“Candy corn was invented in the 1817 and designed to mimic the appearance of a kernel of corn, but was made from wax, sugar, and corn syrup. The only problem? It really does just taste like wax, sugar, and corn syrup. Candy companies now sell their extra yearly inventory to Third World Countries, who use it to pave roads.”
- Monitor costume accessories. Make sure swords, knives and other accessories are short, soft and flexible.
- Avoid trick-or-treating alone. A trusted adult should accompany smaller children, and older children should travel in groups.
- Remain visible. Trick-or-treating is an evening activity, and it can last until after dark. Fasten reflective tape to costumes and bags to increase visibility for drivers, and use flashlights to see and be seen.
- Be cautious with glow sticks. Glow-in-the-dark sticks and accessories should only be used under adult supervision and should never be cut or broken open.
- Examine treats. Parents should inspect all treats for tampering and/or choking hazards before allowing children to enjoy them.
- Limit treats. Limit the amount of candy and treats your children eat. Too much candy at one time can cause an upset stomach.
- Test and remove makeup. If makeup is going to be used as part of a costume, always test the makeup on a small area of skin first to ensure it does not cause irritation. Remove makeup at bedtime to prevent skin or eye irritation.
- Avoid decorative contact lenses. Decorative contact lenses can cause serious eye injuries.
- Obey traffic rules. Look both ways before crossing the street, and use crosswalks when available. Walk on the sidewalks, when possible; if there aren’t any sidewalks, walk along the far edge of the road facing traffic.
- Ensure costumes and accessories fit properly. Masks, costumes and shoes should fit properly to avoid blocked vision, trips and falls.
- Eat only factory-wrapped treats. Avoid homemade treats made by strangers.
- Carefully choose which homes you visit. Only visit well-lit houses, and enter homes only if accompanied by a trusted adult.
- Ensure costumes are flame-resistant. As a precaution, avoid walking near lit candles or luminaries while in costume.
- Carry a cell phone in case of emergency.Following these simple safety tips will help keep your children safe—without any unplanned scares. St. David’s Round Rock Medical Center wishes everyone a fun and safe Halloween.
- Parents should also supervise children while carving pumpkins. Be sure children use pumpkin carving kits—or knives specifically designed for carving—to avoid injury. Younger children can even use paint, markers or other decorations that do not have sharp edges.
- Have a one destination area, a home with all the kids dressed up having a halloween party meet instead of walking around house to house; or what I heard is a group of people all meet in a parking lot with the kids dressed up with their parents having a halloween meet getting there candy for safety.
“While scientists do not know what exactly causes psoriasis, we do know that the immune system and genetics play major roles in its development. Usually something triggers psoriasis to flare. The skin cells in people with psoriasis grow at an abnormal fast rate, which causes the buildup of psoriasis lesions.”
National Psoriasis Foundation
Psoriasis is a common skin condition that speeds up the life cycle of skin cells. It causes cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches that are itchy and sometimes painful.
Psoriasis is a chronic disease that often comes and goes. The main goal of treatment is to stop the skin cells from growing so quickly.
There is no cure for psoriasis, but you can manage symptoms. Lifestyle measures, such as moisturizing, quitting smoking and managing stress, may help.
Psoriasis signs and symptoms are different for everyone. Common signs and symptoms include:
- Red patches of skin covered with thick, silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
There are several types of psoriasis. These include:
- Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be itchy or painful and there may be few or many. They can occur anywhere on your body, including your genitals and the soft tissue inside your mouth.
- Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
- Guttate psoriasis. This type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat. It’s marked by small, water-drop-shaped, scaling lesions on your trunk, arms, legs and scalp.
The lesions are covered by a fine scale and aren’t as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.
- Inverse psoriasis. This mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals. Inverse psoriasis causes smooth patches of red, inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
- Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips.
It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.
- Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
- Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only manifestation of psoriasis or at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn’t as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
When to see a doctor
If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:
- Causes you discomfort and pain
- Makes performing routine tasks difficult
- Causes you concern about the appearance of your skin
- Leads to joint problems, such as pain, swelling or inability to perform daily tasks
Seek medical advice if your signs and symptoms worsen or don’t improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.
