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Aunque pueda contener afirmaciones, datos o apuntes procedentes de instituciones o profesionales sanitarios, la información contenida en el blog EMS Solutions International está editada y elaborada por profesionales de la salud. Recomendamos al lector que cualquier duda relacionada con la salud sea consultada con un profesional del ámbito sanitario. by Dr. Ramon REYES, MD

Niveles de Alerta Antiterrorista en España. Nivel Actual 4 de 5.

Niveles de Alerta Antiterrorista en España. Nivel Actual 4 de 5.
Fuente Ministerio de Interior de España

miércoles, 18 de marzo de 2020

Medicamentos antihipertensivos que actúan sobre el sistema renina angiotensina e infección por COVID-19


Medicamentos antihipertensivos que actúan sobre el sistema renina angiotensina e infección por COVID-19 
Fecha de publicación: 16 de marzo de 2020 
Categoría: medicamentos de uso humano, farmacovigilancia 
Referencia: MUH (FV) 05/2020 

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AVISO IMPORTANTE A NUESTROS USUARIOS
Este Blog va dirigido a profesionales de la salud y publico en general EMS Solutions International garantiza, en la medida en que puede hacerlo, que los contenidos recomendados y comentados en el portal, lo son por profesionales de la salud. Del mismo modo, los comentarios y valoraciones que cada elemento de información recibe por el resto de usuarios registrados –profesionales y no profesionales-, garantiza la idoneidad y pertinencia de cada contenido.

Es pues, la propia comunidad de usuarios quien certifica la fiabilidad de cada uno de los elementos de información, a través de una tarea continua de refinamiento y valoración por parte de los usuarios.

Si usted encuentra información que considera erronea, le invitamos a hacer efectivo su registro para poder avisar al resto de usuarios y contribuir a la mejora de dicha información.

El objetivo del proyecto es proporcionar información sanitaria de calidad a los individuos, de forma que dicha educación repercuta positivamente en su estado de salud y el de su entorno. De ningún modo los contenidos recomendados en EMS Solutions International están destinados a reemplazar una consulta reglada con un profesional de la salud.


INTERPRETACIÓN BÁSICA DE UNA GASOMETRÍA ARTERIAL

INTERPRETACIÓN BÁSICA DE UNA GASOMETRÍA ARTERIAL


INTERPRETACIÓN BÁSICA DE UNA GASOMETRÍA ARTERIAL

Pubicado el : 09/02/2016 23:02:23 
Categorias : Didactica  https://asfure.org/web/blog/mode-c1
En este resumen recordaremos como interpretar una gasometría arterial con un trastorno simple en tan solo 2 pasos.

1 – ¿ACIDOSIS O ALCALOSIS?
Mira el pH.
RECUERDA:  Rango entre 7,35 y 7,45
Si está por encima de 7,45 será ALCALOSIS
Si está por debajo de 7,35 será ACIDOSIS

2 – ¿Y ahora? ¿METABÓLICA O RESPIRATORIA?
Mira el Bicarbonato y la pCO2.
RECUERDA:
            HCO3: Rango entre 22 y 26 mEq/l
            pCO2: Rango entre 35 y 45 mmHg

BICARBONATO:         Si sube provoca ALCALOSIS
                                  Si baja provoca ACIDOSIS


pCO2:                        Si sube provoca ACIDOSIS
                                  Si baja provoca ALCALOSIS

Como veis son mecanismos opuestos, por ello los dos sistemas se intentan compensar alterando el contrario.

