2nd pu sanskrit 2nd chapter guide

2nd pu sanskrit 2nd chapter guide LINK 1 ENTER SITE >>> http://gg.gg/11s6ji <<< Download LINK 2 ENTER SITE >>> http://inx.lv/ZUQ5 <<< Download PDF File Name:2nd pu sanskrit 2nd chapter guide.pdf Size: 2441 KB Type: PDF, ePub, eBook Uploaded: 27 May 2019, 23:52 Rating: 4.6/5 from 622 votes. Status: AVAILABLE Last checked: 16 Minutes ago! eBook includes PDF, ePub and Kindle version In order to read or download 2nd pu sanskrit 2nd chapter guide ebook, you need to create a FREE account. ✔ Register a free 1 month Trial Account. ✔ Download as many books as you like (Personal use) ✔ Cancel the membership at any time if not satisfied. ✔ Join Over 80000 Happy Readers 2nd pu sanskrit 2nd chapter guide Learning CPR can save lives- you can save a life. Here is a brief review of these systems. The trachea, which is sometimes called the windpipe, conducts air down into the lungs through the bronchi, which are smaller tubular branches. The bronchi then divide into smaller and smaller tubules called bronchioles. Air is exchanged in the alveoli, which are tiny sacs that allow oxygen and carbon dioxide to move between the lungs and the bloodstream via tiny capillaries. They release carbon dioxide, a waste product, into the atmosphere when you exhale. Our bodies utilize approximately 4-6 of that oxygen and release about16 back into the atmosphere, along with carbon dioxide, when we exhale. Without oxygen, brain cells begin to die in 4 to 6 minutes. They also require nutrients. Oxygen deprivation, or hypoxia, will cause cells to die within a few short minutes. Carbon dioxide must be eliminated through the lungs through ventilation. While it is important to learn what to do when cardiovascular disease leads to a heart attack or stroke, it is equally as important, if not more so, to understand how to prevent cardiovascular disease from occurring in the first place. Some of these factors can be controlled (modifiable risk factors), while others cannot (non-modifiable risk factors. Americans of all ages should focus on prevention of cardiovascular disease by eating healthy foods, exercising 30 minutes (at least) each day, controlling weight, minimizing stress, consuming healthy fats and oils, and avoiding cigarette or cigar smoking. Plaque is composed of fatty substances, cholesterol, fibrin (a clotting substance in the blood), calcium and cellular waste products. When plaque builds up, it can partially or totally block the flow of blood through an artery in the brain (which causes stroke), the heart (which causes a heart attack), the kidneys, the arms, the legs and other vital areas. 2nd pu sanskrit 2nd chapter guide, 2nd pu sanskrit 2nd chapter guide pdf, 2nd pu sanskrit 2nd chapter guide chapter, 2nd pu sanskrit 2nd chapter guide notes, 2nd pu sanskrit 2nd chapter guide 1. Plaque may break off to block an artery, or a blood clot (thrombus) may form on the surface of the plaque- either of these two circumstances can lead to a heart attack or stroke. About one-third of patients report no chest pain at all. Ischemic strokes are more common. Remember that “Time is brain,” and act quickly. Stroke is the 3 rd leading cause of death in the United States. These changes include: This was one of the major changes that took place in 2010, when research showed that decreasing the delay in beginning chest compressions lead to a higher incidence of ROSC (return of spontaneous circulation). Rescuers are now trained to provide interventions in the following order:It is often hard for even trained providers to identify effective breathing. It is no longer recommended to look, listen and feel to determinewhether a victim is breathing. Rather, if the victim is not responsive, has no pulse, and is not breathing or is breathing in an irregular fashion (i.e. only gasping), begin CPR immediately! High-quality CPR is defined as:If you can’t feel a pulse or if you’re not sure you can feel a pulse, begin CPR. If trained first responders are not present and you don’t have a manual defibrillator, the next best option is an AED with a pediatric dose attenuator. If an AED with a dose attenuator is not available, you CAN use an adult AED on an infant. This may encourage efficiency in assessment and response, rather than following a step-by-step response. In the diagram above, the first two of five steps are visualized The five links in the Adult Chain of Survival include: However, in many situations, there is often more than one rescuer trained and willing to help. The first rescuer should take the role of team leader and delegate tasks. One rescuer can provide compressions, one can prepare to give breaths with a bag-valve mask, and one can prepare the AED. By working together, the most efficient care can be given to the patient. Chest compressions are an attempt to mimic the normal activity of the heart. When a rescuer presses down on a victim’s chest, blood is forced out of the heart and into the arteries. When