The cause of psoriasis isn’t fully understood, but it’s thought to be related to an immune system problem with T cells and other white blood cells, called neutrophils, in your body.
T cells normally travel through the body to defend against foreign substances, such as viruses or bacteria.
But if you have psoriasis, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.
Overactive T cells also trigger increased production of healthy skin cells, more T cells and other white blood cells, especially neutrophils. These travel into the skin causing redness and sometimes pus in pustular lesions. Dilated blood vessels in psoriasis-affected areas create warmth and redness in the skin lesions.
The process becomes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly — in days rather than weeks. Skin cells build up in thick, scaly patches on the skin’s surface, continuing until treatment stops the cycle.
Just what causes T cells to malfunction in people with psoriasis isn’t entirely clear. Researchers believe both genetics and environmental factors play a role.
Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:
- Infections, such as strep throat or skin infections
- Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
- Heavy alcohol consumption
- Vitamin D deficiency
- Certain medications — including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers, antimalarial drugs, and iodides
Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:
- Family history. This is one of the most significant risk factors. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.
- Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
- Stress. Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.
- Obesity. Excess weight increases the risk of psoriasis. Lesions (plaques) associated with all types of psoriasis often develop in skin creases and folds.
- Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.
If you have psoriasis, you’re at greater risk of developing certain diseases. These include:
- Psoriatic arthritis. This complication of psoriasis can cause joint damage and a loss of function in some joints, which can be debilitating.
- Eye conditions. Certain eye disorders — such as conjunctivitis, blepharitis and uveitis — are more common in people with psoriasis.
- Obesity. People with psoriasis, especially those with more severe disease, are more likely to be obese. It’s not clear how these diseases are linked, however. The inflammation linked to obesity may play a role in the development of psoriasis. Or it may be that people with psoriasis are more likely to gain weight, possibly because they’re less active because of their psoriasis.
- Type 2 diabetes. The risk of type 2 diabetes rises in people with psoriasis. The more severe the psoriasis, the greater the likelihood of type 2 diabetes.
- High blood pressure. The odds of having high blood pressure are higher for people with psoriasis.
- Cardiovascular disease. For people with psoriasis, the risk of cardiovascular disease is twice as high as it is for those without the disease. Psoriasis and some treatments also increase the risk of irregular heartbeat, stroke, high cholesterol and atherosclerosis.
- Metabolic syndrome. This cluster of conditions — including high blood pressure, elevated insulin levels and abnormal cholesterol levels — increases your risk of heart disease.
- Other autoimmune diseases. Celiac disease, sclerosis and the inflammatory bowel disease called Crohn’s disease are more likely to strike people with psoriasis.
- Parkinson’s disease. This chronic neurological condition is more likely to occur in people with psoriasis.
- Kidney disease. Moderate to severe psoriasis has been linked to a higher risk of kidney disease.
- Emotional problems. Psoriasis can also affect your quality of life. Psoriasis is associated with low self-esteem and depression. You may also withdraw socially.
“Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD).”
Centers for Disease Control and Prevention (CDC)
Spina Bifida is the most common permanently disabling birth defect in the United States.
Spina Bifida literally means “split spine.”
Spina Bifida happens when a baby is in the womb and the spinal column does not close all of the way. Every day, about 8 babies born in the United States have Spina Bifida or a similar birth defect of the brain and spine.
No one knows for sure the exact cause of spina bifida but have their ideas. Scientists believe that genetic and environmental factors act together to cause the condition.
Although doctors and researchers don’t know for sure why spina bifida occurs, they have identified a few risk factors:
- Race. Spina bifida is more common among whites and Hispanics.
- Sex. Girls are affected more often.
- Family history of neural tube defects. Couples who’ve had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect. That risk increases if two previous children have been affected by the condition.
- In addition, a woman who was born with a neural tube defect, or who has a close relative with one, has a greater chance of giving birth to a child with spina bifida. However, most babies with spina bifida are born to parents with no known family history of the condition.
- Folate deficiency. Folate (vitamin B-9) is important to the healthy development of a baby. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects.
