EXPLAINING SIMPLY

...1:1,00,000 implies that 1 gram of the drug is in 1,00,000 millilitre (ml) of the solution. Gram on left side and ml on right side of the ratio. ...therefore, 1 gm = 1000 mg = 1,000,000 microgram (ug) in 1,00,000 ml. ...thus, 1,000,000 ug in 1,00,000 ml. ...upon cancelling out the 5 zeros from each side will yield: 10 ug in 1 ml i.e. 10 ug/ml. ...obviously, a drug which has the dilution of 1:1,00,000, the drug concentration in the solution is 10 ug/ml. ...similarly, a drug, which has the dilution of 1:1,000, the drug concentration is 1000 ug/ml = 1 mg/ml ...for simple and direct derivation one can just cancel out the number of Zeros from 1,000,000, the six zeros of a million (1 gm) ...if 1:10, then just cancel out one zero from 1,000,000, so the remaining 1,00,000 is the microgram (ug) per millilitre = 100 mg/ml ...if 1:100, then cancel two zeros because 100 has two zeros from 1,000,000 (1 gm), it will yield 10,000 ug/ml = 10 mg/ml. ...so on and so forth!

...DRUGS used during CPR and in ICU; also about ABG interpretation! Understanding the drugs used during cardiac arrest response: https://www.nursingtimes.net/clinical-archive/cardiovascular/understanding-the-drugs-used-during-cardiac-arrest-response/203172.article ABG Interpretation: https://abg.ninja/abg ABG (Arterial Blood Gas) Practice Quizzes with Tic Tac Toe Method: http://www.registerednursern.com/abg-arterial-blood-gas-practice-quizzes-with-tic-tac-toe-method/ Arterial Blood Gas Case Questions and Answers: http://www.fammed.usouthal.edu/Pulmonology/Self-StudyAids/ABGs/ABGCaseQuestions&Answers.pdf

...LOW TIDAL volume (6 ml/kg) and high PEEP have advantage in ARDS (acute respiratory distress syndrome) but PEEP (positive end expiratory pressure) must be individualised according to cardiovascular response and by a new monitoring tool Poes measurements (oesophageal pressure). ...Though, initially must be paralysed and sedated to ventilate, SIMV mode must be used as soon as possible to prevent stacking of breaths, fighting the ventilator and to prevent diaphragmatic disuse atrophy. ...if the patient is not unconscious (conscious and spontaneously breathing), BiPAP is a  preferred mode of ventilation (otherwise intubated and ventilated) for COPD and asthma patients. BiPAP (bi-level positive airway pressure) uses two settings unlike CPAP (continuous positive airway pressure). It uses inspiratory pressure (15-25 cmH2O) and expiratory pressure, PEEP (about one-fourth of the inspiratory pressure, 4-6 cmH2O, generally. ..."Using small (eg, 6 mL/kg) tidal volumes with plateau ai...

...HISTORY of illness for ABG as to "How is the Patient" is the first fact needed to be known before jumping to interpret the ABG (arterial blood gas) or VBG (venous blood gas) result! ...First step, HISTORY; second, PaO2 for oxygenation; third, pH for acidosis or alkalosis; fourth, PaCO2 for respiratory component and finally fifth, HCO3 & BE for renal and net balance! ...if history is not understood first, the Primary cause might be misinterpreted as the Compensatory or vice versa. ...say, a diabetic patient is having uncontrolled sugar despite being on insulin and requires supplemental oxygen. This history itself gives the impression that the Primary cause is Metabolic and Compensatory might be Respiratory. Moreover, the disease process is Chronic rather than Acute. ...Therefore, history indicates that either the kidneys are going wrong or the lungs are going wrong primarily and so the other one is trying to compensate; and whether the process is Acute or Chron...

...Artificial Ventilation! P.S. In the simplest form it is mouth-to-mouth ventilation - Non Invasive Positive Pressure Ventilation! Intubation & Mechanical Ventilation: https://youtu.be/V8VIw0fk4X0

OXYGENATION is not a problem if supplemental oxygen is provided to premature neonates because of the fetal Haemoglobin (Hb) having very high affinity for oxygen: P50 is 19 mm Hg compared to 26.8 mm Hg in adult. P.S. The P50 is the partial pressure (PaO2) of oxygen at which 50% of the Haemoglobin is saturated with oxygen (SaO2 = 50%); lower the P50 higher the affinity of the Haemoglobin for oxygen. So, fetal Haemoglobin having lower P50 = 19 mm Hg, has higher affinity to bind oxygen. A 2.0 kg premature neonate can have a blood volume of 2.0 x 100 ml/kg = 200 ml and if FFP (fresh frozen plasma) is transfused to build up the blood volume and also the coagulation factors instead of giving Vit K, the cardiac output would be adequate. The Hb level of 7.0 gm% would mean total Hb 200 ml x 7.0 gm% = 14.0 gm, which would carry 14.0 x 1.34 ml O2/gm of Hb = 18.8 ml oxygen content in the total blood volume of 200 ml if all the Haemoglobin is saturated with oxygen (SpO2 = 100%), which can be ap...

...OXYGEN is readily released at the tissue level because the partial pressure of oxygen is lower in the tissues and also the pH is acidic! Bohr effect facilitates loading and unloading of oxygen from haemoglobin (Hb), which states that oxygen binding affinity of Hb is inversely related to CO2 and H+ ion concentration (more in tissues; less in lungs). P.S. Each human red blood cell (RBC) contains approximately 270 million of haemoglobin (Hb) molecules; each Hb molecule carries four haem moieties. Hb constitutes about a third of the total red blood cell volume. AFFINITY is high by virtue of low 2,3 DPG in fetal blood, does not mean it won't release oxygen to the tissues. HbF (fetal haemoglobin, P50 19 mm Hg) carries 30% more oxygen than HbA (adult haemoglobin, P50 26.8 mm Hg) by allowing all 4 molecules of oxygen to bind to all 4 haem moieties in each Hb molecule, which is not so efficient in HbA due to higher level of 2,3 DPG and therefore, less than 4 molecules of oxygen bind...