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Simple clotting cascade
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Coagulation is a active process and the understanding of the blood coagulation system has progressed over the current years in anaesthetic practice. Regular coagulation pathway signifys an equilibrium between the pro-coagulant pathway that is accountable for clot development and the mechanisms that slow down the same beyond the injury site. Imbalance of the coagulation system may happen through serious illness, which may be secondary to many factors leading to a tendency of either thrombosis or bleeding
In septic patients, increased levels of PAI-1 inhibit plasminogen activator (t-PA), which converts plasminogen to plasmin. Release of fibrin inhibits fibrinolysis by activation of thrombin-activatable fibrinolysis inhibitor (TAFI). In addition, the release of PAF causes platelet aggregation. This combination of inhibition of fibrinolysis, fibrin strand production and platelet aggregation contribute to a state of coagulopathy. This can lead to microcirculatory dysfunction with isolated or multiple organ dysfunction and cell death. Mr Hertz’s coagulation profile showed a fibrinogen level of 5.6 g/L, indicating that coagulopathies were underway in his system.
Ofri, D (2000). Diagnosis and Treatment of Deep-Vein Thrombosis. Western Journal of Medicine; 173: 194-197.
The two authors of “Initiation” and “On the Sidewalk, Bleeding,” Sylvia Plath and Evan Hunter, use setting and characterization to establish the mood, foundation to the plot, and introduce problems.
Vincent, J. L., & De Backer, D. (2013). Circulatory Shock. New England Journal of Medicine, 369(18), 1726-1734. doi: 10.1056/NEJMc1314999
Webster CS, Merry AF, Larsson L, McGrath KA, Weller J. The frequency and nature of drug administration error during anaesthesia. Anaesth Intensive Care 2001; 29: 494-500.
With the increase in the different methods of determining if a patient is on the brink of PPH, reducing the mortality rate should be much easier than ever before. Current methods such as QBL and EBL are being utilized to determine if a patient is hemorrhaging. Multiple factors should be taken into account such as the volume of blood loss, patient’s vital signs, and general appearance should guide the interventions in recognizing and managing PPH. Interventions include the use of uterotonics, blood transfusions, and crystalloid infusions. Additionally, tranexamic acid can be administered prophylactically. Early recognition and management increase the chances of survival of the subject (Glymph,
The systemic route is the major part of the circulatory system. The systemic route is responsible for transporting blood to all of the tissues located in your body except for the lungs and the heart. Oxygenated blood from the aorta travels through the arteries, veins, and capillaries. The arteries carry the oxygenated blood to the tissues and the veins carry the deoxygenated blood back to the heart.
vessel is too small to see with the naked eye. At that point, it is
Myoglobin consist of single polypeptide chain that made up of 153 amino acid and ahs a size of 18 kDa. Its three-dimensional structure was first determined by X-ray crystallography by John Kendrew in 1957. Myoglobin is a typical globular protein in that it is a highly folded compact structure with most of the hydrophobic amino acid residues buried in the interior and many of the polar residues on the surface. X-ray crystallography revealed that the single polypeptide chain of myoglobin consist of entirely of eight (labelled A-H) alpha-helical. Within a hydrophobic crevice formed by the folding polypeptide chain is the heme prosthetic group. This nonopolypepetide unit is noncovalently bound to myoglobin and is essential for the biological activity of the protein.
Have you ever thought of what your life might be like without the freedom or identity you have now? After reading this book, I thought the same thing. I think ‘On the Sidewalk, Bleeding’ teaches multiple valuable lessons that should be told to teens everywhere, without being overlooked. Here are my personal, three opinions on why ‘On the Sidewalk Bleeding’ teaches the best messages to teenagers.
In Blood In Blood Out is a drama directed by Taylor Hackford, and starring Damian Chapa (Miklo), Benjamin Bratt (Paco), and Jesse Borrego (Cruz), produced by Hollywood Pictures. The film was based off everyday life in East Los Angeles, from the 1970’s through the 1980’s. Damian Chapa stars as Miklo in the film, a Mexican-American who wanted to be accepted, not by his skin but for the Mexican within him. Benjamin Bratt (Paco) was the older cousin of Miklo, who learned his lesson throughout the movie and changed his ways. Jesse Borrego (Cruz) is the step-brother of Paco who was a talent artist, who ended up turning to drugs because of back problems caused by a rival gang incident.
Strangers passing by could mean they want to help or they could hurt you. Andy is laying on the sidewalk bleeding and is being passed by many strangers but none helped. Evan Hunter is the author for "On the Sidewalk Bleeding”. Andy was stabbed for being apart of the gang the Royals and strangers were passing by him but not helping him. They were not helping him because they seen that he had a Royals jacket on so if they helped him he thought the other gang qthe Guardians would be after them. While Andy is on the sidewalk bleeding he is thinking about his girlfriend Laura and how he will miss her and she will miss him. Evan Hunter uses mood/tone in his story of "On the Sidewalk Bleeding" to convey the theme of murder usually leads to misery
Bloodstain pattern analysis is a forensic discipline that deals with the physics of the blood, and determines the bloodstains left at crime scenes using visual pattern recognition. It is used to shed light on the reconstruction of a crime scene which includes the cause of death starting with homicide, suicide, accident, and identifying areas with high possibility of the offender leaving his or her DNA samples. There are documented descriptions of bloodstain shapes at crime scenes that date back to past centuries, but it was the Samuel Sheppard case in 1955, that prompted advances in this field. Bloodstain pattern analysis is employed worldwide by scientists, police officials and medics in an interdisciplinary manner. Both the blood itself and the surfaces on which the bloodstains are found are important in the assessment of bloodstains. The umbrella organization for bloodstain pattern analysts is the International Association of Bloodstain Pattern Analysts (IABPA), which offers various forms of membership. The name of the method (bloodstain pattern analysis) is often abbreviated to BPA.
The ability to determine source of a blood is important to serval fields of science, especially in forensic science (1, 2). Determining the origin of a bloodstain can be beneficial in investigations for wildlife crimes, animal cruelty cases, hit-and-run cases, and other cases as well (1, 2). It can be especially important in hit-and-run cases, because an individual may deny that they were in a vehicular accident where a human was hit (1). They even may lie by telling an investigator that they hit animal to account for the bloodstain and damage to their vehicle (1). As a result, it would be important to link evidence, a crime scene, and/or suspect together.
The coagulation department is included in the hematology department. I really like the Stago instruments we have. They are very easy to use and instrument maintenance is minimal and easily performed. The quality control and specimen testing are straightforward. The specimens need to be filled to the fill line or they will be rejected, the ratio needs to be accurate for an accurate result. D-dimers are the only test we run that is affected by hemolysis so if the specimen is hemolysed we need to have it recollected. I did discover that if a specimen had a clot the PTT result would be elevated maybe even >249 PT results will be affected also with a lower than normal result. We should be checking all specimens before we spin them for clots and have them recollected if one is found.