pressure on the chest is released, blood is allowed to return to the heart. A small amount of oxygen will be present in the bloodstream for several minutes after the heart ceases to beat, just enough to keep the brain alive. Compressions can keep vital organs functioning until higher level care is available. Then place your other hand on top of the first and interlace your fingers. The heel of your hand should be pressing on the bottom two-thirds of the sternum, avoiding the xiphoid process (the small bony prominence at the very bottom of the sternum (breastbone). You Lock your elbows and press down hard, depressing the sternum at least 2 inches (5 cm), but no more than 2.4 inches (6 cm). Your shoulders should be positioned directly over your hands in a straight line. Push hard and fast 100 to 120 times per minute, counting out loud as you do so. It’s important that you allow the chest to recoil (return to it’s normal, relaxed position) in between compressions. If you do not allow the chest to recoil, the heart will not fill completely, which means that less blood (and therefore oxygen) will be pumped out of the heart to vital organs with the next compression. Most people find that they become very fatigued after providing compressions for 2 or 3 minutes. When a person performing compressions becomes fatigued, there is a tendency to compress less firmly and more slowly; for this reason, it is recommended that rescuers trade off doing compressions every 2 minutes to prevent fatigue and optimize the quality of compressions. If you are alone, you will have to do the best you can- keep performing compressions until help arrives or you are physically unable to do so. If the victim is in water or on a road, try to move the victim to a safer area. Simply roll him over onto his back. http://ninethreefox.com/?q=node/16570 Make sure the victim is on a firm surface, in case compressions are needed. Check for breathing.If someone responds, tell him to call for help by dialing 9-1-1. If you are in an area where an AED may be available, tell him to go find the AED. Make sure you tell the person to return to assist you as soon as possible. If you are alone, call for help by dialing 9-1-1 and run to get the AED if you know where one is nearby. If you do not know where an AED is, begin CPR immediately. Feel for a pulse for at least 5 seconds but NO MORE THAN 10 seconds. To check for a carotid pulse, slide 2 or 3 fingers into the groove between the windpipe and the neck muscles at the side of the neck. Provide 30 chest compressions, followed by two breaths.Each compression should be AT LEAST two inches deep (but no more than 2.4 inches) and the rate should be 100-120 compressions per minute. The purpose of CPR is to help the blood flow through the heart and into the rest of the vital organs; if you allow the chest to re-expand, more blood will flow into the heart and will be available to deliver to the rest of the body. Be sure you lift up on the bony part of the jaw and not the soft tissue under the jaw so you don’t block the victim’s airway. Do not use your thumb to lift the jaw. Allow the victim’s mouth to remain slightly open. Although the risk of infection from performing CPR is very, very low, it is expected that healthcare workers use a barrier device when providing CPR. This includes the use of face masks or bag-mask devices (see next section). Make sure the chest rises with each breath. Repeat, giving a second breath. Remember, push HARD and FAST. Alternate chest compressions (30) and giving breaths (2) until help arrives. Untreated, ventricular fibrillation rapidly causes cardiac arrest. Ventricular tachycardia is a rapid rhythm originating in the ventricles. In ventricular tachycardia, the ventricles contract so quickly, albeit in a somewhat organized fashion, that inadequate blood flow is produced. Ventricular tachycardia often precedes ventricular fibrillation. Both rhythms are lethal if not treated. For each minute that defibrillation is delayed, the chance of survival is reduced by 10. (after 10 minutes, few people are successfully resuscitated.) Rescuers should immediately begin chest compressions, and use the AED as soon as it is available and ready to use. In some communities, private AED owners are registering their AEDs with ambulance dispatch, so that they can be easily located by bystanders when needed. Make it a point to learn where the AEDs in your neighborhood or town are located- you never know when you might need one! All you need to do as a rescuer is turn on the machine (the most important step) and listen as the machine guides you through the steps to use the AED safely and effectively. Although there are many brands of AEDs on the market, they all work in a similar fashion and are designed to be used by lay rescuers. In this way, the other rescuer can continue performing CPR until the AED is ready to analyze and deliver a shock (if needed). These will be highlighted in the following