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Foreword:

The role of nursing placed in the current scenario has evolved over time, as it reported by Tanya Buchana, (1999) based on a true story. One fine day, there were hundreds of nurses gathering in a campaign holding posters and placard which had phrases written in it asking for raise in pay without added conditions. One speaker from the group in order to get a verbal response started reading the placard one by one. The nurses were excited and started cheering the speaker, who was not a nurse himself, after each placard was read. When he read the final placard, he questioned the nurses, “Is Florence Nightingale dead?” His idea was to kindle and create a spark among the group asking this stirring  final question The entire campaign of nurses went silent for a while, after which they started whispering among themselves in frenzy.

All the nurses were taken aback and silence prevailed for a very long time. After a few minutes, few of the nurses started laughing uneasily, and some even found the question offending. Some nurses from the crowd started asking the same question among them; “Is Florence Nightingale dead?”. But none of them from the crowd were able to reply back clearly. This showed the lack of certainty among the nurses when it came to the position of Florence Nightingale in the role of nursing. One possibility is that, none of them has thought about the role Nightingale has played in nursing or questioned themselves on the subjects. Further, there was not much distinction between the person Florence Nightingale was and the function her name has come to, in terms of her role of nursing.

Here, I would like to explain how nursing, an important the role in wars and military has evolved over time and the historiography of it linked to Florence Nightingale. There is a difference between history and historiography, because, history, simply means what has happened in the past, but on the other hand, historiography is what has been written about what happened in the past. History is a very vast term and it typically depicts what happened every day and most of it is not recorded.

According to the great historians Michael de Certeau, Hayden White and Michael Faucault, history is nothing but a recording or writing of what happened in the past. According to them, history, which is written, is greatly influenced by the political conditions as well as the power relations of the situation when it is written (Reznick,2011).

This paper does not praise or censure Florence Nightingale or her contribution to the field of nursing. This is just a mere attempt to represent the reader with an efficient history with no criticisms or credibility. As a matter of fact, it is not possible to ignore the existence of a Florence Nightingale, when we describe about the history of nursing. When we talk about nursing, it has been greatly influenced by her personality and her role. However, discourse will not be able to reproduce what Florence Nightingale had done in reality, as against what is produced arc virtual Florence Nightingale (cl. de Certeau 1988:8). The account in this is written by a nurse to be read by nurses to help them enhance the role and responsibility.

War nurse 5

Background

The accounts of history of nursing written in both 19th and early 20th centuries have undergone a lot of criticism and were published somewhere in the 1980s. This resulted in the production of the revisionist accounts (Davies, 2007). Most of the reports that were published or recorded prior to 1960 were just used to rationalise the process of professionalization (Rafferty, 2000). As per the historians, this was the right approach and it was used to bring in more new entrants into this profession, and also to differentiate trained nurses, women who have been doing this without much training as they had claimed the title before the nursing reforms were introduced in the mid 19th century , (Nelson, 2002 ).

History was generally recorded and written in a congratulatory style. This was to provide a simple, precise and uncomplicated version of the history to the readers. It did not address the economic reality or complexity of the situation, social and other important conditions that influenced nursing. Further, it did not even account the role of gender or class or religion played (Mortimer, 2005; Sweet, 2007). This is not a single case that has to be ruled out while writing about the history of nursing. One can see that on the accounts of history of nursing in wars, it features a number of historical events and accounts, and it is even recorded in histories of hospitals written by nurses (Newby, 1985) and doctors (Granshaw, 1989). One can find that, the importance given to the mainstream society when describing how nursing operated or developed in minimal to nil(Margaret  et al 2002).

In this paper, we will discuss the important issues that had great amount of influence on evolution of nursing. Further, we can also discuss how the nursing management developed from its roots in the 19th century to the present stage. This will help us understand the organisation of nursing as a whole in a contemporary way.

When we take into account the development of management of nursing in the United Kingdom, there are 2 different periods that seem to have been mentioned over and over again in the literature. The 1st one is between the middle and the end of the 19th century and the 2nd one is between after the creation of National Health Service in 1940s and the introduction of General Management in 1980s ( Moiden, 2002).

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Role of Nursing during the Wartime

The role played by the American nurses during the wartime for the American military is undeniably one of the most important aspects. The nurse’s duty was very simple in military; which is to provide care and aid to all the soldiers who had wounded themselves in the war. Further, it was also their responsibility to take care of the casualties of the war. If we go through the history we will understand that the view of a military nurse has changed to a greater extent from that of a simple recyclable source used only during the military necessity to be called upon only during the time of crisis to part of the team.

