Commit a64582a1 authored by Rachel Clipp's avatar Rachel Clipp
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Fixes to showcase matrices and adding a reference to the source.bib.

parent 9e494cfa
......@@ -524,12 +524,8 @@ A 40 year old female with a history of asthma is having an asthma attack. She ar
| Segment | Notes | Action Occurrence Time (s) | Sample Scenario Time (s) | Heart Rate (beats/min) | Heart Stroke Volume (mL) | Mean Arterial Pressure (mmHg) | Systolic Pressure (mmHg) | Cardiac Output (mL/min) | Respiration Rate (breaths/min) | Oxygen Saturation (fraction) | End Tidal CO2 (fraction) | PaO2 (mmHg) | PaCO2 (mmHg) | pH (mmHg) |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| "Begin Asthma Attack
(Severity 0.7)" | 10 minutes of asthma attack | 60 | 660 |<span class="success"> Increase @cite adams2012patient </span>|<span class="success"> "Decrease @cite bergeronSME
Decrease is expected with increased heart rate" </span>|<span class="success"> Increase @cite adams2012patient </span>|<span class="warning"> Increase @cite adams2012patient </span>|<span class="warning"> Increase @cite adams2012patient </span>|<span class="success"> Increase @cite adams2012patient @cite Raimondi2013acid </span>|<span class="success"> Decrease @cite adams2012patient </span>|<span class="success"> Decreased peak @cite Nowak1983arterial </span>|<span class="success"> 71.5 ± 12 @cite Nowak1983arterial </span>|<span class="success"> 35.8 ± 6.9 @cite Nowak1983arterial </span>|<span class="danger"> Increase @cite Mountain1990acid @cite Raimondi2013acid </span>|
| "Administer Albuterol
(Albuterol inhaler used correctly, 90.0 ug dose, nozzle loss fraction 0.04)" | Drug Onset in < | 660 | 960 |<span class="danger"> Decrease @cite adams2012patient </span>|<span class="warning"> No Change @cite bergeronSME </span>|<span class="warning"> Decrease @cite adams2012patient </span>|<span class="success"> Decrease @cite adams2012patient </span>|<span class="warning"> No Change @cite bergeronSME </span>|<span class="success"> Decrease @cite adams2012patient @cite Raimondi2013acid </span>|<span class="success"> Increase back to baseline @cite adams2012patient </span>|<span class="warning"> Back to baseline @cite metoyer2016SME </span>|<span class="success"> 78.0 ± 12.7 @cite Nowak1983arterial </span>|<span class="success"> 32.3 ± 4.6 @cite Nowak1983arterial </span>|<span class="success"> Back to baseline @cite Mountain1990acid @cite Raimondi2013acid </span>|
| Begin Asthma Attack (Severity 0.7) | 10 minutes of asthma attack | 60 | 660 |<span class="success"> Increase @cite adams2012patient </span>|<span class="success"> Decrease; @cite bergeronSME Decrease is expected with increased heart rate </span>|<span class="success"> Increase @cite adams2012patient </span>|<span class="warning"> Increase @cite adams2012patient </span>|<span class="warning"> Increase @cite adams2012patient </span>|<span class="success"> Increase @cite adams2012patient @cite Raimondi2013acid </span>|<span class="success"> Decrease @cite adams2012patient </span>|<span class="success"> Decreased peak @cite Nowak1983arterial </span>|<span class="success"> 71.5 ± 12 @cite Nowak1983arterial </span>|<span class="success"> 35.8 ± 6.9 @cite Nowak1983arterial </span>|<span class="danger"> Increase @cite Mountain1990acid @cite Raimondi2013acid </span>|
| Administer Albuterol (Albuterol inhaler used correctly, 90.0 ug dose, nozzle loss fraction 0.04) | Drug Onset in < 5 min | 660 | 960 |<span class="danger"> Decrease @cite adams2012patient </span>|<span class="warning"> No Change @cite bergeronSME </span>|<span class="warning"> Decrease @cite adams2012patient </span>|<span class="success"> Decrease @cite adams2012patient </span>|<span class="warning"> No Change @cite bergeronSME </span>|<span class="success"> Decrease @cite adams2012patient @cite Raimondi2013acid </span>|<span class="success"> Increase back to baseline @cite adams2012patient </span>|<span class="warning"> Back to baseline @cite metoyer2016SME </span>|<span class="success"> 78.0 ± 12.7 @cite Nowak1983arterial </span>|<span class="success"> 32.3 ± 4.6 @cite Nowak1983arterial </span>|<span class="success"> Back to baseline @cite Mountain1990acid @cite Raimondi2013acid </span>|
<center>
<table border="0">
......@@ -567,25 +563,12 @@ A 25 year old male is hiking towards a rock formation to begin a recreational fr
