Friday, January 31, 2020
The use of spinal immobilisation in the prehospital environment An Essay
The use of spinal immobilisation in the prehospital environment An investigative study - Essay Example Findings such as continuous oozing, subcutaneous emphysema and especially expanding haematoma were initially missed. Current literature does not directly address the indications, benefit and risk concerning so-called immobilization for penetrating neck injuries. This is true for both journals and major trauma textbooks. Most authors simply recommend that all patients with such injuries should be immobilized, or merely state that such is the practice in their emergency department and pre-hospital trauma care. Even the manual of the ATLS does not make a distinction between blunt and penetrating neck trauma, generally stating that "any patient with a suspected spine injury must be immobilized above and below the suspected injury site until injury has been excluded by roentgenograms". In addition it stresses that "cervical spine injury requires continuous immobilization of the entire patient with a semi-rigid cervical collar, backboard, tape and straps before and during transfer to a definite-care facility". (Sauerland, 2004) In depth analysis of the text following these statements reveals that the au thor is referring only to casualties from blunt injury! Although there is no proven benefit of spin... Immobilization has been demonstrated to cause back and head pain, resulting in an increased number of radiographs required to clear the spine in the emergency department (ED). Rigid spine immobilization can also cause pressure-related tissue breakdown, restrict respirations, and, if used aggressively, actually cause spinal cord injury. (Jones, 2004) Importance of Spinal Immobilization ED studies have confirmed the ability of clinical criteria to reliably determine the need for spine radiographs, although the majority of these have addressed only the cervical spine. Stevens reported that only a small number of patients with cervical spine injury escaped capture using clinical clearance criteria in the ED. Although the ED use of clinical spine clearance protocols has been reported, the validity of using a similar protocol in the EMS setting has not been fully addressed. The goal of prehospital management of SCI is to reduce neurological deficit and to prevent any additional loss of neurological function. (March, 2002) Therefore, prehospital management at the scene should include a rapid primary evaluation of the patient, resuscitation of vital functions (airway, breathing, circulation; the "ABCs"), a more detailed secondary assessment, and finally definitive care (including transport and admission to a trauma centre). Moreover, after arrival at the scene, it is impo rtant to "read" the scene and to appreciate the mechanism of injury in order to identify the potential for SCI. Prehospital management in general and the management of the airway and ventilation in particular should include immobilisation of the spine in suspicious cases to reduce the risk of a secondary SCI. (Hoffman, 2000) Cardiovascular
Thursday, January 23, 2020
What is Philosophy? :: essays research papers
What is Philosophy?      I believe that Philosophy is the study of different ways of thinking. In philosophy, you should question everything and never take anything for face value. There are always two sides to every coin as there are different ways of looking at things, is what philosophy teaches us. In philosophy, you must throw off all the limitations you have set on yourself when dealing with how you view things and how things seem to be.      Reality is a big topic of discussion in philosophy. How you view things may not be how they really are. A schitzophrenicÕs reality is different from the reality of a ÒsaneÓ persons. Therefore I deem reality to be based on experiences, and perceptions. Something you deem to be wrong may be the same thing your friend deems to be right. So does this mean that there really is no one true reality?      In Philosophy, we learn that it is okay to doubt things that occur in our lives. It is not only okay but it is a natural response to something you are unclear or uncertain about. Sometimes, though, the build-up of doubt becomes too much for someone to handle so they become suicidal or just give up trying to think about it all together. When this happens, there is a tendency to become cynical, and this is a tragedy because then you feel like nothing is really worth trying to figure out.      Most of philosophy deals with the ÒselfÓ. People are always trying to find out who they are; why theyÕre here; or how things relate to them. All of our lives are spent on a road of self discovery, seeing what the world has to offer us, and where our place really is. If we were to actually look closely, we would see that                                                        page 2 we knew who we were all along, we just didnÕt realize it.