Florence Nightingale, with a team of 38 nurses sailed a ship to Turkey to be an unwelcomed guest and provided with an appalled situation and very poor sanitary facility. Further, both the military doctors and the health officers had refused to take into account Florence’s attempts to revamp the military hospital. Only later, when Florence succeeded in the Crimean War, high standards for a nurse and the practice of nursing was established. Post which the number of nursing schools increased and the growth and development of the schools also improved the qualification of nurses and they came to be officially recognised, even in the military hospitals (Buchana, 1999).

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The American Civil War and Nursing

It was only during the American Civil War that women were offered responsibility and introduced as female staff, in the traditional male dominated military environment. This also had a significant improvement of women’s liberalisation in the later days in American society (“Civil War Nurses: The Angels of the Battlefield,” N.D.). The two most important women in revolutionising the nursing concepts were Dorothea Dix and Clara Barton. They were very powerful and changed the concept of nursing during the Civil War. Both of them worked independently in organising a nursing corps, which concentrated on taking care of the sick and wounded from the war. They were also given the title of Superintendent of Women Nurses. Dorothea Dix also known as the ‘Dragon Dix’ was worthy of the title. She also changed the concept and hired middle-aged women who had plain looks to serve as important nurses in Army Medical Bureau. She was proud of her nickname as she successfully created the country’s 1st professional nursing corps Army. Post-Civil War, Clara Barton headed the creation of American branch of the International Red Cross. She was a schoolteacher who shifted base from Massachusetts to Washington to provide nursing care for the injured soldiers of war. By the time, the Healthcare had improved nationwide better and this helped the nurses aid the injured and sick from the war disasters. Further, as they had developed experience, they were also well prepared to manage the future wars or similar conditions, according for a crisis situation ( Blum,2011)

The sign of health care

The World War- I

In 1917, when the United States joined the World War, the number of nurses was very low. However, over a period of time, the number of nurses recruited for active duty increased and it did not in decrease for over a year. When the war ended in November 1918, there are over 21,000 active nurses as part of the ANC and around thousand 400 nurses as a part of the NNC (Reznick ,2011; Cox, 2001).

As the number of casualties during the World War- I was very high, the number of nurses who were well trained and skilled was wanted in great demand. The American Red Cross served as a wing that supplied the well trained and skilled nurses to both the Army and Navy to serve as a part of the wartime nurse corps (“Health and Medicine: Red Cross and World War I,” n.d.). The duty of ANC was to serve in the evacuation zones, mobile travelling units or the surgical units which cared for the wounded. Further, the nurses who work in the hospital train and transport ships during the war throughout the European continent, attending to the soldiers were wounded and sick and those crossing the Atlantic Ocean back to the country (Cox, 2001). This was when the nursing profession had reached its new height. Further, it was the idea of the Navy to create base hospitals in Ireland, Scotland and France. Later they sent in small groups of nurses and mobile units to stay close to the battlefronts. Despite the fact that the nurses were able to provide onsite care for the wounded soldiers, their contribution to serving those returned soldiers back home was undeniably excellent and considered as an accomplishment by the nurse corps. Most of the nurse is in the team served in this providing the basic care to the soldiers and also training the new nurses in the corps. As this was the pre-antibiotic era, the nurses gave priority to clean and hygienic environments, the better chances of saving the wounded (“Nurses and the U.S. Navy, 1917-1919,” 2005).

After a few years, the number of active nurses decreased gradually as the need for them decrease as well. However, though military did not need the number of nurses, the government realised that no war can be won without the help of health care providers. So, this was one of the breaking point that gave the nursing profession a good recognition and was acknowledged for what it was worth.

war nurse 1

World War- II

For the Americans, the world was started on December 17, 1941, after the Pearl Harbor was bombarded by the Japanese army. Post which NNC and ANC recruited 69,000 nurses to take care of the wounded and sick soldiers.They were divided into groups and they worked in the field onsite, medical transport planes, evacuation, hospitals, hospital ships and hospital trains. The medical transport planes were launched as a new part and were called Flight Nursing (Commager, 2002).

When the war began, they were awarded the ‘relative ranking’ and recognised as officers and even provided uniforms. But, they were not eligible for commissions or privileges that were given to the men who served in the Army. Later in the year 1944 22nd June, the Congress government granted the nurses the same privileges and temporary officers rank to all the ANC and NNC nurses who deserved. They were also given the same benefits and commissions, rights and pay at par with the officer of the same cadre. The compassion and the hard work of the nurses had also received the acknowledgement and praises from the society (Blum,2011;Kalisch&Kalisch, 2004).

