#ITT Technical institutes

[wildmonkeysects]

War Profiteers

Remember President Dwight “Ike” Eisenhower, who after green-lighting the overthrow of Iran’s democracy in 1953 at the behest of petrochemical corporations, had a change of heart and warned about the Military Industrial Complex? Here are the top 100 USA Military Industrial Complex “defense” contractors, all corporate welfare queens mooching off the public, who have blood on their hands in Palestine and elsewhere:

Academi

Action Target

ADT Corporation

Advanced Armament Corporation

AECOM

Aerospace Corporation

Aerovironment

AirScan

AM General

American Petroleum Institute

Argon ST

ARINC

Artis

Assett

Astronautics Corporation of America

Atec

Aurora Flight Sciences

Axon Enterprise

United Kingdom BAE Systems

BAE Systems Inc

Ball Corporation

Ball Aerospace & Technologies

Barrett Firearms Manufacturing

Battelle Memorial Institute

Bechtel

Berico Technologies

Boeing Defense, Space & Security

Booz Allen Hamilton

Boston Dynamics

Bravo Strategic

CACI

Carlyle Group

Carnegie Mellon University

Ceradyne

Cloudera

Colt Defense

The Columbia Group

Computer Sciences Corporation

Concurrent Technologies Corporation

CSRA (IT services company)

Cubic Corporation

Omega Training Group

Curtiss-Wright

DeciBel Research

Dillon Aero

Dine Development Corporation

Draper Laboratories

DRS Technologies

DynCorp

Edison Welding Institute

[Israei]l Elbit Systems

M7 Aerospace

Ensco

United Kingdom/Military contractor Ernst & Young

Evergreen International Aviation

Exxon

Fluor Corporation

Force Protection Inc

Foster-Miller

Foster Wheeler

Franklin Armoury

General Atomics

General Dynamics

Bath Iron Works

General Dynamics Electric Boat

Gulfstream

Vangent

General Electric Military Jet Engines Division

Halliburton Corporation

Health Net

Hewlett-Packard

Honeywell

Humana Inc.

Huntington Ingalls Industries

Hybricon Corporation

IBM

Insight Technology

Intelsat

International Resources Group

iRobot

ITT Exelis

Jacobs Engineering Group

JANUS Research Group

Johns Hopkins University

Kaman Aircraft

KBR

Kearfott Corporation

Knight's Armament Company

Kratos Defense & Security Solutions

L3Harris Technologies

Aerojet

Brashear

[France] Lafayette Praetorian Group

Lake Shore Systems

Leidos

EOTech

Lewis Machine & Tool Company

Lockheed Martin

Gyrocam Systems

Sikorsky

LRAD Corporation

ManTech International

Maxar Technologies

McQ

Microsoft

Mission Essential Personnel

Motorola

Natel Electronic Manufacturing Services

Navistar Defense

Nextel

Northrop Grumman

Northrop Grumman Electronic Systems

Northrop Grumman Ship Systems

Northrop Grumman Technical Services

Northrop Grumman Innovation Systems

NOVA

Oceaneering International

Olin Corporation; also see John M. Olin and John M. Olin Foundation

Oshkosh Corporation

Para-Ordnance

Perot Systems

Picatinny Arsenal

Pinnacle Armor

Precision Castparts Corporation

Raytheon Technologies

Collins Aerospace

Rockwell Collins

Goodrich Corporation

Pratt & Whitney

Raytheon Intelligence & Space

Raytheon Missiles & Defense

Raytheon BBN

Remington Arms

Rock Island Arsenal

Roundhill Group

Ruger

Saab Sensis

Science Applications International Corporation (SAIC)

SGIS

Sierra Nevada Corporation

Smith & Wesson

Smith Enterprise (SEI)

SPRATA

Springfield Armory

SRC Inc

SRI International

Stanley

Stewart & Stevenson

Swift Engineering

Tactical Air Support

Teledyne

Teledyne FLIR

Textron

AAI Corporation

Bell Helicopter Textron

Trijicon

TriWest Healthcare Alliance

Unisys

U.S. Ordnance

Verizon Communications

Vinnell Corporation

Westinghouse Electric Corporation

[stressedlawsecretary]

Today's Focus

This is the oldest source I could find for my saved fanart

06.17.24 - Start of a four-day week that is set to contain record-high temperatures. It's going to be so warm that all the schools are doing half-days, even though they only have three days this week. We're all getting Wednesday off for Juneteenth, and the Regents stuff kept kids out today but the half-days are going to keep SJC at home all week since her kids are too young to care for themselves (unlike JJM's kids.) You might ask why I'm wearing long-sleeves; that would be because my office puts the AC up all the way and I get cold.

Work - I don't think I have anything left for myself/backed up at this point. I'm probably waiting on emails, and I'm in the office so I'm sure I'll get asked for a mailing or two.

Background Noise - Back at work means I'm back to YT. I did not add as many over the weekend as I watched over the week so hopefully I can continue to drop my list number down further and further.

I still managed to watch like 11 full videos over the weekend, which helps because that's 11 videos I'm not watching today.

Study - Monday is case law day and I've got two decisions I started that I want to finish and a very long letter to the DOE regarding the misconduct of ITT Technical Institutes. Wish me luck!

I did read like four random articles over the weekend and one or two different (long) Wikipedia pages but I was also out celebrating Father's Day and doing other errands. This isn't bad though.

Extras - Monday means I clean out the catbox from the weekend; I did keep up on all my chores despite being busy so I'm doing super well in minimizing my household labor. I am cooking - turkey BLT burgers because I want to grill but I don't want to keep doing the same old thing. It's WTFIWWY and other various YT videos with hunny today; we go back to Kyuranger this week. Kamen Rider Build is not beating the Gaim 2.0 allegations but I'm picking up on the foreshadowing better because it's less convoluted. Kyuranger is sillier and a good break from the more intense show. Not quite the same kind of silly The Tick is though.