Wednesday, January 15, 2020
Macbeth and the Jacobean Scot
In Macbeth, the Jacobean Scot, and the Politics of the Union, Sharon Alker and Holly Faith Nelson demonstrate a well-informed opinion of the relation between the idea of the Jacobian Scot and it’s arguable relation, or lack thereof, to William Shakespeare’s Elizabethan play, Macbeth. Though many scholars find it easy to draw a connection between the traditional Jacobian Scot that was typically presented in Elizabethan plays during the Jacobian era, Alker and Nelson seek to highlight the ambiguous nature of the play by demonstrating the various ways in which it can be read and/or interpreted. Not only this, but Alker and Nelson also manage to shed light on the conflicting aspects of Macbeth in relation to it’s connection with Jacobean ideas and portrayals of Scots at the time. At the time that Shakespeare’s play, Macbeth, is thought to have been performed in 1606, a huge change was making it’s way across what we now refer to as Great Britain. During this time, the former king of Scotland, James VI, became the king of England as a result of the Union of Crowns, following the death of his cousin, Queen Elizabeth I of England. This union caused much friction between Scotland and England, as many English felt imposed upon and thought the Scottish to be inferior and somewhat barbaric in their ways. Due to the attitudes of many English people towards the Scottish during the Elizabethan era, the Scottish were most often characterized as people who were opposed to what was thought to be â€Å"legitimate†authority by the English, along with being represented as lesser than and in need of subordination to the English. The typical ‘stage Scot’ was often portrayed as dualistic, lacking in loyalty, and intrusive of other’s property in their relentless ambitions for power. However, there were three different views regarding the union of England and Scotland. One English view thought that English systems and such should be most prevalent across Britain, while another view (mainly called for by Scots) looked to equality by maintaining political and religious institutions separately. The third view, held mostly by those who supported King James, sought for a unity â€Å"in the hearts and minds of the two peoples. Due to the fact that Macbeth is thought to have been performed in the time between the proposal of these 3 policies and the actual implementation of any new policies, many critics believe that the play is a direct representation of English views of the ‘Jacobian Scot’. In contrast to this idea, Alker and Nelson would like to â€Å"demonstrate that Shakespeareâ €™s Macbeth does not present a particular position on the Anglo-Scottish politics that defines itself in relation to the belief system of one small political body†. Instead, Alker and Nelson did a more flexible reading of the play that consisted of possible relations to any of the three models of the union. First of all, Alker and Nelson bring the character of Macbeth into consideration, as he is not only the main character of the play, but also natively Scottish. Although Macbeth does seem to maintain all the traditional characteristics of a Jacobian Scot: disloyal, subordinate, and barbaric, Alker and Nelson point out the characteristics of Macbeth that stand in complete contrast to this traditional model. To begin with, the traditional stage Scot would never possess noble values such as loyalty, kinship, and hospitality. However, in Shakespeare’s play the Scottish character of Macbeth, though troubled and duplicitous, is read to possess such qualities somewhere in the make-up of his conscious. This is apparent in Macbeth’s back-and-forth notions of whether or not to kill the king and gain power or preserve his loyalty to the king and maintain his integrity as one of Duncan’s kin. Although Macbeth ultimately proves to allow evil and selfishness to rule his decisions, the agonizing consideration of right and wrong that Macbeth struggles through prior to murdering Duncan shows that Macbeth is not simply a barbaric creature driven solely by greed and desire. Rather, Macbeth is seen working through his conflicting desire for power and his code of honor and sense of respect for the king. The typical stage Scot normally would not embody such qualities as guilt and/or remorse. Also, there is a hint that Macbeth may not fully understand his own desires and actions, as he was not initially driven by the idea of power when the witches first prophesized his coming kinghood. Instead, it was Banquo who first displayed excitement and anxiousness at the witches’ prophecy and spurred later excitement and ambition in Macbeth. Along with Banquo, Lady Macbeth is portrayed to having been more ambitious towards ideas of power and kingship than Macbeth originally was. This aspect of the play hints at the fact that Macbeth was aided, or led to his violent ways, rather than singularly contriving an evil murder plan against the king. The traditional portrayal of the stage Scot would be that of stubborn, insistent, uncivilized, and unconcerned with duties or issues of loyalty. In the case of Macbeth, he was more or less guided into such characteristics as he was governed by his wife’s unrelenting desire for power in order to first summon up such murderous notions and ideas. The typical stage Scot would have possessed these qualities initially, without the need of any sort of encouragement. In conclusion, the character of Macbeth in Shakespeare’s play, Macbeth, as Alker and Nelson would argue, stand in contrast to the role of the typical Jacobian Scot that was predominately presented in Elizabethan plays. Though Macbeth ultimately possessed many of the characteristics that the traditional Jacobian Scot would possess, he also held many contradictory characteristics. Where Scots were typically portrayed as immoral and barbaric, lacking any sense of guilt and/or consideration for others, Macbeth is portrayed as a less-stubborn, remorseful character that is filled with anxiety and logical dualism over any sort of misdeed or wrong doing he considers. Therefore, although Macbeth may be read as a villainous and selfish character driven by greed and other characteristics thought to have been attributed to Scottishness, he can also be read as a regretful and conscious-stricken man whose inner-turmoil is the result of conflicting instincts of morality and of power.