As the nurses were well-trained and able to provide proper nursing care to all the wounded in the World War II, almost 96 soldiers out of hundred who were wounded were saved. This means, only about a 4% of the injured and diseased soldiers died. After end of the war, the society looked upon the field of nursing and as a dignified profession and acknowledged the women who served as nurses in the war. The government announced free nursing education to be provided to all interested in deserving candidates till 1948. As the nurses from the military services had skills developed through experience, they were able to handle wounds and deaths better (Bellafaire, 1993).

War Nurse 3

The War of Vietnam

The Vietnam War which happened between 1959 and 1975 proved to be a very difficult time for the Americans. The need for nurses increased rapidly and the military started recruiting throughout the period. According to an account from, there was already a shortage of nurses in the society. Most of them were reluctant to go and serve in the army as they had opportunities to serve the civilians. The government announced financial aid to all the nurses who served in the Army during the Vietnam War. Recruitment of nurses in the military proved to be even difficult because, the civilian hospitals in the country offered better pay packages and also better working conditions (Teerawichitchainan, 2012; Kalisch&Kalisch, 2004)

 

Iran-Iraq War -1980-88

The Iranian nurses performed most important roles during Iran-Iraq war during 1980-88. The nature of nursing practice in chemical emergency departments was very crucial during this war. The clinical tasks were allocated to the specific nurses in a situation in which they become exposed to chemically contaminated patients and direct attacks on emergency department. Most of the nurses become affected from a gas “Mustard Gas” and suffered from eye, skin and respiratory system diseases. Many of them are still suffering from ill effects of that chemical.(Firouzkouhi et al 2013)

Vietnamtunnel

Gulf and Afghanistan war:

Around 1980s feminist movement has gained advancement in the country and hence women became more and more liberal. Most of them in when given an option to choose being just a mother/ housewife chose to be a business owner as well as a mother. During this time, the military nurses had to be deployed to Afghanistan in 1990s. It further complicated the family situation as Gulf War was the 1st incident in which mothers left their children behind to work in a different country (Schoenfeld, 2012).

During this period, 2200 nurses were recruited and appointed by the military moved to the Middle East under ‘Operation Desert Shield’ . As they had received ample training and prepared for the worst case scenario and distress situations they were able to handle the casualties better. This was the 1st war in American history in which the deployable medical systems were used and combat support hospitals were established. These combat support Hospital were called DEPMEDS and they were constructed using rigid aluminum tents. They were well equipped with pharmacy, radiology, laboratory, surgery departments and sterilisation departments. This was the 1st time when the infliction of diseases faced by the nurses was reduced to a greater extent due to high level of hygiene (Schoenfeld, (2012).

In this period of time, the US military was able to develop excellent combat surgical assets. In this, any injured member can be immediately drawn from the battlefield to the medical facility and at the same time treated during the transportation.

During Iran and Afghanistan wars in 1990s, the Critical Care Air Transport(CCAT) team were used to a larger extend. The critical care team had well-trained physician, respiratory therapist and a critical care nurse. These units are generally called to transfer those who have been wounded severely in the war and to stabilise physical condition of wounded soldiers. The team provides medical care, en route to the hospital, be it out of the war zone or back home to United States. The care given to the wounded patient might vary right from basic first aid care do even life support interventions. This depends upon the availability of the surgeons or the specialised physician (Schoenfeld, 2012).

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The Americans War on Terror

When the incidence of September 11 took place, the policies in establishing the Forward Surgical Teams (FST) and Combat Support Hospitals (CSHs) were in the infancy stage. Only during this incident, and after the establishment of global war on terror, the combat surgical units were used. As the military is aware of the nature of the war and the capability of the enemy, FST or CSHs has never been deployed for the intended purpose. However, it has been functioning as medical treatment centers, and combat support centers during a crisis situation. However, they have not come to a conclusion as to which model best suits the asymmetrical battlefield.  Responsibility was handed over to a team of experts to determine which would serve the purpose better. The mortality rates of people who went for initial treatment to an FST unit were compared to a member receiving all the treatments from CSH. Regardless of the differences, capabilities, as well as the supplies, they were not able to find any reportable statistical difference in terms of survival between the CSHs and FSTs (Garfield et al, 2003).

Nursing management & education in the 19th century

A defining feature of much of the literature about this period is its concentration on the actions and influence of Florence Nightingale. She indeed performed a leading role in nursing reformations and introduced the word “ matrons” in the  hospitals, as part of a new regime which constituted a clean break with the past (Girvin, 1996;Moiden, 2002). The skills introduced by Nightingale were marvelous and her supporters advocated her views, and emphasised  application in the success of the Nightingale School of Nursing (Margaret  et al 2002).

