medical book

Blood gas tests are a group of tests that are widely used and essential for the evaluation and management of a patient's ventilation, oxygenation, and acid-base balance, often in emergent situations, and along with blood gases are other critical care analytes measured on blood: calcium, magnesium, phosphate, and lactate. Blood Gases and Critical Care Testing: Clinical Interpretations and Laboratory Applications, Third Edition, serves as your single most important reference for understanding blood gases and critical care testing and interpretation. The third edition of this classic book is a complete revision and provides the fundamentals of blood gas (pH, pCO2, pO2) and other critical care tests (calcium, magnesium, phosphate, and lactate), including the history, the definitions, the physiology, and practical information on sample handling, quality control and reference intervals. Case examples with clear clinical interpretations of critical care tests have been included to all chapters. This book will serve as a valuable and convenient resource for clinical laboratory scientists in understanding the physiology and clinical use of these critical care tests and for providing practical guidelines for successful routine testing and quality monitoring of these tests. - Provides a step-by-step approach for organizing and evaluating clinical blood gas and critical care test results - Describes several calculated parameters that are used by clinicians for evaluating a patient's pulmonary function and oxygenation status and discusses clinical examples of their use - This new edition includes more detailed information about reference intervals, not only for arterial blood, but for venous blood and umbilical cord blood, and for pH in body fluids - Covers practical information on sample handling and quality control issues for blood gas testing

The S.T.A.B.L.E. Program is a neonatal education program that focuses on the post-resuscitation/pre-transport stabilization care of sick newborns. This work allows you to interpret a neonatal blood gas result in seconds.

This practical manual promotes an evidence-based paradigm of fetal heart rate monitoring during labour, moving away from the traditional 'pattern-based' interpretation to physiology-based interpretation. Aimed at obstetricians and midwives, it is useful to all those involved in multiprofessional intrapartum care.

The placenta is an organ that connects the developing fetus to the uterine wall, thereby allowing nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. Proper vascular development in the placenta is fundamental to ensuring a healthy fetus and successful pregnancy. This book provides an up-to-date summary and synthesis of knowledge regarding placental vascular biology and discusses the relevance of this vascular bed to the functions of the human placenta.

Significantly revised and updated, the new second edition updates the science on neonatal encephalopathy presented in the 1st edition. The new 2nd edition recommends a broad evaluation of all potential contributing factors in every case of neonatal encephalopathy, including maternal medical history, obstetric and intrapartum factors, and placental pathology. This recommendation is a shift from the 2003 report, which focused on determining whether or not a hypoxic-ischemic event was the cause of neonatal encephalopathy. Includes new sections on - Placental pathology - Focal ischemic stroke - Neonatal interventions - Patient safety - Significant advances in neuroimaging This report will assist the clinician in evaluating a newborn with encephalopathy to assist in defining both the cause and timing.

Fetal heart rate monitoring affects the lives of millions of women and infants every year in the United States alone. Used by all members of the obstetric team - nurses, students, midwives, and physicians – it is the primary method to assess fetal oxygenation in both the antepartum and intrapartum setting. Improving outcomes and promoting patient safety depends upon correct use and interpretation of fetal heart rate monitoring, and is crucial to daily obstetric practice. This fourth edition provides the obstetrical team a framework within which to interpret and understand fetal heart rate tracings and their implications. The text covers key issues as the physiological basis for monitoring, a discussion of fetal hypoxemia and neonatal encephalopathy, instrumentation and pattern recognition. In addition to an in-depth review of the standardized NICHD nomenclature and three-tiered FHR Category approach, there are chapters on intrapartum and antepartum management as well as fetal central nervous system effects on monitor patterns. Since fetal monitoring is primarily a screening tool there are also discussions on the use of backup methods for evaluation of abnormal patterns. This 4th edition also brings the addition of Lisa A. Miller CNM, JD, who provides a nursing and midwifery perspective as well an enhanced legal and risk management review. This new fourth edition includes: Review of neonatal encephalopathy and recent studies on CP Currentinformation and discussion of most recent NICHD panel recommendations, both antepartum and intrapartum New chapter on Pitfalls in EFM Detailed chapter on risk management, liability & documentation New section on fetal maternal hemorrhage Update on new instrumentation Crucial information on maternal/fetal coincidence and FDA warnings All chapters include updated practice tips and clinical implications for the entire obstetric team Plus, with this edition clinicians have access to a companion website with full text and an image bank for fast & simplified clinical review.

With an estimated 8,000 deaths per year in the United States from complications of UCA, an initial goal of 50% reduction of loss is possible. To achieve this goal requires the recognition by the obstetrical community of the issue. Recent research into circadian rhythms may help explain why UCA stillbirth is an event between 2:00 a.m. and 4:00 a.m. Melatonin has been described as stimulating uterine contractions through the M2 receptor. Melatonin secretion from the pineal gland begins around 10:00 p.m. and peaks to 60 pg at 3:00 a.m. Serum levels decline to below 10 pg by 6:00 a.m. Uterine stimulation intensifies during maternal sleep, which can be overwhelming to a compromised fetus, especially one experiencing intermittent umbilical cord compression due to UCA. It is now time for the focus to be on screening for UCA, managing UCA prenatally, and delivery of the baby in distress defined by the American College of Obstetricians and Gynecologists as a heart rate of 90 beats per minute for 1 minute on a recorded nonstress test. The ability of ultrasound and magnetic resonance imaging (MRI) to visualize UCA is well documented. The 18 20 week ultrasound review should include the umbilical cord, its characteristics, and description of its placental and fetal attachment. The American Association of Ultrasound Technologists has defined these parameters for umbilical cord abnormalities: B.1.4 Abnormal insertion B.1.5 Vasa previa B.1.6 Abnormal composition B.1.7 Cysts, hematomas, and masses B.1.8 Umbilical cord thrombosis B.1.9 Coiling, collapse, knotting, and prolapse B.1.10 Umbilical cord evaluation with sonography includes the appearance, composition, location, and size of the cord Cord Events: Although many stillbirths are attributed to a cord accident, this diagnosis should be made with caution. Cord abnormalities, including a Nuchal Cord, are found in approximately 30% of normal births and may be an incidental finding. (American College of Obstetrics and Gynecology Practice Bulletin 2009) According to NICHD's recent stillbirth study, UCA is a significant cause of mortality (10%). This finding is in agreement with other international UCA studies. (Bukowski et al. 2011) These histologic criteria identify cases of cord accident as a cause of stillbirth with very high specificity. (Dilated fetal vessels, thrombosis in fetal vessels, avascular placental villi.) (Pediatr Dev Pathol 2012) Finally, defining the morbidity (injury) of cord compression, such as fetal neurologic injury or heart injury identified with umbilical cord blood troponin T levels or pulmonary injury, is the next major area of investigation.

Covers the most important and relevant topics on the anesthetic care of children, using a question-and-answer format.

This textbook provides an up-to-date summary of the scientific basis, assessment for and provision of anaesthesia throughout pregnancy and labour. It is divided into nine sections including physiology, assessment, complications and systemic disease.