Tuesday, January 7, 2020
Environmental Policies Of The United States - 1331 Words
Over the years the United States environmental policies have expanded as well as the awareness of the public and the opinions of many party members, interest groups, and those directly effected by the environment s decline. There are many institutions that have an effect on environmental policy like congress, many federal agencies, the office of management and budget and the executive branch, nongovernmental forces, individual citizens, and the main one, the federal Environmental Protection Agency (EPA) (Cohen, Steven). America s general belief is more contrary to objective reality. Many Americans fear sever water and air pollution over the next 50 years. This is because of industrialization, population growth, and mass consumption. The public have recently started pushing environmental problems to the top of the political agenda. Support for the environmental policies in the United States comes from the way individuals assess the environment, and their perception of the governmenta l regulation of the environment and their relative evaluation of the line between environmental protection and economic forces (Carman, Christopher). Interest groups have been the catalyst of getting environmental information out to the public. They have researched and studied and are made up of individuals with drives to help the world. They passionately push for change in the way America views the environment. America needs to be leaders of the world especially when it comes to saving itShow MoreRelatedEnvironmental Policies Of The United States1438 Words  | 6 Pagesto enter the state arena and took part in the policy making process. Environmentalist scholars were also given positions in the public sector, marking a step forward in the Taiwanese political history. 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A year later, additional legislation was passed to refine the state’s responsibilities in environment al management and enforcement by allowing city and state governments to regulate industrial and manufacturingRead MoreHow Does The Governmental Transfer Of Power Impacts Wildlife And The Workforces That Conserve And Protect Wildlife?1538 Words  | 7 Pagesimpacts wildlife and the workforces that conserve and protect wildlife? The United States government is constantly rotating officials in control of regulating previous and developing laws, forming future concepts and regulations on various assemblies, and striving to improve the lives of the American citizens. However, the ever changing governmental powers may cause a positive or negative impact on wildlife conservation and policy, due to varying opinions of the governmental officials formerly in commandRead MoreCommand And Control Policy. Student’S Name:. Institution:.1523 Words  | 7 Pages Command and Control Policy Student’s Name: Institution: Date: Command and Control Policy Introduction Climate change poses a huge risk to human beings and natural system hence the need for policies to reduce carbon dioxide gas emissions to the environment and the damages caused by the rapidly changing climate. This is the reason countries like the United States of America enacted command and control policies to try and curb the rate of pollution of the environmentRead MoreThe Paris Climate Agreement1292 Words  | 6 Pagesstruggled to combat climate change and reduce global emissions. On Thursday, June 1st, 2017 President Trump announce that the United States would officially withdraw from the Paris climate agreement. Following through on his campaign promise, and defying the wishes of other world leaders who pleaded with him to remain a party in the pact. Governing with an American First policy, he said he was carrying out the will of the voters. â€Å"I was elected by the citizens of Pittsburgh,†Trump said, â€Å"not Paris
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