* CASO 1
pH: 7,23  -   pCO2: 67 mmHg   -   HCO3: 25 mEq/l

1 – pH: 7,23 à pH BAJO à ACIDOSIS
2 – pCO2: 67 mmHg = pCO2 ALTA  > pCO2 alta provoca ACIDOSIS
      HCO3: 25 mEq/l = HCO3 NORMAL
Tenemos una ACIDOSIS RESPIRATORIA


* CASO 2
pH: 7,20  -   pCO2: 31 mmHg   -   HCO3: 19 mEq/l

1 – pH: 7,20 à pH BAJO à ACIDOSIS
2 – pCO2: 31 mmHg = pCO2 BAJA  > pCO2 baja provoca ALCALOSIS
      HCO3: 19 mEq/l = HCO3 BAJO >  HCO3 bajo provoca ACIDOSIS
Tenemos una ACIDOSIS METABÓLICA 

lunes, 16 de marzo de 2020

Medicine in Ancient Egypt. "World's first prosthesis. Artificial toe found with an ancient Egyptian mummy"

Medicine in Ancient Egypt



Medicine in Ancient Egypt

 of the profession of medicine are buried far back before the dawn of history. Nearly as old as mankind itself, practice of medical procedures in some from has paralleled man’s development. In not a few instances, the quality or lack of medical service has profoundly influenced the quality of medical service has profoundly influenced the course of civilizations. Throughout the dawning millennia and much of their recorded history, medicine was intimately associated with the magico-religious practices of various peoples groping for the light knowledge and a better way of life.
The most ancient records presently known indicate the existence of two centers of civilizations having nearly equal development in two of the world’s great river systems: in Mesopotamia, between the Tigris and the Euphrates; and in the Nile valley of northeastern Africa. Organized peoples, enjoying the natural habitational advantages of these areas, were flourishing 6,000 years ago.
Methods of recording events began some ten centuries later, about 3000 B.C., and from that point on, history has for its base a series of factual foundations. However, when recorded history dawned, medicine was already a well-developed profession, and its practitioners had a heritage of experience, knowledge and beliefs handed down from a long line of predecessors by precept and word –of-mouth through countless centuries.
Egypt first became an organized nation about 3000 B.C. Medical interest centers upon a period in the Third Dynasty (2980-2900 B.C.) When Egypt had an ambitious Pharaoh named Zoser; and Zoser, in turn, had for his chief counselor and minister a brilliant noble named Imhotep (whose name means “he who cometh in peace”). Imhotep is said to have constructed the famous step pyramid of Sakkarah, near Memphis, for Pharaoh Zoser. A versatile man, Imhotep seems to have been a priest, a magician, and a poet. But in the Egyptian writings of the Greco-Roman period (third century, B.C.) Imhotep is represented as a physician, is assigned the role of god of medicine in Egypt. The Greeks identified him with their Asclepios, to whom was attributed a similar regard. In this later period, temples were erected to Imhotep in which patients looked for and supposedly found relief in their sleep.
There is a close association in Egyptian medicine between religion and magic. Egyptian physicians used many drugs, but thought their effects primarily magical. The papyri (so Called because they were written on sheets prepared from the papyrus plant) dealing exclusively with medicine abound with magic formulas and prayers. “In some cases in which human help seemed to be impossible,” observes Hermann Ranke, a last attempt was made to get help from a supernatural source. .” a practice not imcompatible with that of the religious-minded physician of today who through prayer seeks aid and guidance. The gods of the Egyptians were no less real to them than is our deity to us.
Physicians of ancient Egypt were probably trained in the temples, as were the priest- magicians and sorcerers. However, they formed a distinct profession, organized in a rigid hierarchy with court physicians at the top. Egyptian medicine was subdivided into many specialties. A proctologist had the poetic name of “shepherd of the anus,” and was much in demand in view of prevalent pathogenic theories. Egyptian specialization seems to have been hangover of primitive conditions rather than a precursor of modern specialization.