In 1854, she was appointed head of nursing school and she assumed the responsibilities when it was established in 1860. She held this office for 33 years, until some feminists started raising objection on failure and abilities along with Bonham-Carter who was secretary of the Nightingale Fund. However, Nightingale contributed a pioneer role in the reform of nursing to Wardroper in 1896 and depicted herself as a powerful force in its development.This positive presentation of Wardroper’s contribution, in contrast to Nightingale’s views of her qualities when she was alive, can be read as a selective reporting of events at a later point in order to enhance the celebratory (Baly, 1997).

In the19th century, attentions were focused on development and improvement of hospital nursing for the sick poor, both in the voluntary and poor public hospitals. These developments have attracted extensive attention from historians and consequently, the history of nursing become associated with the history of nursing in the voluntary general hospital in later decades of 20th century (Carpenter, 1980; Rosenberg, 1982).  Consequently, the management of nursing is discussed as a whole for volunteer hospitals and development of systems in general nursing (Margaret et al 2002).

In the voluntary hospitals, the medical staff acquired extra powers by their involvement in all decision making committees. Margaret et al (2002), emphasized on the role matron for nursing managements and other in house affairs of the hospitals. However, the role and function of the matron were affected by the constitution of rules developed by the National Health Service in 1948 which resulted into grouping of hospitals together for administrative purposes. The matron was forced to work in partnership with the senior administrations of the medical staff to manage the individual hospitals. In England and Wales the Matron was supposed to be present in committee meetings for involving nurses in any discussion regarding them which may be raised by the Governing Body. In this way the matron of the individual hospital became relegated in terms of decision and policy making at the highest level in the new local health service structure (Redman, 2008, Wildman and Hewison, 2009)

  1. Education and management in Australia

As per Margaret et al, (2010), the new nurses found difficulty in Australia while discussing the history of nursing. While most of the students valued teaching history of nursing, they found that the curriculum was over emphasising on technical skills and requirements. At the same time the new nurses were expected to be able to meet unrealistic work pressure. Further, they were also expected to be ready with little to no training at all. According to them, the history was only able to help them to develop the critical thinking and improve professional identity as a nursing student. Including nursing history in the curriculum will help the prospective nurses to prepare themselves to maintain professional ethics and also motivate them and reinforce their identity.

  1. Education and management in Egypt and China

Similarly, in countries like Egypt, the nursing education system developed based on the influence of social, political and economic structure of the current scenario. We can only conclude that most of the developing countries when compared to each other showed that the development of this is totally dependent upon the efforts put in to improve the educational background of the nurses. However, the countries that gave importance and improved their educational preparation based on the requirements of the population showed better nursing education system. Neither could Egypt nor China were able to increase the entrance requirements (Chenjuan et al 2012).

  1. Education and management in Iraq

The war inflicted country of Iraq has significantly suffered due to the wars and this in turn has taken a huge toll on the health system of the country. As the situation has been the same for over 20 years, there is tremendous stress on the health system. The health professionals are not well equipped or skilled as they need to improve their understanding on the current problems. First and foremost, they should take steps to review and improve the health care system and start supporting and accepting their nursing staff. Over the last 5 years, many organisations which include NGOs and union nation delegates have stressed the importance of health-care system and the improvement of the country has to make in it. The government should take measures to review and then take measures to strategise the development of health system, resolve current issues and also improve the quality of nursing (Garfield et al, 2003)

As  discussed, due attention was given for improvement of nursing practices, management, and education after Crimean War, consequently fatality rate dropped in subsequent wars.  The percentage of fatality rate in word war 11, Vietnam, Iraq (Operation desert storm),Gulf and Afghanistan war is presented graphically in figure-1(Schoenfeld, 2012).

                                                    

Nursing Informatics

Nursing informatics is a technique which is developed to use nurse’s information by computer technology .Nursing informatics enhances nursing knowledge and practice by providing better management.

Baker (2012) studied nursing informatics and elaborates different effects on nurses. He considered system and science to coordinate arrangement of working elements for development of precise measurement of knowledge. He divided the research into cognitive, information, computer and nursing science and presented the data analysed in graphical form to evaluate overall nursing informatics. The graphical representation is shown in the figure by redrawing t data.

Saba (1997) provided overview of medical Informatics to focus the new nursing specialties. The researcher provided an overview of data standards, goals, and scope and research initiatives to design the advanced status of nursing informatics

 

                       

 Fig-2:  Nursing Informatics

Background on the Crisis

Regardless of the need for war on Iraq, the nurses should be able to understand the health consequences that the Iraqi civilian population is facing. What kind of health facility should do the Iraqi health professional and provided to the civilians? First-hand accounts should be provided which includes historical context, cultural and unbiased observations. After the Iranian war ended in 1989, the number of nurses in the country had increased to about 12,687, out of which about 6000 of them were qualified. After the 1990, almost 20 universities offered bachelorette coldness in nursing. By the end of the year 2000, the number of nurses in the country increased to about 56,800 out of which about 50% of them hold bachelorette degree as per the country’s financial ministry. However, this information should be analysed as the available data between 1978 and 1997 shows a lower figure of prospective graduating trained nurses. As there are constraints on women in the country, both culturally and socially, the war has worsened the situation further and also reduced the economy. This is not a case of just the nursing but overall in a wider context (Hodgson, 2007; Garfield,2003).

