Thursday, November 22, 2012

Condition That Cause Breathing Difficulty in Asthma Patient

Sitting in Tripod position shows the person had a brathing difficulty
There are many conditions that cause the patient to experience signs and symptoms of difficulty in breathing. Even though the disease processes are different, the assessment and emergency care are basically the same. It is not your responsibility to diagnose the condition or disease causing difficulty in breathing; however, you can identify the signs and symptoms, determining whether the breathing is adequate or inadequate, antecipating deterioration in the patient's status, and providing immediate intervention as necessary.


Asthma is a common respiratory condition where patient will complaint of  severe shortness of breath. Many asthma patient are aware of their condition and have medication to manage the disease. Usually patient will call an ambulance maybe because of the patient itself is suffering an early-onset asthma attack or one in which the patient's medication is not reversing the attack 
Comparison between normal person and asthmatic bronchiole patient

Asthma is characterized by an increased sensitivity of the lower airways to irritants and allergens, causing bronchospasms, which is a diffuse, reversible narrowing of the bronchioles and inflammation to the lining of the bronchiles. The following: 
  • Bronchospasm (constriction of the smooth muscle in the bronchioles)
  • Edema (swelling) of the inner lining in the airways
  • Increased secretion of mucus that causes plugging of the smaller airways

Anatomy of Asthma Attack: Conditions contributing to air flow resistence in asthma

Asthma patients usually suffer acute, irregular, periodic attacks but between the attacks usually have either no or very few signs or symptoms.
A prolonged life threatening attack that produces inadequate breathing and severe signs and symptoms is called Status Asthmaticus. 
Status Asthmaticus is a severe asthmatic attack that does not respond to either oxygen or medication. Patients in status asthmaticus require immediate and rapid transport to hospital

There are generally two different kinds of asthma:
1. Extrinsic asthma (allergic asthma)
-usually results from a reaction to dust, pollen, smoke or other irritants in the air.
-typically seasonal, occurs most often in children and may subside after adolescence.

2.Intrinsic asthma (nonallergic asthma)
-most common in adults
usually results from infection, emotional stress or strenous exercise.

In asthma, the smaller bronchioles have a tendency to collapse when the lungs recoil; therefore, exhalation is much more difficult and prolonged, and air becomes trapped in the alveoli. Because of this, wheezing is heard much earlier upon exhalation. The patient is forced to use energy not only to breathe in but also to eliminate the air from the lungs during exhalation. Thus, exhalation becomes an active process requiring energy that leads to increased breathing workload and eventual exhaustion. Respiratory depression or arrest may shortly follow in severe cases. The loss of wheezing may be an ominous sign of severe bronchoconstriction and deterioration.

Signs and symptoms of asthma:
  • Dyspnea (shortness of breath); may progressively worsen
  • Nonproductive cough
  • Wheezing on auscultation (typically expiratory)
  • Tachypnea (breathing faster than normal)
  • Tachycardia (increased heart rate beyond normal)
  • Anxiety and apprehension
  • Possible fever
  • Typical allergic signs and symptoms; runny nose, sneezing, red or bloodshot eyes, stuffy nose
  • Chest tighness
  • Inability to sleep
  • Spontaneous peripheral oxygenation (SPO2) < 95% before oxygen administration
The following signs indicate an extremely severe condition with inadequate breathing. Begin positive pressure ventilation with supplemental oxygen:
  • Extremely fatigue or exhaustion; the patient is too tired to breathe
  • Inability to speak
  • Cyanosis(bluish coluration) to core of the body
  • Heart rate > 150 per min or slow rate
  • Quiet or absent breath sounds on auscultationof the lungs (Silent Chest)
  • Tachypnea (respiratory rate > 32 breaths per minute)
  • Excessive diaphoresis
  • Accessory muscle use (neck, chest, abdomen)
  • Confusion
  • SPO2 <90% with patient on oxygen

Sunday, August 12, 2012

Ringkasan Eksekutif

Apa itu Ringkasan Eksekutif

-ringkasan eksekutif merupakan laporan ringkas tentang perkara- perkara yang dilaporkan dalam laporan harian (Buku Log dan sebagainya).
-ia bertujuan untuk memberi latihan kepada pelajar untuk menulis laporan yang berkesan tentang aktiviti-aktiviti latihan industri yang diikuti.
- pelajar juga diberi peluang untuk membuat penilaian tentang keberkesanan latihan yang telah diikuti.

