Manoeuvre Warfare Is Not A War History Essay

Manoeuvre Warfare Is Not A War History Essay 2. Doctrinal Base. Manoeuvre warfare has been adopted as the doctrinal basis for various Western armies. The Indian Army has been loosely following it in both theory as well as practice for quite some time, but is still grappling to adopt it as basis of our war fighting philosophy. It would take more than rhetoric to actually transform this concept into practice; there remains a lot of confusion as to what exactly it entails. Out of the many existing definitions only few are capable of concisely and clearly defining what Manoeuvre warfare is and how one does it. Manoeuvre is more of a philosophical approach to campaign design and execution than an arrangement of tactical engagements. Art and philosophy are often the most common terms describing the concept and definition of Manoeuvre warfare. It can be described as the art of tactics concerned with creation of battle array, decision making and understanding the human dimension rather than a science associated with techniques, procedu res and capabilities, 3. Difficult to Understand. Being an art associated with philosophical concept of war fighting; it leaves a lot to the interpretation and understanding of a theorist whose vision is generally obscured by his basic psyche, experience and the knowledge base available to him or his capability to grasp the concept of Manoeuvre. More often than not one acts on the lines of six blind men who wanted to describe an elephant and each used his imagination according to the part of elephant he was touching: So six blind men of Hindustan Disputed loud and long, Each in his own opinion Exceeding stiff and strong; Though each was partly in the right, They all were in the wrong! Applicability yet Of Manoeuvre Warfare 4. Spatial concept? Manoeuvre is traditionally thought of as a spatial concept which is used to gain positional advantage. The US Marine concept of manoeuvre warfare however is war fighting philosophy that seeks to shatter the enemys cohesion through a variety of rapid, focused, and unexpected actions which create a turbulent and rapidly deteriorating situation with which the enemy cannot cope.  [2]  The manual further says: This is not to imply that firepower is unimportant. On the contrary, firepower is central to manoeuvre warfare. Nor do we mean to imply that we will pass up the opportunity to physically destroy the enemy. We will concentrate fires and forces at decisive points to destroy enemy elements when the opportunity presents itself and when it fits our larger purposes.  [3]   5. Should We Adopt it. When deciding upon the war fighting doctrine a nation should deliberate upon a basic question that is how to achieve victory in an acceptable time frame which is economical in terms of men and material? . The answer we seek must be viewed in light of various functions such as the nations military might, economic and political standing in world order compared to his perceived adversaries, likely threat perception and expected duration of war. The Indian Army doctrine does directs our focus on the intellectual understanding, institutionalisation and implementation of Manoeuvre warfare in its chapter on Operational Perspective  [4]  however, remains uncommitted on deciding manoeuvre warfare as our basic war fighting philosophy. 6. Mechanised Association. Since most astounding victories associated with Manoeuvre have a mechanised background, it is often considered to be a word of mechanised domain. The most common examples given is that of Blitzkrieg or Rommel and Pattons gallop across Gazala and the plains of Sicily respectively. Though most of us know that Rommel was an audacious practitioner of manoeuvre warfare during WW -II in his daring exploits but a few actually seemed to be aware of the fact that he learned and perfected his manoeuvre skills as an infantry soldier in WW- I. Indeed it can be debated that the German war philosophy in second World War was deeply influenced by Rommels World war I infantry experiences and his book  [5]  that grew out of those experiences. This lack of historical and conceptual understanding further deepens the dilemma of its applicability in Indian context especially in mountains. 7. Applicability in Mountains. In light of above mentioned aspects we must ask ourselves if manoeuvre warfare is solely applicable to conventional conflicts typified by massed formations of armoured vehicles? Or, are the principles and methods equally applicable to mountainous terrain?. The key to manoeuvre warfare, as expressed by proponents like William Lind and Robert Leonhard, was defeating the enemy by attacking his critical vulnerability rather than going toe-to-toe with his strength. This implies that in difficult terrain like mountains where critical vulnerabilities are of paramount importance and play decisive roles in the success of operations, the manoeuvre warfare assumes rather greater significance. CHAPTER II METHODOLOGY Battles are won by slaughter and maneuver. The greater the general, the more he contributes in maneuver, the less he demands in slaughter. Winston Churchill, The World Crisis, 1923 Statement of the Problem 8. Manoeuvre warfare is considered to be synonymous with mechanised operations and desert terrain by most of us. This thought process restrain us from tapping the actual potential of