[關於反芻動物全身麻醉的風險,反芻動物中,全身麻醉的弊大於利。] 有興趣的朋友可以多了解一下喔! (中文翻譯的部分為Google翻譯的,能夠閱讀英文的朋友建議看原文會比較清楚喔)
還有很多很多相關的學術發表,就不貼那麼多出來啦!
Cooper結紮的日期是4月26日,他現在很健康很調皮。
(德叔真的超級超級愛看這些學術發表的文章,但是我還是相信醫生的專業。)
https://www.researchgate.net/publication/334673867_The_Use_of_Epidural_Anaesthesia_over_General_Anaesthesia_in_Ruminants
全身麻醉是現代醫學的重要組成部分。它是一種藥物誘導的可逆病症,包括特定的行為和生理特徵,包括無意識、健忘症、鎮痛和運動不能——伴隨自主神經、心血管、呼吸和體溫調節系統的穩定性。
[反芻動物全身麻醉具有內在風險,如瘤胃內容物反流、唾液分泌過多和肺部誤吸的可能性;因此並不總是推薦使用本地或區域技術。硬膜外麻醉是一種中樞神經阻滯技術,經常用於獸醫實踐中,用於治療家畜會陰、骶骨、腰椎和尾椎部位的不同產科和外科手術干擾。關於在反芻動物和其他物種的各種外科和實驗室程序中使用硬膜外麻醉的科學研究已經有幾項。總之,全身麻醉的弊大於利,特別是在反芻動物中。因此,硬膜外麻醉是首選。
General anaesthesia is an essential component of modern medicine. It is a drug induced reversible condition that includes specific behavioral and physiological traits unconsciousness, amnesia, analgesia, and akinesia- with concomitant stability of the autonomic, cardiovascular, respiratory, and thermoregulatory systems.
[General anesthesia in ruminants has inherent risks such as regurgitation of ruminal contents, excessive salivation and the possibility of pulmonary aspiration; therefore it is not always recommended and local or regional techniques may be used instead. Epidural anaesthesia is a central neuraxial block technique which is used regularly in veterinary practice for treatment of different obstetrical and surgical interferences in the perineal, sacral, lumbar, and caudal parts of the thoracic region of domestic animals. There have been several scientific researches on the use of epidural anesthesia in ruminants and other species for various surgical and laboratory procedures. In conclusion, the disadvantages of general anaesthesia outweigh the advantages especially in ruminant specie. Therefore, epidural anaesthesia is the most preferred.
https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118886700.ch1
瘤胃鼓脹、腹脹、反流和吸入性肺炎是與家畜全身麻醉相關的常見問題,應通過適當的預防措施和必要的麻醉前考慮來預見和解決。家畜在麻醉期間可能會出現胃內容物反流和誤吸,尤其是未禁食的動物。反芻動物在麻醉期間通常會大量分泌唾液。惡性高熱的觸發因素包括壓力(例如興奮、運輸或麻醉前處理)、鹵化吸入麻醉劑(例如氟烷、異氟烷、七氟烷和地氟烷)和去極化神經肌肉阻滯藥物(例如琥珀膽鹼)。同樣,氟烷似乎是豬惡性高熱的最有效和最常見的觸發因素。麻醉前禁食可能不能完全防止反流,但會減少瘤胃內容物中的固體物質數量。獸醫應將這些知識與適當的麻醉前準備和適當的圍手術期管理相結合,以確保這些動物的麻醉成功。
Ruminal tympany, bloat, regurgitation, and aspiration pneumonia are common problems associated with general anesthesia in farm animal species that should be anticipated and addressed with proper precautions and the necessary preanesthetic considerations. Regurgitation and aspiration of stomach content can occur in farm animal species during anesthesia, especially in nonfasted animals. Ruminants normally salivate profusely during anesthesia. The triggering agents of malignant hyperthermia include stress (e.g., excitement, transportation, or preanesthetic handling), halogenated inhalation anesthetics (e.g., halothane, isoflurane, sevoflurane, and desflurane), and depolarizing neuro-muscular blocking drugs (e.g., succinylcholine). Similarly, halothane appears to be the most potent and most frequently reported trigger of malignant hyperthermia in pigs. Preanesthetic fasting may not completely prevent regurgitation, but it will decrease the amount of solid matter in the rumen content. Veterinarians should incorporate the knowledge with proper preanesthetic preparations and appropriate perioperative management to ensure successful outcome of anesthesia in these animals.
同時也有10000部Youtube影片,追蹤數超過2,910的網紅コバにゃんチャンネル,也在其Youtube影片中提到,...
「aspiration pneumonia」的推薦目錄:
- 關於aspiration pneumonia 在 Facebook 的最佳貼文
- 關於aspiration pneumonia 在 Dr 文科生 Facebook 的最佳貼文
- 關於aspiration pneumonia 在 Dr 文科生 Facebook 的最讚貼文
- 關於aspiration pneumonia 在 コバにゃんチャンネル Youtube 的最讚貼文
- 關於aspiration pneumonia 在 大象中醫 Youtube 的最佳貼文
- 關於aspiration pneumonia 在 大象中醫 Youtube 的最佳解答
- 關於aspiration pneumonia 在 Aspiration Pneumonia - YouTube 的評價
aspiration pneumonia 在 Dr 文科生 Facebook 的最佳貼文
《偽科學打手繼續玩弄科學》
我見某專頁話自己引用左三篇論文去證明佢嘅論點
而我唔知道到底嗰位自稱科學家嘅人有冇認真去睇清楚嗰三篇嘅論文,其中一篇丹麥嘅論文
1. https://doi.org/10.7326/M20-6817?fbclid=IwAR3Sd69faOzsR4tdGJsR67W94qBU7oqrEVb0GG2ElyshBt0sBckRp4PzzKU
眼超超醫生已經詳細地分析他們的實驗設計並不能夠套用在香港的處境上
1. Objective: To assess whether recommending surgical mask use outside the home reduces wearers' risk for SARS-CoV-2 infection in a setting where masks were uncommon and not among recommended public health measures.