[matekonkol]

Megjelent egy (első?) angol nyelvű kritika a kultúrás Fordulat lapszámról, ami nagy örömömre a legtöbb recenzióval szemben behatóan foglalkozik a magyar filmiparról szóló tanulmányommal is (nem úgy, mint a magyar filmszakma, ahol sajnos semelyik lap nem élt a párbeszéd lehetőségével).

Idézem itt hosszabban ezt a szakaszt a LeftEast-cikkből:

"Next, “I Hope Next Time You Will Manage to Apply ” grapples with the issue of ‘independence’ in the film industry and its dilemmas within the contemporary Hungarian scene. Due to limitations such as language and the still miniscule private capital involved, film production (a grossly expensive form of culture) in a small country like Hungary has been historically funded by the state through an ever-changing institutional framework. Author Máté Konkol shows that, surprisingly, during the ten years of the existence of Orbán regime’s funding body, the National Film Fund (NFI), almost 30% of feature-length films were ‘independent’ productions. This was due to the fact that NFI allocated most of its budget to popular productions aligned with the regime’s ideological values, benefiting a small and interconnected slice of the field, leading to a wide-scale refusal of filmmakers to apply for state funding. Konkol focuses on this 30%, examining ‘independently’ produced films through a Bourdieuian lens, where independence refers to the productions’ funding schemes (as opposed to aesthetic decisions, regarding which the author discusses the term autonomy and concludes that it is always-already a ‘relative autonomy’ one can talk about, given the interplay of various dependencies in the production process). Due to the lack of financial resources, these indy productions have been forced to adapt to conditions of scarcity. Using the social and cultural capital of the already well-known filmmakers, many of them managed to access the technical means of production for (almost) free, and employed staff based on ‘deferred payments’ or on a volunteer basis (free labour). Konkol offers real-world insight to the reader by analysing the production (and distribution) of a feature he worked on as the director’s assistant. The case study reveals that, although the director (Szabolcs Hajdu) was already locally and internationally renowned, the film had a very low production budget (Hajdu did not apply for NFI funds). The film was produced by the free labour of the director’s students (at a private art university), and went on to win the Karlovy Vary film festival. The author claims that the students who made the film did not feel that they were exploited in the production process, as the lack of remuneration was compensated with gains in cultural capital, and thus, future opportunities.

In his conclusion, Konkol identifies the urgent need for a movement that would oppose the structures and standards of the film industry set by patriarchal capitalism. He claims that for this, a new network ought to be organised that is integrated into a wider network of the ‘solidarity economy’, is open, and allows for the participation of those currently outside elite circles.

I cannot agree more. For this to happen, I believe, we must confront not only the far-right, ethnonationalist post-fascists, but also the liberal elites who still claim the position of the makers of ‘good culture’, while remaining blind to the slew of exploitation they perpetuate for the sake of the end product and success for the few."

[acls-cheat-sheet-3g]

acls cheat sheet mod menu RQ4#

💾 ►►► DOWNLOAD FILE 🔥🔥🔥🔥🔥 Free ACLS Provider Manual. The perfect precourse assessment to help you pass your ACLS megacode. Review our AHA updated pdf at no charge today! ACLS Cheat Sheet. Basic BLS You see a man collapse at a grocery store. Shake and shout. Establish unresponsiveness. What is the first thing you do? View Notes - ACLS CHEAT SHEET from NU at ITT Technical Institute Springfield campus. Cardiac Arrest Algorithm Note the key change in BLS sequence: begin. Looking for a quick cheat-sheet that will help you obtain your ACLS certification? You may want to read this first. 9 When autocomplete results are available use up and down arrows to review and enter to select. Touch device users, explore by touch or with swipe gestures. Log in. Sign up. Acls Cheat Sheet. Collection by Tina Poudrette. Similar ideas popular now. Acute Nursing. Cardiac Nursing. Nursing Tips. Nursing Notes. Acls Algorithm. Paramedic Student. Advanced Cardiac Life Support. Acute Coronary Syndrome. Critical Care Nursing. Acute Coronary Syndrome algorithm. Nursing Cheat. Nursing School Tips. Nursing Study. Nursing Schools. Lpn Schools. Nursing Degree. Tori Hobson. Nursing Career. Nursing Programs. Cardiac Rn. Lpn Programs. ACLS page, where have you been during all my codes? Nursing School Studying. Funny Nursing. Med Surg Nursing. Nursing School. Acls Study. Paramedic School. Nursing School Notes. Nursing Mnemonics. Nursing Assessment. Pediatric Nursing. Pals Algorithm. Nursing Math. Cardiology Nursing. Nicu Nursing.

[mapeidubai]

Epoxy tiles adhesive to know

KERAPOXY ADHESIVE

Two-component epoxy adhesive with no vertical slip for ceramic tiles and stone material. Conformity of Kerapoxy Adhesive is declared in ITT certificate n° 25070399/Gi (TUM) issued by the Technische Universität München laboratory (Germany) and in ITT certificates n° 2008-B-2748/4.1, 2008-B-2748/5.1 and 2008-B-2748/6.1 issued by the MPA Dresden Institute (Germany). Choose this product from Mapei who are the best epoxy tiles adhesive manufacturers UAE.

TECHNICAL DATA: Pot life of mix: 45 minutes. Open time: 60 minutes. Set to light foot traffic: approx. 10-12 hours. Ready for use: 2 days. Colors: Comp A: Grey; Comp B: Beige. Color of the mix: White Application: suitable notched trowel. Storage: 24 months. Consumption: 1.5 kg/m ² per mm of thickness. Packaging: 10 kg units. (Comp A: 8kg + Comp B: 2kg)

CLASSIFICATION ACCORDING TO EN 12004 Kerapoxy Adhesive is an R2T classified reactive (R), improved (2) adhesive with no vertical slip (T). Conformity of Kerapoxy Adhesive is declared in ITT certificate n° 25070399/Gi (TUM) issued by the Technische Universität München laboratory (Germany) and in ITT certificates n° 2008-B-2748/4.1, 2008-B-2748/5.1 and 2008-B-2748/6.1 issued by the MPA Dresden Institute (Germany).