this universal war fighting philosophy, whose applicability is irrespective of the type of terrain or the arm using it .The aim of this paper is to analyse the concept of manoeuvre warfare as the war fighting philosophy for Indian Army and examine the feasibility of its application in mountainous terrain in Indian context. Hypothesis 9. Manoeuvre warfare is not a hard science and does not have a rigid list of theorems or formulae, which can define its applicability to a particular arm or terrain. It is very much applicable in Indian context, especially to mountainous terrain. Justification of the Study 10. Inability to Accept Manoeuvre Warfare. Over the years we have developed an attrition-based approach to warfare. Our training institutes are teaching tactics as a science having set piece solutions with mathematical framework and rigid utilization of resources. Though we claim to accept most logical and workable solutions but nine out of ten exercises end up with same lessons and solutions being culled out in the end. Another factor, which largely contribute towards our inability to accept manoeuvre warfare at tactical level is our fascination to adopt westernised terms and concepts. This is acceptable till they are used as building blocks to enhance our operational efficiency. But when templated without giving a proper thought to the fiber of our society, training and our basic approach towards life and philosophy  [6]   results in mere lip service and resentment at grass root level where they are to be executed. This misleads them to perceive manoeuvre warfare as extension of widespread military jargon or another fascinating word for what we have always done or common sense tactics  [7]  . This needs an urgent change in thought process. 11. Geo-Politico-Military Factor. India is wedged between two hostile neighbours having boundary disputes with both, which can lead to a potential conflict in future. With western adversary we enjoying vast superiority both in numbers and economy but the situation is not so very same with the eastern. Indian philosophy and ethos are against loss of any territory this when coupled with no first use of force places the military force at initial disadvantage of wresting the initiative before any conflict. This more or less drives India towards the attritionist practices in war where territory is of vital importance and its loss is unacceptable even in lieu of operational or tactical advantage it accrues. Superior force ratios are considered necessary to protect or regain the lost territory at any cost. 12. Battle Field Milieu. These potential situations when coupled with future battlefield scenario having nuclear backdrop, own political will and international pressure assures high intensity, fluid, short term and intense battle field in a reactive scenario. Such characterized conflicts cant be won just by attritionist approach. We need a philosophy, which provides us victory in shortest time frame with economy in men and material. 13. With approximately two third of our borders resting on the high mastiffs of mountainous terrain, it is easy to acquire a defensive mentality and orthodox approach to war fighting. This attitude stems from a blinkered outlook that any other approach to warfare is of no concern in this topography and the war will be nothing but a peak to peak slogging match. In the light of these, it is imperative that one takes a fresh look at our approach to warfare and reconsiders the applicability of manoeuvre warfare to mountainous terrain to win any future conflicts with minimal losses and within acceptable/quickest timeframe. We must understand that manoeuvrist approach to operations is as important to a commander in the high mountains as it is to a mounted general. Scope 14. This paper carries out an analysis of modern works on the theory of Manoeuvre warfare and tries to establish link between various theories and figure out basic components of manoeuvre warfare. The work just touches the concept based on the premise that basic knowledge of manoeuvre exist with the reader The scope will be limited to the instigating the aspects needing attention in the Indian armys basic doctrine and war philosophy to make it more manoeuvristic. The paper will concentrate more on organisational, institutional and functional changes necessary to facilitate this and the explore the concepts that can be applied while operating in mountainous terrain. . Methods of Data Collection 15. Books, military journals and periodical have been referred to from Defence Services Staff College Library, online sources and personal subscriptions contributed towards the research. Some contents have also been taken from the interviews of German generals after World War II (WW II) which were available from Defence Sites after translations. My own understanding of subject that accrued from discussions with peers, seniors and the Guide Directing Staff Colonel Rohit Mehta on the topic has come handy in making few suggestions for the dissertation. The casual discussion with Gen (Retd) HS Panag and lecture by Gen (Retd) Mehta in DSSC were instrumental inshaping the ideas expressed in the research. The bibliography of sources is affixed at the end of the document Organisation of Data 16. The text has been divided into five chapters excluding the introduction and conclusion. The initial chapters examine the