The Viking Society and Culture - 2981 Words

â€Å"We and our fathers have now lived in this fair land for nearly three hundred and fifty years and never before has such a terror been seen in Britain as we have now suffered at the hands of a pagan people. Such a voyage was not thought possible. The church of St. Cuthbert is spattered with the blood of the priests of God.† These are the words of Alcuin of York, an Anglo-Saxon scholar, describing the first recorded presence of Norsemen warriors and their attack on Lindisfarne, a holy monastic undefended island of the coast of England in 793 A.D. This attack by pagans from Scandinavia introduced a new kind of warrior to the known world and established a new chapter in history known as the Viking Age. From this moment and for the next†¦show more content†¦From the moment a Norsemen is born, one’s own death was already chosen by fate. Nothing could be done to alter this moment. But it was understood that a man had complete control over his decisions while aliv e, and his actions were only of his own doing. Therefore, one ought to make the best of every moment, fully charging at life’s challenges. Either the worst that could happen was death which was out of one’s control or the most desired outcome could take place which was increased honorable reputation and fame. An example of this is presented in Sverris Saga about King Sverrir of Norway and his words to his army. The king told a story about a farmer who accompanied his son to the warships and gave him counsel, telling him to be, â€Å"valiant and hardy in perils,† saying, â€Å"How would you act if you were engaged in battle and knew beforehand that you were destined to be killed?† the son answered, â€Å"Why then should I refrain from striking right and left?† The farmer said, â€Å"Now suppose someone could tell you for certain that you would not be killed?† The son answered, â€Å"Why then should I refrain from pushing forward to the utmo st?† The farmer said, â€Å"In every battle you fight, one of two things will happen: you will either fall or come away alive. Be bold, therefore, for everything is preordained. Nothing can bring a man to his death if his time has not come and nothing can save one doomed to die. To die in flight is theShow MoreRelatedOn How Ecounters between People, Societies, Cultures and Material Objects Had an Impact on Early Globalization in the Viking Age679 Words   |  3 PagesIntroduction: In my essay I will talk about how the encounters between people, societies, cultures and material objects had an impact on early Globalization in the Viking age. Between 8th and 12th centuries the Vikings moved over and tied large parts of the world together. Vikings with their plundering and colonising were the forerunners of what we now call globalization. They were the first Europeans to cross the Atlantic and discovered Greenland, Iceland and North America with their ships. TheyRead MoreA Vikings Civilized World1265 Words   |  5 PagesWere the Vikings barbaric, or were they civilized? The Vikings were a civilized and organized culture. 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Legalizing Infant Euthanasia Free Essays

Since the evolution of man, infants have been born with severe illnesses. These infants may be able to survive due to advancing technologies, but are left with possible and probable defects. Many infants will die even though they are being treated because they are not equipped to sustain life. We will write a custom essay sample on Legalizing Infant Euthanasia or any similar topic only for you Order Now These circumstances have led to the debatable issue of infant euthanasia, or mercy killing, to allow these babies an end to their suffering, and die peacefully. While many people feel that euthanasia is murder, infant euthanasia should be legalized to spare terminally ill newborns of long, painful deaths, and to spare them of possible life-long disabilities. Euthanasia is said to be morally wrong by pro-life groups. They point out that infant’s may not be suffering while they are dying. They also emphasize that advances in pain management make it possible to relieve all or almost all pain. These people say that children should be saved at all costs, no matter how great the disability may be. They accentuate that the infants may be saved due to advancing technology, and that there are also therapy treatments for their possible disabilities. However, in considering whether or not to treat a newborn, the main goal should be to spare infants of long, painful deaths. Most experts believe that the primary answer to this issue is to follow what’s in the child’s best interests. If his mental and physical handicaps are overwhelming and it would be inhumane to prolong his life, then treatment should be withheld or withdrawn. After all, saving an infant for a life of suffering