This element is necessary to determine whether or not the offense can be considered to be aggravated sexual assault.
Explain why locating the point of origin is so important in arson investigation.

Determining the point of origin of a fire is a crucial first step in any investigation. This step is so important because it may illuminate the cause of the fire, and further identify whether the fire was criminal in nature. Fire investigation is difficult, due to the fact that evidence is often destroyed by the blaze. Before the cause of a fire can be determined, the point of origin must be identified. Often the point of origin of a fire is known, but the cause is not, and sometimes the reverse is true.

List and describe the several stages of a burglary investigation.

There are five main activities used by the authorities to respond to burglaries of dwellings (Coupe & Griffiths,…...

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References

Archambault, J., Faugno, D.K. (2001). Overcoming a consent defense to sexual assault. The Journal of Emergency Nursing, 27, 204-8.

Coupe, T., Griffiths, M. (1995). Police investigations into residential burglary. The British Criminology Conferences: Selected Proceedings, 1, 18-21.

Jukanin, T.J. (1996). Model guidelines and sex crimes investigation manual for Illinois law enforcement. Illinois Law Enforcement and Training Standards Board. Retrieved 6/11/2007 at http://www.ptb.state.il.us/publications/sexassualt.pdf.

Still others must actually undergo the experience of trying to perform procedures themselves under guidance to learn effectively.
Looking back at some of my clinical experiences, I can recall instances where I took an approach to patient education that was based mainly on my convenience and preference rather than on an assessment of what teaching approach would be most beneficial to patients. More recently, I have tried to incorporate adult learning theory into patient education in connection with post-surgical follow-up self-care and wound care, among other areas. For example, I have recently begun asking patients whether they would prefer to have informational resources in printed form, or whether they would prefer to observe demonstrations. When patients indicate their desire to observe clinical procedures, I also offer them the opportunity to try the procedures under my guidance, taking advantage of the fact that some of them may learn best from experiential…...

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References

Brookfield, S. (1995). Adult learning: An overview. In The International Encyclopedia of Education (Ed. A.Tuinjman). Oxford: Pergamon Press.

Cercone, K. (2008). Characteristics of adult learners with implications for online learning design. AACE Journal, 16(2), 137 -- 159.

Clardy, A. (2005, August 1). Andragogy: Adult learning and education at its best. Online Submission, (ERIC Document Reproduction Service No. ED492132). Retrieved

August 27, 2009, from ERIC database. (ERIC database)

Military Application of Tranexamic Acid in Trauma Emergency esuscitation
This is an article that reviews military use of tranexamic acid in cases of resuscitation in the instance of a trauma emergency.

Scular disturbance with concomitant bleeding is one of the main death causes in military and civilian trauma. Experience from Afghanistan and Iraq wars has caused developments in resuscitation of hemorrhage victims, with the use of optimum blood component ratio identification (Morrison, et.al, 2012). The new approaches involved balanced and early delivery of packed BCs (red blood cells), FFP (fresh frozen plasma), cryoprecipitate and platelets to restore clotting factor 6 and circulating volume. Notwithstanding these developments, the usefulness of a treatment to reduce hemorrhagic shock related mortality is yet to be established.

The Problem

As a result of wars in Iraq and Afghanistan, there has been a need to find advances towards revitalization for hemorrhagic shock. Optimal blood ratio components have been identified to…...

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References

Additional Information

Morrison, J., Dubose, J., Rasmussen, T., & Midwinter, M. (2012). Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study. Achieves of Surgery, 147(2). Retrieved, from http://118.139.163.84:8088/2161431/Article_2.pdf

Professional oles and Values
A good number of patients visiting emergency departments are in a position to make independent decision concerning their care. Nevertheless, a significant proportion of them are extremely incapacitated either mentally or physically to the extent that they cannot solely make decisions regarding their treatment. Some of the conditions associated with this incapacitation include organic brain disorder, hypoxia, or head trauma. Jones et al. (2005) describes an emergency department as a very hostile environment where patients may lose control of the nature of care they undergo. Such is the case scenario in this current study. Mr. E is developmentally delayed and hypoxic. Dr. K considers his situation as an emergency and a ventilator must support it. The fact that Mr. E had already signed an advance directive under the supervision of a patients advocate that he did not want a ventilator or cardiopulmonary resuscitation complicates the matter even…...