WHERE TO USE Internal and external bonding of ceramic, porcelain and stone to floors and walls, on all substrates normally used in the building industry. Some application examples · Bonding of all types and forms of ceramic tiles. · Rigid bonding of bullnose and special ceramic tile shapes. · Bonding tiles in fibreglass swimming pools. · Bonding marble doorsteps and windowsills.

[tenders4you]

Understanding PPMS Tenders: A Comprehensive Guide

Introduction to PPMS Tenders

In today's competitive business environment, securing Public Procurement Management System (PPMS) tenders is crucial for companies looking to expand their market reach and drive revenue growth. PPMS tenders provide a structured and transparent method for organizations to bid on public contracts, ensuring that government agencies and public institutions receive the best value for their investments. This guide delves into the intricate details of PPMS tenders, offering insights and strategies to help your business successfully navigate the tendering process.

What are PPMS Tenders?

PPMS tenders are formal invitations issued by government bodies and public sector organizations inviting suppliers to submit proposals for the supply of goods, services, or works. These tenders are governed by stringent regulations and guidelines to promote fairness, transparency, and competition. Participating in PPMS tenders allows businesses to tap into lucrative public sector opportunities and establish long-term contracts with governmental entities.

Benefits of Securing PPMS Tenders

Winning a PPMS tender can provide numerous benefits to your business, including:

Revenue Growth: Securing a public sector contract can lead to significant revenue streams and business expansion.

Market Credibility: Winning a government tender enhances your company's reputation and credibility in the market.

Long-Term Contracts: Public sector contracts often span multiple years, ensuring a steady flow of income.

Innovation and Improvement: The competitive nature of tendering encourages companies to innovate and improve their offerings to meet high standards.

The PPMS Tendering Process

Understanding the PPMS tendering process is essential for submitting a competitive bid. The process typically involves the following stages:

1. Pre-Tender Stage

At this stage, government agencies identify their needs and prepare the tender documents. Businesses should actively monitor tender notices and subscribe to relevant procurement portals to stay informed about upcoming opportunities.

2. Tender Release

Once the tender is released, the tender documents are made available to the public. These documents usually include:

Invitation to Tender (ITT)

Request for Proposal (RFP)

Tender Specifications

Terms and Conditions

3. Bid Preparation

This is the most critical phase where businesses prepare their proposals. Key components of a compelling bid include:

Executive Summary: A concise overview of your proposal.

Technical Proposal: Detailed description of how your solution meets the tender requirements.

Financial Proposal: Comprehensive cost breakdown and pricing strategy.

Compliance Checklist: Ensure all mandatory criteria and documentation are met.

4. Bid Submission

Submit your bid before the deadline, adhering to the specified format and requirements. Late submissions are typically not accepted, so timely delivery is crucial.

5. Evaluation and Award

The evaluation process involves assessing bids based on pre-defined criteria such as technical capability, cost-effectiveness, and compliance. The contract is awarded to the most suitable bidder, often through a competitive scoring system.

Strategies for Winning PPMS Tenders

To increase your chances of winning PPMS tenders, consider the following strategies:

1. Thorough Research

Understand the specific requirements and objectives of the tendering authority. Tailor your proposal to address their needs and demonstrate your expertise.

2. Strong Compliance

Ensure your bid meets all mandatory criteria and includes all required documentation. Non-compliance can lead to disqualification.

3. Competitive Pricing

Offer a competitive and realistic pricing structure. Highlight the value for money your proposal provides without compromising on quality.

4. Clear and Concise Proposal

Present a clear and well-structured proposal. Use headings, bullet points, and visuals to enhance readability and convey your message effectively.

5. Highlight Experience and Expertise

Showcase your company's track record, relevant experience, and expertise in delivering similar projects. Provide case studies and client testimonials to build credibility.

Common Challenges in PPMS Tendering

Participating in PPMS tenders can be challenging due to the following reasons:

1. Complex Requirements

Tenders often have complex and detailed requirements that can be difficult to interpret and meet. Investing time in understanding the tender documents is crucial.

2. Intense Competition

The public procurement market is highly competitive, with many businesses vying for the same opportunities. Differentiating your proposal is key to standing out.

3. Administrative Burden

Preparing a tender response can be time-consuming and resource-intensive. Effective project management and allocation of resources are essential.

4. Regulatory Compliance

Adhering to stringent regulatory requirements can be challenging, particularly for businesses new to public sector procurement.

Tips for Successful PPMS Tendering

To navigate these challenges successfully, consider these practical tips:

1. Build a Dedicated Tender Team

Assemble a team with the necessary skills and expertise to manage the tendering process. This team should include project managers, technical experts, and financial analysts.

2. Invest in Training and Development

Provide your team with ongoing training and development opportunities to keep them updated on best practices and regulatory changes in public procurement.

3. Leverage Technology

Use procurement software and tools to streamline the tendering process, manage documentation, and ensure timely submissions.

4. Establish Strong Partnerships

Collaborate with other businesses or consultants who have experience in PPMS tenders. Partnerships can enhance your capabilities and improve your chances of success.

5. Conduct Post-Tender Reviews

After the tendering process, conduct a review to identify areas for improvement. Analyze feedback from the tendering authority and incorporate lessons learned into future bids.

Conclusion

Securing PPMS tenders requires a strategic approach, thorough preparation, and a deep understanding of the tendering process. By following the strategies and tips outlined in this guide, your business can enhance its chances of success and unlock valuable public sector opportunities.