| Segment | Notes | Action Occurrence Time (s) | Sample Scenario Time (s) | Heart Rate (beats/min) | Heart Stroke Volume (mL) | Mean Arterial Pressure (mmHg) | Systolic Arterial Pressure (mmHg) | Diastolic Arterial Pressure (mmHg) | Oxygen Saturation (mmHg) | Core Temperate (C) | Skin Temperature (C) | Sweat Rate (mL/min) |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| "Hike
(Hiking at exercise intensity 0.1)" | Exercising heavily for 20 minutes in bulky clothing at an ambient temperature of 16 to 20C | 60 | 1260 </span>|<span class="success"> > 80 @cite metoyer2016SME </span>|<span class="danger"> Increase @cite rmetoyer2016SME </span>|<span class="danger"> Increase @cite Pickering1982blood </span>|<span class="danger"> "Increase
< 34.4% above resting (168) Christie1987clinical
< 28.8% above resting (161) [7]" </span>|<span class="warning"> No significant change (86) @cite Christie1987clinical, (80) @cite Pickering1982blood </span>|<span class="success"> Decreasing @cite Brutsaert2000higher </span>|<span class="success"> Increase @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat </span>|
| "Rest
" | | 1260 | 1320 </span>|<span class="danger"> Decrease @cite metoyer2016SME </span>|<span class="success"> Some recovery@cite rmetoyer2016SME </span>|<span class="danger"> Some recovery @cite rmetoyer2016SME </span>|<span class="success"> Some recovery @cite rmetoyer2016SME </span>|<span class="danger"> Some recovery @cite rmetoyer2016SME </span>|<span class="danger"> Some recovery @cite rmetoyer2016SME </span>|<span class="success"> No change @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> No change @cite rmetoyer2016SME </span>|
| "Climb
(Climbing at exercise intensity 0.45)" | Heat stroke is evident after 10 more minutes of exercise at a rising temperature | 1320 | 1920 </span>|<span class="success"> 120 - 180 @cite Pickering1982blood |<span class="danger"> "121.9 @cite ODonnell1977hemodynamic
101 - 121 @cite Christie1987clinical" </span>|<span class="success"> Increasing @cite Pickering1982blood then decreasing with heat stroke @cite ODonnell1977hemodynamic </span>|<span class="danger"> "Increase toward max exertion values
34.4% above resting (168) @cite Christie1987clinical
28.8% above resting (161) @cite Pickering1982blood" </span>|<span class="warning"> No significant change (86) @cite Christie1987clinical, (80) @cite Pickering1982blood </span>|<span class="danger"> Decreasing @cite Brutsaert2000higher </span>|<span class="warning"> >40 degC @cite Bouchama2002heat </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> "
For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat" </span>|
| "Bystander Actions
(Move to cooler environment, remove clothing, apply cold pack, and start IV fluids)" | The patient's clothing is removed. IV saline is administered and active cooling begun. | 1920 | 2010 </span>|<span class="success"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="danger"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="danger"> Decrease @cite ODonnell1977hemodynamic </span>|<span class="danger"> < 120 @cite Bouchama2002heat </span>|<span class="warning"> "No significant change (86) @cite Christie1987clinical, (80) @cite Pickering1982blood
Possible slight decrease @cite Bouchama2002heat, @cite Benzinger1969heat" </span>|<span class="danger"> Increase @cite rmetoyer2016SME </span>|<span class="warning"> Decreasing with treatment @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> "
For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat" </span>|
| Transportation | The patient is transported to a medical treatment facility. | 2010 | 2610 </span>|<span class="success"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="danger"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="success"> Decrease @cite ODonnell1977hemodynamic </span>|<span class="danger"> < 120 @cite Bouchama2002heat </span>|<span class="warning"> "No significant change (86) @cite Christie1987clinical, (80) @cite Pickering1982blood
Possible slight decrease @cite Bouchama2002heat, @cite Benzinger1969heat" </span>|<span class="success"> Increase @cite rmetoyer2016SME </span>|<span class="success"> Decreasing with treatment @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success">
For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat </span>|