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References

Dickey, S.B. (2003-2004). Nurses should be concerned about the ethical implications of HIPAA regulations (pp. 1-5). Washington, DC: American Nurses Association

Fowler, D.M. (2008). Guide to the code of ethics for nurses. Silver Springs, MD: American Nurses Association

Jones S, Davies K, Jones B (2005). The adult patient, informed consent and the emergency care setting. Accident and Emergency Nursing. 13, 3, 167-170

ight to Die
Physician-Assisted Suicide

The case of Mildred D: The right to die

The core dilemma of 'the right to die' of Mildred D. revolves around Mildred's alleged statement to her children that she wanted no heroic means to continue her life. There is also the question of whether intravenous feeding is 'heroic' means, since removing the NG will effectively 'starve' her and ending her life before it would naturally terminate were the NG tube not removed. Food is usually not considered 'additional' means of life support, although it is debatable whether food not administered by mouth constitutes heroic means. Mildred had no living will clarifying her wishes and is now not competent to make the decision herself.

Legally, in the U.S. Supreme Court case of Cruzan v. Director, Missouri Department of Health, "the Court considered whether Missouri could insist on proof by 'clear and convincing evidence' of a comatose patient's desire to…...

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References

Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261 (1990). Retrieved:

 http://biotech.law.lsu.edu/cases/consent/Cruzan_SC.htm 

The right to die. (2012). Exploring Constitutional Conflicts. Retrieved:

 http://law2.umkc.edu/faculty/projects/ftrials/conlaw/righttodie.htm

patient most likely manifest hypervolemia?
A patient would most likely develop hypervolemia through eating sodium-based foods, from blood transfusions, medications and diagnostic contrast dyes. (Silverstein, 2006)

What blood pressure, central venous pressure, and arterial pressure would be indicative of hypervolemia?

Any individual who is suffering from hypervolemia would have higher levels of blood (160 / 100), central venous (179 / 109) and arterial pressure (180 / 110). (Silverstein, 2006)

How would a nurse recognize that a hypovolemic patient had received adequate volume replacement?

The way a nurse would recognize a hypovolemic condition is to look for swelling in the legs and arms. At the same time, there will be an increase in the patient's weight. When there is adequate replacement, these levels will come down dramatically. (Silverstein, 2006)

How do neurohormonal mechanisms contribute to the development of heart failure?

Neurohumoral adaptations are impacting the systemic pressure through vasoconstriction. This leads to a redistribution of blood flow…...

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References

Silverstein, A. (2006). Heart Disease. Minneapolis, MN: 21st Century Books.

A study in this regard by Ainslie Nibert, entitled, Teaching clinical ethics using a case study family presence during cardiopulmonary resuscitation, states that Critical care nurses often find themselves in the midst of challenging ethical situations that involve conflict between the needs of critically ill patients and the patients' family members and the preferences of physicians and other healthcare providers who initiate and manage resuscitation measures. Yet, many critical care nurses have reported that they received little preparation in their basic education programs to deal with these sensitive issues. (Nibert, Ainslie T. 2005)
This may constitute a moral dilemma as the study points out. "A moral conflict exists because two opposing obligations collide: an obligation to the family members who desire to be present with their loved one during CPR and an obligation to the healthcare providers who do not want patients' family members to witness resuscitation efforts." (ibid)

The study…...

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Bibliography

Brown, J., & Ritchie, J.A. (1990). Nurses' perceptions of parent and nurse roles in caring for hospitalized children. Children's Health Care, 19, 28-36.

Bauchner H, Waring C. And Vinci R. (1991)

Parental presence during procedures in an emergency room: results from 50 observations. Department of Pediatrics, Boston City Hospital.. Retrieved February 24, 2005, from Pediatrics. Web site:  http://pediatrics.aappublications.org/cgi/content/abstract/87/4/544 

Desy, Pierre. (2003) Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses. American Journal of Critical Care, May 1.

