Youtube daily Dec 28 2017

Title: Morning Coffee Music for your morning coffee: 3 Hours of Morning Coffee Music Playlist

For more infomation >> Morning Coffee Music for your morning coffee: 3 Hours of Morning Coffee Music Playlist - Duration: 3:33:38.

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Toys Cars for Kids Children Toddlers Wooden Cars Toys for Kids Video for KIds with Cars - Duration: 9:15.

Toys Cars for Kids Children Toddlers Wooden Cars Toys for Kids Video for KIds with Cars

For more infomation >> Toys Cars for Kids Children Toddlers Wooden Cars Toys for Kids Video for KIds with Cars - Duration: 9:15.

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The rush is on to pay property taxes in Hamilton County - Duration: 1:51.

For more infomation >> The rush is on to pay property taxes in Hamilton County - Duration: 1:51.

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Teams prepare for Battle of the Bluegrass - Duration: 1:47.

For more infomation >> Teams prepare for Battle of the Bluegrass - Duration: 1:47.

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Valiente chihuahua defiende a su familia de un coyote | Al Rojo Vivo | Telemundo - Duration: 0:30.

For more infomation >> Valiente chihuahua defiende a su familia de un coyote | Al Rojo Vivo | Telemundo - Duration: 0:30.

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First Alert: Temps could get near 30 degrees Friday - Duration: 2:16.

For more infomation >> First Alert: Temps could get near 30 degrees Friday - Duration: 2:16.

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2018 Kawasaki H2 SX Sport Tourer Debuts—Get Ready To Wet Your Gore Tex - Duration: 10:11.

2018 Kawasaki H2 SX Sport Tourer Debuts—Get Ready To Wet Your Gore Tex

For more infomation >> 2018 Kawasaki H2 SX Sport Tourer Debuts—Get Ready To Wet Your Gore Tex - Duration: 10:11.

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Video: Protect your pets from winter weather - Duration: 1:48.

For more infomation >> Video: Protect your pets from winter weather - Duration: 1:48.

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Video: Man arrested in Baltimore County road rage incident - Duration: 2:17.

For more infomation >> Video: Man arrested in Baltimore County road rage incident - Duration: 2:17.

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Cuñada del príncipe Harry se enfurece con su alteza | Al Rojo Vivo | Telemundo - Duration: 5:36.

For more infomation >> Cuñada del príncipe Harry se enfurece con su alteza | Al Rojo Vivo | Telemundo - Duration: 5:36.

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The Post Movie Review - Duration: 7:47.

By far and away the best thing about The Post

is seeing Matthew freakin' Rhys

tapped by Steven freakin' Spielberg

to open the movie!

For more infomation >> The Post Movie Review - Duration: 7:47.

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Medical Acid Base Balance, Disorders & ABGs Explained Clearly (Remastered) - Duration: 12:34.

thank you for joining me today we're going to talk about Medical acid-base

acid-base disturbances in patients and the purpose of this lecture is to make

acid-base demystified. A lot of students come in or confused about

acid-base I've seen a lot of lectures on the internet about acid-base. Some get it

right some don't get it so right. I want to take acid base as a whole and

just start off in the basics and go through what you need to know and crack

it down so that you can take a patient with an acid-base problem and not only

figure out what the patient has but also to be able to talk intelligently to

other people about what that patient has and how you figured it out and do it in

a systematic way so you could understand. so let's demystify acid base the first

thing I want to talk about is some of the definitional things of acid base and

that can sometimes be the most difficult. you know the way you talk to people is a

measure of how intelligent you are and let's get some definitions down because

sometimes these are confused. so there's two things that you'll see a lot of in

acid base and that is people talking about an acidosis.

so acidosis versus acidemia what's the difference in acidosis and acidemia in

fact what's the difference between an osis and anemia in terms of anything

that alkalosis alkalemia and the way I like to think about that is in terms of

a seesaw. imagine this big dichotomy in acid base you've got pH of

7.40 which is kind of where you want to keep things right in

the middle and that's a neutral pH and you can go all the way up to seven point

four five and all the way down to seven point three five and and what happens is

you get processes that occur in the body so and so you've got a metabolic

acidosis here and you've got another metabolic acidosis occurring here but

over here you've got a you know a respiratory alkalosis or another

metabolic alkalosis these are processed that can occur and they're all occurring

at the same time and depending on the balance of these because some of these

could be big some these can be small that's when you get your emia. so an emia

is a state of being you know you have hyponatremia hypokalemia these are all

situations that are occurring in the blood so the key point here is that an

emia is a state of being and that's basically completely determined on what

your pH is if your pH is less than seven point three five then you're gonna have

an acidemia if your pH is greater than 7 point 45 then you're gonna have an

alkelemia okay so what is an OSIS? an OSIS is a process it's something that's

actually occurring you could have many different processes occurring at the

same time so is it possible for you to have an acidosis but be alkelemic?