| Hike (Hiking at exercise intensity 0.1) | Exercising heavily for 20 minutes in bulky clothing at an ambient temperature of 16 to 20C | 60 | 1260 </span>|<span class="success"> > 80 @cite metoyer2016SME </span>|<span class="danger"> Increase @cite rmetoyer2016SME </span>|<span class="danger"> Increase @cite Pickering1982blood </span>|<span class="danger"> Increase< 34.4% above resting (168); @cite Christie1987clinical < 28.8% above resting (161) @cite Pickering1982blood </span>|<span class="warning"> No significant change (86) @cite Christie1987clinical, (80) @cite Pickering1982blood </span>|<span class="success"> Decreasing @cite Brutsaert2000higher </span>|<span class="success"> Increase @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat </span>|
| Rest | | 1260 | 1320 </span>|<span class="danger"> Decrease @cite metoyer2016SME </span>|<span class="success"> Some recovery@cite rmetoyer2016SME </span>|<span class="danger"> Some recovery @cite rmetoyer2016SME </span>|<span class="success"> Some recovery @cite rmetoyer2016SME </span>|<span class="danger"> Some recovery @cite rmetoyer2016SME </span>|<span class="danger"> Some recovery @cite rmetoyer2016SME </span>|<span class="success"> No change @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> No change @cite rmetoyer2016SME </span>|
| Climb (Climbing at exercise intensity 0.45) | Heat stroke is evident after 10 more minutes of exercise at a rising temperature | 1320 | 1920 </span>|<span class="success"> 120 - 180 @cite Pickering1982blood |<span class="danger"> 121.9; @cite ODonnell1977hemodynamic 101 - 121 @cite Christie1987clinical </span>|<span class="success"> Increasing @cite Pickering1982blood then decreasing with heat stroke @cite ODonnell1977hemodynamic </span>|<span class="danger"> Increase toward max exertion values 34.4% above resting (168); @cite Christie1987clinical 28.8% above resting (161) @cite Pickering1982blood </span>|<span class="warning"> No significant change (86); @cite Christie1987clinical (80) @cite Pickering1982blood </span>|<span class="danger"> Decreasing @cite Brutsaert2000higher </span>|<span class="warning"> >40 degC @cite Bouchama2002heat </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat </span>|
| Bystander Actions (Move to cooler environment, remove clothing, apply cold pack, and start IV fluids) | The patient's clothing is removed. IV saline is administered and active cooling begun. | 1920 | 2010 </span>|<span class="success"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="danger"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="danger"> Decrease @cite ODonnell1977hemodynamic </span>|<span class="danger"> < 120 @cite Bouchama2002heat </span>|<span class="warning"> No significant change (86); @cite Christie1987clinical (80); @cite Pickering1982blood Possible slight decrease @cite Bouchama2002heat, @cite Benzinger1969heat </span>|<span class="danger"> Increase @cite rmetoyer2016SME </span>|<span class="warning"> Decreasing with treatment @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat </span>|
| Transportation | The patient is transported to a medical treatment facility. | 2010 | 2610 </span>|<span class="success"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="danger"> Decreasing (to baseline over 12 hours) @cite ODonnell1977hemodynamic </span>|<span class="success"> Decrease @cite ODonnell1977hemodynamic </span>|<span class="danger"> < 120 @cite Bouchama2002heat </span>|<span class="warning"> No significant change (86); @cite Christie1987clinical (80); @cite Pickering1982blood Possible slight decrease @cite Bouchama2002heat @cite Benzinger1969heat </span>|<span class="success"> Increase @cite rmetoyer2016SME </span>|<span class="success"> Decreasing with treatment @cite rmetoyer2016SME </span>|<span class="success"> < Core @cite Benzinger1969heat </span>|<span class="success"> For direct calc = 2.3045e-5*(core-37.1) NOTE this may be low @cite Benzinger1969heat </span>|
<center>
<table border="0">
......@@ -612,23 +595,10 @@ A 17 year old female leaves her Alaskan home in the mid-winter to retrieve a new
*Table 11. The validation results for the Environmental Exposure Showcase scenario.*
</center>
| Segment | Notes | Action Occurrence Time (s) | Sample Scenario Time (s) | Heart Rate (beats/min) | "Mean Arterial Pressure
(mmHg)" | "Systolic Arterial Pressure
(mmHg)" | "Respiration Rate