Deontology and DNR: Addressing the Issue Introduction
Do Not Resuscitate (DNR) orders are an issue for a number of care providers in hospitals, especially those who work within the context of hematology and oncology care. As Weissman (1999) notes, DNR is a stumbling block for many nurses and nursing students: for example, he states that his students unanimously struggle to understand the purpose of asking terminally-ill patients what their preferences are on resuscitation—“We know it’s required under hospital policy to ask patients their preference about resuscitation, but these cancer patients . . . well . . . you know . . . they’re dying . . . it doesn't make sense” (Weissman, 1999, p. 149). Weissman (1999) states that while DNR orders were “designed to ensure patient autonomy while at the same time identifying patients in whom resuscitation is not indicated,” they have come to serve, unfortunately, as “an example of how…...

But there will also be situations where clinicians are asked to discuss with a patient whether they want to or should have resuscitation if they have had a cardiac arrest or life-threatening arrhythmia. The potential likelihood for clinical benefit in accordance with the patient's preferences for intervention and its likely outcome, involves careful consideration, as with many other medical decisions, in deciding whether or not to resuscitate a patient who suffers a cardiopulmonary arrest. Therefore, decisions to forego cardiac resuscitation are often difficult.
Cardiopulmonary resuscitation (CP) is a set of specific medical procedures designed to establish circulation and breathing in a patient who's suffered an arrest of both. CP is a supportive therapy, designed to maintain perfusion to vital organs while attempts are made to restore spontaneous breathing and cardiac rhythm (Braddock 2).

The standard of care is to perform CP in the absence of a valid physician's order to withhold…...

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References

Braddock, C.H. (1998) Termination of life-sustaining treatment. University of Washington School of Medicine. Seattle: Department of Medical History and Ethics. Retrieved 3/12/07 at  http://depts.washington.edu/bioethx/topics/termlife.html .

Frequently asked questions. (2007). The World Federation of Right to Die Societies. Retrieved at  http://www.worldrtd.net/faqs/qna/?id=8 .

Guru, V., Verbeek, P.R. And Morrison, L.J. (1999). Response of paramedics to terminally ill patients with cardiac arrest: an ethical dilemma. CMAJ. 61 Nov; 161(10).

Hilz, L.M. (1999). Psychology Terms: Transference and countertransference. Kathy's Mental Health Review. Riverside, CA: Mental Health. Retrieved at  http://www.toddlertime.com/mh/terms/countertransference-transference-3.htm .

, 2008).
Known Flaws & Potential Dangers:

One issue which became apparent with this device in particular was the possibility for the lights which indicate the length and frequency of ventilation were prone to malfunctions. This issue has been addressed by the manufacturer and has been reasonably rectified to a standard of being able to be used confidently in emergency situations (Thayne et al., 2005). The potential danger of such a malfunction is apparent in a high risk situation. Though emergency personnel are trained in the correct technique of CP method, in such high stress situations it is not uncommon for the adrenaline of the situation to result in over ventilation leading to a significant decrease not only in blood pressure but also in the efficacy of CP itself.

The device since the manufacturing adjustment has been implemented in a number of real world emergency services. It has functioned since without fail and…...

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References

1. Cooper, J. & Cooper, J. (2008). New stragtegies for cardio pulmonary resuscitation. Current Treatment Options in Cardiovascular Medicine, 10, 49 -- 58.

2. Rea, T., Eisenberg, S., Sinibaldi G, & White, D. (2004) Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation, 63, 17 -- 24.

3. Thayne RC, Thomas DC, Neville JD, Van Dellen A. (2005). Use of an impedance threshold device improves short-term outcomes following out-of-hospital cardiac arrest. Resuscitation,67, 103-108

4. Wiggington, J. (2005). The inspiratory impedance threshold device for treatment of patients in cardiac arrest. Business Briefing: Long-Term Healthcare, 1-5.

An adult do not need to make all decisions in advance, but educating oneself is a vital first step. (Death with Dignity: Planning Ahead for End-of-Life Care) few guidelines for signing a DN order are given here. A Do Not esuscitate Order - DN is a physician's order to not to employ cardiopulmonary resuscitation - CP in case of cardiac or pulmonary arrest. Competent adult patients may relinquish CP for medical or non-medical reasons. The patient may make such requests verbally irrespective of whether or not he/she is fatally ill. An appeal to relinquish CP may also be part of an Advance Directive. When it has been determined that the patient is short of decision-making capacity, the suitable substitute decision-maker should be recognized to make treatment decisions, including decisions to relinquish CP, if no such person has been appointed by an Advance Directive. If the patient is out of…...