list of steps so they are easily recognizable. This is the most important step- turning on the machine will enable the AED unit to guide you through the next steps. To turn on the AED, open the top of the carrying case and push the ON button. Note: some models will turn on automatically when you lift the lid of the carrying case. Expose the patient’s chest. Dry it off if wet, shave excessive hair if possible. Choose adult pads for victims who are 8 years of age or older. Peel off the adhesive backing. Place one pad on the upper right chest just below the collarbone. Place the other pad on the patient’s lower left ribcage, a couple of centimeters beneath the armpit. Some pads are marked- there will be a red heart on the pad that is to be placed on the victim’s left side (the heart side). Press pads firmly onto the patient’s chest. Then attach the connecting cables to the AED unit. Note: some cables will come preconnected. If the AED unit instructs you to, CLEAR the victim while the machine is analyzing the victim’s heart rhythm. This means you should ensure that no one is touching the victim, including yourself. The rescuer performing chest compressions or giving breaths will need to stop at this point. Note: some AEDs will begin to analyze the victim’s rhythm independently; for others, you will need to push the ANALYZE button. Analyzing the victim’s rhythm will take up to 10 seconds, so don’t be alarmed by this. You should ensure that no one is touching the victim, including yourself. You need to look around to make sure no one is touching the victim’s body while stating “CLEAR” or some similar message that warns others a shock is to be delivered. Once you are certain that no one is touching the victim, push the SHOCK button. You will notice that the victim’s muscles contract strongly. Here’s what to do when faced with one of the following: If the machine continues to prompt you, quickly pull off the pads- this should remove enough hair to allow a new set of pads to adhere firmly to the victim’s skin. Many AED machines are coming equipped with a razor in the carrying case to combat this problem. If you happen to own an AED, ensure that a razor is included in the case. You are not in danger of getting a shock if the victim is in water. Water is a great conductor of electricity, so if the victim is in water, the shock will be dispersed across the skin of the victim, and the victim will not receive the full dose of electrical energy required to convert them to a normal rhythm. If the victim’s chest is wet, quickly dry the chest with a towel or your sleeve; however, the chest does NOT need to be completely dry. If the victim is lying in a small puddle or in snow, you can safely use the AED without moving the victim. You will recognize these devices as a small lump under the skin on the chest, usually the upper chest on either side. Some older models may be implanted in the abdomen. They are generally about the size of a deck of cards or smaller. You will also be able to see a scar over the area. If the victim has one of these devices, avoid placing the AED pad directly over it; doing so may block delivery of the shock. These includes pain medications, hormones, smoking cessation drugs, nitroglycerin and others. Do not place an AED pad over one of these patches. If it won’t delay delivery of a shock, remove the patch and wipe the skin before applying the AED pad. These patches may cause the skin to burn under the AED pad if left in place, or they may block delivery of the shock. Thus far, we’ve learned how to perform compressions, maintain the airway and use an AED on an adult victim. Now it’s time to put it all together. The following steps outline how to perform CPR with an AED when there are two rescuers present. At the same time, observe the victim’s chest for breathing. If the victim is not breathing, or is breathing abnormally or only gasping, stay with the patient and prepare to perform the next steps. If a pulse is not felt, or the rescuer is not sure if there is a pulse, the rescuer will expose the chest (in preparation for AED use) and begin CPR, starting with chest compressions. Rescuer 1 will continue cycles of chest compressions and ventilations with a pocket mask or bag-mask device until Rescuer 2 returns with an AED. Rescuer 2 powers on the AED and attaches the pads to the victim’s chest, also attaching the cables to the AED unit if necessary. Rescuer 1 should continue CPR while the pads are being placed, right up until it is time to analyze the victim’s heart rhythm. During analysis, which can take up to 10 seconds, Rescuer 2 and Rescuer 1 should switch positions, so that Rescuer 1 CLEARS the victim, pushes SHOCK if a shock is advised, and immediately resumes chest compressions (or performs chest compressions if no shock is advised). Rescuer 2 then takes over management of airway and breathing. Rescuers should switch positions every 2 minutes when it is time to ANALYZE the victim’s