2. Limitation: Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.
當呢一篇丹麥論文嘅作者,已經開宗明義咁講咗呢個研究到底有幾多限制嘅時候,同時亦都將研究嘅objective講得好清楚,係調查係一啲佩戴口罩並不常見或者佩戴口罩並非控制疫情的公共衛生措施的地方,少部份人佩戴口罩到底有沒有保護的效果。
當香港已經有口罩令,而絕大部份的市民亦主動經常佩戴口罩保護自己保護他人的時候,這份研究的methodology跟findings根本不能套用在香港。
另外兩篇論文
2. https://academic.oup.com/jid/article/201/4/491/861190
3. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0029744
其實研究結果係suggest face mask may reduce respiratory illnesses especially in shared or crowded living setting
作者同時指出使用多重的公共衛生保護措施,如戴口罩和勸洗手,有可能可以減少respiratory illness的傳播以及mitigate influenza pandemic
而我唔知到底呢個自稱係生物科學家嘅作者到底點樣分析文獻同論文,得出戴口罩完全無助減少傳染,實為指鹿為馬。
至於該生物學家一次又一次佢話根本沒有研究支持佩戴口罩防疫,我想她大概不懂使用Google或PubMed吧,隨便搜索一下就已經能夠找到好幾份研究支持並建議佩戴口罩作防疫之用。
4. To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186508/?fbclid=IwAR20JbSJe1u-GWXYSIHKu9cgsph-3ljKH__buPZz3wWujVtMIWVC1gyEhEQ
5. Mask or no mask for COVID-19: A public health and market study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428176/?fbclid=IwAR2q1GD3dfFVh9Y3P0wSOOvu1kG0pMADZGoua2KZo7eU_6bQxIQXvz0YPwQ
6. Efficacy of masks and face coverings in controlling outward aerosol particle emission from expiratory activities
https://www.nature.com/articles/s41598-020-72798-7
7. A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191274/
8. Reducing transmission of SARS-CoV-2
https://science.sciencemag.org/content/368/6498/1422?utm_campaign=SciMag&utm_source=JHubbard&utm_medium=Facebook
當你追擊得偽科學多,你就會發現好多這種玩弄文字藝術嘅人其實係真心無料,不過佢地有嘅係時間,會不斷talk shit轉話題,再自我感覺良好去話自己係高質argument,玩泥漿摔角玩到你心累唔再同佢地爭論時,佢地就會覺得贏咗。
*留意下佢地永遠錯咗柒咗之後都會扮無嘢
例如Hands only CPR竟然要先擔心aspiration pneumonia、無心跳但又識瘋狂自主呼吸、開口埋口保持氣道暢通但連airway maneuver都唔識、呢兩日加多個胡亂解讀paper
我地要小心提防呢種經常玩弄文字,搬弄似是而非的概念嘅人,頭腦一唔清就會被誤導。
Hopefully this would be the last post about this matter, this is really going nowhere
aspiration pneumonia 在 Dr 文科生 Facebook 的最讚貼文
我覺得急救知識和醫學知識有需要正視聽
話說最近見到同業 我的救護日誌 - 救護車上的柯南.道爾 抽擊一個「偽專家」嘅post
咁個「偽專家」page就話St John嘅急救guideline改咗
話要先幫病人戴口罩再CPR係會令病人失救
呢個係非常之錯嘅概念,point form回應
1. 有上過急救堂嘅人都知DRABCDE係咩
2. DANGER行先、DANGER行先、DANGER行先
3. 如果現場環境唔安全真係會唔救,先顧好自身安危先可以去救人
4. 幫病人戴口罩係講緊係做CPR嘅過程好可能會generate aerosol而COVID可以透過aerosol傳播
5. 如果你唔去assess風險就走去做aerosol generating procedure,你唔單止係危害自己,仲可能危害埋身邊嘅人
6. 如果你因為輕視AGP嘅風險而感染,就可能會瘋狂傳播開去,呢個係極為不負責任嘅做法
7. 唔係是但加個(括號)寫個(aspiration pneumonia)就突然會有說服力,如果係CPR嘅過程中佢要aspirate,有無口罩都會aspirate
8. 如果CPR完ROSC你recovery position而個病人又嘔吐又aspirate嘅話到時可以再除口罩
9. Aspiration pneumonia絕對係come secondary to DANGER同Circulation,你無circulation仲講咩aspiration
10. 近年的確係推廣全民學CPR,但所以CPR都係建基於現場環境安全。Hands only CPR已經推廣咗好多年,做唔做人工呼吸已經係secondary concern,你CPR嘅negative pressure已經可以俾到少少空氣
11. 為arrest病人戴口罩係AHA最新嘅guideline,急救證書課程嘅內容係建基於AHA guideline
12. 你要唔信個guideline唔緊要,但d醫學概念唔好錯成咁
#其實aspirationpneumonia係aspirate緊d乜嘢
#arrest做CPR急救到底點樣導致aspiration
#佢係唔會話你聽
#醫學同急救知識要正視聽
aspiration pneumonia 在 Aspiration Pneumonia - YouTube 的推薦與評價
Aspiration PneumoniaInstructional Tutorial VideoCanadaQBank.comQBanks for AMC Exams, MCCEE, MCCQE & USMLEURL: http://youtu.be/HcBKvqlg1Nc. ... <看更多>