essential elements of Manoeuvre warfare and how it differs from attrition warfare with special reference to analysis of modern writings on the subject and culls out the essence of these theories. The next chapter deals with relevance of this theory in the Indian context. The penultimate chapter is a follow up of the previous chapter and highlights the organisational, institutional and functional changes necessary for implementing manoeuvre theory by Indian Army. The next chapter gives some recommendations to apply the concept of manoeuvre warfare in mountainous terrain bordering India.Thereafter reiterating the essence of what has been said in the entire dissertation the conclusion settles the dissertation. CHAPTER III UNDERSTANDING MANOEUVRE WARFARE à ¢Ã¢â€š ¬Ã‚ ¦ Manoeuvre theory has nothing to do with vast numbers of men and machines charging down the countryside. Manoeuvre theory is about amplifying the force which a small mass is capable of exerting; it is synonymous with the Indirect Approach. -Richard E Simpkin Evolution of Manoeuvre Theory 17. Manoeuvre warfare is a philosophy for fighting smart to ensure success in war. The first manoeuvre on a large scale in battle, recorded in history, was during the Battle of Marathon in 490 BC  [8]  . In this battle, the Greeks under Miltiades scored a decisive victory through manoeuvre where the Greek phalanx hit the Persians from both flanks inflicting a total defeat. However, Alexander the Great can be considered as the first great practitioner of art of manoeuvre. Most of his victories are classic examples of Manoeuvre warfare. In 331 BC in the battle of Arbela he defeated Persian monarch, Darius III who had a numerical superiority of 5:1 against him. Sun Tzu also captured the essence of this philosophy in his classic work  [9]  . 18. The most important development of manoeuvre theories took place in Germany and the USSR during the 1920s and 1930s, notably with the development of the Deep Battle concept that was integrated into the Red Army field regulations doctrine by Marshal Tukhachevsky  [10]  . While the Wehrmacht developed from this the operations named Blitzkrieg, in the USSR this led to the creation of the Cavalry Mechanised Groups during the Second World War, and the Operational manoeuvre groups during the Cold War.  [11]  The Soviets used the concept of Deep Battle (which they continued through the Cold War). 19. In spite of all these years of rich history, only recently has a clear and acceptable definition of Manoeuvre warfare has been offered for modern tactics and operations. Two of the best works on modern manoeuvre warfare come from Robert R Leonhard  [12]  and William S Lind  [13]  . While they both draw heavily from Sun Tzu, Richard Simpkin, Sir Basil Liddell-Hart and Second World War German and Russian theories, they synthesize these thoughts and produce what could be called the modern school of Manoeuvre warfare. Modern Works On Manoeuvre Warfare 20. William S Lind Observe, Orient, Decide, Act (OODA) Cycle. Linds understanding of manoeuvre warfare theory is based basically on the research done by Retired Air Force Colonel John Boyd, who studied the US success with the F-86 fighter aircraft in combat over Korea fighter aircraft and derived Boyd Theory, Pattern of conflicts  [14]  . He observed that fighter pilots, who were able to observe their opponent, orient themselves to the situation, decide on a course of action and act upon decided action faster than their enemy counterparts usually embraced victory. The idea was that the pilot who went through his OODA loop also known as a Boyd Cycle) faster than his opponent was able to render his opponents actions irrelevant and gain the upper hand in the dogfight. Lind uses this as base to conceptualise Manoeuvre theory and summarise it as- Conflict can be seen as time-competitive cycles.  [15]  He concluded that the armies, which are able to decide, move and fight faster, would quickly render the enemys reactions irrelevant and would result in destroying his cohesion. The enemy who finds the irrelevancy of his actions with each passing moment are subjected to panic or become passive and this is an ideal outcome for the victor, because a panicked or passive enemy can be annihilated or captured at the lowest cost in friendly casualties.  [16]   21. To achieve such end state ground forces must have capability to conduct faster Boyd Cycles/OODA cycle .The various methods suggested by Lind are Decentralized Command and Control, Initiative at all levels of command to exploit the fleeting opportunities. Mission-Type Orders that tell subordinates only the intent of higher commander and not how to achieve it; the designation of a Main Effort to focus the resources at disposal towards common objective to promote Unity of Effort and reliance on Reconnaissance Pull to Exploit Gaps and Avoid Surfaces in enemy defence. He further adds that Manoeuvre warfare means not only to Accept confusion and disorder but also successfully operates in it and warns to avoid all patterns, recipes and formulae i.e. to say Be Unpredictable and achieve surprise.  [17]   22. Therefore, it can be understood the soul of Linds theory is tempo which is supported by Sun Tzu What is of the greatest importance in war is extraordinary speed; one cannot afford to neglect opportunity . . . An attack may lack ingenuity, but it must be delivered with supernatural speed and further explained by Richard Simpkin as the operational rate of advance.  [18]   23. Robert Leonhard and Art of Manoeuvre. Leonhard expands upon Linds theory of manoeuvre warfare by looking beyond tempo to other methods of defeating enemy. But agrees with Lind on defeating enemy with the minimal necessary force. As described by Leonhard, manoeuvre warfare attempts to defeat the enemy through means other than the simple destruction of his mass.  [19]  The other means of Leonhard include (a) Pre-Emption which is the most economical and often most successful method to defeat enemy. Indeed the highest and purest application of maneuver theory is to pre-empt the enemy, that is, to disarm or neutralize him before the fight.  [20]  This is in consonance with Linds emphasis on tempo and Boyd Cycles. (b) Dislocation is regarded as the next most preferred method, after pre-emption, i.e., which he explains as à ¢Ã¢â€š ¬Ã‚ ¦removing the enemy from the decisive point, or vice versa, thus rendering them useless and irrelevant to the fight.  [21]  Dislocation can be further sub divided as positional or functional dislocation. Positional dislocation involves making the enemys location irrelevant through Manoeuvre while Functional dislocation refers to rendering an enemys strength irrelevant. (c) Disruption as the third method for defeating the enemy more economically. He defines it as attacking the enemys Centre of gravity(COG), which he further explain using the King Queen theory  [22]  -taking analogy from game of chess to he describe the understanding of of COG for attritionist as the queen or source of strength and for maneouvrist as king or the critical vulnerability. Which when addressed causes the enemy to lose cohesion and the will to fight. Disruption is closely linked to battlefield psychology and its target is not the enemy forces per se but rather the mind of enemy commander Essentials of Manoeuvre Warfare. 24. Other than the concepts mentioned above; keeping present and future battle field Directive Style Of Command, Mission Type Orders, Small Team Concept, Integrated Battle Approach With True Jointmanship, Simultaneity Of Operations, Mental Mobility Of Commanders at all levels and High Initiative with Mastering The Basic Skills are other essentials demanded for a manoeuvristic approach. There is a large gap between the philosophical concept and its practical application. Manoeuvre warfare is not a concept that can be practiced independently by tactical units. It requires the support of entire army as well as each individual soldier for the required transformation. Manoeuvre Vs Attrition. 25. In most situations, attrition warfare is best able to achieve the principle of concentration of force, unity of command, security, cooperation and simplicity. The outcome of WWI was decided by attrition If either side had been able to force part of the enemy alliance from the field, it would have reduced the enemys available resources and forces. Additionally it would have forced the enemy to spread its fewer forces over a larger area, potentially allowing greater room for maneuver. However attrition was forced on the belligerents until the combat power ratios  [23]  were changed and the Allies gained a clear advantage. It is a comparatively simple way to wage war and demands little initiative from subordinates. Higher commanders with the help of staff available plan battles in micro details whereas junior officers merely follow orders to the cut. However, this makes attrition war predictable and sequential. 26. By contrast, manoeuvre warfare regards application of military force as only one of the ways of to the attain politico military aim. Manoeuvre warfare draws its power mainly from opportunities and still more on winning the battle of wills by surprise or, failing this, by speed and aptness of response.  [24]  Manoeuvre warfare is thus concerned with amplifying the force, which a small mass is capable of exerting and conveying a threat commensurate with the mission. Field Commanders Adoption of Different Warfare in Similar Situations. 27. Field Marshal Montgomery and General Patton were two of the most effective allied commanders who were faced with roughly similar conditions, practiced effective dissimilar methods of war fighting. While Patton stressed on audacity, surprise, speed and always relied on mental mobility of subordinate commanders to exploit battle opportunities, Montgomery emphasised on caution and preferred a balanced orthodox approach. Montgomery has often been criticised for his aversion to taking risk but his approach to war was certainly an effort to minimise the risk. Comparing the two commanders lead to deduction that both concepts focus on compelling the enemy to do our will or reducing his ability to resist us until he finally accedes to our will  [25]  . A major assumption is that a war of manoeuvre is of a higher order than a war of attrition and that the general who defeats his enemy in a war of manoeuvre is superior to another who practices attrition warfare. Many still think of Gene ral Grant as a the butcher owing to the methods he used to defeat the Confederate armies or have general belief that all World War I generals lacked inspiration because they seemed incapable of breaking the stalemate at the front. Which certainly needs reconsideration, as both the theories are