Tenders4you

[pghlesbian]

(via Why Was Minnesota Trans Woman Savannah Williams Brutally Murdered?)

Savannah was from Minneapolis, Minnesota. She studied at the ITT Technical Institute and had most recently been working for Amazon since 2018. According to her social media, she liked Nicki Minaj, Beyonce. and Drake, She also enjoyed baseball, acrylic painting, swimming, and animal rescue. She is survived by her husband of seven years, Courtney Matthews. He cherished her because “she was a very loving, caring person.”

Last week, family members told MPR News that Savannah was Cuban and Native American, descended from the Red Lake Nation. According to friends, Savannah was involved with Tea Time, a support group for transgender women, at The Aliveness Project.

#SavannahWilliams #RIP #TransWomen

By my count, we now have exceeded the total deaths in 2022.

[hello-liverpool]

Senior Structural Engineer Role and Responsibilities

Manage your pool of resources effectively and efficiently to ensure successful outcomes for all projects under your remit.

Undertake site surveys and lead intrusive investigations to assess the extent and cause of defect and damage, often working in live environments, and be capable of developing pragmatic solutions.

Deliver high-quality designs, drawings, and reports using engineering materials including concrete, steel, masonry, timber, etc., together with soils, foundations and drainage, and in a form that can readily be checked by another member of staff.

Apply Eurocodes, British Standards, current Construction (Design and Management) (CDM) Regulations and other design codes/information as appropriate.

Undertake thorough site investigations, complete inspections, and identify and resolve any issues as appropriate.

Undertake project design from commencement to completion.

Represent the company at design team meetings.

Manage, encourage, support and motivate junior Engineers and Technicians in the process of project design.

Undertake appropriate Continuing Professional Development and maintain CPD records in accordance with the requirements of the Institution of Structural Engineers and/or the Institution of Civil Engineers.

Recognise the importance of clear communication with all members of the design and/or construction team regarding matters of structural safety, and keep up-to-date with information provided by CROSS (Collaborative Reporting for Safer Structures (see www.cross-safety.org/uk).

Undertake Business Development for the benefit of CCL.

HYDROCK (Structural Engineer Role)

The role will include: 

Delivery of scheme and concept designs.

Delivery of detailed design including full tender and construction packages.

Preparation of calculation packages for submission to Building Control

Attendance at client, design and site meetings.

Management and development of engineers and technicians.

Liaison with statutory authorities, architects, the design team and contractors.

Preparation of fee proposals, input into project bids, ITTs etc.

The attributes we expect you to bring to the role and company:

MEng or BEng in civil or structural engineering.

Chartered membership/ Associate membership of the IStructE/ ICE OR working towards Chartership.

Significant experience in building structures design.

Self-motivated team player with good people skills.

Strong communication, analysis, technical design and drawing skills.

Experience using analysis and design software packages.

Ability to design through hand calculations.

Understanding of BIM requirements up to and including Level 2.

Developing marketing/ business development skills.

Someone ambitious, who believes in our values and wishes to be part of Hydrock and our success.

[acls-cheat-sheet-sh]

