapes).
Coughing may be the first symptom and is often so severe that the person cannot ask for help. The person may grasp both hands near the throat. Breathing and speaking can become weak or stop. There can be high-pitched or snoring sounds. The person can turn blue, have a seizure, or faint.
First-Aid Treatment
Treatment for a person who is choking takes precedence over calling for emergency medical care.
Performing Abdominal Thrusts
The rescuer stands behind the person and encircles the person's abdomen with the arms. With one hand, the rescuer forms a fist and clasps the other hand around the fist. The rescuer places the hands halfway between the breastbone and navel and thrusts the hands inward and upward.
A strong cough often expels the object from the airway. A person with a strong cough should be allowed to continue coughing. A person who can speak normally usually still has a strong cough. If a person who is choking cannot cough, the rescuer delivers abdominal thrusts (Heimlich maneuver). The abdominal thrusts increase pressure in the abdomen and chest, which expels the object.
If the person is conscious, the rescuer approaches from behind, using the arms to encircle the person's abdomen. The rescuer forms a fist, with the thumb pointing inward, and places it between the breastbone and navel, toward the person. The other hand is placed firmly over the fisted hand. The hands are then thrust inward and upward forcefully, 5 times in succession. Less force should be used if the person is a child. Series of thrusts should be repeated until the object is expelled. If the person loses consciousness, the rescuer should stop the thrusts.
If the person loses consciousness, steps are taken to open the airway and provide artificial respiration (see First Aid: First-Aid Treatment). Failure of the chest to rise indicates that the airway is still blocked. The rescuer checks the airway for, and removes, visible objects. Artificial respiration is then resumed.
Clearing a Blocked Airway in an Infant
The infant is held face down with the chest resting on the rescuer's forearm. Then, the rescuer strikes the infant's back between the shoulder blades.
The infant is turned face up with the head lower than the body. Then, the rescuer places the second and third fingers on the infant's breastbone and thrusts inward and upward.
For an infant, abdominal thrusts are not performed. Instead, the infant is turned face down, the chest resting on the rescuer's forearm, with the head lower than the body. The rescuer then strikes the infant between the shoulder blades 5 times using the heel of the hand (back blows). The strikes should be firm but not hard enough to cause injury. The rescuer then checks the mouth, removing any visible objects. If the airway remains blocked, the rescuer turns the infant face up with the head down, and using the second and third fingers, thrusts inward and upward on the infant's breastbone 5 times (chest thrusts). The rescuer then checks the mouth again.
source:Merck.com
Coughing may be the first symptom and is often so severe that the person cannot ask for help. The person may grasp both hands near the throat. Breathing and speaking can become weak or stop. There can be high-pitched or snoring sounds. The person can turn blue, have a seizure, or faint.
First-Aid Treatment
Treatment for a person who is choking takes precedence over calling for emergency medical care.
Performing Abdominal Thrusts
The rescuer stands behind the person and encircles the person's abdomen with the arms. With one hand, the rescuer forms a fist and clasps the other hand around the fist. The rescuer places the hands halfway between the breastbone and navel and thrusts the hands inward and upward.
A strong cough often expels the object from the airway. A person with a strong cough should be allowed to continue coughing. A person who can speak normally usually still has a strong cough. If a person who is choking cannot cough, the rescuer delivers abdominal thrusts (Heimlich maneuver). The abdominal thrusts increase pressure in the abdomen and chest, which expels the object.
If the person is conscious, the rescuer approaches from behind, using the arms to encircle the person's abdomen. The rescuer forms a fist, with the thumb pointing inward, and places it between the breastbone and navel, toward the person. The other hand is placed firmly over the fisted hand. The hands are then thrust inward and upward forcefully, 5 times in succession. Less force should be used if the person is a child. Series of thrusts should be repeated until the object is expelled. If the person loses consciousness, the rescuer should stop the thrusts.
If the person loses consciousness, steps are taken to open the airway and provide artificial respiration (see First Aid: First-Aid Treatment). Failure of the chest to rise indicates that the airway is still blocked. The rescuer checks the airway for, and removes, visible objects. Artificial respiration is then resumed.
Clearing a Blocked Airway in an Infant
The infant is held face down with the chest resting on the rescuer's forearm. Then, the rescuer strikes the infant's back between the shoulder blades.
The infant is turned face up with the head lower than the body. Then, the rescuer places the second and third fingers on the infant's breastbone and thrusts inward and upward.
For an infant, abdominal thrusts are not performed. Instead, the infant is turned face down, the chest resting on the rescuer's forearm, with the head lower than the body. The rescuer then strikes the infant between the shoulder blades 5 times using the heel of the hand (back blows). The strikes should be firm but not hard enough to cause injury. The rescuer then checks the mouth, removing any visible objects. If the airway remains blocked, the rescuer turns the infant face up with the head down, and using the second and third fingers, thrusts inward and upward on the infant's breastbone 5 times (chest thrusts). The rescuer then checks the mouth again.
source:Merck.com
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