- Some medications. Anti-seizure medications, such as valproic acid (Depakene), seem to cause neural tube defects when taken during pregnancy, perhaps because they interfere with the body’s ability to use folate and folic acid.
- Diabetes. Women with diabetes who don’t control their blood sugar well have a higher risk of having a baby with spina bifida.
- Obesity. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida.
- Increased body temperature. Some evidence suggests that increased body temperature (hyperthermia) in the early weeks of pregnancy may increase the risk of spina bifida. Elevating your core body temperature, due to fever or the use of saunas or hot tubs, has been associated with increased risk of spina bifida.
- If you have known risk factors for spina bifida, talk with your doctor to determine if you need a larger dose or prescription dose of folic acid, even before a pregnancy begins.
There are different types of Spina Bifida:
Occult Spinal Dysraphism (OSD) Infants with this have a dimple in their lower back. Because most babies with dimples do not have OSD, a doctor has to check using special tools and tests to be sure. Other signs are red marks, hyperpigmented patches on the back, tufts of hair or small lumps. In OSD, the spinal cord may not grow the right way and can cause serious problems as a child grows up. Infants who might have OSD should be seen by a doctor, who will recommend tests.
Spina Bifida Occulta It is often called “hidden Spina Bifida” because about 15 % of healthy people have it and do not know it. Spina Bifida Occulta usually does not cause harm, and has no visible signs. The spinal cord and nerves are usually fine. Visible indications of spina bifida occulta can sometimes be seen on the newborn’s skin above the spinal defect, including:
- An abnormal tuft of hair
- A collection of fat
- A small dimple or birthmarkMeningocele A meningocele causes part of the spinal cord to come through the spine like a sac that is pushed out. Nerve fluid is in the sac, and there is usually no nerve damage. Individuals with this condition may have minor disabilities.
- Many people who have spina bifida occulta don’t even know it, unless the condition is discovered during an X-ray or other imaging test done for unrelated reasons. People find out they have it after having an X-ray of their back. It is considered an incidental finding because the X-Ray is normally done for other reasons. However, in a small group of people with SBO, pain and neurological symptoms may occur. Tethered cord can be an insidious complication that requires investigation by a neurosurgeon.
Myelomeningocele (Meningomyelocele), also called Spina Bifida Cystica This is the most severe form of Spina Bifida. It happens when parts of the spinal cord and nerves come through the open part of the spine. It causes nerve damage and other disabilities. 70 to 90% of children with this condition also have too much fluid on their brains. This happens because fluid that protects the brain and spinal cord is unable to drain like it should. The fluid builds up, causing pressure and swelling. Without treatment, a person’s head grows too big, and may have brain damage. Children who do not have Spina Bifida can also have this problem, so parents need to check with a doctor. Usually, however, tissues and nerves are exposed, making the baby prone to life-threatening infections.
Neurological impairment is common, including:
- Muscle weakness of the legs, sometimes involving paralysis
- Bowel and bladder problems
- Seizures, especially if the child requires a shunt
- Orthopedic problems — such as deformed feet, uneven hips and a curved spine (scoliosis)Treatment for spina bifida depends on the severity of the condition.
- Spina Bifida Treatment
- Most people with spina bifida occulta require no treatment at all.
- Children with meningocele typically require surgical removal of the cyst and survive with little, if any, disability.
- Children with myelomeningocele, however, require complex and often lifelong treatment and assistance. Almost all of them survive with appropriate treatment starting soon after birth. Their quality of life depends at least partially on the speed, efficiency, and comprehensiveness with which that treatment is provided.
- A child born with myelomeningocele requires specialty care.
- The child should be transferred immediately to a center where newborn surgery can be performed.
- Treatment with antibiotics is started as soon as the myelomeningocele is recognized; this prevents infection of the spinal cord, which can be fatal.
The operation involves closing the opening in the spinal cord and covering the cord with muscles and skin taken from either side of the back. The most common complications are tethered spinal cord and hydrocephalus, which can have very severe consequences.
“The immediate cause of sudden cardiac arrest is usually an abnormality in your heart rhythm (arrhythmia), the result of a problem with your heart’s electrical system.”