acls cheat sheet new 3WY&

💾 ►►► DOWNLOAD FILE 🔥🔥🔥🔥🔥 Free ACLS Provider Manual. The perfect precourse assessment to help you pass your ACLS megacode. Review our AHA updated pdf at no charge today! ACLS Cheat Sheet. Basic BLS You see a man collapse at a grocery store. Shake and shout. Establish unresponsiveness. What is the first thing you do? View Notes - ACLS CHEAT SHEET from NU at ITT Technical Institute Springfield campus. Cardiac Arrest Algorithm Note the key change in BLS sequence: begin. Looking for a quick cheat-sheet that will help you obtain your ACLS certification? You may want to read this first. 9 The first step in any resuscitation is to make sure the rescuers you! Therefore, if your victim is in the middle of the highway or in a burning building, the first step is to move the victim to safety. Assuming you and the victim are in a safe location, the next step is to assess whether the patient is responsiv. Adult BLS is slightly different if there is one provider solo or more than one provider team present. The difference between solo provider BLS and team BLS is that responsibilities are shared when more than one person is present. For healthcare providers, the difference between a witnessed cardiac arrest and a victim who is found down is the order of the initial steps. Cardiac arrest is the sudden sensation cessation of blood flow to the tissues in brain the results from a heart that is not pumping effectively. Four rhythms may occur during cardiac arrest: ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity, and asystole. While ACLS provides algorithms for each of these cardiac arrest rhythms, in the real world a patient may move between these rhythms during a single instance of cardiac arrest. Therefore, the provider must be able to accurately assess and adapt to changing circumstances. After every 2 minutes of CPR, check for a pulse and check the cardiac rhythm. If the rhythm has switched from shockable or to shockable, then switch algorithms. This energy may come in the form of an automated external defibrillator AED defibrillator paddles, or defibrillator pads. VFib and VTach are treated with unsynchronized cardioversion, since there is no way for the defibrillator to decipher the disordered waveform. In fact, it is important not to provide synchronized shock for these rhythms. Ventricular fibrillation is recognized by a disordered waveform, appearing as rapid peaks and valleys as shown in this ECG rhythm strip:. Ventricular tachycardia may provide waveform similar to any other tachycardia; however, the biggest difference in cardiac arrest is that the patient will not have a pulse and, consequently, will be unconscious and unresponsive. Two examples of ventricular tachycardia are shown in this ECG rhythm strips. The first is narrow complex tachycardia and the second is wide complex tachycardia:. Pulseless electrical activity or PEA is a cardiac rhythm that does not create a palpable pulse is even though it should. A PEA rhythm can be almost any rhythm except ventricular fibrillation incl. It represents a lack of electrical activity in the heart. It is critically important not to confuse true asystole with disconnected leads or an inappropriate gain setting on an in-hospital defibrillator. Asystole may also masquerade as a very fine ventricular fibrillation. If the ECG device is optimized and is functioning properly, a flatline rhythm is diagnosed as asystole. Note that asystole is also the rhythm one would expect from a person who has died. Consider halting ACLS efforts in people who have had prolonged asystole. It is inappropriate to provide a shock to pulseless electrical activity or asystole. Cardiac function can only be recovered in PEA or asystole through the administration of medications. While cardiac arrest is more common in adults than respiratory arrest, there are times when patients will have a pulse but are not breathing or not breathing effectively e. A person who has a pulse but is not breathing effectively is in respiratory arrest. When you encounter a patient in need, you will not know he or she is in respiratory arrest, so perform a BLS survey:. In ACLS, the term airway is used to refer both to the pathway between the lungs and the outside world and victim in the devices that help keep that airway open. As if the victim may have experienced head or neck trauma, airway management should include a jaw thrust, which leaves the head and neck unmoved, but which opens up the airway. A nasopharyngeal airway, which extends from the nose to the pharynx, can be used in both conscious and unconscious patients. An oropharyngeal airway can only be used in unconscious patients because it may stimulate the gag reflex. Advanced airways such as endotracheal tubes ET tubes and laryngeal mask airways LMAs usually require specialized training, but are useful in-hospital resuscitations especially LMAs. Many different disease processes and traumatic events can cause cardiac arrest, but in an emergency, it is important to be able to rapidly consider and eliminate or treat the most typical causes of cardiac arrest. To facilitate remembering the main, reversible causes of cardiac arrest, they can be organized as the Hs and the Ts. Atrial fibrillation is the most common arrhythmia. It is diagnosed by electrocardiogram, specifically the RR intervals follow no repetitive pattern. Some leads may show P waves while most leads do not. Atrial contraction rates may exceed bpm. The ventricular rate often range is between to bpm. Atrial flutter is a cardiac arrhythmia that generates rapid, regular atrial depolarizations at a rate of about bpm. This often translates to a regular ventricular rate of bpm, but may be far less if there is a or conduction. By electrocardiogram, or atrial flutter is recognized by a sawtooth pattern sometimes called F waves. Narrow QRS complex tachycardias include several different tachyarrhythmias. One of the more common narrow complex tachycardias is supraventricular tachycardia, shown below. Wide complex tachycardias are difficult to distinguish from ventricular tachycardia. Ventricular tachycardia leading to cardiac arrest should be treated using the ventricular tachycardia algorithm. A wide complex tachycardia in a conscious person should be treated using the tachycardia algorithm. There are four main types of atrioventricular block: first degree, second degree type I, second degree type II, and third degree heart block. Second degree heart block Mobitz type I is also known as the Wenckebach phenomenon. Atrioventricular blocks may be acute or chronic. Chronic heart block may be treated with pacemaker devices. From the perspective of ACLS assessment and intervention, heart block is important because it can cause hemodynamic instability and can evolve into cardiac arrest. In ACLS, heart block is often treated as a bradyarrhythmia. The PR interval is a consistent size, but longer or larger than it should be in first degree heart block. Complete dissociation between P waves and the QRS complex. No atrial impulses reach the ventricle. The results of the ECG will be the primary guidance for how the patient with possible cardiac chest pain is managed. The ECG diagnosis of acute coronary syndrome can be complex. In people who are candidates for fibrinolytics, the goal is to ad mister the agent within 3 hours of the onset of symptoms. ACLS in the hospital will be performed by several providers. These individuals must provide coordinated, organized care. Providers must organize themselves rapidly and efficiently. Resuscitation demands mutual respect, knowledge sharing, and constructive criticism, after the code. When performing a resuscitation, the Team Leader and Team Members should assort themselves around the patient so they can be maximally effective and have sufficient room to perform their role. Advanced Cardiac Life Support, or ACLS, is a system of algorithms and best practice recommendations intended to provide the best outcome for patients in cardiopulmonary crisis. ACLS protocols are based on basic and clinical research, patient case studies, clinical studies, and reflect the consensus opinion of experts in the field. Once you become certified in ACLS, the certification is valid for two years. However, we encourage you to regularly login back in to your account to check for updates on resuscitation science advances. As we learn more about resuscitation science and medicine, physicians and researchers realize what works best and what works fastest in a critical, life-saving situation. Therefore, it is necessary to periodically update life-support techniques and algorithms. If you have previously certified in advanced cardiovascular life support, then you will probably be most interested in what has changed since the latest update in The table below also includes changes proposed since the last AHA manual was published. These changes will likely appear in future editions of the provider manual. The Chain of Survival is a sequence of steps or links that, when followed to its completion, increases the likelihood that a victim of a life-threatening event will survive. The adult and pediatricchains of survival are slightly different. The person who is providing BLS is only responsible for the early links, that is, making sure the person is cared for by emergency personnel. The emphasis on early care is to reinforce that time is a critical factor in life supportcare. The standards include the concept of out of hospital care versus in-hospital care. In fact, it is assumed that all people who are pursuing ACLS will be competent in the techniques of BLS—so much so that it is considered a prerequisite to ACLS The first step in any resuscitation is to make sure the rescuers you! Assuming you and the victim are in a safe location, the next step is to assess whether the patient is responsiv If patient is not responsive, move to BLS survey If patient is responsive, move to ACLS survey. Shake and Shout! Check for effective breathing for 5 to 10 seconds. In the community, call and send for an AED 3. Circulation Check the carotid pulse for no more than 10 seconds. If no pulse, begin high quality CPR. Defibrillation If there is a shockable rhythm, pulseless ventricular tachycardia or ventricular fibrillation, provide a shock. If you are alone and witness a victim suddenly collapse: Assume cardiac arrest with a shockable rhythm. If you are alone and find an unresponsive adult: Tailor response to the prospective cause of injury. Check to see if the victim is responsive. Shake and shout! Is the victim breathing effectively? Does the victim have a pulse in the carotid artery? If you witnessed the victim suddenly collapse, assume cardiac arrest with a shockable rhythm. Follow directions on the AED. After providing a shock, immediately resume CPR. Keep going until EMS arrives or the victim regains circulation. The other provider s stays with the victim. Provide High Quality CPR includes Fast and deep compressions, compressions per minute Two inches deep, complete rebound If you can provide breaths, 2 breaths for 30 comps If you cannot provide breaths, just give chest comps The provider who retrieved the AED applies the AED and follows directions given by the device. Check for a pulse and cardiac rhythm every two minutes. If a shock is indicated, clear everyone and administer a shock. After providing a shock, immediately resume Team CPR. In Team CPR, the provider giving chest compressions changes every 2 minutes Keep going until EMS arrives or the victim regains spontaneous circulation. Cardiac Arrest Cardiac arrest is the sudden sensation cessation of blood flow to the tissues in brain the results from a heart that is not pumping effectively. Ventricular fibrillation is recognized by a disordered waveform, appearing as rapid peaks and valleys as shown in this ECG rhythm strip: Ventricular tachycardia may provide waveform similar to any other tachycardia; however, the biggest difference in cardiac arrest is that the patient will not have a pulse and, consequently, will be unconscious and unresponsive. Ventricular Fibrillation and Pulseless Ventricular Tachycardia Algorithm Once you have determined that a