complimentary. Different Wars. 28. Wars of manoeuvre can be referred as wars of annihilation or destruction because the enemys ability or will to fight is annihilated after a decisive battle or a series of decisive battles in different theatres. Whereas wars of attrition may be referred as wars of exhaustion as they focus on the enemys ability or will to resist be exhausted. Attrition wars can be presumed to be more costly to in terms of loss of personnel, materiel and time unless one side completely dominates the other. In contrast to attrition theory, which concentrates on the enemys field forces, manoeuvre theory thrives on outperforming the enemys thought processes with the intent to destroy force cohesion. Why Modern Wars Become Attrition Wars? 29. The inspiration for the attrition theory basically comes from Clausewitzs Vernichtungsprinzip or principle of annihilation.  [26]  If wars of attrition are generally more costly than wars of maneuver and practitioners of attrition are perceived as less enlightened than those who succeed through maneuver and a decisive battle, then why do modern wars so often become wars of attrition? There are reasons to it: (a) Often the combat power that can be generated at the front is almost equal. Temporary stalemate and attrition follow until one side achieves a advantage in terms of numbers, firepower, leadership, manoeuvre, protection or Information. (b) Perception that the chances of success through a strategy of attrition have less risk element and uncertainty for the commander. (c) Nations which, possess a large army and and population which accepts the loss of lives in wars as a natural outcome accept attrition warfare. (d) When asymmetry exist between two warring fractions attrition warfare is followed unconsciously by superior fraction. The Other Side Of Manoeuvre Theory 30. Every coin has a flip side so as every theory. There are certain conditions to be fulfilled while practicing this type of warfare. This requires additional effort compare to attrition theory of warfare. (a) Dependence upon individual leadership. (b) There are also immense and glaring cultural differences between a decentralised manoeuvre military and a centralized attritional service. Attaining the latter involves people, time, and resources while the former requires something more rare and difficult to achieve and that is the development of military tradition, free thinking by soldiers and commanders, mutual trust at all levels and education in the military art. (c) Delegation of responsibility by higher commander for crucial combat decisions to subordinates implies highest degree of interpersonal understanding and trust not easily achievable. Such trust and understanding must be forged within the framework of a mutual drive towards the achievement of final objective. Creating such frame of reference and bonding of shared values and morals is exceedingly difficult to achieve. (d) Involvement of higher degree of risk and uncertainty. Maneuver warfare usually entails more risk. There is consoling certainty in programing warfare as quantifiable, logically measurable and scientifically less intuitive. It recedes the mystery and terror of something otherwise uncontrollable, indecipherable, and probability based. (e) The maneuver doctrine required relentless tempo that could not afford an operational pause. It was one of the factor leading to German failure during Barbarossa.  [27]   CHAPTER IV MANOEUVRE WARFARE FOR INDIAN ARMY Theory Suitable For Our Nation ? 31. The answer to this most commonly asked question depends upon ones needs, assets, and the kind of political supervision. Irrespective of national or military inclinations toward any theory, there are certain parameters which determine what type of warfare a nation should adopt. (a) Human Resource. Contrary to expectation that attrition requires a lower level of intellect and imagination than does maneuver; One must understand that most people can be made to adhere to checklists and taught to operate or maintain even the most complex pieces of technology. However, maneuver warfare requires creativity and innovativeness towards the unorthodox approach and independent cast of mind. (b) Equipment. Attrition-warfare armament must exceed at least the quality and preferably the quantity of that of the enemy. Developing countries will find adoption or continued adherence to attrition theory unjustifiable, unless they expect even more compelled foes (only western adversary in our case). (c) Threat. A military selecting a particular warfare theory will need to consider its likely threats. Will it encounter a conventional army with high standard of training, morale and motivation equivalent to his (west in our case) or a more resourceful nation with edge in terms of political freedom, technology, and numbers (East in our case). (d) Duration of war. In short term conflicts attrition has not performed well against maneuveristic army. It is only after extended periods of stalemate (and frequently heavy casualties) can those who employ attrition theory could overcome their maneuveristic enemies. (e) Risk / Higher Directions of War. The level of acceptable risk that the leadership is willing to take is extremely important when selecting a suitable theory. (f) Strategy. If a particular nation has some territorial disputes but its strategy is to maintain a status quo, it is not going to opt for large-scale manoeuvre warfare. However, since it has to remain prepared for any attempts to alter the status quo it may opt for a slightly higher bias towards Manoeuvre than attrition. (g) Some of the other determinants for planned offensive could be: (i) How deep are we planning to go? (ii) Is there a requirement of going that deep? (iii) What type of punishment do we want to inflict? (iv) What type of punishment are we anticipating? 