Halloween is right around the corner, which for most children means bags of free candy and a chance to build a stockpile of sweets for the winter. No surprise, Halloween can also present parents with a variety of health and safety challenges. “It’s OK to eat that candy on Halloween but it’s important to have a eating plan of the goodies to help protect the teeth from constant exposure to sugars to the teeth and even the waist line to prevent cavities and obesity. This makes complete common sense to mom and dad with older sisters or brothers and even role models to the little peeps who may need direction by you helping them eat the goodies in a moderate way with no pigging out on the candies.
Here’s a few ideas on how you can help your family stay mouth healthy on Halloween and even through out the year for lovers of sweet goodies; especially young ones who may need direction.
So how do we go about this? Well here are some ideas that you may find useful:
1.) Know when the time is right to eat the goodies.
Eat Halloween candy (and other sugary foods) with meals or shortly after mealtime. Saliva production increases during meals. This helps cancel out acids produced by bacteria in your mouth and rinse away food particles.
2.) Choose the candy carefully you give out Halloween or have at Halloween parties for kids with the candies you allow your kids to keep throughout the year.
Avoid hard candy and other sweets that stay in your mouth for a long time. Aside from how often you snack, the length of time sugary food is in your mouth plays a role in tooth decay. Unless it is a sugar-free product, candies that stay in the mouth for a long period of time subject teeth to an increased risk for tooth decay.
3.) Avoid candies that can put your teeth in sticky situations.
Sticky candies cling to your teeth. The stickier candies, like taffy and gummy bears, take longer to get washed away by saliva, increasing the risk for tooth decay.
4.) Have a plan that you put together.
It’s tempting to keep that candy around, but your teeth will thank you if you limit your candy laying out around the house after the Halloween day or parties. So what you do is have the family pick their favorites and even consider donating the rest, like to family and friends in a moderate amount to school teachers to even your doctors at a visit for the staff to even homeless. ” If you even can take the time look for organizations that help you donate candy to troops overseas, like Operation Gratitude to boy/girl scout organizations, etc… Do a little researching.
5.) Drink more water when eating candy.
If you choose bottled water, look for kinds that are fluoridated. Drinking fluoridated water can help prevent tooth decay. The kids won’t even know the difference.
6.) Maintain a healthy diet.
Your body is like a complex machine. Just like cars we the human body needs its fuel. For us the fuel is food. The foods you choose as fuel are so important with how often you “fill up” with them which in the end affecting your general health; this includes your teeth and gums including obesity.At these Halloween parties or on Halloween day or in even everyday life avoid excess in sodas, sport drinks and flavored waters. When teeth come in frequent contact with beverages that contain sugar, the risk of tooth decay is increased.
7.) Give out on Halloween/the Halloween parties chewing gum that are with the ADA Seal.
Chewing sugarless gum for 20 minutes after meals helps reduce tooth decay, because increased saliva flow helps wash out food and neutralize the acid produced by bacteria. You might even want to think about giving sugarless gum out as a treat instead of candy.
8.) Other general ideas with the candy suggestions is have the children do the following:
– Brush your teeth twice a day for two minutes with an ADA-accepted fluoride toothpaste. Remember, replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won’t do a good job of cleaning your teeth.
– Cleanse between the teeth. Floss your teeth once a day. Decay-causing bacteria get between teeth where toothbrush bristles can’t reach. Flossing helps remove plaque and food particles from between the teeth and under the gum line.
-Visit an ADA Dentist
Regular visits to your ADA-member dentist can help prevent problems from occurring and catch those that do occur early, when they are easy to “treat.” This can also can help prevent them going into bigger problems and more expensive treatments to the mouth.
The rhythms above are heart blocks (HB) that occur in the bottom of the upper chambers which can occur in some people. There is 1st degree HB where you can live a completely normal life with but 2nd and 3rd degree HB needs treatment (usually a pacemaker) by cardiologist surgeon. After treatment with 2nd and 3rd degree HB you can live a completely normal life with follow up with your cardiologist and yearly pacemaker checks.
In this rhythm below the Ventricular Tachycardia is with a point on the top but than flips upside down (commonly called Torsedes Pointes). This is commonly due to Magnesium Level low and IV Magnesium in the hospital is given 1 to 2 gm.
