Non Medical Assessment Example: Fill & Download for Free

'How long will it be before humans no longer have to worry about organ donation to save lives? What can be done until then to mitigate the problem?'Perceived organ shortage has mistakenly seeped into collective consciousness as a major healthcare issue when the actual problem is unsustainable increase in demand. Since transplants became a viable medical option, rather than being inadequate, organ supply gradually increased and now remains steady while organ demand kept increasing much more rapidly over the same time period.A great deal of organ demand is rooted in non-medical lifestyle-related risk factors (type II diabetes, cardiovascular diseases, obesity, metabolic syndrome). Reducing organ demand through sustained lifestyle changes (diet, exercise, no smoking, moderate alcohol intake) is more a socio-political rather than medical problem.Sustainably increasing organ supply requires solving a biotechnology problem, for regenerative medicine to deliver on its promise of growing tissues and organs in vitro from a patient's own cells.Actual Organ Donation Problem: Unsustainable Increase In Organ Demand & Not Inadequate Organ SupplyChronic kidney disease offers an illustrative example. Eventually leading to ESRD (end stage renal disease), which requires kidney transplants, its underlying causes differ greatly between poor and affluent countries.Poor countries tend to have fairly stable levels of urological diseases and glomerulonephritis, which are typically not lifestyle related.OTOH, chronic lifestyle-related diseases such as type II diabetes, cardiovascular disease (hypertension) and metabolic syndrome (obesity) increase dramatically as a country becomes more 'developed' (see below from 1).When kidney transplants became a viable medical option in the late 1960s to early 1970s, kidney donations initially increased in response to demand. However, demand in affluent countries increased unsustainably beginning in the mid-1980s and has stayed as high ever since (see below figures on the situation in Europe, left, and the US, right, respectively, from 2 and 3). Organ supply simply couldn't keep pace with such frenzied increase in demand.In affluent countries such as the US as well as across much of Europe, decades of unhealthy lifestyles have led to dramatic increases in 'diseases of affluence' or 'Western diseases' (4), such as cardiovascular disease, type II diabetes, and metabolic syndrome (5).Such chronic health conditions ultimately lead to end stage organ diseases such as ESRD (end stage renal disease), ESLD (end stage liver disease), ESPD (end stage pulmonary disease) that can often only be alleviated by organ or tissue transplants.Rather than being some kind of inevitability, modifiable lifestyle-related risk factors are associated with increasing prevalence of such 'diseases of affluence' whose reduction would reduce need for transplants.Bibliography1. Nugent, Rachel A., et al. "The burden of chronic kidney disease on developing nations: a 21st century challenge in global health." Nephron Clinical Practice 118.3 (2011): c269-c277. https://www.karger.com/Article/Pdf/3213822. http://www.eurotransplant.org/cms/mediaobject.php?file=Eurotransplant+JV+PDF.pdf3. Knauf, Felix, and Peter S. Aronson. "ESRD as a window into America's cost crisis in health care." Journal of the American Society of Nephrology 20.10 (2009): 2093-2097. ESRD as a Window into America's Cost Crisis in Health Care4. Ezzati, Majid, et al. "Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development." PLoS medicine 2.5 (2005): e133. http://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0020133&type=printable5. Forouzanfar, Mohammad H., et al. "Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015." The Lancet 388.10053 (2016): 1659-1724. https://ac.els-cdn.com/S0140673616316798/1-s2.0-S0140673616316798-main.pdf?_tid=9ae0d21d-a4f6-4cfb-9726-00c70255f5c8&acdnat=1527446230_fa0965e0982d20d985f4f0e96b5a9b9bThanks for the R2A, Daniel Kaplan.

Hi,I am a Registered Nurse and was recently the most senior medical person on an airplane with a medical emergency. Approximately 1/2 hour into our 5-1/2 to 6 hour flight over water, the call came for any medical person on board to ring their bell for the flight attendant. As a nurse, I feel I am obligated to assist under my state practice act, unless there is a more senior medical person on the scene.In an airplane, medical personnel are not covered by the Good Samaritan Act, but rather the American Aviation Act. I am unsure what the equivalent International laws are, but I do remember reading there are some provisions in place. The American Aviation Act also stipulates the minimum medical equipment that must be onboard an aircraft.It is important to know that flight attendants have minimal basic training, but are not equipped to deal with medical assessments. As such, airlines have an medical 'advisory' doctor with whom they communicate in the case of emergency situations. All medical personnel should ask to speak directly to this physician as he or she can assist in making decisions to divert a flight and aid in covering medical liability under the American Aviation Act. A diverted flight can cost an estimated $30,000 to $100,000 for the airline, and studies have shown that the contracted doctors are better equipped to make this decision in conjunction with medical personnel onboard the flight.My experience was quite interesting. The young woman was having an allergic reaction, which she had once before. The previous incident had not had an identified allergen. She also had asthma and had a respiratory illness for approximately 1 month. Her eyes were almost swollen shut and she had difficulty breathing. She took her own inhaler and we obtained permission to give 50mg of Benadryl from the advisory Doctor. The flight did not carry an epipen, although there is legislation pending to require all flights to carry them.Initially her condition improved and the decision was made, with my agreement, to continue the flight. By the time her condition began to deteriorate, the flight was over water; turning back was the same distance as going to our destination.The advisory Doctor initially did not want to speak with the "nurse" (me) who was caring for the patient. This can be a typical behavior by some physicians, but nurses are well versed in dealing with this. I was also grateful that the flight crew recognized the behavior and also did not listen to the physician. They simply handed me the phone, ignoring his instruction that he did not need to speak with me. As a nurse, I need to have a physician order for treatments, and decisions should be made collaboratively (especially since I was his eyes and ears on the patient). We got over his basic behavior and were able to collaborate.I was given permission to apply oxygen as her respiratory status decreased, and continue to give her the inhaler. I gave her more benedryl at some point into the flight. I asked to give an albuterol nebulizer, which was available via my own supply, but was told it could not be given due to liability issues (the plane did not carry it).Regardless, her breathing was maintained until the end of the flight when the airport paramedics came onboard to take her off the first. They asked me to come with them, for the purpose of providing them information, so I did.After I retrieved my things from the plane and went to baggage claim, the paramedics were still with the young woman and her family. The paramedics were trying to convince them to go to the hospital and asked me to come over to speak with them. Her oxygen level on a non-rebreather was 86%. This left me to wonder what her oxygen levels were on the plane.So, what did I receive from the airline? The flight attendants were most gracious and appreciative, which in and of itself meant a lot. They gave me a 'goody bag' with a very nice bottle of wine, a bottle of champagne, and three large bags of macadamia snacks. This was very nice.I was asked to fill out a form so the 'airline' could properly thank me for my service. I filled this out, but as of 5 weeks later, I have not received anything. I cannot receive 'pay' for my service, as this would invalidate the liability 'coverage' afforded me under the American Aviation Act. However, they can provide reimbursement for my unused airline services (i.e. my seat, entertainment, etc...) in the form of a gift or other future upgrades. Again, it is not why I performed/offered my services...but it would be nice.