(Breaths/min)" | "Core Temperature
(C)" | "Oxygen Consumption
(mL/min)" | "Carbon Dioxide Production
(mL/min)" | "Metabolic Rate
(W)" |
| Segment | Notes | Action Occurrence Time (s) | Sample Scenario Time (s) | Heart Rate (beats/min) | Mean Arterial Pressure (mmHg) | Systolic Arterial Pressure (mmHg) | Respiration Rate (Breaths/min) | Core Temperature (C) | Oxygen Consumption (mL/min) | Carbon Dioxide Production (mL/min) | Metabolic Rate (W) |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| "Cold Exposure
(Environment change to Alaska outdoors for 10 minutes)" | Patient exposed to very low temeratures for 10 minutes | 60 | 2460 </span>|<span class="warning"> Increase initially then decrease @cite mallet2002pathophysiology </span>|<span class="success"> Small rise then gradual fall below baseline @cite reuler1978hypothermia </span>|<span class="success"> Small rise then gradual fall below baseline @cite reuler1978hypothermia </span>|<span class="success"> Increasing @cite mallet2002pathophysiology </span>|<span class="warning"> < 35 @cite reuler1978hypothermia </span>|<span class="success"> "Decrease in hypothermia @cite reuler1978hypothermia
1130 - 1320 with light activity [1]" </span>|<span class="success"> Decrease in hypothermia @cite reuler1978hypothermia </span>|<span class="warning"> approximately 350% increase over BMR (304.38 W for this patient) @cite williams2005rewarming </span>|
| "Active Heating and Additional Clothing
(Environment change to indoors and active heating applied to skin)" | Patient indoors and actively heated for 10 minutes | 2460 | 3090 </span>|<span class="warning"> Back toward baseline @cite rmetoyer2016SME </span>|<span class="success"> "Increasing back to baseline @cite reuler1978hypothermia
Back to baseline @cite rmetoyer2016SME" </span>|<span class="success"> Increasing back to baseline reuler1978hypothermia </span>|<span class="success"> Decreasing to baseline @cite mallet2002pathophysiology </span>|<span class="success"> > 35 @cite reuler1978hypothermia </span>|<span class="success"> Increase @cite reuler1978hypothermia </span>|<span class="success"> Increase @cite reuler1978hypothermia </span>|<span class="success"> Back toward baseline @cite rmetoyer2016SME </span>|
| Cold Exposure (Environment change to Alaska outdoors for 10 minutes) | Patient exposed to very low temeratures for 10 minutes | 60 | 2460 </span>|<span class="warning"> Increase initially then decrease @cite mallet2002pathophysiology </span>|<span class="success"> Small rise then gradual fall below baseline @cite reuler1978hypothermia </span>|<span class="success"> Small rise then gradual fall below baseline @cite reuler1978hypothermia </span>|<span class="success"> Increasing @cite mallet2002pathophysiology </span>|<span class="warning"> < 35 @cite reuler1978hypothermia </span>|<span class="success"> Decrease in hypothermia; @cite reuler1978hypothermia 1130 - 1320 with light activity @cite herman2007physics </span>|<span class="success"> Decrease in hypothermia @cite reuler1978hypothermia </span>|<span class="warning"> Approximately 350% increase over BMR (304.38 W for this patient) @cite williams2005rewarming </span>|
| Active Heating and Additional Clothing (Environment change to indoors and active heating applied to skin) | Patient indoors and actively heated for 10 minutes | 2460 | 3090 </span>|<span class="warning"> Back toward baseline @cite rmetoyer2016SME </span>|<span class="success"> Increasing back to baseline; @cite reuler1978hypothermia Back to baseline @cite rmetoyer2016SME </span>|<span class="success"> Increasing back to baseline reuler1978hypothermia </span>|<span class="success"> Decreasing to baseline @cite mallet2002pathophysiology </span>|<span class="success"> > 35 @cite reuler1978hypothermia </span>|<span class="success"> Increase @cite reuler1978hypothermia </span>|<span class="success"> Increase @cite reuler1978hypothermia </span>|<span class="success"> Back toward baseline @cite rmetoyer2016SME </span>|
<center>
......
Methodology Sources and References
@book{herman2007physics,
title ={Physics of the human body},
author ={Herman, Irving},
pages ={347},
year ={2007},
publisher ={Springer Science \& Business Media}
}
@book{army200968w,
title ={68W advanced field craft: combat medic skills},
author ={Army, US and others},
......
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