is hardly a humane and loving act. An infant was born with a skin condition similar to third-degree burns over almost all of its body for which there was no cure. The baby’s mother was young, unwed, and indigent. Providing basic nursing care caused tearing away of the skin. The infant could not be fed orally because of blistering in the mouth and throat. Any movement of the infant seemed to cause it pain. Even with intensive care its life expectancy, at most, was believed to be days. It would have been reasonable, merciful, and justifiable to have shortened the baby’s dying by an intended direct action chosen by the parent and the neonatologists. In cases relevantly like this, it is not immoral or morally wrong to intend and effect a merciful end to a life that, all things considered, will be meaningless to the one who lives it and an unwarranted burden for others to support. Among the women who work in the Stanford intensive care nursery, several said that if they were to have an extremely premature baby, they would not want it to be treated aggressively. One woman said that if she knew what was about to happen she would stay away from a hospital with a sophisticated intensive care unit. Others say they would make sure they were under the care of a doctor who would not press the extremes on survival. Many parents would make a similar choice but are not given the opportunity. It has been called a violation of God’s commandment not to kill. â€Å"†¦ in effect, the demand that physicians fight death at all costs is a demand that they play God. It is a demand that they conquer nature, thereby declaring themselves more powerful than God’s order. † Perhaps the ideal of conquest will be replaced by the ideal of living in agreement with nature. The most benign technology works in harmony with natural causes rather than intruding on them. The â€Å"Baby Doe† rule is a list of guidelines stating that a baby should be treated aggressively with very few exceptions. These exceptions to the rule are when â€Å"the infant is chronically and irreversibly comatose†, when the treatment would merely prolong dying, not be effective in ameliorating or correcting all of the infant’s life-threatening conditions, or otherwise be futile in terms of the survival of the infant†, and when â€Å"treatment would be virtually futile in terms of the survival of the infant and the treatment itself under such circumstances would be inhumane†¦ This policy rather loudly states that parents and professionals may not consider the salvageable infant’s life prospects no matter how harmful they may appear. A graphic illustration of the potential harm in the treatment of a handicapped infant is provided by Robert and Peggy Stinson’s account of their son Andrew who was born at a gestational age of 24 1/2 weeks and a weight of 800 grams. He was placed on a respirator against his parents’ wishes and without their consent, and remained dependent on the respirator for five months, until he was finally permitted to die. The seemingly endless list of Andrew’s afflictions, almost all of which were iatrogenic, reveals how disastrous this hospitalization was. Baby Andrew was, in effect saved by the respirator to die five ling, painful, and expensive months later of the respirator’s side effects. â€Å"†¦ the physicians who treated him violated an ancient and honored Hippocratic principle of professional ethics,`Primum non nocere’, First do no harm. As shown in the examples above, infants that are treated aggressively will die more slowly and painfully than if they were allowed a quick and peaceful death. By using aggressive treatment on severely ill infants, many are â€Å"saved† to live with life-long disabilities. To demand that physicians use intensive care technology beyond the point when it is likely to assist with a patient’s problems, as the Baby Doe regulations require, is to demand that they violate their professional commitment to do no harm. To argue that infants must be treated aggressively, no matter how great their disabilities, is to insist that the nursery become a torture chamber and that infants unequipped to live be deprived of their natural right to die. Helen Harrison, author of â€Å"The Premature Baby Book: a Parent’s Guide to Coping and Caring in the First Years†, wrote about how families are at the mercy of an accelerating life-support technology and of their physicians’ personal philosophies and motives concerning its use. She wrote after interviewing numerous parents and physicians in heartbreaking situations of delivery-room and nursery crises, â€Å"I sympathize with physicians’ concerns when parents request that there be no heroic measures. However, I sympathize infinitely more with families forced to live with the consequences of decisions made by others. Above all, I sympathize with infants saved for a lifetime