patient has a shockable rhythm, immediately provide an unsynchronized shock. If you are using biphasic energy, use recommended settings on the device. If you do not know what that setting is, use the highest available setting, to J. If you are using a monophasic energy source, administer J. Resume CPR immediately after a shock. Minimize interruptions of chest compressions. Provide 2 rescue breaths for each 30 compressions. Lidocaine may replace amiodarone when amiodarone is not available. First dose: Pulseless Electrical Activity and Asystole Pulseless electrical activity or PEA is a cardiac rhythm that does not create a palpable pulse is even though it should. After 2 min. Remember, chest compressions are a means of artificial circulation, which should deliver the epinephrine to the heart. Without chest compressions, epinephrine is not likely to be effective. Chest compressions should be continued while epinephrine is administered. Rhythm checks every 2 min. Respiratory Arrest While cardiac arrest is more common in adults than respiratory arrest, there are times when patients will have a pulse but are not breathing or not breathing effectively e. Airway Management In ACLS, the term airway is used to refer both to the pathway between the lungs and the outside world and victim in the devices that help keep that airway open. Choose the device that extends from the corner of the mouth to the earlobe Clear the mouth or blood or secretions with suction, if possible. Insert the device so that the point is toward the roof of the mouth or parallel to the teeth Do not press the tongue back into the throat Once the device is almost fully inserted, turn it so that the tongue is cupped by the interior curve of the device. Choose the device that extends from the tip of the nose to the earlobe. Use the largest diameter device that will fit. Lubricate the airway with a water-soluble lubricant Insert the device slowly, straight into the face not toward the brain! It should feel snug; do not force the device. If it feels stuck, remove it and try the other nostril. Tips on Suctioning Adequate suctioning usually requires negative pressures of — 80 to mmHg. Wallmounted suction can deliver this, but portable devices may not. When suctioning the oropharynx, do not insert the catheter too deeply. Extend the catheter to the maximum safe depth and suction as you withdraw. Therefore sterile technique should be used. Each suction attempt should be for no longer than 10 seconds. Monitor vital signs during suctioning and stop suctioning immediately if the patient experiences hypoxemia O2 sats 94 has a new arrhythmia, or becomes cyanotic. You can detect spontaneous circulation by feeling a palpable pulse at the carotid artery. The patient is at risk for reentering cardiac arrest at any time. Therefore, the patient should be moved to an intensive care unit. If so, it should be placed. If not, there may be neurological compromise. Does the person have signs of myocardial infarction by ECG? Move to ACS algorithm. Rapid Differential Diagnosis of Cardiac Arrest Many different disease processes and traumatic events can cause cardiac arrest, but in an emergency, it is important to be able to rapidly consider and eliminate or treat the most typical causes of cardiac arrest. Bradycardia Bradycardia Algorithm. Bradycardia is any heart rate less than 60 bpm. In practice, however, bradycardia is only a concern if it is unusual or abnormal for the patient or causing symptoms. New cases of bradycardia should be evaluated, but most will not require specific treatment. Evaluation of bradycardia includes cardiac and blood oxygen monitoring and a 12 lead ECG if available. Unstable bradycardia i. Unstable bradycardia is first treated with intravenous atropine at a dose of 0. Additional doses can be given every 3 to 5 min. Pulseless bradycardia is considered PEA. If atropine is unsuccessful in treating symptomatic, unstable bradycardia, consider transcutaneous pacing, dopamine or norepinephrine infusion, or transvenous pacing. An intensive or cardiologist may need to be consulted for these interventions and the patient may need to be moved to the intensive care unit. Tachycardia Atrial fibrillation is the most common arrhythmia. Tachycardia Algorithm Tachycardia is any heart rate greater than bpm. In practice, however, tachycardia is usually only a concern if it is New cases of tachycardia should be evaluated with cardiac and blood oxygen monitoring and a 12 lead ECG if available. Consider beta-blocker or calcium channel blocker. Wide QRS tachycardia may require antiarrhythmic drugs. Acute Coronary Syndrome Acute coronary syndrome or ACS is a spectrum of signs and symptoms ranging from angina to myocardial infarction. Cardiac chest pain any new chest discomfort should be evaluated promptly. This includes high degree of suspicion by individuals in the community, prompt rapid action by EMS personnel, assessment in the emergency department, and definitive treatment. People with symptoms of cardiac ischemia should be given oxygen, aspirin if not allergic , nitroglycerin, and possibly morphine. The patient should be assessed in the ED within 10 min. Draw and send labs e. Give statin if not contraindicated. Obtain chest Xray. Unstable angina is new onset cardiac chest pain without ECG changes, angina that occurs at rest and lasts for more than 20 min. People with unstable angina will not have elevated cardiac markers. His may include anti-platelet drug s , anticoagulation, a beta-blocker, an ACE inhibitor, a statin, and either PCI or a fibrinolytic. Patients with unstable angina are admitted and monitored for evidence of MI. While in transit, the EMS team should try to determine the time at which the patient was last normal, which is considered the onset of symptoms. EMS administer oxygen via nasal cannula or face mask, obtain a fingerstick glucose measurement, and alert the stroke center. Within 10 min. They should obtain vital signs and IV access, draw and send labs e. Within 25 min. Within 45 min. Within 60 min. If the patient with an ischemic stroke is not a candidate for fibrinolytic, administer aspirin if the patient is not allergic. If the patient is having a hemorrhagic stroke, neurosurgery should be consulted. Time is Brain! Stroke Time Goals for Evaluation and Therapy In people who are candidates for fibrinolytics, the goal is to ad mister the agent within 3 hours of the onset of symptoms. Fibrinolytic Checklist for 3 to 4. Stroke Time Goals for Evaluation and Therapy…………………………………………………. Overview of Advanced Cardiovascular Life Support Advanced Cardiac Life Support, or ACLS, is a system of algorithms and best practice recommendations intended to provide the best outcome for patients in cardiopulmonary crisis. Updates to ACLS in As we learn more about resuscitation science and medicine, physicians and researchers realize what works best and what works fastest in a critical, life-saving situation. If a feedback device is in place, depth can be adjusted to maximum of 2. In the community, call and send for an AED. Check the carotid pulse for no more than 10 seconds. If there is a shockable rhythm, pulseless ventricular tachycardia or ventricular fibrillation, provide a shock. Select an airway that is the correct size for the patient Too big and it will damage the throat Too small and it will press the tongue into the airway. Choose the device that extends from the corner of the mouth to the earlobe. Clear the mouth or blood or secretions with suction, if possible. Insert the device so that the point is toward the roof of the mouth or parallel to the teeth Do not press the tongue back into the throat. Once the device is almost fully inserted, turn it so that the tongue is cupped by the interior curve of the device. Select an airway that is the correct size for the patient. Lubricate the airway with a water-soluble lubricant. Insert the device slowly, straight into the face not toward the brain! Adequate suctioning usually requires negative pressures of — 80 to mmHg. Rapid heart rate, narrow QRS complex,. Fluid resuscitation. Decreased heart rate. Airway management, oxygen. Hydrogen Ion Acidosis. Fingerstick glucose testing. IV Dextrose. Flat T waves, pathological U wave. IV Magnesium. Peaked T waves, wide QRS complex. History of cold exposure. Tension Pneumothorax. Slow heart rate, narrow QRS complex, acute dyspnea, history of chest trauma. Thoracotomy, needle decompression. Tamponade Cardiac. Rapid heart rate and narrow QRS complex. Variable, prolonged QT interval, neuro deficits. Thrombosis pulmonary. Rapid heart rate, narrow QRS complex. Fibrinolytics, embolectomy. Thrombosis coronary. Fibrinolytics, Percutaneous intervention. Second or third degree heart block; tachycardia due to poisoning. Pulseless ventricular tachycardia Ventricular fibrillation. First dose: mg bolus Second dose: mg Max: 2. Second or third degree heart block; hypotension may result with rapid infusion or multiple doses. Symptomatic bradycardia No longer recommended for PEA or asystole. Cardiac arrest Anaphylaxis Symptomatic bradycardia instead of dopamine. Cocaine-induced ventricular tachycardia May increase oxygen demand. Symptomatic bradycardia if atropine fails Pressor for hypotension. Wide complex bradycardia Should not be used in cases of acute myocardial infarction Observe for signs of toxicity. Wide complex tachycardia with pulse: 0. Rapid bolus may cause hypotension and bradycardia; Can also be used to reverse digitalis poisoning. Deliver through central line Peripheral IV administration can cause tissue necrosis. Inclusion Criteria. Exclusion Criteria. Ischemic stroke with neurological deficit. Onset of symptoms 3 hours. History of brain. Age 18 years old. Brain tumor, arteriovenous malformation, or aneurysm. Brain or spine surgery in last. Arterial line or blood draw in last week. Possible subarachnoid hemorrhage. Serum glucose. Currently bleeding internally or bleeding diathesis. Elevated aPTT if known. Currently taking anticoagulants. Hemorrhage on CT. Relative Exclusion Criteria. Minor neurologic deficits. Rapidly improving neurologic deficits. Heart attack in last 3 months. Seizure with stroke with postictal period. Meets all criteria for fibrinolytic use at 3 hours plus these criteria:. Ischemic stroke with neurological deficit Currently taking anticoagulants. Onset of symptoms 3 to 4. Age 18 to 79 years old. Previous ischemic stroke and diabetes. Usually stands at the foot of the bed. Stands in a position dictated by role. Competent in all ACLS duties. Competent in specific role at least. Directs Team Members in a professional, calm voice. Responds with eye contact and voice affirmation. Assigns roles. Listens for confirmation from Team Member. Informs Team Leader when task is complete. Ask for ideas from Team Members when needed. Openly share suggestions if it does not disrupt flow. Provides constructive feedback after code. Documents resuscitation in patient chart. Provides information for documentation as needed. Check for response by tap and shout Call for help and Activate the area emergency response system Obtain an AED Check breathing and pulse at same time If no pulse, begin chest compressions Defibrillate. Systematic Approach Primary Assessment name change. Airway Breathing Circulation Disability Exposure. Systematic Approach Secondary Assessment new. High Quality CPR. Compression rate at least per minute Compression depth of at least 2 inches in adults Allow complete chest recoil after compressions Compressions should not be interrupted for more than 10 seconds Excessive ventilation should be avoided Switch providers of compressions every 2 minutes. Compression rate of to per minute Compression depth of at least 2 inches in adults. Consider hypothermia treatment for 12 to 24 hours in comatose patients. Consider hypothermia treatment for at least 24 hours in comatose patients Not recommended to cool patients in out of hospital setting with cold IV fluids. If an advanced airway is in place, ventilate every 6 to 8 seconds. If an advanced airway is in place, ventilate every 6 seconds. ACLS Bradycardia. Consider hypothermia treatment for at least 24 hours in comatose patients.