absolutely you can have something down here which is pushing your which is

trying to push your pH toward the acid side but if you have something bigger up

here that's pulling it in the other direction and it's bigger you'll still

have a alkyl leimia because your pH is greater than 7 point

4 or 5 but you could have an acidosis so again basically line there is when

you're talking about the pH or something make sure you use amia when you're

talking about a process that's occurring think of a metabolic or respiratory

acidosis that's a process that's occurring okay let's clear the screen

here and I want to start off with a little bit of equations it'll tell us

kind of the basics for where we want to go so what is the pH well pH as some of

you all know is equal to the negative log of the concentration of protons so

that's important because as the number of protons in the body goes up the pH is

going to go down and so we know that a low pH means more acid and then this in

the body is sort of put together in an equation water plus carbon dioxide is

equilibrated with carbonic acid which is h2co3 which equilibrate s--

with that proton plus hco3 - okay so why is this important well because

everything in the body sort of goes along with this equation and I think the

big key here is how the body deals with this player right here protons okay cuz

protons is acid as we just saw and how does the body deal with that acid well

it deals with it using bi carbonate bicarbonate is the body's buffer that

buffers against protons so if extra protons are hanging around that could

make the pH go down away from where it should be of a pH of seven point four

zero or 7.35 to 7.45 which is that normal range bicarb is used up our

bicarb can be used up either because the acidosis is the loss of that bicarbonate

or bicarbonate can be used up because it's having to buffer these protons and

take these excess protons away and so you can see what happens is the bicarb

plus the proton goes to carbonic acid carbonic acid freely diffuses into water

which the body could always use and carbon dioxide which the body can

breathe out so if we put that into an a new equation and if you're lost here so

far don't worry we're gonna get to the final equation that I want you to sort

of commit to memory and that's this henderson hasselbalch equation which the

body is governed by which is the ph of the body is equal to six point one plus

the log of the concentration of bicarb over the pco2 times 0.03 okay now this

looks like a daunting equation but let's go over it there are two factors here

that you need to be very cognizant of number one is the bicarbonate

okay bicarbonate is a substance that is a base okay so it's an antacid it's

primarily made in the kidney and it takes a few days for that production to

either go up or to go down it could also be made anywhere acid is lost in the

body through some metabolic process and it can be used anywhere in the body to

buffer acid at the same time so anything that happens with bicarbonate by

definition is a metabolic process so if we if we have this bicarb going down

then that would be a metabolic acidosis if we have this bicarb going up that is

a metabolic alkalosis that is a process that is occurring it may translate into

a pH but we have to look at the other factor the other factor here is P co2

what is P co2 pco2 is the partial pressure of carbon dioxide in the blood

where does this carbon dioxide come from well you know where this comes from it

comes from cellular respiration okay so remember glucose gets broken down into

two three carbon units and those two three carbon units get broken down into

two two carbon units goes through Krebs cycle or kreb cycle oxidizes that carbon

down to carbon dioxide and then it gets released and that co2 needs to be

released carbon dioxide is a Lewis acid this is

an acid this is produced in almost every single cell of the body and only has one

way of getting out and that is through the lungs so if this is going up that

means the lungs are not getting rid of them and that means this is accumulating

in the body and that would be a if this is going up therefore this would be a

respiratory acidosis so everything having to do a co2 is

respiratory if this is going down that means the lungs are getting rid of co2

more that would be hyperventilation for instance that would be a respiratory

alkalosis and so what we see here is a balance we see bicarbonate which is

produced mainly in the kidney and can be lost anywhere in the body so it's

produced everywhere in the body and regulated through the kidney whereas

pco2 is made when the bonding is regulated through

the lungs if bicarb goes up that's a metabolic alkalosis bicarb goes

primarily down that's metabolic acidosis if co2 goes up

that's a respiratory acidosis and if co2 goes down that's a respiratory alkalosis