of suffering. † The decisions involving the care of hopelessly ill and disabled newborns should be left to the traditional processes, to parents and physicians who do the best they can under difficult circumstances. B. D. Cohen, author of â€Å"Hard Choices† wrote, â€Å"Until such time as society is willing to pay the bill for truly humane institutions of twenty-four-hour home care for all such infants, to offer than death or living death, shouldn’t these decisions be left to those who will have to live with them? † There is a disease called Spina Bifida which affects between six thousand and eleven thousand newborns in the United States each year. The children are alive but require urgent surgery to prevent their handicap to intensify and bring about death. Paralysis, bladder and bowel incontinence, hydrocephalus or water on the brain are all part of the child’s future. Severe mental retardation, requiring total custodial care, is the likely fate of 10% of the 15% of the children. Some 10% of the children will die prior to reaching the first grade, in spite of aggressive medical care. These infants, incapable of making their own decisions, deserve to be spared the pain and suffering of such severe diseases and illnesses. Although some claim that euthanasia is the killing of a human, infant euthanasia should be legalized to spare severely ill babies of drawn-out, excruciating deaths, and to spare them of the possible defects from their illnesses. Infants continue to be born with such disabling illnesses daily. Many parents are left burdened throughout their lifetimes. They may not be prepared to provide the round-the-clock treatment that is needed. New York State should bring about peace by legalizing euthanasia, and end the suffering for all people intimately involved in situations described previously. How to cite Legalizing Infant Euthanasia, Essay examples

Surgical Options For A Patient Presenting With A Mid-Shaft Fractured

Question: Discuss about the Identify Surgical Options For A Patient Presenting With A Mid-Shaft Fractured Femur. Answer: Surgical treatment options The surgery for mid-shaft fractured femur depends on time. Mid-shaft femur fractures are treated depending upon pattern of fracture. Femoral neck fractures, percutaneous pinning or sliding of hip screw and anthroplasty is done for the elderly patients like in the given case study of Mr.Brown. If the skin around the fracture is still not broken, then it is advisable to wait to make it stable before surgery. If the fracture is open, it might be exposed to environment and so need to be cleaned urgently to prevent infection before immediate surgery. The leg is placed in skeletal fraction or long-leg splint between the period of initial emergency care and surgery. This helps to keep the broken bones aligned and maintain length of leg. There are three surgical treatment options available for the mid-shaft fractured femur. External fixation is a type of operation where screws or metal pins are placed in bones above and below the site of fracture. The screws and pins are attached to bar outside skin that act as stabilizing frame for the holding bones in proper position for fast healing. It is a temporary treatment where external fixators are applied which provide temporary and good stability until the femur is healed (Kulshrestha, Roy, Audige, 2011). Intramedullary nailing is another surgical option where and currently in use for the mid-shaft femoral fractures opted commonly by most surgeons. In this procedure, a specially designed metal rod is inserted in femur marrow canal. The rod then passes across fracture that helps to it in position. The intramedullary nail is inserted in the canal at the knee or hip in small incision. There is crewing at the bones at both ends. This keeps the bone and nail in proper position at the time of healing (Gelalis, et al., 2012). Screws and plates are also done as a surgical operation when the bone segments are reduced or first repositioned in their normal alignment. Metal plates and special screws are attached to the bone outer surface. These screws and plates are often used during intramedulalry nailing which is not possible for the fractures that are extended to knee or hip joints (Smith, Parvizi, Purtill, 2011). Complications Patients who sustain mid-line femur fracture after a traumatic accident like tractor accident of Mr. Brown, encounter complications depending upon the severity of break or fracture location. The complications include infection, bone healing problems, nerve damage, compartment syndrome or surgical complications (Kong Sabharwal, 2014). In fractured femur, there can be bone breaking the skin and that increases the risk for infection. If there is wrong alignment of bones or infection that causes irritation, the healing process is delayed and there is requirement of