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💾 ►►► DOWNLOAD FILE 🔥🔥🔥🔥🔥 Free ACLS Provider Manual. The perfect precourse assessment to help you pass your ACLS megacode. Review our AHA updated pdf at no charge today! ACLS Cheat Sheet. Basic BLS You see a man collapse at a grocery store. Shake and shout. Establish unresponsiveness. What is the first thing you do? View Notes - ACLS CHEAT SHEET from NU at ITT Technical Institute Springfield campus. Cardiac Arrest Algorithm Note the key change in BLS sequence: begin. Looking for a quick cheat-sheet that will help you obtain your ACLS certification? You may want to read this first. 9 When autocomplete results are available use up and down arrows to review and enter to select. Touch device users, explore by touch or with swipe gestures. Log in. Sign up. Acls Cheat Sheet. Collection by Tina Poudrette. Similar ideas popular now. Acute Nursing. Cardiac Nursing. Nursing Tips. Nursing Notes. Acls Algorithm. Paramedic Student. Advanced Cardiac Life Support. Acute Coronary Syndrome. Critical Care Nursing. Acute Coronary Syndrome algorithm. Nursing Cheat. Nursing School Tips. Nursing Study. Nursing Schools. Lpn Schools. Nursing Degree. Tori Hobson. Nursing Career. Nursing Programs. Cardiac Rn. Lpn Programs. ACLS page, where have you been during all my codes? Nursing School Studying. Funny Nursing. Med Surg Nursing. Nursing School. Acls Study. Paramedic School. Nursing School Notes. Nursing Mnemonics. Nursing Assessment. Pediatric Nursing. Pals Algorithm. Nursing Math. Cardiology Nursing. Nicu Nursing.