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References

Care of the Sick and Dying. Roman Catholic Bishops of Maryland. Retrieved at   Accessed on 17th March 2005http://www.mdcathcon.org/Care.htm .

Collins, Tony. Dealers of Death. Retrieved at   Accessed on 17th March 2005http://www.envoymagazine.com/planetenvoy/Update-TCollins-TerriS-Jan04-Full.htm .

Dealers of Death. 30 November, 2004. Retrieved at   on 17th March 2005http://www.catholicexchange.com/vm/index.asp?vm_id=2&art_id=26177Accessed 

Do not Resuscitate- DNR Orders. 1 January, 2001. Retrieved at   on 17th March 2005http://www.healthsystem.virginia.edu/internet/housestaff/policy-manual/dnr.cfmAccessed 

The hospital should always defer to the patient and family that has an advanced directive in place, and if the patient cannot speak for themselves but has an advanced directive, then a proxy must make the decision. The only case where the hospital should be allowed to make the decision on futile care is in the absence of a proxy, in the absence of an advanced directive, and only if it is in the best interest of the patient.
In this psychological-based model, the healthcare professional and hospital is put in the position of negotiating with the family and/or patient. Burns and Truog (2007) state that in these situations the healthcare professional should always follow the wishes of the patient's family in futile care efforts (Burns & Truog, 2007). However, that view places a burden on the healthcare professional to compromise medical principles when that professional deems the care to…...

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References

Burns, J., & Truog, R. (2007). Futility: A Concept in Evolution. Chest, 1987-1993.

Forde, R. (1998). Who is to define the futility of treatment -- the patient or the physician? Tidsskr nor Laegeforen (Norwegian), 2652-2654.

Jonson, a., Seigler, M., & Winslade, W. (2002). Clinical Ethics 5th ed. New York, NY: McGraw-Hill.

Lachman, V. (2009). Ethical Challenges in Health Care: Developing Your Moral Compass. New York, NY: Springer Publishing.

New Sepsis Guidelines and Nurses: Factors, Compliance and Consideration
Introduction to Sepsis

Sepsis refers to the body’s dangerous reaction to an existing infection. Sepsis is extremely serious and if not treated swiftly with appropriate action it can lead to fast tissue and organ damage and death. The medical community has long been focused on getting better control of sepsis, as it is a damaging and debilitating condition that contributes to a host of preventable deaths. In fact, sepsis is one of the primary reasons for death in the number of hospitalized patients and is the cause of 20% of all admissions to intensive care units. (Ferrer et al., 2008). This data clearly indicates that sepsis is an aggravated problem that experts need to have better protocol for and preventative measures to counteract. In America, the rate of death from sepsis is one of the highest rates in the world with a mortality…...

Nursing Educator and the AED
Personal Experience of Teaching and Helping Other Nurses to be More Ready in the Use of a Phillips Heart Start Defibrillator (AED)

Children and young adults as well as other adults can and do have cardiac arrest. Estimations state that undiagnosed heart conditions cause the deaths of one individual every three days in organized youth sports in the United States. (AED Universe, 2012, paraphrased) The Survivor's Foundation states that 460,000 deaths occur each year in the U.S. from sudden cardiac arrest. Sudden cardiac arrest (SCA) is reported to occur "when the lower chambers of the heart (the ventricles) suddenly stop beating normally and develop what is called ventricular fibrillation (VF). VF is a chaotic heart rhythm that is similar where the heart muscle begins quivering which prevents the heart from effectively pumping blood. If this condition is not corrected immediately, death will follow within ten minutes.

The AED

The…...

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Bibliography

Automated External Defibrillators Reviewed (2003) Survivor's Foundation. Retrieved from:  http://firstaidcoach.com/AED_comparison.pdf 

Deakin C. et al. (2010) European Resuscitation Council Guidelines for Resuscitation 2010. Section 3. Electrical therapies: Automated external defibrillators, defibrillation, cardioversion and pacing. Resuscitation; 81: 1293-1304.