This rhythm above with a pulse=also a rhythm pulsating in different areas of the heart in the ventricles only causing the rhythm not to look identical throughout the tele strip above = Polymorphic V- Tac- meaning the stimulus in the ventricles to make the heart beat is coming from different areas of the ventricles for each beat. Each jagged tooth is a beat that makes up the whole strip shown above for Ventricular Tachycardia.
Than when the atriums aren’t working as the natural pacemaker that took over for the sinus node but now they don’t work so now the ventricles take over and the rhythms of all ventricle rhythms are with NO p waves since the atriums are not working so no p wave is involved but we have QRS waves but their wide in measurement because the rhythm starts in the ventricles. The rhythms are PVC (Premature Ventricular Contractions), Idioventricular Rhythm, Ventricular tachycardia (Monomorphic and Polymorphic-rhythm getting more irregular. When regular and monomorphic=looking identical with every ventricular beat or contraction as opposed to polymorphic=not looking identical each contraction but each one is a ventricular contraction), Torsades De Pointes Ventricular Tachycardia (the rhythm starts upright but turns upside down but each contraction without a p wave and a wide contraction meaning a ventricular contraction), and Ventricular Fibrillation, to asystole.
Here’s what they look like:
Accelerated Idioventricular Rhythm
Accelerated idioventricular rhythm occurs when three or more ventricular escape beats appear in a sequence. Heart rate will be 50-100 bpm. The QRS complex will be wide (0.12 sec. or more).
A regular QRS measures less than 0.12 which is with all atriums rhythms.
Asystole is the state of no cardiac electrical activity and no cardiac output. Immediate action is required.
Idioventricular rhythm is a slow rhythm of under 50 bpm. It indicates that then ventricules are producing escape beats.
Premature Ventricular Complex (above 1st strip)
Premature ventricular complexes (PVCs) occur when a ventricular site generates an impulse. This happens before the next regular sinus beat. Look for a wide QRS complex, equal or greater than 0.12 sec. The QRS complex shape can be bizarre. The P wave will be absent.
Premature Ventricular Complex – Bigeminy a QRS after every 2 regular beats
Premature Ventricular Complex – Trigeminy a QRS after every 3 regular beats
Premature Ventricular Complex – Quadrigeminy a QRS after every 4 regular beats
Ventricular Fibrillation (in above strip-3rd one)
Ventricular fibrillation originates in the ventricules and it chaotic. No normal EKG waves are present. No heart rate can be observed. Ventricular fibrillation is an emergency condition requiring immediate action.
Ventricular Tachycardia (in above strip-2nd one)
A sequence of three PVCs in a row is ventricular tachycardia. The rate will be 120-200 bpm. Ventricular Tachycardia has two variations, monomorphic and polymorphic. These variations are discussed separately.
Ventricular Tachycardia Monomorphic
Monomorphic ventricular tachycardia occurs when the electrical impulse originates in one of the ventricules. The QRS complex is wide. Rate is above 100 bpm. Each V tac beat looks identical like in the strip above.
Ventricular Tachycardia Polymorphic
Polymorphic ventricular tachycardia has QRS complexes that very in shape and size. If a polymorphic ventricular tachycardia has a long QT Interval, it could be Torsade de Pointes. The strip shows the pulses are not identical=polymorphic since the pulse beats are coming from all different areas of the ventricles.
Torsade de Pointes (the rhythm strip at the top under Heart Blocks)
Torsade de Pointes is a special form of ventricular tachycardia. The QRS complexes vary in shape and amplitude and appear to wind around the baseline. This is an example or polymorphic ventricular tachycardia.
Ventricular ending line needs to be treated stat to be switched back to atrial rhythm since the heart is missing ½ of the conduction it’s to normally receive from the atriums and if not reversed the heart will go into failure to heart attack or to asystole flat line and go into a cardiac arrest.
With PVCs=Premature Ventricle Contractions asymptomatic we just closely monitor the pt and telemetry the pt is on. Now a pt with PVCs and symtomatic usually meds with 0xygen (sometimes 02 alone resolves it but other times with meds) but if it gets worse into V Tachycardia the treatment is below.