heart rhythm. This will prevent rescuer fatigue and ensure that rescuers are able to provide high-quality chest compressions at the proper rate and depth. CPR and analysis with the AED should continue until EMS arrives. For most children, this will be about 2 inches. The number of hands used will depend on the size of the child.Therefore, the goal is to intervene before the child goes into cardiac arrest. For this reason, when to call EMS is dependent upon whether you witnessed the child’s arrest. If you did NOT witness the child’s arrest (unwitnessed arrest) and you are alone, you should provide CPR for 2 minutes prior to calling EMS and finding an AED. If you witness the arrest (i.e., the child suddenly collapses), you should call EMS and get an AED before returning to the child to start CPR. Because children are more prone to respiratory arrest and shock, it is essential to recognize airway and breathing problems before they occur to prevent cardiac arrest and ensure survival and full recovery. For this reason, an extra link in the chain of survival- prevention- has been added. Therefore, the Pediatric Chain of Survival includes: Note: if you witnessed the child’s collapse, leave the child to activate EMS and retrieve an AED if you know where one is located. Depending on the age of the child, you might be able to feel a carotid pulse in the side of the neck. In younger children with shorter and chubbier necks, you can palpate the femoral artery in the groin area, midway between the pubic bone and the hip bone and just below the crease where the leg meets the abdomen. Breaths should be delivered with a face mask or a bag-mask device in the same way as for adults- perform a head tilt-chin lift to open the airway, place the mask on the child’s face using the bridge of the nose as a guide, seal the mask to the child’s face and lift the jaw into the mask. Each breath should go in over 1 second and should cause visible chest rise. Avoid excessive ventilation- chest rise should appear natural and gradual rather than sudden and forceful. Masks should fit correctly and should not extend below the child’s chin or cover the eyes. For now, we’ll move on to CPR for infants. There are a few differences as follows: To check for responsiveness in an infant, tap the soles of the feet while calling to the infant in a loud voice. To locate the brachial artery, place 2 or 3 fingers on the inside of the upper arm between the shoulder and elbow. Press the fingers gently for 5 to 10 seconds to feel for a pulse. Pushing too firmly may occlude the infant’s pulse. To landmark, place 2 fingers in the center of the infant’s chest, just below the nipple line. Push down on the infant’s chest one-third the depth of the chest, or approximately 1 ? inches. Allow the chest to fully recoil (return to its neutral position) in between compressions.To perform this technique, position yourself at the infant’s feet. Place your thumbs side by side on the center of the infant’s chest just below the nipple line. Encircle the infant’s chest so that the fingers of both hands support the infant’s back. This technique also allows for more consistent chest compressions and superior blood flow and blood pressure compared to the 2-finger technique. When two rescuers are present, the compression: ventilation ratio drops to 15:2, the same as in children. Therefore, the goal is to intervene before the infant goes into cardiac arrest. For this reason, when to call EMS is dependent upon whether you witnessed the infant’s arrest. If you did NOT witness the infant’s arrest (unwitnessed arrest) and you are alone, you should provide CPR for 2 minutes prior to calling EMS and finding an AED. If you witness the arrest (i.e., the infant suddenly becomes unresponsive), you should call EMS and get an AED before returning to the child to start CPR. Place 2 or 3 fingers on the inside of the upper arm between the shoulder and elbow. Press the fingers down gently for 5 to 10 seconds to feel for a pulse. Remember: pushing too firmly may occlude the infant’s pulse. Use the correct sized face mask or bag-mask device for the infant (the mask should cover the mouth and nose without extending past the chin or covering the eyes). A breath should require only a small puff of air into the mouthpiece of the device to cause chest rise- avoid excessive ventilations. Lastly, rather than performing a head tilt-chin lift maneuver to open the infant’s airway, the infant’s head should be placed in “sniffing position” with the infant’s head tilted just enough that the nose appears to be sniffing the air. In this position, the external ear canal should be level with the top of the infant’s shoulder. Avoid hyperextending the neck- you also want to avoid allowing the chin to fall down towards the neck. You can do this by placing one hand on the infant’s forehead while you perform chest compressions. In this way, the infant’s airway will remain open and will not close off. Then