32. Social Fiber of Society. Attrition theory generally suits the style of societies that believe human nature is inherently good; that war takes place between military forces with clearly designated combatants; that there are clear-cut demarcations and chivalry still exists during any combat. While the foundation of manoeuvre warfare is based on the philosophical tenets- that human nature is inherently flawed, that because of human greed and frailty; warfare is an inevitable fact of life, that war is an all-embracing human activity that is not confined to the clear demarcation of the battlefield and that the crux of warfare is mans mind. Which Direction Should We Embark 33. Rarely has superior firepower and attritionist approach determined the outcome of any major conflict. Nations have historically demonstrated a remarkable resiliency while enduring the punishment wrought by bombs, artillery, missiles and loss of men and material but victories are achieved only when the commander orchestrates a balance

Discuss About Intravenous Urography Health And Social Care Essay

I would wish to discourse approximately endovenous Urography in this paper. Intravenous Urography or merely known as IVU is a process to analyze the urinary system by utilizing contrast media. It had been start utilizing in twelvemonth 1930 to analyze the upsets of urinary system. It is performed to diagnosed nephritic map and investigates the anatomy of the kidneys, ureters and urinary vesica. The indicants for executing a IVU scrutiny are suspected urinary piece of land pathology, repeated harm, haematuria, injury and probe of hypotension in immature grownup. Urography may besides utilize to execute the pre- or post-therapeutic evalution of rock disease. The urography imaging sequence is design to supply diagnostic. The contrast media is brought to the kidneys through blood circulation, filtered in the glomeruli and concentrated in the nephritic tubules. Then the contrast media will delivered to the pelvic girdle, ureter and vesica where radio-opaque show on X-ray movies. Normally this scrutiny will be performed by the physician to avoid unfortunate incidences. The intent of IVU is the primary probe for urinary disease such as urinary rock, urinary rednesss, urinary injury and obstructor, assorted and contraindications. Some necessary safeguards are taken to avoid the allergic reactions. This safeguards include ask whether patient is allergic to any medical specialty or nutrient, is patient ( adult females ) pregnant or have any opportunity to pregnancy within a hebdomad and any diseases that may do patient to hold anaphylactic daze during scrutiny. Equipments that are needed during Intravenous Urography are exigency cart to the full equipped and handily placed, instrument for injection is arranged on a little, movable tabular array or on a tray, often used unfertile points must be readily available, disposable acerate leafs and panpipes are widely used in this process, nonsterile points such as compression bandage, little waste bin, vomit basin, disposable rub, contrast media that is required, and dressing for puncture site must be required. Besides that, a pillow or folded tower that can be place under patient ‘s cubitus during the injection of contrast media to diminish force per unit area. The equipment for endovenous disposal equipment are 50ml syringe, make fulling needle, skin homework, gluey tape, choice of acerate leafs, straight/'Butterfly ‘ 16,19,21,23 gage and compression bandage or blood force per unit area turnup. Emergency drugs and equipment such as steroid injection, adrenaline injection, antihistami ne injection, endovenous dextrose trickle and O for inspiration must be checked every twenty-four hours and easy to get during IVU scrutiny. Basically, we are utilizing 3 types of contrast media during IVU scrutiny. They are Niopam 300, Omnipaque 350 and Urograffin 370. Doses of contrast media that injected into a 70 kilogram, normal blood urea grownup are 50 milliliters through endovenous. Before injected the contrast media to patient, the contrast media must be warmed to personify temperature. To shoot the contrast media into the vena, a 19 gage acerate leaf must be punctured into the average cubital vena. Then the contrast media that been warmed to about 36-37 grade Celsius will be injected. This process is ever performed by the Radiologists or physician. Then movies are taken at intervals will show whole nephritic system. At the twenty-four hours of scrutiny, patient is necessitating to alter to hospital gown. Make certain patient had emptying the vesica to forestall dilution of contrast media with urine. Patient is placed on the tabular array with supine place in the X-ray room, the MSP of the patient perpendicular to the midplane of the grid. Support patient ‘s articulatio genus by utilizing a pillow to cut down dipped curvature of lumbar spinal column. This can supply a more comfy