further surgery. Nerve damage can also occur where there might be weakness or numbness that is a rare complication. Compartment syndrome is also a rare complication of femoral mid-shaft fractures where there is compression of blood vessels, nerves, muscles inside compartment or closed space within the body. This generally occurs within the thigh with bleeding or inflammation because of trauma that is associated with the fract ure. In case of this syndrome, immediate operation is required. Surgical complications can also occur due to hardware failure that is required to stabilize bone or hardware piece that causes pain or irritation. Nerve damage is the possible surgical complication in mid-shaft femoral fracture (Park, Noh, Kam, 2013). Major complications, nursing interventions and monitoring Depending on the femoral fracture, the major complications in mid shaft femoral fracture affects the knee, however, in a different way. Femur movement when it breaks, there is ligament damage in knee that demand immediate operation for repairing the damage. Heterotopic ossification, pudendal nerve injury and Acute compartment syndrome are major complications that might occur post-operation of fractured femur (Kaiser, et al., 2011). Heterotopic ossification occurs with an incidence of 25% as a post-operative complication after femur fracture surgery. In this, there is varying severity where bone debris from endosteal canal reaming is deposited in soft tissues that surround the site of nail insertion in Intramedullary nailing surgery (Botolin, Mauffrey, Hammerberg, Hak, Stahel, 2013). These debris are stimulate the heterotopic bone formation that decreases debris amount left in tissues after the nailing leading to heterotopic ossification. This complication occurs at the proximal end of reamed intramedullary femoral nail posing a complication after the procedure. Thenursing intervention is the physical therapy where the nurse keeps the patient with involved joint at rest to maintain a functional position and perform Passive Range of Motion (PROM) where the body parts are moved within the available range without muscle activation (Martinez de Albornoz, Khanna, Longo, Forriol, Maffulli, 2011). It is monitored by keeping into account the movement range of the patient and pain management. Pudendal nerve injury is another main complication that is associated with the fracture surgery where there is static interlocking in the femur nailing. This neurologic injury is a combination of direct compression and localized ischaemia of perineum against post fracture countertraction. In this, there is branching of sensory terminals of pudendal nerve that appear susceptible to injury causing complications after the surgery. It is an important and common complication after intramedullary femur nailing that might result in complete sensory loss. Thenursing intervention involves pain management and medical interventions. Nurses would reduce the pudendal nerve irritability through lifestyle changes. They would perform sitting modification, avoidance of physical activities that irritate nerves, bladder and bowel management help to prevent straining of nerves and its compression that might cause nerve irritation. Continuous monitoring and refereeing to a physiotherapist would help to r elax the muscles and decrease nerve irritation. Acupunture and psychotherapy can also be helpful for reducing pain and irritation of nerve (Fisher Lotze, 2011). Acute compartment syndrome is a rare but important complication that takes place post femur fracture. It is a highly painful condition when the muscle pressure builds to alarming levels. This can decrease flow of blood preventing oxygen and nourishment from reaching muscle and nerve cells. The pressure need to be released or else can cause permanent disability. This requires surgery when the surgeon makes incisions in the muscle coverings and skin to relieve pressure (Kalyani, Fisher, Roberts, Giannoudis, 2011). Thenursing intervention involves pain management by medications like epidural analgesia to relieve pain. Multimodal approach that includes use of non-steroidal anti-inflammatory drug (NSAID)and paracetamol along with an opioid considered best after pressure release through surgery. Patient education is also required before discharge after pressure release surgery by nurses for predisposition to this syndrome. The monitoring involves evaluation of any medication side effects and compartment pressure that should be less than 15mmHg via single pressure readings or continuous pressure monitoring. Nursing interventions and Rationale Heterotopic ossification(HO) In HO, there might be complications related to skin and musculoskeletal system where there might be problems regarding osteomyelitis and skin pressures. Skin complications can occur due to immobility, changes in flow of