okay so now since we've talked about by carbon pco2 let's go over some of the

normal values for these things so pH as we said is equal to 7.35 to 7.45 and

that's the normal range and what happens if things go out of this range well the

body doesn't work so well proteins start to denature and that's why the body

wants to keep things between that range and we'll see how it does that

pco2 okay is equal to about 35 to 45 you kind of remember that because there's

similar numbers there so we kind of like 7.40 pco2 we kind of like 40 so 7.40 is

kind of the normal 40 is kind of middle and finally for the bicarb here the

range there is 22 to 26 with the normal being about 24 okay so that is the the

middle of the range now couple of definitional issues sometimes you'll see

bicarb also listed as co2 okay you'll see that on what we call the chem 7 or

something like that or like a little graphic here that kind of looks like

this where you'll have the sodium and we'll talk about this you'll have the

sodium up here at the potassium here the chloride and they'll say co2 down here

okay that's co2 in that chem 7 it's really the same as bicarbonate okay it's

not the same as the pco2 that's different

pco2 is the partial pressure car the oxide here this is the total

dissolved co2 synonymous with bicarb so if you see co2 it's the same as hco3

- just be aware that those are the same numbers but that's different than the

pco2 which has a normal of about 40 okay the other thing that you'll see is a

blood gas sometimes you'll see an ABG and the form for that is you'll have the

pH listed first then you'll have the pco2 second and the po2 third and then

you'll finally have the bicarbonate last so a normal would be for instance seven

point four zero / 40 / 90 / 24 that would be a normal blood gas okay so

we've gone over the normals again this would be sodium up here potassium here

chloride here co2 there this would be something called the blood urea nitrogen

we'll get to that and different lecture this is cracking and that's glucose if

you've never seen this before you might as well get used to because it's kind of

standard this completes the first lecture of the basics where we go into a

lot more detail here in the next ensuing lectures thank you very much

you

For more infomation >> Medical Acid Base Balance, Disorders & ABGs Explained Clearly (Remastered) - Duration: 12:34.

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Oldham County woman accused of sex act with teenage boy - Duration: 1:36.

For more infomation >> Oldham County woman accused of sex act with teenage boy - Duration: 1:36.

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BREAKING! TRUMP Just Took $285 MILLION From Them!! THEY WON'T MESS WITH HIM AGAIN!!! - Duration: 4:53.

BREAKING!

TRUMP Just Took $285 MILLION From Them!!

THEY WON'T MESS WITH HIM AGAIN!!!

During Barack Obama's presidency, he did all that he could to compromise America's

sovereignty and weaken our country with disgusting policies that favored our enemies around the

world.

Obama also allowed floods of refugees and illegal immigrants to swarm over our borders

in an attempt to fundamentally transform the country into a socialist nightmare.

Obama then alienated our allies such as Israel and in turn, buddied up to Muslim nations

that pledged to do America harm.

To add insult to injury, Obama then handed the United Nations more power in our countries

affairs than ever before to pursue a one world government.

Everything was going along swimmingly for the global elite in their attempt to destroy

America until Donald Trump was elected.

Those plans to destroy the last beacon of freedom and hope in the world has been dashed,

and the left is beside themselves with anger.

Now, Trump just issued another blow to these anti-Americans which will show them not to

mess with the United States again.

Earlier this month, the left and the majority of Muslim world lost their minds when President

Trump formally recognized Jerusalem as the capital of Israel and pledged he would move

the United States embassy to that location.

Predictably, the left went into a meltdown, not to mention the Muslim world, promising

more bloodshed and attacks on the small nation.

Soon after the announcement, the United Nations, who has a long history of animosity toward

Israel, voted overwhelming to reject Trump's recognition of Israel's capital.

So Trump did what Trump does best, and has cut the United Nations budget by 285 million

dollars, the most significant budget cut in UN history.

The following is the statement that UN Ambassador Nikki Haley put out about this stunning budget

reduction.

Today, the United Nations agreed on a budget for the 2018-2019 fiscal year.

‎Among a host of other successes, the United States negotiated a reduction of over $285

million off the 2016-2017 final budget.

In addition to these significant cost savings, we reduced the UN's bloated management and

support functions, bolstered support for key U.S. priorities throughout the world, and

instilled more discipline and accountability throughout the UN system.

"The inefficiency and overspending of the United Nations are well known.

We will no longer let the generosity of the American people be taken advantage of or remain

unchecked.

This historic reduction in spending – in addition to many other moves toward a more

efficient and accountable UN – is a big step in the right direction.

While we are pleased with the results of this year's budget negotiations, you can be sure

we'll continue to look at ways to increase the UN's efficiency‎ while protecting

our interests," said Ambassador Haley.

What makes this budget cut so interesting is that it comes right after the UN General

Assembly voted 128 to 9 against Trump's decision to recognize Jerusalem as the capital

of Israel.

Even though the two are not related, this budget cut sends a strong message to the United

Nations that America will not be swayed and we will decide what is best for our country.

Even further, this budget reduction is a clear warning shot to other countries around the

world that are against Israel that receive funding from the United States.

Trump has publically warned other countries that voted against recognizing Jerusalem as

Israel's capital could witness their financial aid reduced too.

According to Reuters:

U.S. President Donald Trump on Wednesday threatened to cut off financial aid to countries that

vote in favor of a draft United Nations resolution calling for the United States to withdraw

its decision to recognize Jerusalem as Israel's capital.

"They take hundreds of millions of dollars and even billions of dollars, and then they

vote against us.

Well, we're watching those votes.

Let them vote against us.

We'll save a lot.

We don't care," Trump told reporters at the White House.

Our country is in tremendous debt and cutting aid to nations that despise us and our greatest

ally and friend is one way for us to save a few bucks.

For years under the Obama administration, our country was stripped of our countries

sovereignty and it is the time we take that back.

The decisions we make as a nation should not be based on what is best for the "global

community" but what is best for our country, and if they don't like it, they don't

have to be involved.

The United Nations was given way too much power by the Obama administration and President

Trump is just taking it back and handing it back to the people of the United States.

What do you think about this?

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