place to patient. Compression devices must be prepared before the scrutiny, so that it will be ready to application in a specific clip. Obtain a preliminary radiogram of the venters. Then fix for the first post-injection before the contrast medium is injected. A cassette with movie is placed in the bucky tabular array, place the cassette and set on markers on the cassette. Changes are made on focus and exposure factors based on the prelim movie. Contrast media for injection intent is prepared utilizing sterile techn ique. Administration of contrast media into patient ‘s organic structure is normally done by the physician harmonizing to the patient ‘s organic structure size, ages and weight. Several radiogram will be taken at specified intervals get downing from the clip the contrast media is wholly emits into patient ‘s organic structure. In approximately 2 to 8 proceedingss the contrast media will get down to look in the pelvicaliceal system. Patient demand to empty their vesica as the scrutiny is over and a radiogram will be taken to guarantee that contrast media is wholly removed from the organic structure. The typical exposure values for IVU are 65-75kVp, 50-70mAs, 100cm of Film Focusing Distance ( FFD ) , used grid to diminish spread radiation and utilize regular film/screen. 5 X-ray movies will be taken during this scrutiny. The first X ray besides known as preliminary movie is a normal abdomen X ray. The movie should include most of the venters and pelvic girdle ( kidneys, ureters and vesica ) . If the movie is demoing unsatisfactory component such as gases and a tonss of fecal matters inside the patient venters, we might hold to prorogue the scrutiny. This is cause by the patient that did non follow the direction right. This is usually go on on the out-of-door patient. This scrutiny will be go on when patient have achieved proper readying. The 2nd movie ( immediate movie ) is after the patient is injected with the contrast media. The intent of this movie is to show AP nephritic disease by demoing nephrogram, examples the nephritic parenchyma. The 3rd movie or merely known as 5 proceedingss movie is taken to find whether farther dosage of contrast media is required or non. We might use compaction to dilate pelvicalyceal system so that it can clearly sho w make fulling defects in the 3rd movie ( 15 proceedingss movie ) . The Forth movie ( 25 proceedingss movie ) is taken to show the distended vesica. This can be done by concentrating 15 degree caudal angulations and the upper boundary line of the symphysis pubic bone is centered. The last movie ( station urination movie ) will show the emptying success of vesica and the antecedently distend lower terminals of ureters had been returned to normal. There are besides some extra projections required such as inspiratory, expiratory and oblique projection so that relationship of opacities and make fulling defects to the nephritic piece of land is demonstrated. Purpose of imaging is to show lineations nephritic and overcome darkening from the gastro enteric piece of land. An immediate station injection radiogram should show the kidneys addition in denseness because of the contrast within the uriniferous tubules. Different denseness nephrograms may bespeak nephritic nephritic arteria stricture, if this is suspected a series of movies at 1, 2, and 3 proceedingss after injection can convey more accurate visual image. The kidney lineations should be smooth and does non concentrating contrast media. If it is concentrating the medium, it is likely cause by tumours. The calyces, nephritic pelvic girdle and portion of ureter should be seeable in the 5 or 10 proceedingss movie. Both kidneys should hold the same denseness as the nephrogram is reduced. If we see 1 of the kidney denseness is lower, it might be cause by ureteric diseases such as urinary obstructor. To find site of obstructor, a delayed movie is required after 45 to 60 proceedingss after injection. 15 proceedingss movie shall demo the cause of urinary obstructor. Urinary obstructor might be caused by stne, coagulum or tumor near the ureteric opening. If the ureters are dilated, the cause is likely in the vesica or urethra. The intent of taking vesica movie is to name the unnatural size of vesica that might be cause urinary diseases. Examples of the diseases are prostate expansion, urethral obstructor, neurogenic vesica, TB, Schisotosomiasis, rocks, calcification, tumor and gas in the vesica. It is the duty of a Radiographer to use to patient and radiographer to diminish the radiation doses that receive. Guidelines refering radiation protection are using gonad shield to patient if it does non overlap the part of involvement. Collimation need to be applied so that lone part of involvement merely will have radiation. Do non reiterate the scrutiny so that patient will non have external radiation. Male patient shall be shield for all scrutinies. Some patient might shown some symptoms such as sickness, minor urticarial roseolas, on occasion terrible laryngeal hydrops, anaphylactic daze and cardiac apprehension. As the marks of these symptoms appear on patient, injection of contrast media must be stopped instantly. Emergency drugs such as antihistamines and steroids are given to patient. Decision is IVU is a safe scrutiny with all the set up in the X-ray room and it gives detail information to physician for diagnose intent.

