Lymphocytes and Immunity

lymphocyte-eletron-microscopeA lymphocyte is a type of white blood cell in the vertebrate immune system.There are two broad categories of lymphocytes, namely the large granular lymphocytes and the small lymphocytes depending on their appearance under microscope.

Most, but not all large granular lymphocytes are more commonly known as the natural killer cells (NK cells). The small lymphocytes are the T cells and B cells. Lymphocytes play an important and integral role in the body’s defenses

NK cells are a part of innate immune system and play a major role in defending the host from both tumors and virally infected cells. NK cells distinguish infected cells and tumours from normal and uninfected cells by recognizing alterations in levels of a surface molecule called MHC (major histocompatibility complex) class I. [Read more...]

Scoop and Run Versus Field Stabilization

It is not possible to conclude whish system of prehospital care is better than the other. The answer may vary depending upon geopolitical conditions, available medical facilities and expertise. While scoop and run may be a good option in densely populated areas with specialized care being not very far, in filed stabilization or popularly known as stay and play is better an infrastructure of a more uniformly and less densely populated.

The kind of trauma also influences the decision. It may be the best decision to transfer the patient to the hospital in cases of penetrating trauma, blunt trauma may warrant stabilization of thepatient before transfer to the center. [Read more...]

Active and Passive Immunity

6. Acquired immune (adaptive/specific) responses can be active or passive. Describe and differentiate the two.

Both are types of acquired immunity..

Active immunity is so named because the host plays an active role in responding to the foreign antigen. The best example of active immunity is immunization, whereby a vaccine containing a foreign antigen is administered to a nonimmune host, resulting in active production of specific antibody and lymphocyte-based memory.

Passive immunity refers to transfer of soluble factors (either antibodies or cells) from an immune individual to a nonimmune host. This process confers immunity passively, without the recipient needing prior exposure to the antigen. A good example of passive immunity is parenteral administration of immune serum globulin to travelers as preexposure prophylaxis against unusual infections.

Prehospital Management – Circulation

After airway and breathing comes circulation in resuscitation of trauma patient. circulatory management and support for hypovolemic trauma patients is probably the most controversial. The original ATLS guidelines recommended insertion of two large-bore cannulae and administration of sufficient IV fluid to restore circulating volume to a normovolemic state but  Controversy still exists over the quantity, type, and timing of IV fluid administration for hypotensive trauma patients.

Animal and clinical studies show that in an uncontrolled hemorrhage, aggressive fluid resuscitation increases blood pressure, and this increase in pressure simultaneously dilutes coagulation factors and dislodges blood clots, combining to accelerate the rate of blood loss. [Read more...]

Trauma Resuscitation Area

A  dedicated space for trauma resuscitation is recommended in thge trauma centers where a substantial load of trauma is dealt with on daily basis. The size of the area  largely depends on the volume and acuity of trauma managed .

The trauma resuscitation area should be adjacent but physically separate from the general casualty. Maintaining separate access and a dedicated area facilitates security and minimizes disruption to the main casualty while allowing the trauma team to focus on trauma resuscitation and care.

Natuarally, the access to any nonessential personnel should be limited. A convenient access to the radiology suite, operating room, and intensive care unit is ideal. If loads are higher,   access to plain radiography and computed tomography should be located within the trauma resuscitation area. [Read more...]

Levels of Trauma Centers

prehospital-careA trauma center is a hospital equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries. Trauma centers were established as the medical establishment realized that traumatic injuries often require complex and multi-disciplinary treatment, including surgery in order to give the victim the best possible chance for survival and recovery.

Trauma centers vary in their specific capabilities and are identified by “Level” designation: Level-I being the highest, to Level-IV is the lowest).

Higher levels of trauma centers will have trauma surgeons available. Lower levels of trauma centers may only be able to provide initial care and stabilization of a traumatic injury and arrange for transfer of the victim to a higher level of trauma care. [Read more...]

Overview of The Immune System

immunityThere are  two broad categories of immunity involved in host defense – natural or  innate and acquired. While natural immunity is more generalized, acquired immunity is more specific and adaptive. There are various levels of host defense that protect human body from invading attacks.

These are [Read more...]

Disaster Classification

There are many classification schemes for disasters that should be understood. The most useful of these is based on the level of resources needed to manage the property damage and casualties, which correlates closely with the overall magnitude of the event. This classification best reflects the essential characteristic of disasters. [Read more...]

What Is Bone?

Bone is a mineralized connective tissue.

It is comprised of two subtypes: cortical or compact bone and cancellous or trabecular bone.

Cortical bone comprises 80 percent of the skeleton and is increased in long bone shafts.

Cancellous bone is in contact with bone marrow cells and is enriched in the vertebral bodies, pelvis, and proximal ends of femora, all of which are subject to osteoporosis and fractures.

Bone is comprised mainly of type I collagen and contain three cells types:

Osteoclasts, which resorb mineralized bone

osteoblasts, which synthesize the proteins of the bone matrix

Osteocytes which are probably osteoblasts that have secreted bone matrix and become buried within it.

Osteocytes communicate with each other through a canalicular system.

The skeleton contain 99 percent of the total body calcium, 80-85 percent of the phosphorus, and 66 percent of the magnesium.