blood, improper positioning, venous stasis vasomotor tone loss and hypoxia. Contractures, muscle atrophy, osteoporosis, HO and spasticity can also occur due to immobility, joint stiffness, muscle atrophy, weakness and much more. Nursing intervention Rationale Treatment for spasticity Physical, medicine and drug therapy It is done to promote mobility, manage leg weakness, allowing the patient to stand and provide strength. It would also provide manual dexterity by improving muscle therapy and functioning. Passive Range of Motion (PROM) As movement is restricted in the patient, it provides exercise options for the, in enhancing mobility. It is done to provide a range of motion exercises that aid in movement and reduction of stiffness. It improves circulation and muscle strength along with maintenance of flexibility and pain management. Controlling of parameters Temperature, fatigue, anxiety, decubitus ulcers also checked as the patient has minimum mobility and can be prone to spasticity. Repositioning of the patient It is important at every 2 hours to avoid irritation or rubbing of skin and to avoid remaining of the patient at one position for a long time. Patient education It is also important for patient and families by instructing them ROM exercises to watch for potential complication signs in OH and prevent pressure sores (Mavrogenis, Soucacos, Papagelopoulos, 2011). Monitoring Rationale Serum C-reactive protein levels and pain level It is important to monitor this protein level to check for inflammation reaction that can potentially occur in OH. Serial bone scans It is done to monitor the metabolic activity of OH and fix time for surgical resection in cases of postoperative complication and resurgence. Pudendal nerve injury This nerve is stretched, damaged or can cause permanent neuropathy in the patient. There can be irreversible nerve damage that can cause impaired mobility and stretch injury and permanent damage. Nursing intervention Rationale Physical therapy Kegal exercise should be avoided as it affects pelvic floor that is already tight and this exercise makes it tighter. Until the symptoms of pudendal nerve injury is not treated, it is important to avoid it. This is required to avoid further nerve damage and irritation. This is also important to check as it can lead to permanent nerve damage (Montoya, Calver, Carrick, Prats, Corton, Anatomic relationships of the pudendal nerve branches. , 2011). Lifestyle modifications There should be avoidance of bending, sitting, avoiding of exercises and only follow approved exercises along with bicycling that help to prevent permanent nerve damage. This is important to prevent recurrence of nerve damage that can cause irreversible damage leading to impaired mobility (Montoya, Calver, Carrick, Prats, Corton, 2011). Bladder and bowel movement management It can cause stretch injury as straining during constipation causes damage of pudendal nerve. Patient should drink prune juice, organic whole grain high fibre, black-eyed peas and psyllium husk to avid constipation. This is a potential thing to avoid in pudendal nerve injury as it causes straining during constipation. This can further increase damage of nerve and cause irritation that might result in permanent nerve damage. Pain management It is important to take care as manipulation in connective tissue and nerve can constrict nerve impairment. This includes conservative management of pain through medications and rating of pain on the scale from 1 to 10. Medication management It is also important as it is considered a gold standard and first line of treatment that manages its symptoms. Superior Hypogastric Block is used to treat pain in the pelvic region where a thin needle is inserted through fluoroscopy in skin and then advanced to L5 location of vertebra of superior hypogastric plexus to decrease the pain by 70% (Masata, Hubka, Martan, 2012). Monitoring Rationale Pain monitoring It is important for the nurses to monitor pain through Nerve Integrity Monitoring System (NIMS, Medtronics) that helps to prevent pain impulses and risk for central sensitization and release pain syndrome. It also prevents fibroblasts prevention and risk for scar formation. Acute compartment syndrome Acute compartment syndrome is surgical emergency that can cause permanent nerve damage and causes severe injury. This cam cause permanent damage of muscles and can prevent oxygen and nourishment to reach muscles and nerve causing permanent loss of nerve sensation. Nursingintervention Rationale Multimodal approach Opoids and NSAIDS along with paracetamol are used to manage pain in the patients. Paracetamol, NSAID and IV morphine is given at 0.1-0.2mg/Kg titrated is given to the patient. This helps to reduce pain in the patient for traumatic pain that decreases with surgery time. Pain is managed through controlled steps