basic neurophysiology of opioid analgesia
Integrated emergency medicine and anesthesia awareness education
Advantages of neurophysiology-based education Benefits of neurophysiology-based education Disadvantages of neurophysiology-based education Safety concerns Neurophysiology-based education is highly compatible with other modalities of emergency medical education such as the “DOT” training model. These three components are a fundamental tool for the educator in emergency medical education: For information on the chemistry and health effects of barium, see Barium (mineral). For the past 200 years, humans have treated barium as a medicinal and a radiological agent. Like most metallic elements, barium salts and alloys have many applications in industry. Historically, barium salts have been used as a laxative and a treatment for asthma.
Barium gallate, in comparison to aqueous gallic acid, may be more effective in the treatment of asthma. For children suffering from asthma, milk or barium carbonate and sulfate are administered. Barium sulfate can be given orally or intravenously. The preparation of a sulfate/barium solution begins by mixing powdered barium sulfate with water in a small glass or plastic container. The solution is kept below 50 °C and has to be stirred until it is homogeneous. To add a small amount of water to the solution at a time, the container is tilted, while stirring. One liter of water added in this way results in a 20 gram volume of solution. The child swallows about one third of this volume of solution. An intravenous injection of 100 to 150 mg of barium sulfate given at intervals of about 15 minutes may be enough for the child to take a maximum of 4 doses of intravenous barium sulfate.
As a diuretic, barium sulfate reduces the amount of fluid entering the body, thus regulating the amount of fluid the kidney will filter and excrete. Therefore, barium sulfate will not irritate the kidneys. Barium sulfate can also be used to treat angina pectoris (chest pain due to inadequate blood flow to the heart). While barium sulfate does not affect the heart, it may reduce chest pain. A pediatric controlled study showed that barium sulfate, taken by mouth, is more effective than a placebo in reducing ventricular-related shortness of breath in children with chronic lung disease. In pediatric emergency medicine, it is typically used along with an analgesic, antiemetic and antiarrhythmic agents to manage acute pain in children who have gastroesophageal reflux disease, vomiting, and fever. Barium sulfate can also be used in pediatric emergency to treat pain and delirium after dehydration has occurred after a traumatic accident. During the first month of life,
especially following traumatic injury, the newborn's central nervous system is very sensitive. Barium sulfate can be used in preterm infants with no other form of support for relief of pain in addition to narcotics. During surgery, barium sulfate is administered either intravenously, intraoperatively or a mixture of the two. The latter is used when it is desired to precisely control the volume administered, while maintaining adequate intraoperative solution volume. Barium sulfate is administered in the intraoperative setting when in a mannitol infusion. This is because the mannitol acts to attenuate systemic adverse effects of the toxic barium ions. Barium sulfate is also administered in the setting of partial peptic ulcer and gastric surgery to avoid feeding problems following surgery, particularly in those having undergone gastrectomy. During the early phases of gastrointestinal surgery, when large amounts of gastric contents are required to be removed, large amounts of solution are required.
This can pose a challenge as various factors, including fluid balance and circulation, must be considered. Entering the stomach in such a manner ensures that the stomach contents are evacuated slowly and uniformly.
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