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Bleeding

Bleeding known as a hemorrhage, haemorrhage, or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, ear, vagina or anus, or through a wound in the skin. Hypovolemia is a massive decrease in blood volume, death by excessive loss of blood is referred to as exsanguination. A healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties; the stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery. The use of cyanoacrylate glue to prevent bleeding and seal battle wounds was designed and first used in the Vietnam War. Today many medical treatments use a medical version of "super glue" instead of using traditional stitches used for small wounds that need to be closed at the skin level. Hemorrhaging is broken down into four classes by the American College of Surgeons' advanced trauma life support.

Class I Hemorrhage involves up to 15% of blood volume. There is no change in vital signs and fluid resuscitation is not necessary. Class II Hemorrhage involves 15-30% of total blood volume. A patient is tachycardic with a reduction in the difference between the systolic and diastolic blood pressures; the body attempts to compensate with peripheral vasoconstriction. Skin may start to be cool to the touch; the patient may exhibit slight changes in behavior. Volume resuscitation with crystalloids is all, required. Blood transfusion is not required. Class III Hemorrhage involves loss of 30-40% of circulating blood volume; the patient's blood pressure drops, the heart rate increases, peripheral hypoperfusion with diminished capillary refill occurs, the mental status worsens. Fluid resuscitation with crystalloid and blood transfusion are necessary. Class IV Hemorrhage involves loss of >40% of circulating blood volume. The limit of the body's compensation is reached and aggressive resuscitation is required to prevent death.

This system is the same as used in the staging of hypovolemic shock. Individuals in excellent physical and cardiovascular shape may have more effective compensatory mechanisms before experiencing cardiovascular collapse; these patients may look deceptively stable, with minimal derangements in vital signs, while having poor peripheral perfusion. Elderly patients or those with chronic medical conditions may have less tolerance to blood loss, less ability to compensate, may take medications such as betablockers that can blunt the cardiovascular response. Care must be taken in the assessment. Although there is no universally accepted definition of massive hemorrhage, the following can be used to identify the condition: " blood loss exceeding circulating blood volume within a 24-hour period, blood loss of 50% of circulating blood volume within a 3-hour period, blood loss exceeding 150 ml/min, or blood loss that necessitates plasma and platelet transfusion." The World Health Organization made a standardized grading scale to measure the severity of bleeding.

Upper head Intracranial hemorrhage – bleeding in the skull. Cerebral hemorrhage – a type of intracranial hemorrhage, bleeding within the brain tissue itself. Intracerebral hemorrhage – bleeding in the brain caused by the rupture of a blood vessel within the head. See hemorrhagic stroke. Subarachnoid hemorrhage implies the presence of blood within the subarachnoid space from some pathologic process; the common medical use of the term SAH refers to the nontraumatic types of hemorrhages from rupture of a berry aneurysm or arteriovenous malformation. The scope of this article is limited to these nontraumatic hemorrhages. Eyes Subconjunctival hemorrhage - bloody eye arising from a broken blood vessel in the sclera; the result of strain, including sneezing, vomiting or other kind of strain Nose Epistaxis - nosebleed Mouth Tooth eruption – losing a tooth Hematemesis – vomiting fresh blood Hemoptysis – coughing up blood from the lungs Lungs Pulmonary hemorrhage Gastrointestinal Upper gastrointestinal bleed Lower gastrointestinal bleed Occult gastrointestinal bleed Urinary tract Hematuria – blood in the urine from urinary bleeding Gynecologic Vaginal bleeding Postpartum hemorrhage Breakthrough bleeding Ovarian bleeding - this is a catastrophic and not so rare complication among lean patients with polycystic ovary syndrome undergoing transvaginal oocyte retrieval.

Anus Melena - upper gastrointestinal bleeding Hematochezialower gastrointestinal bleeding, or brisk upper gastrointestinal bleeding Vascular Ruptured Aneurysm Aortic transection Iatrogenic injury Bleeding arises due to either traumatic injury, underlying medical condition, or a combination. Traumatic bleeding is caused by some type of injury. There are different types of wounds; these include: Abrasion - Also called a graze, this is caused by transverse action of a foreign object against the skin, does not penetrate below the epidermis. Excoriation - In common with Abrasion, this is caused by mechanical destruction of the skin, although it has an underlying medical cause. Hematoma - Caused by damage to a blood vessel that in turn causes blood to collect under the skin. Laceration - Irregular wound caused by blunt impact to soft tissue overlying hard tissue or tearing such as in childbirth. In some instances, this can be used to describe an incision. Incision - A cut into a body tissue or organ, such as by a

ATV: Quad Frenzy

ATV: Quad Frenzy is a 2005 racing video game developed for the Nintendo DS by Skyworks Technologies and published by Majesco Entertainment. It was released for the Nintendo DS handheld games console on November 14, 2005 in North America, on June 16, 2006 in Europe and on October 25, 2007 in Australia. ATV: Quad Frenzy features five different game modes, which all center around ATV racing which takes place in various environments. Reviews of the game were critical; the ATV: Quad Frenzy game engine combines 3D graphics and a programming technique called a voxel. While at the time of the game's development the voxel was considered obsolete on the PC, it was used in ATV: Quad Frenzy to create 3D graphics despite the DS's graphical limitations. Like most games on the DS, ATV: Quad Frenzy takes advantage of the console's dual screen nature: the top screen shows the player's quad bike while the bottom screen displays the heads-up display which provides the player with information such as the quad bike's current speed, the player's score and a lap counter.