return to the infant to continue CPR. Place 2 or 3 fingers on the inside of the upper arm between the shoulder and elbow. In this way, the infant’s airway will remain open and will not close off. When the second person returns, change the ratio of compressions to ventilations to If you use an AED that is pediatric-capable, it will have special features that you will need to know about in order to operate the AED. For example, some AEDs may come with child pads, which are smaller in size. In some AEDs, there may be a key or switch that you will need to activate to use the AED on children or infants; in others you will plug the child AED pads into a separate receptacle when using the AED on infants or children. All AEDs typically come with instructions, so when all else fails, read the instructions. Turning the Machine ON will cause the AED to begin voicing instructions as well. If the AED does not have child pads, you may use adult pads; however, you should ensure the pads do not touch or overlap. If the pads are too large, you can use alternative placements, such as the anterior-posterior pad placement: When nothing else is available, and adult AED may be used- after all, the alternative is death, and studies have not shown that infants and children resuscitated with an adult AED suffer any permanent damage to the heart. Try to immobilize the spine and protect the head, neck, and back if it is necessary to move a victim If another person is available, ask them to activate EMS, get an AED and return to provide assistance. Return to the victim to resume CPR and use the AED as soon as possible. Check mouth for obstruction, foreign matter. Head should be in “sniffing” position. Use roll under shoulders to maintain proper positioning. Watch for chest rise. Watch for chest rise. May use anterior-posterior pad placement. If one is not available, use child attenuator pads; if not available, use adult pads, don’t pads contact each other.May use anterior-posterior pad placement. All that’s left to do is pass the multiple choice examination. You can access the link to the practise exam and final exam at the bottom of this page or by going to My Account. Some masks are equipped with a one-way valve that allows the rescuer’s breaths to enter the victim’s airway, but prevents the victim’s expired air from coming in contact with the rescuer’s airway. These masks also prevent contact with vomitus and blood, which could pose an infection risk to the rescuer. It takes practice to learn how to use these masks effectively to provide ventilations. Using a Face Mask: If you are a lone (single) rescuer, positioning yourself at the victim’s side will allow you to provide both ventilations and compressions without having to move. Masks are usually triangular in shape, and you will notice that the mask has a “pointy” end- this end goes over the bridge of the victim’s nose. To do this, take the hand that is closest to the top of the victim’s head and place it along the edge of the mask. With the thumb of your other hand, apply pressure along the bottom edge of the mask. Then place the remaining fingers of your second hand along the bony edge of the jaw and lift the jaw upwards. Open the airway by performing a head-tilt chin-lift procedure. While you lift the jaw, ensure that you are sealing the mask all the way around the outside edge of the mask to obtain a good seal against the victim’s face. Remember, you should be lifting the victim’s jaw into the mask, rather than simply pushing the mask down onto the victim’s face. Check for a pulse every 2 minutes- if there is no pulse, start chest compressions along with ventilations at a rate of 30:2. They are commonly used to provide positive-pressure ventilations during CPR. They can be attached to an oxygen source to provide 100 oxygenation during resuscitation. As with the face mask, it takes practice to be able to use a bag-mask device. It can also be very difficult for one person to use a bag-mask device; therefore, it is recommended that use of a bag-mask device be used only when there are two rescuers available. Watch for chest rise. If you do not observe chest rise, you do not have a tight seal. If this occurs, reposition the mask and try again. Be careful not to overinflate the lungs- each breath should result in visible and natural chest rise. If the victim loses their pulse, you will need to begin chest compressions. This could further damage the neck or spinal cord. Instead, you should use the jaw thrust maneuver to open and maintain the victim’s airway. Rest your elbows on the surface that the victim is laying on. There are many reasons why bystanders are reluctant to get involved. Let’s take a look at some of these reasons so that you can understand why they have no real basis of support. Good Samaritan laws may differ for professional health care providers from state to state. Implied consent means that there is an assumption that if an unconscious person were able