Apnea Essays - Sleep Disorders, Sleep Apnea, Central Sleep Apnea

Apnea Apnea is involved with the respiratory and central nervous systems. The respiratory system allows a person to breathe in oxygen and excrete carbon dioxide (Deepak 116). After entering the mouth or the nose, oxygen travels into the pharynx, the larynx, and then the trachea. The trachea splits into two branches which then split into smaller tubes called bronchioles. Hair-like projections called cilia cover the bronchioles and protect them from foreign particles. From the bronchioles, air enters tiny air sacs called alveoli, each of which is surrounded by capillaries containing the blood that gathers oxygen to be transported throughout the body and releases carbon dioxide so that it can be exhaled. Contractions of the diaphragm cause the lungs to be inflated and deflated. According to Janet Fricker, sleep apnea is "the periodic reduction or cessation of breathing caused by temporary oropharyngeal collapse during sleep"; in other words, it occurs when a person literally stops breathing while asleep (Fricker 122). There are two main processes that produce sleep apnea. The first, known as central sleep apnea, involves the level of brain activity during sleep. The nighttime failure of the part of the brain that controls breathing, located in the brain stem, results in unmonitored oxygen Sumner 2 levels during sleep. When oxygen levels become too low and carbon dioxide levels become too high, stimulation becomes strong enough to temporarily awaken the brain to do its job. The brain triggers a snorting or sucking of air in order to restore the balance of oxygen and carbon dioxide in the body. The episodes recur as the brain returns to its sleep state (Coren 147-48). The second form of sleep apnea, known as obstructive sleep apnea, is characterized by a severe relaxation of the tongue, throat, and pharynx.(Deepak 116). The severe relaxation of the tongue causes it to cover the opening to the trachea, stopping the flow of oxygen into the lungs. After ten to ninety seconds of an apnea respiratory centers alert the brain of its oxygen-deprived state, causing the repeated sleep/wake cycle of the sufferer (Fricker 122). Sleep Apnea affects about 4 percent of middle-aged men and 2 percent of middle-aged women (Walling 851). Symptoms of sleep apnea include loud snoring, gasping, and choking. It causes breathing problems that cause a person to cough and gasp as many as several hundred times a night (Pressman 65). Because a build up of fatty tissues in the mouth tends to flow over the opening of the trachea, it is most common in middle aged, overweight males (Coren 148). About sixty percent of sufferers are overweight. However, it is not actual poundage but the thickness of the neck that affects breathing. Men often develop thicker throat tissues and gather more fat in their abdomen, neck, and shoulders than women. Men with a neck circumference of seventeen inches or more and women with that of sixteen inches or more are most likely to have sleep apnea, as well as Sumner 3 those with a double chin or a lot of excess fat around the waist. Sleep apnea will worsen with age as throat tissues become looser and people gain weight.(Barone 81). Many side affects can occur due to sleep apnea. Sufferers can awaken to headaches, irritability, difficulty in remembering, and problems with concentration (Barone 81). More serious problems can occur, such as drowsiness in the daytime, oxygen scarcity, and respiratory arrest while struggling to breathe during sleep. Because there is less oxygen going to the heart, it has to work harder; adrenaline is released and blood pressure rises rapidly. Repeated bursts of nighttime blood pressure may cause hypertension during the day, leading to increased risk of heart attack, stroke, and heart rhythm disturbances (Barone 82). Diagnosing sleep apnea has become common only in recent years, since the disorder was not officially defined until 1965. Snoring, daytime fatigue, and a short attention span can be clues for diagnosis. If these symptoms persist for a prolonged period of time it may become necessary to be placed under the care of a pulmonary specialist, or an ear, nose, and throat doctor. Diagnosis is made possible by examinations of the nose, throat, and jaw. It is also helpful for a sufferer's mate to answer questions about snoring and sleep habits. The best way to make an accurate diagnosis and determine the severity of the disorder is a polysomnography exam, usually involving an overnight stay in a sleep clinic. There specialists are able to monitor blood oxygen levels, heart rate, body temperature, brain waves, and the number of times breathing stops. The sleep

