临床医学姚晨玲急性一氧化碳中毒ppt课件.pptVIP

Toxicity, Carbon Monoxide;Background;Pathophysiology;Pathophysiology;;Clinical;delayed neuropsychiatric symptoms Long-term exposures or severe acute exposures frequently result in long-term neuropsychiatric sequelae. Additionally, some individuals develop delayed neuropsychiatric symptoms, often after severe intoxications associated with coma (about 3%-10% of all patients) After 2-60days “normal period”, chronic headaches, memory problems, and parkinsonian-type tremor, re-occur . ;delayed neuropsychiatric symptoms;Lab Studies;Arterial blood gas PaO2 levels should remain normal. Oxygen saturation is accurate only if directly measured but not if calculated from PaO2, which is common in many blood gas analyzers. PCO2 levels is normal or mildly decreased ;EEG CT scan ;Diagnosis;Differentials;Treatment;Emergency Department Care Continue 100% oxygen therapy until patient is asymptomatic and HbCO levels are below 10%. Perform intubation for the comatose patient or, if necessary, for airway protection Early blood samples may provide much more accurate correlation between HbCO and clinical status; however, do not delay oxygen administration to acquire them. cardiac monitoring ;Treatment;The rationale for the use of HBO;Treatment;Prognosis;我劝一个草率结婚的朋友离婚。她平静的告诉我，如果说当初鲁莽结婚是个错误。那么，现在草率离婚是一错再错。这位朋友后来还是离婚了，大家一致认为她的行为很理性。同样的故事正在互联网搜索巨头谷歌身上发生，但是谷歌选择了草率“离婚”。饮鸩止渴由于急于抑制苹果iphone手机翻天覆地的产业冲击，谷歌采取急功近利的粗糙型开放策略。饮鸩止渴的策略一时取得了成果。市场研究公司尼尔森最近公布的数据显示，在通过Verizon Wireless、ATT和Sprint Nextel三大运营商经销后，谷歌Android手机在美国市场上的销售量已经超过iPhone。另一家市场研究公司iSuppli甚至认为，全球范围内使用Android操作系统的手机数量将在 2012年超过苹果iPhone。 表面繁华的背后，是Android生态系统的一团糟，谷歌正在为自己的粗放型开放策略买单。用户对谷歌手机的态度从开始的好奇、后来的犹豫，变成强烈的批评。“大多Android手机程序都是垃圾，乱七八糟的”，一位手机发烧友迅速投奔了iphone的阵营：??同样的植物人大战僵尸游戏，在谷歌手机和iphone手机上的体验简直没法比”混乱，还是混乱。一切一切的乱象，折射出谷歌已经失去对Android生态系统的控制。这一切的根源，我的判断是开放策略初期过于宽松，导致失去控制权。混乱的生态系统表现在用户手机上，就是应用程序的混乱和粗燥。一错再错为此，谷歌开始采取对策。最近，有国内厂商称新的Android3.0开始关闭应用程序的API(应用程序编程接口)，统一Android界面。这意味着，谷歌将放弃其初始开放策略，开始封闭管理。粗看之下，谷歌认识到自己的错误。既然是过度开放导致的错误，那么收紧