Extracorporeal Cardiopulmonary Resuscitation

Extracorporeal cardiopulmonary resuscitation (ECPR) is a method of resuscitation in which venoarterial (VA) extracorporeal membrane oxygenation(ECMO) is initiated during refractory cardiac arrest. ECPR promises to enhance outcomes after cardiac arrest by minimizing neurological deficits, stabilizing the patient for early reperfusion and hypothermia, and serving as a bridge to treatment or transplant. ECPR must be initiated according to structured guidelines and protocols, which are based on the patient’s age, comorbidities, code status, neurological baseline, no flow time, and low flow time. If a patient achieves return of spontaneous circulation on ECMO, the patient will receive post cardiac arrest care which includes but is not limited to therapeutic hypothermia, early reperfusion, intra-aortic balloon pump insertion, tight glycemic control, and low ventilation. While ECPR has been shown to improve outcomes, multiple complications including bleeding, infection, renal failure, limb ischemia, and stroke can result from the treatment. Nurses play a key role in monitoring these critical patients and achieving therapeutic outcomes. As ECPR is expensive, carries high risk of complications, and can not always be performed under informed consent, thus there are ethical implications. A review of the literature indicates that low flow time, age, percutaneous intervention, and sustained ventricular fibrillation are independent factors that directly impact patient outcomes. With advances in ECPR and its use in the clinical setting, it is evident that randomized control trials and uniform ECPR protocols and guidelines are essential to improve evidence base practice and patient outcomes

An exploratory analysis and creative interpretation of female performers in the traditional travelling circus

This thesis explores the history of the modern circus, with a particular focus on discussing hidden female performers from traditional travelling circuses. Through conducting interviews and archival research, the information on the lives of the female performers in the circus separates into three areas: performance, gender, and lifestyle. These three areas create topics for the creative interpretation section of this project, forming a five-track EP, Our Circus, of original songs. By using the art form of music to celebrate the art of the female circus performer, a voice is given to those whose stories have not been heard as loudly as their opposite sex in modern circus history. This practice-based research allows information to reach both the academy and public domain, showing that creative research enhances social science research whilst projecting the stories of incredible women in the arts through music, creating a connection and awareness beyond academic fields and to the wider public

Hypertension maligne: Une maladie qui endommage aussi l’œil — Rapport de cas

Résumé: Dans cet article, nous examinerons le cas d’un patient de 49 ans souffrant de rétinopathie hypertensive maligne et le déclin visuel qui en résulte. RAPPORT DE CAS Une hypertension grave non maîtrisée s’est manifestée sous la forme d’une rétinopathie hypertensive maligne. Le patient présentait des changements rétiniens et visuels importants et a fait l’objet d’un suivi pendant plus de 6 mois. Bien que l’acuité visuelle du patient se soit nettement améliorée, des dommages rétiniens importants se sont produits et le patient a subi une perte de vision qualitative et de champ visuel qui a persisté. DISCUSSION Les changements observés dans le fond de l’œil correspondent à un ris-que élevé de morbidité et de mortalité associé à l’hypertension. La prise en charge des maladies systémiques est une étape cruciale pour inverser les manifestations rétiniennes et réduire au minimum le risque de perte de vision permanente. Le caractère critique du traitement systémique s’applique également à la réduction du risque d’événements vasculaires systémiques qui peuvent compromettre la qualité de vie. Ce cas démon-tre que l’amélioration de l’acuité de Snellen ne correspond pas toujours à l’amélioration fonctionnelle de la vision. Les fournisseurs de soins oculo-visuels qui prennent ces cas en charge doivent tenir compte à la fois des risques systémiques et des résultats visuels

Malignant Hypertension: Damaging Disease of the Eye and Beyond

Abstract: Case review follows a 49-year-old patient with malignant hypertension with retinopathy and resultant visual decline. Case Report: Severely uncontrolled hypertension manifested as malignant hypertensive retinopathy. The patient presented with substantial retinal and visual changes and was monitored over 6 months. While the patient experienced marked improvement in visual acuity, significant retinal damage occurred and the patient experienced persistent qualitative vision and visual field loss. Discussion: Observed fundus changes are consistent with advanced risk for morbidity and mortality associated with hypertension. Management of systemic disease is a critical step in reversing retinal manifestations and minimizing the risk for permanent vision loss. The criticality of systemic treatment also applies to lowed risk for systemic vascular events that may compromise quality of life. This case demonstrates that improvement in Snellen acuity does not always parallel functional visual improvement. Eye care providers managing these cases should consider both systemic risks and visual outcome

Emily Carr College of Art and Design Catalogue 91-92

Muli-media (sic

Emily College of Art and Design 1984-1985

Anite Sharpe (sic) - should be Anita Sharp