Opetusmateriaali vammapotilaan ensiarviosta ja henkeä turvaavista toimenpiteistä - Prosessi-kaavio

Vaikeasti vammautuneen potilaan kohtaaminen on eräs ensihoidon haastavimmista tehtävistä. Ensihoidon toiminnalla on vaikeasti vammautuneen potilaan selviytymisen kannalta suuri merkitys. Vammapotilaan hoidon periaatteet ovat kuitenkin varsin yksinkertaisia, ja näitä tilanteita tulisi kouluttaa ja harjoitella. Opinnäytetyön tarkoituksena on kuvata vammapotilaan kohtaamista, ensiarvion suorittamista sekä henkeä turvaavien toimenpiteiden tarpeen tunnistamista ensihoidossa. Opinnäytetyössä esitetyn tutkitun tiedon pohjalta luotiin prosessikaavio vammapotilaan ensiarviosta ja henkeä turvaavista toimenpiteistä. Tavoitteena on kehittää ensihoitajaopiskelijoiden valmiuksia vammapotilaan kohtaamiseen ja ensiarvion suorittamiseen. Aiheesta tehtiin kirjallisuuskatsaus hyödyntäen alan kirjallisuutta ja tietokannoista haettuja tutkimusartikkeleita. Ensiarvion tekemisen tulee olla nopeaa ja suoraviivaista. Ensiarvion suorittamisessa pitäydytään ABCDE-mallissa sen yksinkertaisuuden ja tunnettavuuden vuoksi. Malli on yleisesti käytössä opetuksessa ja sairaalan ulkopuolisessa ensihoidossa. Tavoitteena on tunnistaa potilaan elintoimintoja välittömästi uhkaavat häiriöt ja puuttua niihin viipymättä. Järjestelmällisen ensiarvion suorittaminen nopeuttaa potilaan pääsyä lopulliseen hoitopaikkaan, mikä on potilaan selviytymisen kannalta kriittistä. Vammapotilaan kohtaamisessa johdonmukainen ja järjestelmällinen ensiarvion suorittaminen on tästä syystä tärkeää. Henkeä turvaaviksi toimenpiteiksi on valittu kirjallisuuden perusteella ilmatien turvaaminen, hengityksen tukeminen, suuren ulkoisen verenvuodon tyrehdyttäminen, paineilmarinnan purkaminen sekä avoimen ilmarinnan peittäminen.Treating a severely injured trauma patient is one of the most challenging situations in pre-hospital care. However, pre-hospital care has a significant role in the survival and recovery of such a patient. The principles of trauma care are straightforward, and there should be considerable educational and training effort regarding these situations. The purpose of this thesis is to describe the initial contact and primary survey of a trauma patient and the identification of the need for life-saving interventions in pre-hospital care. Based on the research illustrated in the thesis, we also create a process chart for the primary survey and life-saving interventions for a trauma patient. The aim is to develop the abilities of paramedic students in the initial contact and primary survey of a trauma patient. The thesis contains a literary survey, which uses relevant literature and research articles from various databases. A primary survey should be rapid and straightforward. Our primary survey is within the ABCDE model due to its simplicity and popularity. This model is widely used in both curriculums and on the field. The aim is to recognize the threats to vital functions without delay and to then intervene rapidly. Systematic primary survey facilitates a more rapid transport of the patient into definitive care, a critical factor in the patient’s survival. A logical and systematic primary survey is thus of essence. Based on the literature, the life-saving interventions in this thesis are securing the airway, supporting breathing, controlling major external hemorrhages, treating a tension pneumothorax and covering an open pneumothorax

Efficient generation of energetic ions in multi-ion plasmas by radio-frequency heating

We describe a new technique for the efficient generation of high-energy ions with electromagnetic ion cyclotron waves in multi-ion plasmas. The discussed three-ion scenarios are especially suited for strong wave absorption by a very low number of resonant ions. To observe this effect, the plasma composition has to be properly adjusted, as prescribed by theory. We demonstrate the potential of the method on the world-largest plasma magnetic confinement device, JET (Joint European Torus, Culham, UK), and the high-magnetic-field tokamak Alcator C-Mod (Cambridge, USA). The obtained results demonstrate efficient acceleration of He-3 ions to high energies in dedicated hydrogendeuterium mixtures. Simultaneously, effective plasma heating is observed, as a result of the slowing-down of the fast He-3 ions. The developed technique is not only limited to laboratory plasmas, but can also be applied to explain observations of energetic ions in space-plasma environments, in particular, He-3-rich solar flares.Peer reviewe

Predicting Quantitative Genetic Interactions by Means of Sequential Matrix Approximation

Despite the emerging experimental techniques for perturbing multiple genes and measuring their quantitative phenotypic effects, genetic interactions have remained extremely difficult to predict on a large scale. Using a recent high-resolution screen of genetic interactions in yeast as a case study, we investigated whether the extraction of pertinent information encoded in the quantitative phenotypic measurements could be improved by computational means. By taking advantage of the observation that most gene pairs in the genetic interaction screens have no significant interactions with each other, we developed a sequential approximation procedure which ranks the mutation pairs in order of evidence for a genetic interaction. The sequential approximations can efficiently remove background variation in the double-mutation screens and give increasingly accurate estimates of the single-mutant fitness measurements. Interestingly, these estimates not only provide predictions for genetic interactions which are consistent with those obtained using the measured fitness, but they can even significantly improve the accuracy with which one can distinguish functionally-related gene pairs from the non-interacting pairs. The computational approach, in general, enables an efficient exploration and classification of genetic interactions in other studies and systems as well