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💾 ►►► DOWNLOAD FILE 🔥🔥🔥🔥🔥 Free ACLS Provider Manual. The perfect precourse assessment to help you pass your ACLS megacode. Review our AHA updated pdf at no charge today! ACLS Cheat Sheet. Basic BLS You see a man collapse at a grocery store. Shake and shout. Establish unresponsiveness. What is the first thing you do? View Notes - ACLS CHEAT SHEET from NU at ITT Technical Institute Springfield campus. Cardiac Arrest Algorithm Note the key change in BLS sequence: begin. Looking for a quick cheat-sheet that will help you obtain your ACLS certification? You may want to read this first. 9 When autocomplete results are available use up and down arrows to review and enter to select. Touch device users, explore by touch or with swipe gestures. Log in. Sign up. Acls Cheat Sheet. Collection by Tina Poudrette. Similar ideas popular now. Acute Nursing. Cardiac Nursing. Nursing Tips. Nursing Notes. Acls Algorithm. Paramedic Student. Advanced Cardiac Life Support. Acute Coronary Syndrome. Critical Care Nursing. Acute Coronary Syndrome algorithm. Nursing Cheat. Nursing School Tips. Nursing Study. Nursing Schools. Lpn Schools. Nursing Degree. Tori Hobson. Nursing Career. Nursing Programs. Cardiac Rn. Lpn Programs. ACLS page, where have you been during all my codes? Nursing School Studying. Funny Nursing. Med Surg Nursing. Nursing School. Acls Study. Paramedic School. Nursing School Notes. Nursing Mnemonics. Nursing Assessment. Pediatric Nursing. Pals Algorithm. Nursing Math. Cardiology Nursing. Nicu Nursing.

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💾 ►►► DOWNLOAD FILE 🔥🔥🔥🔥🔥 Free ACLS Provider Manual. The perfect precourse assessment to help you pass your ACLS megacode. Review our AHA updated pdf at no charge today! ACLS Cheat Sheet. Basic BLS You see a man collapse at a grocery store. Shake and shout. Establish unresponsiveness. What is the first thing you do? View Notes - ACLS CHEAT SHEET from NU at ITT Technical Institute Springfield campus. Cardiac Arrest Algorithm Note the key change in BLS sequence: begin. Looking for a quick cheat-sheet that will help you obtain your ACLS certification? You may want to read this first. 9 When autocomplete results are available use up and down arrows to review and enter to select. Touch device users, explore by touch or with swipe gestures. Log in. Sign up. Acls Cheat Sheet. Collection by Tina Poudrette. Similar ideas popular now. Acute Nursing. Cardiac Nursing. Nursing Tips. Nursing Notes. Acls Algorithm. Paramedic Student. Advanced Cardiac Life Support. Acute Coronary Syndrome. Critical Care Nursing. Acute Coronary Syndrome algorithm. Nursing Cheat. Nursing School Tips. Nursing Study. Nursing Schools. Lpn Schools. Nursing Degree. Tori Hobson. Nursing Career. Nursing Programs. Cardiac Rn. Lpn Programs. ACLS page, where have you been during all my codes? Nursing School Studying. Funny Nursing. Med Surg Nursing. Nursing School. Acls Study. Paramedic School. Nursing School Notes. Nursing Mnemonics. Nursing Assessment. Pediatric Nursing. Pals Algorithm. Nursing Math. Cardiology Nursing. Nicu Nursing.