Jevon, Phil (2011) Defibrillation 1: Using an AED Outside Hospital. Nursing Times. 23 Sept 2011. Retrieved from:  http://www.nursingtimes.net/5035495.article 

Philips Announces 8-year warranty on Heartstart Onsite and FRx AED's (2012) AED Universe. Retrieved from:  http://aeduniverse.blogspot.com/

Staff Nurses' Perceptions of the Advantages and Disadvantages of apid esponse Teams
apid esponse Teams (T) are critically important in hospital settings to reduce the failure to resuscitate patients however, there are questions as to the perceptions of nurses concerning Ts.

The significance of this study is the knowledge that will be added to the existing base of knowledge on the perceptions of nurses of Ts.

The work of Heintz and Schreiner (2007) entitled "Improving Patient Safety Through the Use of apid esponse Teams" states in relation to the perceptions of nurses to rapid response teams that staff nurses "… may be fearful that T members will criticize their clinical judgment." In a separate work entitled "apid esponse Teams: educing Codes and aising Morale" it is reported that many hospital nurses like the idea of a apid esponse Team and in fact "an addition to their significant value as a clinical tool, apid…...

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References

Johal, Jagdeep (2008) Staff Nurses' Perceptions of Rapid Response Teams in Acute Care Hospitals. Queens Research & Learning Repository. Retrieved from:  http://qspace.library.queensu.ca/handle/1974/1503 

Heintz, Anne and Schreiner, Mary Ann (2007) Improving Patient Safety Through the Use of Rapid Response Teams" Dateline. Vol. 6, No. 1. Online available at:  http://www.mlmic.com/portal/Files/Dateline/DatelineSpring07_6.pdf 

Tee, A., et al. (2008) Bench-to-Bedside Review: The MET Syndrome -- the Challenges of Researching and Adopting Medical Emergency Teams. Critical Care 23 Jan 2008.

Rapid Response Teams: Reducing Codes and Raising Morale. Institute for Healthcare Improvement. Online Retrieved from:  http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories/FSRapidResponseTeamsReducingCodesandRaisingMorale.htm

1. The Neurobiology of Near-Death Experiences (NDEs):

Explore the scientific evidence behind the subjective experiences reported by individuals who have had NDEs.
Analyze the neurobiological mechanisms underlying these experiences, including altered brain activity and the release of neurochemicals.
Discuss the implications of NDE research for understanding the relationship between consciousness and physical death.

2. The Anthropology of Afterlife Beliefs and Practices:

Compare and contrast the afterlife beliefs and practices across different cultures and historical periods.
Examine the social and cultural factors that shape these beliefs, including religious traditions, social structures, and environmental conditions.
Analyze the role that afterlife beliefs play in....

Technological Advancements in Pediatric Surgery: Improving Outcomes for Young Patients

Pediatric surgery, specializing in the surgical care of children from birth to adolescence, faces unique challenges due to the developmental differences and vulnerabilities of young patients. However, technological advancements have revolutionized the field, significantly enhancing surgical outcomes and improving the quality of life for countless children.

1. Minimally Invasive Surgery (MIS)

MIS techniques, such as laparoscopy and thoracoscopy, utilize small incisions and specialized instruments to access the surgical site through natural body openings or small incisions. MIS offers numerous benefits, including:

- Reduced pain and scarring
- Shorter hospital stays
- Faster recovery times
- Improved cosmetic....

Basic life support (BLS) is a critical skill that every individual should possess. It involves simple yet effective techniques that can be used to save lives in emergency situations. In this essay, we will explore the importance of BLS training, the key principles of BLS, and how to properly administer BLS techniques to someone in need. By the end of this essay, readers will have a better understanding of the fundamental concepts of basic life support and its significance in emergency medical care.
One of the key ways that basic life support training can impact emergency response in critical situations is....

Impact of Basic Life Support Training on Emergency Response in Critical Situations
Basic life support (BLS) training plays a crucial role in improving emergency response effectiveness during critical situations, providing the foundation for swift and potentially life-saving interventions. This training equips individuals with essential knowledge and skills to recognize and respond to life-threatening emergencies, such as cardiac arrest, choking, and airway emergencies.
Enhanced Recognition of Cardiac Arrest and Prompt Response:
BLS training teaches individuals how to identify the signs of cardiac arrest, a condition where the heart suddenly stops beating. It emphasizes the importance of calling for emergency services (e.g., 911) immediately and....