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The Famous Personalities in the History of Wars

A survey conducted by Margaret et al, 2010, on the Australian nurses and the role played by them showed the contributions made by a number of historical personalities, specifically those who served during the war period. The 1st name that is mentioned is Florence Nightingale, who is considered to be the lady who changed the outlook of nursing. Few other names are Mary Seacole, Edith Cavell, Mother Teresa and Dorothy Dix; they are internationally famous nurses. The 2 personalities who changed the face of nursing during the civil war in America; Clara Barton and Dorothea Dix get a special mention in our review (“Civil War Nurses: The Angels of the Battlefield,” N.D.). Another famous personality who came to be famous during the Vietnam War is Diana Carlson Evans. The Russian nurse Alexander Kerensky was the one who changed the face of nursing in Russia (Alexandra Feodorovna: Alix of Hesse”n.d). Likewise, 2 other famous personalities in the field of nursing are Cheryl Ruff ( Rushton et al, 2008) , who made tremendous contributions to nursing in the operation ‘Desert Storm’ that took place during the Iran War and Ana Justina Ferreira Neri who contributed from Brazil during the Paraguayan War (“Paraguayan War” n.d.)

However, it would be a difficult task to remember and mention the names of all the nurses who had served their duties and saved the lives of millions of soldiers and civilians during the wartime. The history behind their life can only be brought to limelight through biographical accounts, which in turn will inspire the aspiring nurses to contribute. Further, it will also help them be prepared, gain confidence, be resilient and at the same time overcome the challenges. However, one should understand that all achievements and struggles were not achieved by single personalities or in isolation.

Conclusion:

An average American in the real sense witnessed the war or ‘saw’ the war and the effect it had on people via clips and pictures that were telecasted in the TV and published in newspapers. The Vietnam War showed the face of violence to the civilians who had no idea how wrathful a war would be in reality. When the soldiers returned back home from Vietnam they received a very low support by the civilians. However, this was the war in which the nurses who served in the military and helped millions of soldiers receive acknowledgement and praise. Vietnam Women’s Memorial shows the respect and support for all the military nurses who had worked in the war. One can say that though war brought about death, pain and tragedy, it also helped in improving the medical and nursing care. Further, this was also the time when the military personnel and the government understood the importance of nurses, as well as the effect of proper medical and emotional care to the wounded soldiers. After the Crimean war ended, the nursing profession gained new heights. To Support the war on terrorism by the Americans; over 2000 military nurses who are well trained and equipped, have been deployed to Iraq. One can never know what the positive or negative effects a war will have on any country, but nursing profession will definitely serve its purpose, just like it served in all its wars and crisis situations.

 

 

Referances

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Andrew J. Schoenfeld, (2012), ‘The combat experience of military surgical assets in Iraq and Afghanistan: a historical review’, The American Journal of Surgery, Vol. 204,pp.377-383

Baly, M., (1997),’Florence Nightingale and the Nursing Legacy’,  Second edition. Whurr, London.

Bellafaire, J. A. (2000),The Army Nurse Corps: a commemoration of World War II service , Viewed September 1, 2013, from http://www.history.army.mil/books/wwii/72-14/72-14.HTM

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Chenjuan, Patricia D’Antonio, Jing Li, and Howieda Fouly, (2012), ‘The education of nurses in China and Egypt’,Nursing Outlook, Vol.60, pp.127-133.

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http://history.amedd.army.mil/ANCWebsite/anchhome.html

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TRAUMA OF STROKE AND HUMAN LIFE

Introduction

A stroke is a phenomenon which is transpired by blockage of an artery or vessel due to a blood clot leading to interrupted blood supply in the brain. Brain cells start dying due to unavailability of oxygen and brain become damaged. When brain cells start dying during a stroke, abilities or functions controlled by that portion of the brain are lost. These abilities or function may include speech, movement and memory. Someone who has suffered a minor stroke may experience only minor problems such as weakness of a leg or arm. People who have suffered massive strokes may even get paralysed on one side or may suffer other types of malfunctions in his body. Some people may recover completely from strokes, but about two third of survivors will have some residual disability.