Medicine as practiced by the ancient Egyptians was not primitive, however. Just as they had transcended primitive levels in statecraft, agriculture, technology and especially architecture and art, so did the Egyptians also reach higher levels in medicine. Some medical papyri are predominantly religious, but others are predominantly empiric rational. Strangely enough, those recording the more rational observations stem from the earliest periods (1600-1500 B.C.). Among these are the Edwin Smith Papyrus and the Ebers papyrus. The first was intended primarily for the use of a surgeon; the latter is a collection of recipes for the physician. Each of these documents, though ancient in its own right, appears by language and explanations to reflect traditions much older. Says Ranke of the Smith papyrus: “That the bulk of the main text goes back to the Old Kingdom (about 2500 B.C.) is shown by a great number of glosses (explanatory notes) added to the text of some of the cases, which explains words that in the course of time had become obsolete.” Breasted dates the Smith papyrus in the seventeenth century B.C., but states that it is a copy of a document at least one thousand years older.
Dealing primarily with wounds, the Edwin Smith papyrus is admired for the diagnostic acumen exhibited in the case histories detailed, where symptoms such as feeble pulse (2500 years before reference to the pulse appears in Greek medical treatises), palsy, and deafness are all recorded and referred to as due to one common cause- a head wound. In addition to many surgical conditions, a great number of recognizable internal afflictions are reported in the papyri, such as worms, eye diseases, diabetes, rheumatism and schistosomiasis. The ancient existence of some of these conditions is confirmed by paleopathology (the examination of bones and tissues of mummies for evidence of disease); and, unfortunately, those afflictions are still prevalent in Egypt.
The papyri prescribe many rational methods of treatment, such as diet, physiotherapy and drugs. Many of the drugs named undoubtedly were worthless, but some, such as tannic acid, turpentine, gentian, senna, and lead, and copper salts, are still used in medical practice. Castor oil, used externally and internally, was a great favorite with the doctors of Egypt. The style used in prescription writing today is pretty much the same as then.
The cases of the Edwin Smith papyrus are not only systematically constructed; each within itself, but their arrangement throughout is a systematic one. First comes a superscription, which briefly gives the name of the illness. This is followed by a careful description, which always begins with the words, “ If you examine a man who…” has this or that illness. Then comes a diagnosis that always begins with the words, “You should say” he suffered from this or that ailment. This diagnosis always ens with the words: “An ailment which…’ and then one of three possibilities follows. The Surgeon may say: “An ailment which I shall treat, “or, “An ailment which I shall combat,” or, “An ailment which I will not treat.” (The latter discrimination was practiced by some physicians in almost all periods and was regarded as ethical up to the eighteenth century.) Except in entirely hopeless cases, there followed a method of treatment, beginning with the words, You must do…” this or that. Then the healing substances are given.
Of the 48 surgical dissertations in the Smith papyrus, Case 7 is of particular interest. According to Breasted’s translation, it reads, in part;
“If thou examinest a man having a gaping wound in his head, penetrating to the bone, and perforating the sutures of his skull, thou should palpate his wound, although he shudders exceedingly. Thou shouldst cause him to lift his face; if it is painful for him to open his mouth, and heart beats feebly; if thou observe his spittle hanging at his two lips and not falling off, while he discharges blood from both his nostrils and from both his ears; he suffers with stiffness in his neck, and is unable to look at his two shoulders and his breast, thou shouldst say regarding him: {here the findings are restated}. An ailment with which I will contend.”