Charting a New Course for Schools Essay

Marc Tucker’s article, â€Å"Charting a New Course for Schools,† highlights the most urgent problems that the American education system currently faces. He mentions the need to reform the education system in order to compete in today’s global economy.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Tucker pointed out the deficiencies of the educational system in the country today. Furthermore, he stressed on the need to implement changes to the system. The author focused on information that evidently shows why there is an urgent need to overhaul the educational system.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According to Tucker, the report of New Commission on the Skills of the American Workforce, â€Å"Tough Choices or Tough Times, provides an overview of the current status of the American labor force. It shows how the American workers are lagging behind workers from developing countries in terms of skills and abilities. Also, Tucker points out that workers from developing countries possess the same skills and knowledge as American workers and yet are paid lower wages. This poses a problem for American workers since it is a given that any business man would choose to lower costs for the same quality. American workers are losing their edge in the labor market due to the antiquated education system of the country.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The dilemma for American workers is this, they must either give up their current standard of living or they must improve themselves in terms of skills, talents, and abilities. The latter, according to Tucker, is the reason why a revamp of the country’s education system has become a necessity.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Tucker points out two criteria that the United States must meet in order for its workers to continue commanding their high wages and maintain their standard of living. The author says that first, American workers must match the best academic performance in the world. At the same time, Tucker said, the country must offer workers that are the most creative and innovative.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The article also highlighted the characteristics of a premium worker or the worker that deserves to be paid premium wages. According to the author American workers should become premium workers in order to receive the current wages that they are receiving. He described a premium worker as someone who has a high level of preparation in the general areas of reading, speaking, mathematics, history, literature, fine arts, and science. Furthermore, a premium worker should be comfortable with new ideas and abstractions. He must also be creative and possess the imagination to come up with meaningful and useful products for the company. Premium workers must also possess the ability to solve problems by using their knowledge from various fields. Lastly, Tucker described a premium worker as someone who is a team player and can easily adapt to the various changes around him.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Premium workers are products of a good and up-to-date educational system. This is the current problem of the education in the country as the current system is no longer adept with the conditions of today. To tackle this problem, Tucker suggested seven steps that can be taken to reform the American educational system. First, Tucker suggested charting a new course for student progression through the system. This requires a total reorganization of the system and opening of new educational opportunities as the students progress. Secondly, the author pointed out the need to reinvest resources where they are most needed and where they will be most efficiently used. This means that available resources should be allocated to areas of the system which can produce the greatest amount of rewards for the students. Another step is to initiate a universal preschool educational system. Tucker viewed preschool education as the foundation of school-based learning. If students are to become highly-skilled workers, they must have a good education foundation and preschool education is the integral aspect of such foundation. For teacher recruitment, Tucker suggested that schools recruit those coming from the top third of the college class. This will ensure highly-educated and competent teachers. Moreover, Tucker suggested the adoption of high-performance management modes to improve schools and districts. Also, he pointed out the need to provide strong support to disadvantaged students. Finally, he proposed the rebuilding of standards, assessment, and curriculum to reflect today’s needs and tomorrow’s requirements. In general, Marc Tucker’s article discusses the problems of the antiquated American educational system and its severe effects on the country’s labor force. I believe that there is indeed a pressing need to revamp the current educational system. Education in the country today no longer meets the needs of the economy. The labor force that the educational system produces is insufficient in terms of skills and abilities. The workers lack the necessary skills that warrant the wages they get. It is for this reason that American and international firms seem to turn to developing countries for their labor needs. If American workers are to remain deserving of the wages they receive, they must become more competent and highly-skilled. It is my opinion that the only way that the country will produce highly-skilled, creative, and innovative workers is to change the educational system. The system should focus more on the development of skills necessary for the various employment needs today. It is the right of every citizen to be properly and adequately educated in order to survive. The current system can no longer provide the educational needs of the people. The primary reason why people go to school is to prepare them for work. Since workers currently receive sub-standard education, they lack the skills and abilities that the labor market needs. Evidently, the only solution to this dilemma is, I believe, to revamp the educational system.

The Five Step Risk Management Process Essay - 1473 Words

Establishing Facts Step 2 in the five step risk management process involves analyzing the risk events and impacts identified in Step 1. This step is designed to help identify which risks are significant enough to the monorail project to require active risk management. To ensure action plans implemented in Step 4 are effective, it is essential to gain a better understanding of why a risk event or impact may occur, as well as its effect on the total loss with respect to the project’s total cost. The goal of Step 2 is to develop a list of drivers for each risk event and impact, identify the probability of occurrence for each risk event or impact, estimate the total loss associated with each risk event, and determine the risk likelihood and expected loss for each risk event. In order to employ effective risk mitigation techniques in later steps of the risk management process, Step 2 must consider the facts associated with the risks identified for the project. 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