Automotive Nurse Travel

Types of stroke

According to medical point of view, the stroke is generally classified into Ischemic, Embolic, Thrombotic, and Hemorrhagic. In most cases, Thrombotic stroke happens in the large arteries and is caused by atherosclerosis followed by rapid blood clotting. Thrombotic stroke patients mostly suffer from coronary disease, and heart failure is a common reason of death in patients who have had this particular type of brain attack. When the stroke occurs due to blockage of small arteries, it is called lacunar infarction stroke and mostly associated with hypertension or high blood pressure.

Results and characteristics of stroke also varied based on sex of the patient. Maeda et al (2012) conducted a study to evaluate the effects of stoke by considering basic patient characteristics, subtype of stroke, results and conditions based on sex. They selected almost forty thousand patients, including 13,323 women suffering with acute ischaemic stroke. Their study used computerized database by using a multicenter, hospital-based registration in different institutes of Japan. The results showed that women were more prone to ischaemic stroke comparative to old men.

How to recognise an early stroke?

The prediction of stroke is tremendously variable and is subjective to availability of collateral circulation. Non-invasive tests are helpful to recognising patients with a poor collateral potential. These methods can be used to identify potential patients who are on risk of stroke.

Voice plays a pivotal role in recognition of stroke early. Acquainted voice is an achievement of the human brain that allows human beings to recognise familiar people even with closed eyes. Human voice recognition is a discrete process which is not associated to language comprehension (Habermann et al 2009).

Depression is another important cause of stroke which provides specific signs of depression present in potential patients. Whitney et al (1993) developed observational depression index  to exploit the measurable symptoms  of potential victims of a stroke.

Messe et al (2004) studied thrombolytic type of drugs which helps to reestablish the flow of blood flow to the brain by removing the clots, which block the flow of blood. The first established treatment for acute ischemic stroke to be approved by the Federal Food and Drug Administration (FDA) in June, 1996 is also known as the clot buster.

 

 

Treatment and preventive measures for stroke

Activase is used by the medical professionals to enhance dissolving of a blood clot and should be given within three hours of initial attack of stroke. Patients are advised to go hospital when they feel signals of stroke. Activase is known as tissue plasminogen activator .Thrombolytic therapy should be given as soon as possible to ensure results (Maeda et al 2012).

Messe et al (2004) focused on Concentric Medical’s innovative for patients who are not eligible for receiving recombinant tissue plasminogen activator (RTPA). The system is suitable for patients who get the treatment after the 3-hour. This method is meant to restore blood flow in larger vessels of brain by dissolving blood clots. In this process, a tiny cork-screw shaped device wraps around the clot and traps it for removal.

Maeda et al (2012) introduced another system for treatment named “Penumbra”. This system provides provision for safe revascularization of blocked vessels in case of an ischemic stroke. The system also ensures restoration of brain blood flow by suction to remove the blood clots in the brain in case of stroke.  This system is much revolutionary as before introduction of this system, treatment and rehabilitation was seemed to be limited. This system is a device which is effective even if used within eight hours of the onset of the symptom.

Gotoh et al (2000) conducted the first large scale study by multi-center trials in Japan as a randomized double blind investigation in order to determine the effectiveness of Cilostazol, which is an antiplatelet drug, for preventing the recurrence of cerebral infarction in case of patients who had suffered from cerebral infarction in 1 to 6 months before the entering the trial.

 

Preventive measures for Stroke

Preventive measures which should considered by a patient are as below:

  1. A person of over age 18 years, good blood pressure is considered to be lower than 120/80. A blood pressure reading or regularly higher than 120/80 and up to 139/89 is considered to be pre-hypertension. High blood pressure situation is when a measurement of 140/90 or more is reached.
  • Be aware about blood pressure. In case of high blood pressure, immediately consult with the doctor.
  • Keep himself relaxed to avoid hypertension.
  • Keep blood pressure apparatus at home for frequent self-monitoring.
  • Keep diet balanced with consultancy of your physician.
  • Get your blood pressure checked at least once a year , more often in case you have a history of high blood pressure or have a background of  a heart attack or a stroke, are diabetic, having kidney disease, high cholesterol, or overweight.
  • Adopt habit of regular exercise besides medicines that facilitate for maintaining blood pressure.