Idioventricular Rhythm (IVR)is usually with a slow brady pulse and needs meds. Accelerated IVR (AIVR) is usually hemodynamically tolerated and self-limited; thus, it rarely requires treatment.
Occasionally, patients may not tolerate AIVR due to (1) loss of atrial-ventricular synchrony, (2) relative rapid ventricular rate, or (3) ventricular tachycardia or ventricular fibrillation degenerated from AIVR (extremely rare). Under these situations, atropine can be used to increase the underlying sinus rate to inhibit AIVR.
Other treatments for AIVR, which include isoproterenol, verapamil, antiarrhythmic drugs such as lidocaine and amiodarone, and atrial overdriving pacing are only occasionally used today.
Patients with AIVR should be treated mainly for its underlying causes, such as digoxin toxicity, myocardial ischemia, and structure heart diseases. Beta-blockers are often used in patients with myocardial ischemia-reperfusion and cardiomyopathy
With Ventricular rhythms with fast pulse over 100 with symptomatic signs for the patient we may use as simple as valsalva pressure on the neck that medical staff only do but when pt is in asymptomatic (no symptoms) Ventricular Tachycardia (V-Tac) to even medications but when symptomatic if in V-Tac start cardioversion with a pulse if no pulse called pulseless V-Tac we use a defibrillator since there is no pulse there is no QRS to pace with in having the shock hit at the R wave, why? NO PULSE.
Treatment for Torsade de Pointes is Magnesium deficiency and Mag. Supplement given IV 2gms. Usually effective but if necessary the same as above as directed for it with a pulse or the other V Tac. (without a pulse)-See above.
Ventricular Fibrillation is when the ventricles are just quivering and the atriums in any ventricular rhythm doing nothing. The pt needs CPR and ASAP a defibrillator in hopes the shock will knock the rhythm back to a normal sinus or some form of a real rhythm.
Asystole which is a straight line, no pulse and this is CPR with epinephrine or Vasopressin 40 for only the replacement of the 1st or 2nd dose of Epinephrine 1mg. This is given 3-5 minutes (epinephrine). No defibrillation since no pulse. A rhythm may come back and if not the MD will call when CPR stops. Asystole is hard to resolve in most cases highier probability of resolution if in a hospital where close monitoring is done and its detected quicker.
The PURPOSE in treating any rhythm abnormal to the human heart is to reach the goal of a optimal or healthiest rhythm (a normal sinus rhythm , the best rhythm the heart can be in) and if not reaching an atrial rhythm. We the medical field aim to reach a heart rhythm the patient can live with and hopefully reaching the best NSR-Normal Sinus Rhythm. Normal sinus rhythm that is a rhythm starting from the upper right chamber extending to the left one and continues down on both sides to the bottom of the ventricles. This rhythm is giving the most effective oxygen perfusion to the heart to allow it to do its function (pumping good oxygenated blood flow out of the left ventricle at the same time pumping highly carbon dioxide blood from the right side of the heart to the lungs to get more oxygen). Doing this it allows the human body to get good amounts of oxygen to all our tissues=good overall oxygen perfusion to all tissues. At the same time what happens is red blood cells from all tissues with mostly used up oxygen from the cell and more carbon dioxide in the cell are also being pumped by the heart to return to the right side to the lungs to go through this whole process again in getting more oxygen in the RBCs which keeps us alive. A human without oxygen or low oxygen to their tissues or any tissue is going to reach cellular starvation which in turn causes starvation to the tissues (in general) or to a tissue (Ex. Diabetic the foot to lack of 02 to cyanotic purple tissue to necrotic black tissue=dead to amputated since the tissue is dead.).
Cardiac Arrest or Heart Attack are more likely to occur in a irregular rhythm especially making the heart work to hard being RVR afib in the atriums that can lead easily to ventricular tachycardia to ventricular fibrillation and not treated immediately.
Cardiac Arrest is an electrical problem with the conduction of the heart whereas a Heart Attack is caused by a blockage of blood (Ex. coronary artery) to the heart that can lead to a bad rhythm due to lack of 0xygen that leads to worse rhythms as the heart gets more stressed out.