that help to adjust the dose of morphine use as opioids for the pain management (Waterman, Laughlin, Kilcoyne, Cameron, Owens, 2013). Patient education In this, one need to know about the various symptoms of this syndrome so that they can immediately report in case of severe complications that might require surgery and failing can cause permanent nerve damage. It is important to understand the reoccurrence and study of complications that need to be looked for after the surgery for acute compartment syndrome. It is also important to improve their health behaviour by keeping a check on their improvement and prevent reoccurrence of this complication. Monitoring Rationale Side effects of medication This multimodal approach causes many potential side effects that can affect the patient and adverse the complicated situation. Side effects are renal toxicity, gastric ulceration, platelet aggregation inhibition that can cause hemorrhagic complications. This can aggravate the complication of acute compartment syndrome. Nurses have to monitor the potential side effects of multimodal approach to avoid high risk for further trauma injuries, increased risk for potential side effects of medication therapy that might affect the patient and deteriorate the condition. Pressure monitoring It is an invasive procedure that has an huge impact on the patient having acute compartment syndrome following fracture surgery. The pressure should be below 15 mmHg to avoid complications. It is done through single pressure readings, fibreoptic transducer (camino-catheter) which is simple and reliable. Nurses have to keep monitoring the compartment pressure as it can cause complications like inflammation, swelling, and blood supply loss in muscles, muscle scarring, loss of function and contracture. Therefore, it is important to monitor the pressure levels. Bibliography Aubut, J. A., Mehta, S., Cullen, N., Teasell, R. W., Team, G. t. (2011). A comparison of heterotopic ossification treatment within the traumatic brain and spinal cord injured population: an evidence based systematic review. NeuroRehabilitation, 151-160. Botolin, S., Mauffrey, C., Hammerberg, E. M., Hak, D. J., Stahel, P. F. (2013). Heterotopic ossification in the reaming tract of a percutaneous antegrade femoral nail: a case report. Journal of medical case reports, 90. Fisher, H. W., Lotze, P. M. (2011). Nerve injury locations during retropubic sling procedures. . International urogynecology journal, 439-441. Gelalis, I. D., Politis, A. N., Arnaoutoglou, C. M., Korompilias, A. V., E., P. E., Vekris, M. D., ... Xenakis, T. A. (2012). Diagnostic and treatment modalities in nonunions of the femoral shaft. A review. Injury, 980-988. Kaiser, M. M., Wessel, L. M., Zachert, G., Stratmann, C., Eggert, R., Gros, N., ... Rapp, M. (2011). Biomechanical analysis of a synthetic femur spiral fracture model: influence of different materials on the stiffness in flexible intramedullary nailing. . Clinical Biomechanics, 592-597. Kalyani, B. S., Fisher, B. E., Roberts, C. S., Giannoudis, P. V. (2011). Compartment syndrome of the forearm: a systematic review. The Journal of hand surgery, 535-543. Kong, H., Sabharwal, S. (2014). External fixation for closed pediatric femoral shaft fractures: where are we now?. Clinical Orthopaedics and Related Research, 3814-3822. Kulshrestha, V., Roy, T., Audige, L. (2011). Operative versus nonoperative management of displaced midshaft clavicle fractures: a prospective cohort study. Journal of orthopaedic trauma, 31-38. Martinez de Albornoz, P., Khanna, A., Longo, U. G., Forriol, F., Maffulli, N. (2011). The evidence of low-intensity pulsed ultrasound for in vitro, animal and human fracture healing. . British medical bulletin. Masata, J., Hubka, P., Martan, A. (2012). Pudendal neuralgia following transobturator inside-out tape procedure (TVT-O)case report and anatomical study. International urogynecology journal, 505-507. Mavrogenis, A. F., Soucacos, P. N., Papagelopoulos, P. J. (2011). Heterotopic ossification revisited. . Orthopedics, 177-177. Montoya, T. I., Calver, L., Carrick, K. S., Prats, J., Corton, M. M. (2011). Anatomic relationships of the pudendal nerve branches. American journal of obstetrics and gynecology, 504-e1. Park, S. S., Noh, H., Kam, M. (2013). Risk factors for overgrowth after flexible intramedullary nailing for fractures of the femoral shaft in children. Bone Joint, 254-258. Smith, E. B., Parvizi, J., Purtill, J. J. (2011). Delayed surgery for patients with femur and hip fracturesrisk of deep venous thrombosis. Journal of Trauma and Acute Care Surgery , E113-E116 . Waterman, C. B., Laughlin, C. M., Kilcoyne, C. K., Cameron, K. L., Owens, L. B. (2013). Surgical treatment of chronic exertional compartment syndrome of the leg: failure rates and postoperative disability in an active patient population. JBJS, 592-596.