2    In case of fibrillation which is an irregular heartbeat, consult with your physician prescribing medicines.

 

  1. Smoking habits
  • Smoking multiplies the risk for a stroke.
  • Stop smoking to drop the risk of stroke.
  • Within five years of quitting, the stroke risk is similar as that of a person who has never smoked.
  1. Drink alcohol within a moderate limits.
  • Drinking a glass of beer, wine, or one peg of mixed drink in a day may lower your risk of stroke, provided there is no other medical reason for not drinking alcohol.
  • Heavy drinking can increase the risk for stroke.
  • Remember alcohol is also a drug and it can interact with the other prescribed drugs that you are taking. If you do not drink then don’t start.
  1. Cholesterol level should within standard limits:
  • Lowering your cholesterol will reduce the risk of stroke. High cholesterol level puts you at a greater risk of heart disease, which might increase the stroke risk.
  • LDL and HDL cholesterol should be below 200.
  • High cholesterol may be controlled with exercise and diet; though some time medication become unavoidable.
  • Recent studies have also shown that some individuals even with normal cholesterol levels may lower their risk of stroke by taking certain cholesterol lowering medication.
  1. In case of diabetes, follow doctor’s advice in order to get your blood sugar number under control because:
  • Diabetes puts you at an increased risk of stroke.
  • Exercise healthy diet and medicine with consultancy of your physician..
  1. Inclusion of exercise in your daily routine is highly desirable.
  • Minimal Exercise like a brisk walk, swimming or bicycling can improve your health and reduce the stroke risk.
  • According to the Centers for Disease Control and Prevention, adults should ideally perform moderate level physical activities for at least 30 minutes for five or more days in a week.
  • Before starting an exercise program it is advisable to consult with your physician.
  1. Enjoy a low sodium and low fat diet.
  • Cutting down salt and fat in your diet, you may reduce your blood pressure and lower your risk for stroke.
  • Eat a balanced diet every day, with adequate amount of fruits, vegetables, whole grains and a moderate quantity of protein like meat, fish, milk, nuts, eggs, tofu, and beans.
  1. A fatty deposit can block the arteries that carry blood from your heart to the brain. If left it untreated, these blockages can result in a stroke.
  • Get tests conducted for such problem. Doctors can even listen to the arteries, just like they listen to the heart or look at pictures of the arteries with the help of medical equipment.
  • Circulation problems can mostly be treated with medication. When your doctor prescribes the medicine, take it exactly as recommended.
  • Surgery is necessary in some cases to correct circulation problems such as blocked arteries.
  1. In case, you feel symptoms of stroke, call for immediate help to save your life.

Conclusion

Conclusively, a stroke is a life threatening phenomena with long term acute effects and even death. When a person feels symptoms like numbness or weakness of face, arm or leg especially on one side of the body, trouble in speaking or understanding and loss of balance, he should consult with physician immediately to prevent himself from a stroke. Though, many techniques have been developed for treatment of stroke, but still this a harmful disease due its effects. The physical, cognitive and emotional functioning is influenced by different parts of the brain. The effects are experienced in different degrees at various phases of recovery. Stroke is a trauma and can take long time for recovery..

 

 

Work Cited

Andrei  V. Alexandrov, Louis R. Caplan, Merrill P. Spencer Charles H. Tegeler , Viken L. Babikian, and Robert J. Adams,(1998) ,’ The Evolving Role of Transcranial Doppler in Stroke Prevention and Treatment’, Journal of Stroke and Cerebrovascular Diseases, Vol. 7, No. 2,  pp 101-104.

Fay W. Whitney, and  Eileen Michaels Burns (1993), ‘Recognizing depression: Preliminary testing of the Whitney Observational Depression Index’, Journal of Stroke and Cerebrovascular Diseases,Vol.3, No.3, pp.193-201.

Fumio Gotoh, YastloOhashi,(2000),’Design and Organization of the Cilostazol Stroke Prevention Study’,  Journal of Stroke and Cerebrovascular Diseases, Vol. 9, No. 1,pp. 36-44.

Koichiro Maeda, Kazunori Toyoda, Shotai Kobayashi,and Kazuo Minematsu,(2012), ‘Effects of Sex Difference on Clinical Features of Acute Ischemic Stroke in Japan, journal of Stroke and Cerebrovascular Diseases, Vol. Nill,pp.1-6( Article in Press).

Paelecke-HabermannY, K. Somborski,,  M. Paelecke, M. Knörgen, O. Kneidel, C. Gaul,(2009), ‘Recognizing people by their voices: An fMRI-study of healthy people and patients after stroke’ Clinical Neurophysiology, Vol. 120,N0.1,pp.69-88.

Steven R. Messe´, Steven R. Levine,  David Tanne, Andrew M. Demchuk, Scott E. Kasner, and Brett L. Cucchiara (2004), ‘Dosing Errors May Impact the Risk of rt-PA for Stroke: The Multicenter rt-PA Acute Stroke Survey’, Journal of Stroke and Cerebrovascular Diseases, Vol. 13, No. 1,pp. 35-40.

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Introduction

Palliative care is well defined by the World Health Organization, and is “The active total care of patients whose disease is not responsive to curative treatment.” In 21st century, many plans have been designed to enhance the quality of life for the survival of affected patients. But a reliable epidemiological study is required for evidence and assessment of expected survival of the patients.