Directions for treatment follow:

“Now as soon as thou findest that the cord of that man’s mandible, his jaw, is contracted, thou shouldst have made for him something hot, until he is comfortable, so that his mouth opens. Thou shouldst bind it with grease, honey, and lint, until thou knowst that he has reached a decisive point.”
Two other possible examinations are outlined- the second, in which;
“the flesh of that man has developed fever… his countenance is clammy, the ligaments of his neck tense, his face is ruddy, and… the odor of the chest of his head [crown] is like the urine of sheep, his mouth is bound…” This, the ancient author admonishes, is “An ailment not to be treated.”
“If, however, thou findest that that man has become pale and already has shown exhaustion… Thou shouldst have made for him a wooden brace padded with linen and put into his mouth. Thou shouldst have made for him a draught of the… fruit [probably a nutritious fruit or grain]. His treatment is sitting, placed between two supports of brick, until thou knowest he has reached a decisive point.’
This early physician evidently recognized that if tetanus had invaded the wound, there was little he could do; but until he was certain, he would try to improve the patient’s condition.

Egyptian physicians were highly respected all over the ancient world for thousands of years. Homer regarded them as the best in his time. Egyptian physicians were called to the courts of Persian emperors and other Eastern potentates; and only in the sixth century B.C. were they replaced by Greek physicians. Beyond the psychotherapeutic values of magic and religion, Egyptian medical men made solid advances in observation and rational treatment. Their contributions are worthy of a place beside other accomplishments of this great ancient civilization. The dominant position occupied by Egyptian medicine for 2,500 years seems fully justified.

THE PICTURE

A moment in the life of an Egyptian physician of the Eighteenth Dynasty (1500-1400 B.C.) is captured in this painting. The physician is confronted with a patient having symptoms paralleling those cited in the third diagnosis of the seventh case history recorded in the Edwin Smith papyrus. Most of the elements of ancient Egyptian medicine are here: The physician, clothed in clean white linen and a wig, as becomes the dignity of his status. The patient, likely a member of a noble household, supported by a “brick chair.” Treatment is proceeding under the sure, sympathetic hands of the physician in accordance with the course prescribed in the scroll held in the hands of an assistant. Magico-religious rites are being observed by priests trained in this adjunctive specialty. The best care that the science and knowledge of the day can provide is focused on the patient. 


World's first prosthesis.
Artificial toe found with an ancient Egyptian mummy.

AVISO IMPORTANTE A NUESTROS USUARIOS


Este Blog va dirigido a profesionales de la salud y publico en general EMS Solutions International garantiza, en la medida en que puede hacerlo, que los contenidos recomendados y comentados en el portal, lo son por profesionales de la salud. Del mismo modo, los comentarios y valoraciones que cada elemento de información recibe por el resto de usuarios registrados –profesionales y no profesionales-, garantiza la idoneidad y pertinencia de cada contenido.

Es pues, la propia comunidad de usuarios quien certifica la fiabilidad de cada uno de los elementos de información, a través de una tarea continua de refinamiento y valoración por parte de los usuarios.

Si usted encuentra información que considera erronea, le invitamos a hacer efectivo su registro para poder avisar al resto de usuarios y contribuir a la mejora de dicha información.

El objetivo del proyecto es proporcionar información sanitaria de calidad a los individuos, de forma que dicha educación repercuta positivamente en su estado de salud y el de su entorno. De ningún modo los contenidos recomendados en EMS Solutions International están destinados a reemplazar una consulta reglada con un profesional de la salud.

Plan de contingencia frente a Coronavirus Ministerio de Salud Publica Republica Dominicana

Plan de contingencia frente a Coronavirus Ministerio de Salud Publica Republica Dominicana 
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2019-nCoV wuhan SOBRE CORONAVIRUS 

https://emssolutionsint.blogspot.com/2020/01/procedimiento-de-actuacion-frente-casos.html . 



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Dr. Ramon Reyes, MD 



MANUALES DE MEDICINA SUTURA, CIRUGIA, CIRUGIA MENOR GRATIS EN PDF



Balística de las heridas: introducción para los profesionales de la salud, del derecho, de las ciencias forenses, de las fuerzas armadas y de las fuerzas encargadas de hacer cumplir la ley http://emssolutionsint.blogspot.com/2017/04/balistica-de-las-heridas-introduccion.html

Guía para el manejo médico-quirúrgico de heridos en situación de conflicto armado by CICR http://emssolutionsint.blogspot.com/2017/09/guia-para-el-manejo-medico-quirurgico.html

CIRUGÍA DE GUERRA TRABAJAR CON RECURSOS LIMITADOS EN CONFLICTOS ARMADOS Y OTRAS SITUACIONES DE VIOLENCIA VOLUMEN 1 C. Giannou M. Baldan CICR http://emssolutionsint.blogspot.com.es/2013/01/cirugia-de-guerra-trabajar-con-recursos.html
Protocolo de cirugía menor en Atención Primaria. PDF Gratis by Gobierno Canario de Salud. España http://emssolutionsint.blogspot.com/2018/06/protocolo-de-cirugia-menor-en-atencion.html
Manual Suturas, Ligaduras, Nudos y Drenajes. Hospital Donostia, Pais Vasco. España http://emssolutionsint.blogspot.com/2017/09/manual-suturas-ligaduras-nudos-y.html