Contoh Format Ringkasan Eksekutif 

Bilangan halaman: 6-10 muka surat (selang 2 jarak); tidak termasuk muka hadapan
Saiz kertas: A4
Had ruang teks: 2.5cm dari kiri, kanan, atas dan bawah
Fon: Times New Roman (12pt)

Contoh isi kandungan Ringkasan Eksekutif

a) maklumat tentang pelajar dan organisasi latihan (SATU muka surat sahaja)

  • Nama, no.telefon, dan no. pelajar
  • Tempoh latihan (dengan tarikh mula dan tarikh tamat)
  • Nama dan alamat organisasi latihan (beserta dengan no.telefon dan no. faxs)
  • nama dan alamat penyelia latihan (beserta dengan no.telefon dan no.faxs)
  • kaedah mendapatkan tempat
  • jumlah dan kadar elaun yang diterima
b)maklumat tentang program latihan
  • penerangan ringkas tentang organisasi latihan
  • senarai tugasan/projek
  • jadual kerja
c)penerangan terperinci untuk SETIAP tugasan/projek yang dilaporkan dalam (b)
  • tajuk.tugasan/projek
  • penerangan tentang tugasan/projek ini
  • perkara-perkara yang dipelajari dari tugasan/projek ini
  • hubung kait teori yang dipelajari dengan pengalaman praktikal (dengan contoh)
d)kesimpulan dan cadangan penambahbaikan program yang disediakan

Selamat Berjaya

Sumber: Buku Log Latihan Industri Program Sarjanamuda Sains Perubatan Kecemasan, Fakulti Perubatan, Pusat Perubatan Universiti Kebangsaan Malaysia

Sunday, January 8, 2012

Balik Kampung...

This morning(8 January 2012),
ibu, ayah and me went to kampung Juasseh, Negeri Sembilan
we went to my childhood village Maksu's House
Since ive finished my final exam so this can be assumed as my vacation
and my relaxation day.


I don know whats this tree is

this is langsat..i think??


is this cempedak or nangka??

trying to console a chick

with ayah watching NS vs Kelantan the encore at maksu's house ..Ns win 2-1

the siamese cat

so what are u lookin for??

please tell me if u know what this tree is


the result..this is not for sale ok..share with neighbour at KL 

ibu and ayah at pasar Kuala Pilah (near the kedai rojak)

ibu and ayah discuss how much Gula Anau to buy

is it Durian's tree??

so tall..


this is not sawit..this is anau it??

At Terachi..

what a beutiful scenery

fish pond near the road

mountain..i think this is Gunung Dato'

Bukit Putus

This is what happen if u r stress n not takin a healthy lifestyle

view from the rambutan tree on the tree
ayah so excited to 'kait' rambutan

be at kampung is the one of the best place to go..
hope to come back next time..insyallah

Wednesday, January 4, 2012

Cadangan Aktiviti Untuk Cuti Sem

Memandangkan minggu peperiksaan dah nak tamat..terfikir apa aktiviti nak buat apabila cuti sem..Banyak benda yang boleh buat antaranya ialah..

Hantar surat atau kad ucapan pada teman-teman

'Camping', 'Hiking' atau 'Jungle Tracking'

Pergi kursus

Balik kampung

Belajar resepi baru

Belajar jadi jurugambar

 Buat kelas tambahan untuk pelajar sekolah dan tadika

Tolong ibu kemas rumah


Jadi nelayan atau pergi berkayak

Beribadat serta bergotong-royong di masjid atau surau

Tolong mak memasak

Bersenam dan bersukan

Pergi kelas memasak

Belajar buat kek

Buat kerja amal atau ikuti program universiti

'Shopping' atau jadi 'promoter'

'Study' atau 'Revision'

Pergi gim

Berkahwin atau pergi kenduri 

Merantau atau bercuti atas angin
Pergi kelas muzik

Kerja katering atau tolong jadi penanggah

Buat kerja 'part-time'

Main boling atau beriadah

Pergi memancing

Belajar memandu

Semoga cuti kita menjadi bermanfaat...