Archive for April, 2011

 

Currently looking for RN/RRT (Sleep Therapist) Purpose of Job: To provide a high standard of patient care for sleep disordered breathing within RN/RRT scope of practice.  ? Primary Responsibilities:

Oximetry Reporting

• Review and report on oximetry downloads?• Liaise with Patient Care Team to ensure reports are faxed and filed

CPAP Fitting and Follow-up

• Liaise with Patient Care Team ?• Liaise with Inventory Coordinator?• Reporting (charting)

Patient Education

• Plan short lectures for patient education events ?• Participate in group education events

Other Duties

• Complete other duties as assigned??Secondary Responsibilities:

Assist with community education

• Speak at community events ?• Participate in community education events

Assist with marketing initiatives

• Work with marketing to develop relationships with physicians in assigned territories??Working Conditions: • Work hours are between 9:00 am and 5:00 pm (paid lunch hour) 3 days/week.?• Physical demands are minimal.??Requirements of the Position: • RN/RRT (registration must be current)?• Superior communication skills and command of the English language  (other languages considered an asset.)?• Experience with sales/marketing considered an asset.?• Proficient with computers and software including: Microsoft Office, Outlook?• Ability and willingness to learn new software and technologies.?• Commitment to lifelong learning.?• Ability to work independently or as a team

Contact us for more information or to apply

CanSleep Services Inc., Att. Sheryl Smyth or Kim Waines-Naudi

604-468-5858  or email kim@cansleep.ca

 

 

 

PDE4 inhibition in COPD

From “ThinkCOPDDifferently”:

The inhibition of PDE4 as a new approach in the treatment of COPD has been discussed and investigated by the medical community for many years. The crucial role of PDE4 in COPD-specific inflammation makes it a very interesting target.

 

Read More

 

 

Check out more info on PDE4

 

 

 

 

 

New England Journal of Medicine:

Conclusions

These results show that, in patients with moderate-to-very-severe COPD, tiotropium is more effective than salmeterol in preventing exacerbations. (Funded by Boehringer Ingelheim and Pfizer; ClinicalTrials.gov number, NCT00563381.)

 

Mode of action

Tiotropium is a muscarinic receptor antagonist, often referred to as an antimuscarinic or anticholinergic agent. Although it does not display selectivity for specific muscarinic receptors, on topical application it acts mainly on M3 muscarinic receptors[1] located on smooth muscle cells and submucosal glands not to produce smooth muscle contraction and mucus secretion, thus producing a bronchodilatory effect.

 

Asthma – COPD Spirometry Diagnosis Calculator

Enter FEV1/FVC  etc…

Start the Application

Westermark sign


COMMENTS

The Westermark is an eponym indicating the abrupt cutoff of pulmonary vascularity distal to a large central pulmonary embolus. The presumed mechanism behind the image arises from the nearly complete obstruction of bloodflow to the pulmonary artery distal to the embolic clot.Presumably the lack of flow to these more distal vessels results in their radiographic transparency and an appearance of an abrupt truncation as is shown in this exemplary case.

 

 

Click Here to See COMPLETE Anatomy CXR’s

 

Medscape:

History

The history is important for distinguishing methemoglobinemia between cyanosis that is due to cardiopulmonary abnormalities and that from other causes of discoloration of the skin and mucous membranes. Acute methemoglobinemia can be life threatening and usually is due to toxic exposure or drugs. Therefore, obtaining a history of exposure to substances that can induce methemoglobinemia is important. In contrast, patients with hereditary methemoglobinemia are often asymptomatic despite the presence of cyanosis. The failure of 100% oxygen to correct cyanosis is suggestive of methemoglobinemia.

Symptoms are proportional to the level of methemoglobin.

  • Less than 10% methemoglobin – No symptoms
  • 10-20% methemoglobin – Skin discoloration only (most notably on mucus membranes)
  • 20-30% methemoglobin – Anxiety, headache, dyspnea on exertion
  • 30-50% methemoglobin – Fatigue, confusion, dizziness, tachypnea, palpitations
  • 50-70% methemoglobin – Coma, seizures, arrhythmias, acidosis
  • Greater than 70% methemoglobin – Death

Methemoglobinemia Clinical Presentation (PDF)

More Information

Mediastinoscopy is the ‘gold standard’ method for determining the presence of nodal metastases in the mediastinum. Generally performed as an outpatient surgical procedure, it is associated with a low rate of serious adverse effects (<1%) and the procedure is highly accurate, with false negative rates reported to be between 6% and 9%. Endobronchial ultrasound (EBUS) guided fine needle aspiration biopsy of mediastinal nodes offers a less invasive alternative for histologic sampling of the mediastinal nodes. The procedure has been widely adopted by pulmonologists and is poised to replace mediastinoscopy in the future. For thoracic surgeons, the technique can be easily learned and it may be important to do so if our specialty is to maintain its traditional and important role in the diagnosis and staging of thoracic malignancies.

Read More Below:

Endobronchial Ultrasound (EBUS) Biopsy of Mediastinal Lymph Nodes.

Download User Guide

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