to request care, they would do so. Remembering the correct number of compressions or the number of compressions to ventilations is not as important as the willingness to respond and to push hard and fast. Hands-only CPR is designed to provide simple life support. You can’t hurt someone who is dead, and any injuries you may unknowingly cause (such as injured ribs) can be dealt with in a surviving victim of cardiac arrest. If the scene is not safe for you to enter, you must not enter. This will only result in more victims. Under no circumstances should you risk becoming a victim. Instead, you should call for help (activate EMS). When you have determined that the victim requires CPR, start CPR beginning with compressions. When the second person returns (without an AED in this case): The second rescuer should give two rescue breaths after every 30 compressions, using a face mask or a bag-mask device. If you are counting out loud, two minutes is about 5 cycles of thirty compressions and two breaths. You should change positions sooner if the person doing compressions becomes too tired to perform high-quality compressions. Once an advanced airway is in place, there is no longer a need to pause compressions to deliver breaths. An advanced airway means that air is reliably delivered to the lungs, regardless of whether a rescuer is applying force to the chest at the same time a breath is being delivered. Breaths are delivered over 1 second simultaneously at a rate of 1 breath every 6 seconds (10-12 breaths per minute). Should a cardiac arrest occur at home, you would likely not hesitate to perform mouth-to-mouth breathing for a relative or loved one; you might choose to give mouth-to-mouth to a friend as well. In cases such as these, you will likely decide the benefit outweighs the risk to your own health. Be careful not to ventilate too forcefully, as doing so may cause lung damage. You may need to try to providebreaths at a few different positions before you achieve airway patency (airway is in an open position). In actual fact, your expired air contains about 17 oxygen- this is just enough oxygen to meet the victim’s needs. Doing so may cause air to enter the stomach rather than the lungs, which can cause gastric inflation. Gastric inflation may result in vomiting, and an unconscious victim may develop pneumonia if vomitus makes its way to the lungs. To avoid gastric inflation, give each breath slowly over 1 second and deliver just enough air to make the chest rise. During respiratory arrest, as well as inadequate breathing, the victim will still have some amount of cardiac output, which you will be able to detect as a palpable pulse. These abnormal respirations are inadequate to support life. Respiratory arrest inevitably leads to cardiac arrest if not treated, therefore healthcare providers should intervene quickly to prevent this deterioration by providing rescue breathing. The heart is a muscular organ supplied by the coronary arteries. It is located below your breastbone (sternum) and, in an adult, is approximately the size of your fist. Here we will discuss basic life saving interventions for patients in respiratory and cardiac distress and the importance of teamwork in a critical emergency. The life saving interventions of BLS are primarily for the purpose of maintaining circulation and oxygenation of the brain and other vital organs until Advanced Cardiac Life Support (ACLS) or other interventions can be initiated by trained healthcare providers. Here you will be able to review critical interventions needed to save a life and earn your BLS provider card. Learn more about our BLS certification. This is CAB-D (Circulation, Airway, Breathing, Defibrillate). The following scenario will help guide you in performing CAB-D. You find an adult lying on the ground. Assess to make sure the scene is safe for you to respond to the down patient. Assess Responsiveness: Stimulate and speak to the adult asking if they are ok. Look at the chest and torso for movement and normal breathing. Start with chest compressions: This is 30 compressions every 15 to 18 seconds. If two providers are present: switch rolls between compressor and rescue breather every 5 cycles. Watch for abnormal breathing or gasping. Avoid the recovery position if it will sustain injury to the patient. Look at the chest and torso for movement and normal breathing. This is 30 compressions every 15 to 18 seconds. One between the nipple line and the other 1cm below. Watch for abnormal breathing or gasping. Begin use on patient as soon as it arrives). If the manuals defibrillator is not available the next best option is an AED with a pediatric attenuator. An AED without a pediatric attenuator can also be used. This is 30 compressions every 15 to 18 seconds. Watch for abnormal breathing or gasping that will require additional ventilatory support. Use immediately upon its arrival to the scene). An AED without a pediatric attenuator can also be used.