Soot-doped natural snow and its albedo — results from field experiments

Soot has a pronounced effect on the cryosphere and experiments are still needed to reduce the associated uncertainties. This work presents a series of experiments to address this issue, with soot being deposited onto a natural snow surface after which the albedo changes were monitored. The albedo reduction was the most pronounced for the snow with higher soot content, and it was observed immediately following soot deposition. Compared with a previous laboratory study the effects of soot on the snow were not as prominent in outdoor conditions. During snowmelt, about 50% of the originally deposited soot particles were observed to remain at the snow surface. More detailed experiments are however needed to better explain soot's effect on snow and to better quantify this effect. Our albedo versus soot parameterization agreed relatively well with previously published relationships.Peer reviewe

Games without Frontiers: Theories and Methods for Game Studies and Design

Pelialan ammattilainen väittelee pelien tutkimus- ja suunnittelumenetelmistä Aki Järvisen väitöskirja käsittelee pelien tutkimista ja suunnittelemista. Games without Frontiers: Theories and Methods for Game Studies and Design on lähes kymmenvuotisen tutkimus- ja kehitystyön tulos, jota Järvinen on valmistellut peleihin liittyvien työtehtävien rinnalla. Tutkimus on monitieteinen kokonaisesitys peleistä ja pelaamisesta sekä siitä, miten aihetta voidaan akateemisesti tutkia ihmistieteiden näkökulmista. Games without Frontiers kattaa nimensä mukaisesti "pelit vailla rajoja" eli sen perustana on yli sadan pelin empiirinen otanta, joka sisältää niin video- ja tietokonepelejä, lautapelejä, korttipelejä, rahapelejä kuin televisiovisailuitakin. Tutkimus soveltaa mm. psykologian ja estetiikan teorioita tähdäten käytännön sovelluksiin pelien tuottamisessa ja tutkimisessa. Väitöskirjan pääasialliseen yleisöön kuuluvat paitsi peleistä kiinnostuneet tutkijat myös pelialan opettajat, opiskelijat sekä pelisuunnittelijat. Järvinen on luennoinut tutkimustyöstään viljalti maailmalla, mikä kertoo työn merkittävyydestä kansainvälisesti. Hänen tutkimushavaintojaan valittiin vuoden 2007 kymmenen merkittävimmän pelejä koskevan tutkimuslöydöksen joukkoon parhaillaan Kaliforniassa koolla olevassa Game Developers Conferencessa. Lisätietoa: http://www.gameswithoutfrontiers.net http://gamegame.blogs.com http://www.avantgame.com/top10.htmPh.D. on studying games, game play, and game design Aki Järvinen defends his Ph.D., titled Games without Frontiers: Theories and Methods for Game Studies and Design for the discipline of Media Culture at the University of Tampere. The study is a result of the author's almost ten-year long work on the research and development of games. As the name of the dissertation suggests, the study covers games of all kinds. Järvinen has studied an empirical sample of over 100 games, which include computer and video games, board games, card games, and television game shows. The study introduces a set of concepts, categorizations, and analysis methods deduced from the above sample. The concepts can be used in trying to understand games from the perspectives of design and consumption as a particular form of entertainment. Järvinen's study is multi-displinary, as it draws and applies theories from psychology, aesthetics, communication, cognitive science, etc. Besides a wealth of observations regarding games and play, the main results of the work are analysis methods aimed for practical applications in game studies and development. Games without Frontiers consists of five parts: The first part outlines the young history of game studies as an academic discipline and situates the work in to its contexts. The second part is a cornerstone of the work, as it documents a theory of what parts games are made of. The theory of game elements, as the author calls it, defines nine different elements found across games, and the theory functions as the reference point for the concepts and methods introduced in later chapters. Part two also introduces an analysis method based on the theory, and a card game inspired by the theory and designed by the author. Part three focuses on the psychological nature of game play. It introduces a theory of player experience, i.e. a theoretical framework for understanding experiences of playing games from the perspectives of cognition, emotion, pleasure, and entertainment. Study of the psychology of goals and emotions is a central aspect of part three, and it yields a number of observations of playing games as goal-orientated activity that entertains planning and performing in the face of goals. Part four, Studies in game systems , focuses in detail into certain aspects of games, such as genre and the ways that games communicate and persuade their players. The final and fifth part summarises the work by applying the theories formulated into practice by defining a set of analysis methods for studying games and the play experiences they facilitate. These analysis methods constitute the main results of the work, and they have been iteratively developed through analysing and re-analysing the sample of over 100 games. The primary audience of Games without Frontiers includes game scholars, but also teachers, students, and practitioners in the field of games. Järvinen is an internationally known game scholar whose work is expected to have an impact on the emerging field of academic study of games. His work was recently included in the Top 10 Gamestudies Download 2008 in Game Developers Conference in San Francisco. More information: http://www.gameswithoutfrontiers.net http://gamegame.blogs.com http://www.avantgame.com/top10.ht

Konkretiaa eurooppalaisen junien kulunvalvonnan käyttöönottoon rataverkolla ja vetävässä kalustossa

ISBN 1798-6664 (pdf