Math, Science, History, Geography, Spanish, and Music from School:"HOMES" for The Great Lakes:Huron, Ontario, Michigan, Erie, Superior"King Henry Doesn't Mind Discussing Church Matters" for the Metric System:Kilometer, Hectometer, Decameter, Meter, Decimeter, Centimeter, Millimeter"King Phillip Came Over From the German Shore" for Biologic Classification/taxonomy (many other variations exist): Kingdom, Phylum, Class, Order, Family, Genus, Species"My Very Educated Mother Just Showed Us Nine Planets" for the planets in order of distance from the sun, back when there were 9:Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune, Pluto"Never Eat Shredded Wheat" for Compass Directions (could also be sour watermelons):North, East, South, West"Please excuse my dear Aunt Sally" or "PEMDAS" for order of operations in math:Parenthesis, Exponents, Multiplication & Division, Addition & Subtraction"SOH-CAH-TOA" for Trigonometry:Sine = Opposite over Hypotenuse, Cosine = Adjacent over Hypotenuse, and Tangent = Opposite over Adjacent."How you feel and where you are, always use the verb estar" for determining which verb for "to be" to use, Ser or Estar"In 1492 Columbus sailed the ocean blue" for remembering the year of Columbus's voyageFACE and All Cows Eat Grass for Music ClefsFrom Boy Scouts:"Red on Yellow, Watch out, Fellow. Red on Black, Friend of Jack." for differentiating the markings of poisonous and non-poisonous snakes. There's lots of variations for this and it may only apply in North America."STOP" for what to do when lost:Stay Calm, Think, Observe, Plan“Face is red, raise the head; face is pale, raise the tail.” for treating shock“Leaves of three, let it be.” for poisonous plants"RICE" for treating strains, sprains, soft tissue injuries, etc:Rest, Ice, Compression, Elevation. (I would add take some ibuprofen but that wasn't part of it)“reach, throw, row, go” for the order of things you should do to save someone from drowningFrom my EMT Training:"ABC" for priorities in initial assessmentAirway, Breathing, Circulation (now it's C-A-B though)can also be ABCD with the D standing for Decision (relating to urgency of transport)"AVPU" for levels of responsiveness:Alert, Verbal (Responds to verbal stimuli only), Pain (Responds painful stimuli only), UnresponsiveSAMPLE for medical history:Signs & Symptoms, Allergies, Medications, Pertinent past history, Last oral intake, Events leading to injuryOPQRST, also for medical history:Onset, Provocation, Quality, Severity, Time (as a bonus, add I for Interventions)"I Pass Gas" for medical assessment/treatment of breathing issues: Inspect, Palpate, Auscultate, Seal, Stabilize, Oxygen."VCR-SS" for medical assessment/treatment of circulatory issues:Voids, Carotid, Radials (also Cap Refill), Skin, Shock"CTC" for the things to note about about skin: Color, Temperature, ConditionD-CAPP-BTLS for things to check for in a trauma:Deformities, contusions, abrasions, punctures, penetrations, burns, tenderness, lacerations, and swelling"7-12-5-5-4" for the number of vertebrae in each part of the spine -- not a very good mnemonic to read but my teacher said it to a beat 10 times when we learned it and I never forgot it, so it worked for me."SOAP" for what goes in a patient care report:Subjective, Objective, Assessment, Plan (always thought this one was dumb)"AEIOU-TIPS" for altered mental status causes:Alcohol/Arrythmia, Epilepsy/Environment, Insulin, Overdose, Underdose/Uremia,Trauma, Infection, Psychosis/Poison, Shock/Stroke/Seizure"My baby looks hot tonight." for order of straps for KED:Middle, bottom, legs, head, top.From Living in NYC:"Evens go east" to remember street direction