Players can choose from six different ATV's which can be raced in five different game modes: Practice, Quick Race, Championship Race Circuit, Championship Style Circuit, Head-to-Head. In Practice mode, players can race on any unlocked track so far, allowing them to practice their driving skills, while Quick Race provides the same only with computer-controlled opponents racing against the player; the Championship modes provide a career-progression gameplay style, allowing the player to obtain in-game currency which can be spent upgrading their ATV. In the Championship Style Circuit, stunts performed have an effect on race time, whilst in the Championship Race Circuit the player must come first or second to advance. Head-to-Head allows players to race against up to three other human players using the DS's wireless link, provided that all players own a copy of the game. All racing modes include a series of gates which must be passed through, 25 different tracks are available to race on, offering a variety of terrains including "country backroads, swampy bogs, slick, snowy tracks".

Reception for the game was poor. Though some praised the graphics and the in-game music, the game's user interface was criticized. GameSpot articulated its unhappiness with the sense of speed felt by players, calling it "practically nonexistent", termed the trick system "clunky and incoherent", its biggest criticism was reserved for the game's menu system, which it called "...one of the worst presentation setups we've seen in a long time. The main game menu is at once ugly and horrifically organized...". The review approved of the music, some praise was afforded to the ATV graphical models; the review from IGN echoed the praise of the game's graphics and, noting the good use of voxels, called the result "pretty darn nice". The IGN review panned the game's user interface, calling it a "chore to navigate and understand"; the lack of a feeling of speed for players when racing was noted. The reviewer concluded that despite reasonable gameplay and graphics, ATV: Quad Frenzy was "clearly shipped half-complete" due to its lackluster and cumbersome presentation.

VideoGamer took issue with the game's perceived extreme similarity to Monster Trucks DS, going so far as to call ATV: Quad Frenzy a "simple cut and paste job". The slow speed of the ATVs and concerns about the game's user interface were raised, with the reviewer concluding that it was "quite disgraceful that they made it onto store shelves."

Things Not Seen

Things Not Seen is a first-person novel written by Andrew Clements and his third novel after Frindle and The Landry News. The story revolves around Bobby as he deals with his'disease', tries to get back to normal, befriends a blind girl; the title is taken from Hebrews 11:1,"Now faith is the substance of things hoped for, the evidence of things not seen." In the King James Version of the Bible. The book was released in 2002 by Philomel Books, an imprint of Penguin Group, but was re-released in 2006 as a platinum edition by Puffin; the platinum edition includes a short interview with a redesigned cover. This book was followed by two sequels, Things Hoped For and Things That Are. Robert Phillips, known by his nickname "Bobby", wakes up one day to find that he can no longer see himself. To make sure he was right he looked in the mirror and could not see himself. Upon discovery, he tries to convince his parents that it's not a trick, he drinks a glass of orange juice, which to the astonishment of his parents, seems to make a "spoon float in the air."

After a brief argument with his mother, Bobby is told to stay at home until his parents get back from work. After his parents are gone, Bobby heads to the library, bundled up to conceal his secret invisible self, after a brief walk around, he hurriedly leaves, bumping into a girl, his scarf comes off. He helps to retrieve her things, realizes she's blind when he hands her back her cane. Upon returning home, he gets in trouble, his parents leave to get dinner and Bobby watches TV and takes a nap. When he wakes up, the TV says, he sees. The police come to his door and check on him. After they leave Bobby goes to the hospital to see his parents; when he gets there he goes to find his parents. He can only find his Mom. After talking to his Mom he uses money he goes home, he returns to the library the next day. He goes naked this time, stumbles upon the blind girl in a listening room, he enters the room with her permission and they start talking. He learns that her name is Alicia, befriends her. Part of Bobby's journey to become visible involves invading the Sears-Roebuck corporate headquarters.

During which he steals a list of names of people who complained to Sears-Roebuck about a "bad blanket". Bobby uses this list to locate Sheila Borden, who became invisible a few years prior to the events in the book, she tells him never to tell anyone. Bobby tells Alicia, however. Bobby instant messages Alicia. Bobby wants to give up on finding a cure, she tells him. So, if he gets his blanket and sleeps with it, his problem will be reversed. Bobby crawls under the blanket, he awakens to find several loud voices. Ms. Phillips, his mother, a random agent come into his room. Bobby doesn't realize now, with several people staring at him naked, he covers up. And his mom says, his dad is happy that he is mad he didn't think before acting. He goes to tell Alicia the news, she doesn't take it well. Bobby tries to instant message her, she replies with an e-mail and a poem. Bobby goes over to her house to tell her. Bobby Phillips - Main character, a high school student who turns invisible Alicia Van Dorn - A blind girl a high school student, who befriends Bobby Emily Phillips - Bobby's mother, a professor of English literature Mrs. Van Dorn - Alicia's mother Dr. David Phillips - Bobby's father, a professor of physics Shelia Borden - A victim of being invisible as well.

Mr. Van Dorn - An Astronomer as well as Alicia's father Mrs. Pagett - A social worker sent to look for Bobby after he had not been at school for many days The book won the 2005 Middle School/Junior High California Young Reader Medal; the book won the American Library Association's 2004 Schneider Family Book Award. The Invisible Man, an 1897 novella by H. G. Wells Memoirs of an Invisible Man, a 1988 science fiction novel by H. F. Saint Fade, a 1988 YA novel by Robert Cormier Andrew Clements' Official Website Penguin Books listing "Most teens feel invisible now and then" - a review by Courtney Williamson