Técnicas de Suturas para Enfermería ASEPEYO y 7 tipos de suturas que tienen que conocer estudiantes de medicina http://emssolutionsint.blogspot.com/2015/01/tecnicas-de-suturas-para-enfermeria.html

Manual Práctico de Cirugía Menor. Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http://emssolutionsint.blogspot.com/2013/09/manual-practico-de-cirugia-menor.html

Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana. Marzo 2016 http://emssolutionsint.blogspot.com/2016/09/protocolo-de-atencion-para-cirugia.html
Manual de esterilización para centros de salud. Organización Panamericana de la Salud http://emssolutionsint.blogspot.com/2016/07/manual-de-esterilizacion-para-centros.html

Articulos relacionados:

Sindrome de Latigazo Cervical 
Compilacion, PDF, Videos e Imagenes by Dr. Ramon Reyes, MDhttp://emssolutionsint.blogspot.com/2016/11/sindrome-de-latigazo-cervical.html
Cinematica de Trauma ATROPELLO, Explosion, Peatones
http://emssolutionsint.blogspot.com.es/2016/07/cinematica-de-trauma-en-peatones.html

Inmovilizacion Espinal en el Paciente de Trauma, Inmovilizacion Selectiva, El NEXUS, El Canadian C-Spine Rule, Consenso Británico http://emssolutionsint.blogspot.com/2016/09/es-necesario-inmovilizar-todos-los.html

MAS LIBROS MEDICINA Y SALUDhttps://www.facebook.com/pg/DrRamonReyesMD/photos/?tab=album&album_id=620883388254594



CURSO


Medical Doctor for complex and high-risk missions
        
Medicina Bona Locis Malis
EU Medical Doctor / Spain 05 21 04184
Advanced Prehospital Trauma Life Support /Tactical Combat Casualty Care TCCC Instructor and Faculty 
ACLS EP / PALS American Heart Association and European Resuscitation Council Instructor and Faculty
Member SOMA Special Operational Medical Association 
Corresponding Member Dominican College of Surgeons 
DMO Diving Medical Officer- USA
Air Medical Crew Instructor DOT- USA
Tactical Medical Specialist and Protective Medicine -USA
TECC Tactical Emergency Casualty Care Faculty and Medical Director by C-TECC
MLinkedIn 



AED Automatic External Defibrillator . UN compacto, economico y seguro https://emssolutionsint.blogspot.com/2019/08/aed-automatic-external-defibrillator-un.html

DESCARGA MANUAL PDF en Español 


AVISO IMPORTANTE A NUESTROS USUARIOS

Este Blog va dirigido a profesionales de la salud y publico en general EMS Solutions International garantiza, en la medida en que puede hacerlo, que los contenidos recomendados y comentados en el portal, lo son por profesionales de la salud. Del mismo modo, los comentarios y valoraciones que cada elemento de información recibe por el resto de usuarios registrados –profesionales y no profesionales-, garantiza la idoneidad y pertinencia de cada contenido.

Es pues, la propia comunidad de usuarios quien certifica la fiabilidad de cada uno de los elementos de información, a través de una tarea continua de refinamiento y valoración por parte de los usuarios.

Si usted encuentra información que considera erronea, le invitamos a hacer efectivo su registro para poder avisar al resto de usuarios y contribuir a la mejora de dicha información.

El objetivo del proyecto es proporcionar información sanitaria de calidad a los individuos, de forma que dicha educación repercuta positivamente en su estado de salud y el de su entorno. De ningún modo los contenidos recomendados en EMS Solutions International están destinados a reemplazar una consulta reglada con un profesional de la salud.