Freeze Drying and How it Works

Freeze Drying and How it Works The basic process of freeze drying food was known to the ancient Peruvian Incas of the Andes. Freeze-drying, or lyophilization, is the sublimation/removal of water content from frozen food. The dehydration occurs under a vacuum, with the plant/animal product solidly frozen during the process. Shrinkage is eliminated or minimized, and a near-perfect preservation results. Freeze-dried food lasts longer than other preserved food and is very light, which makes it perfect for space travel. The Incas stored their potatoes and other food crops on the mountain heights above Machu Picchu. The cold mountain temperatures froze the food and the water inside slowly vaporized under the low air pressure of the high altitudes. During World War II, the freeze-dried process was developed commercially when it was used to preserve blood plasma and penicillin. Freeze drying requires the use of a special machine called a freeze dryer, which has a large chamber for freezing and a vacuum pump for removing moisture. Over 400 different types of freeze-dried foods have been commercially produced since the 1960s. Two bad candidates for freeze drying are lettuce and watermelon because they have too high a water content and freeze dry poorly. Freeze-dried coffee is the best-known freeze-dried product. The Freeze-Dryer Special thanks goes to Thomas A. Jennings, PhD, author of  for his reply to the question, Who invented the first freeze-dryer?   Lyophilization - Introduction and Basic Principles, There is no real invention of a freeze-dryer. It appears to have evolved with time from a laboratory instrument that was referred to by Benedict and Manning (1905) as a chemical pump. Shackell took the basic design of Benedict and Manning and used an electrically driven vacuum pump instead of the displacement of the air with ethyl ether to produce the necessary vacuum. It was Shackell who first realized that the material had to be frozen before commencing the drying process - hence freeze-drying. The literature does not readily reveal the person who first called the equipment used to conduct this form of drying a freeze-dryer. For more information on freeze-drying or lyophilization, one is referred to my book Lyophilization -  Introduction and Basic Principles or to the INSIGHTs that appear on our website. Thomas A. Jennings - Phase Technologies, Inc. Dr. Jennings company has developed a number of instruments that are directly applicable to the lyophilization process, including their patented D2 and DTA thermal analysis instrument. Freeze-Dried Trivia Freeze-dried  coffee  was first produced in 1938, and lead to the development of powdered food products. Nestle company invented freeze-dried coffee, after being asked by Brazil to help find a solution to their coffee surpluses. Nestles own freeze-dried coffee product was called Nescafe, and was first introduced in Switzerland. Tasters Choice Coffee, another very famous freeze-dried manufactured product, derives from a patent issued to James Mercer. From 1966 to 1971, Mercer was chief development engineer for Hills Brothers Coffee Inc. in San Francisco. During this five-year period, he was responsible for developing a continuous freeze drying capability for Hills Brothers, for which he was granted 47 U.S. and foreign patents. How Freeze Drying Works According to  Oregon Freeze Dry, the purpose of freeze drying is to remove a solvent (usually water) from dissolved or dispersed solids. Freeze drying is the  method for preserving materials which are unstable in solution. In addition, freeze drying can be used to separate and recover volatile substances, and to purify materials. The fundamental process steps are: Freezing: The product is frozen. This provides a necessary condition for low-temperature drying.Vacuum: After freezing, the product is placed under vacuum. This enables the frozen solvent in the product to vaporize without passing through the liquid phase, a process known as sublimation.Heat: Heat is applied to the frozen product to accelerate sublimation.Condensation: Low-temperature condenser plates remove the vaporized solvent from the vacuum chamber by converting it back to a solid. This completes the separation process. Applications of Freeze-Dried Fruits in Confectionery Products In freeze drying, moisture sublimes directly from the solid state to vapor, thus producing a product with controllable moisture, no need for cooking or refrigeration, and natural flavor and color.

Quality Improvement Program of Naval Hospital Essay

Quality Improvement Program of Naval Hospital - Essay Example The command's Risk Management Plan is in accordance with Bureau of Medicine and Surgery (BUMED) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) guidelines. Risk Management means loss prevention, preventing harm, and decreasing the risk of liability to staff and facility. Improving quality of care, improving patient satisfaction and patient outcomes have a direct effect on reducing risks and, conversely, reducing risk has a direct effect on patient outcomes. A proactive, systematic, command-wide approach to identify, analyze, report and correct adverse, or potentially adverse events is followed. The credentials division analyzes and evaluates the effectiveness of the program in meeting established goals and objectives. It is the primary interface between directors, department heads, professional staff, and Professional Affairs Coordinators at other commands, higher echelons, and professionals at civilian, state, and federal agencies. It prepares and prese nts comprehensive orientation training to support staff and health care providers. Finally, the Infection Control Division is responsible for the surveillance, prevention, and control of infection function by identifying and reducing the risks of acquiring and transmitting infections among patients, employees, physicians and other licensed independent practitioners, contract service workers, volunteers, students, and visitors. COMPARISON WITH A MODEL FACILITY An ideal healthcare facility with continuous quality improvement program follows the principles of CQI. It meets the needs of those being served, the patients in this case. The risk management division of the naval healthcare facility focuses on "risk reduction by improving patient satisfaction and patient outcomes". Thus, the satisfaction of the patient needs and expectations implies a well directed effort to CQI. Another aspect of an ideal healthcare facility will be working as a team. Here again, the naval hospital is seen to have a well organized team for quality management with sub-divisions to carry out different functions of quality improvement, like, performance improvement, risk management etc. Also, the provision of a credentials division allows for "use of data and measurement tools is key to improving processes and outcomes". Above all, the commitment to quality principles and practices by the management can be understood from the fact that the naval healthcare facility h as a separate department devoted to quality improvement. All the aforementioned points authenticate the fact that the healthcare facility meets the recognized standard for CQI. RECOMMENDATIONS Achieving total quality and having continuous quality improvement in the healthcare facility only result in the improvement in patient care. In order to improve patient care, the facility must not stop with reaching a particular target in quality but there must be a continuous adherence to the TQM principles. The plan-do-study-act cycle of CQI must continue with revised plans after every action is taken. ADHERENCE TO TQM PRINCIPLES It