Reading and writing germination thought is the most popular early reading and writing thought in the world. The children who are formed are learning to read and write in their lives. Children are the active learners o...Reading and writing germination thought is the most popular early reading and writing thought in the world. The children who are formed are learning to read and write in their lives. Children are the active learners of reading and writing. Children learn to read and write is a kind of social process and reading. And the development of the interrelatedness of writing, it demands that the early reading and writing course of children have four characteristics active curriculum orientation, integrated curriculum content, infiltration curriculum implementation and meaningful reading and writing environment. The Chinese current kindergarten read-write curriculum develops should respect the baby language law of development, fulfills the initiative construction the curriculum orientation that makes uniform baby’s read-write experience, the curriculum content link baby lives the world and the building interaction read-write scene, the establishment has the significance language environment.展开更多
Purpose： Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strateg...Purpose： Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room. Methods： A retrospective review of all patients at a suburban level I trauma center who underwent emergency department resuscitative thoracotomy as an adjunct to the resuscitation efforts normally delivered in the trauma receiving area over a 22 year period was performed. Survival of emergency department resuscitative thoracotomy was defined as restoration of vital signs and transport out of the trauma resuscitation area to the operating room. Results： Sixty-eight patients were identified, of whom 27 survived the emergency department resusci- tative thoracotomy and were transported to the operating room. Review of pre-hospital and initial hospital data between these potential long term survivors and those who died in the emergency department failed to demonstrate trends which were predictive of survival of emergency department resuscitative thoracotomy. The only subgroup which failed to respond to emergency department resuscitative thoracotomy was patients without signs of life at the scene who arrived to the treatment facility without signs of life. Conclusion： The patient population of the ＂potential survivor＂ has been expanded due to advances in critical care practices, technology, and surgical technique and every opportunity for survival should be provided at the outset. Emergency department resuscitative thoracotomy is warranted for any patient with thoracic or subdiaphragmatic trauma who presents in extremis with a history of signs of life at the scene or organized cardiac activity upon arrival. Patients who have no evidence of signs of life at the scene and have no organized cardiac activity upon arrival should be pronounced.展开更多
文摘Reading and writing germination thought is the most popular early reading and writing thought in the world. The children who are formed are learning to read and write in their lives. Children are the active learners of reading and writing. Children learn to read and write is a kind of social process and reading. And the development of the interrelatedness of writing, it demands that the early reading and writing course of children have four characteristics active curriculum orientation, integrated curriculum content, infiltration curriculum implementation and meaningful reading and writing environment. The Chinese current kindergarten read-write curriculum develops should respect the baby language law of development, fulfills the initiative construction the curriculum orientation that makes uniform baby’s read-write experience, the curriculum content link baby lives the world and the building interaction read-write scene, the establishment has the significance language environment.
文摘Purpose： Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room. Methods： A retrospective review of all patients at a suburban level I trauma center who underwent emergency department resuscitative thoracotomy as an adjunct to the resuscitation efforts normally delivered in the trauma receiving area over a 22 year period was performed. Survival of emergency department resuscitative thoracotomy was defined as restoration of vital signs and transport out of the trauma resuscitation area to the operating room. Results： Sixty-eight patients were identified, of whom 27 survived the emergency department resusci- tative thoracotomy and were transported to the operating room. Review of pre-hospital and initial hospital data between these potential long term survivors and those who died in the emergency department failed to demonstrate trends which were predictive of survival of emergency department resuscitative thoracotomy. The only subgroup which failed to respond to emergency department resuscitative thoracotomy was patients without signs of life at the scene who arrived to the treatment facility without signs of life. Conclusion： The patient population of the ＂potential survivor＂ has been expanded due to advances in critical care practices, technology, and surgical technique and every opportunity for survival should be provided at the outset. Emergency department resuscitative thoracotomy is warranted for any patient with thoracic or subdiaphragmatic trauma who presents in extremis with a history of signs of life at the scene or organized cardiac activity upon arrival. Patients who have no evidence of signs of life at the scene and have no organized cardiac activity upon arrival should be pronounced.