Main objective of palliative care is to achieve the quality of life for the patient and his family. Since the building of first ever modern hospital in 1960, the number of incurable cancer patients and palliative care units have been increased manifold, especially in countries having sufficient funds for health care. But qualitative and quantitative scientific research is still unable to meet the expectations and fundamental goals.

History of Palliative Care

White et al (2004) reported flaws prevailing in remote areas of Australia and public facing life threat disease. Disease progression is high in absence of palliative care and patients died in loneliness away from their homes. Furthermore little research is available regarding these remote communities which consequently challenged by palliative care patients. The situation is much different in comparison with urban area which is unjustified. This devaluing and underneath resourcing of remote area palliative care and research, the discreet response from health and social policy is inequity in social background. However, keeping in view social and health policy, improving access to palliative care services conveys some requirement need to be addressed in the surrounding issues and expenses. Moreover, it enabled more cultured and geographically appropriate palliative care research in remote areas. It is accompanied by the potential to improve clarity about needs and issues with the possible increase in costs. Though few areas have access to devoted and soothing care services, but they declared it persistent underprivileged and deprived social environment for native Australians living in remote areas even.

Radbruch et al (2002) reported in his article that the resolved question about permission for omission of therapy is not much clearly documented in Germany. They found that rejection of recovery for any patient was not documented in some units and 78% of patients in other units. In the different units consent on omission between varied from 0% to 88% of patients for additional chemotherapy .They indicated that documented direction were only 18% in Germany compared to United States which was up to 79% of patients. In addition, more specific research and setting of the fundamental documentation is required in this area in Germany for better assessment. The survey showed high rate of outcome of inpatient palliative care and large percentage of patients with good symptom control, minimal or no residual pain and high satisfaction with therapy. The relationship between assessment by staff and self-assessment were available only for few patients, and showed moderate association of outcome ratings with the omission of a higher correlation for pain relief.

In late 20th century, United Kingdom started providing death service and this idea got inspiration for improved care for fatally ill patients. One of the basic philosophies is to provide relief of stressful symptoms, the incorporation of mystical and psychological aspects of care, and the provision of a supportive system to ill patients. In addition, reports have been considered to access and the provision of sanatorium care to all fatally ill patients rather than only cancer patients. The philosophy and goals of palliative care are unquestionable. Efforts have been made to fulfill rules within a severe setting (Willard, 1999).

Current Scenario of Palliative Care in Australia

Palliative care has been developed across Australia in variable ranges and ways by healthcare professionals working in general practice settings, hospitals and clinics. Cancer patients constitute the mainstream of the palliative care patient inhabitants in Australia (Mitchell, 2011). Brooma et al (2013) outlined palliative care units and reported availability of superior palliative care units with specialised and comprehensive facilities both for in-patient and community based palliative care. More than 80% of patients are initially referred to such units by medical specialists instead of general practitioners. In some cases, patients rely on personal specialist due to their established relationship and for limited palliative care requirements. Their study focused on a specialist palliative care unit situated within a particular private hospice run government funding and community contribution.

Role of Emotion in Palliative Care

Palliative care is one area of medical science where emotions play a significant and inevitable role. Most often, the referral to a specialized palliative care system is seen as a step towards ‘letting go’. This is why transferring patients under active treatments to palliative care is an emotionally challenging and complex clinical practice. However, sociological research on emotions and forms of sentimentality with reference to discussions about referral to palliative care remains a hitherto unexplored domain (Brown, 2009). Taking into consideration various academic disciplines, though they might differ tremendously in their specializations, it is possible to gain some insights into the intricacies of how end-of-life discussions can be embedded in emotional and inter-subjective challenges. For example, the clinical trajectory adopted by some doctors in the case of small cell lung cancer patients is a good illustration of medical activism that is designed to aid them as well as their patients into channeling treatment procedures into a smaller, less emotionally charged path that has more optimistic end points. Such practices also make it clear that there is a potential possibility of optimism coproduced as a result of a collusion founded in emotionality and rationality in medical contexts. Given the potential for emotion and sentimentality in palliative care related discussions, how is the need for such a specialized system of care tropicalised and dealt with by doctors? Surprisingly, no significant studies have been carried out in this area (Brooma et al, 2013).

In short, each of the factors contributes to a complex interpersonal as well as highly charged situation. In such conditions, most of the medical specialists take approaches or make decisions patient based on the subjectivity and emotional mindset of the patient. In most cases, subjective influences have a subtle influence on the treatment decisions specifically, the timings, choices made and the route or trajectory taken. However, it is not applicable to medical practitioners who have a distant relationship or are dispassionate with the patients as they take decisions based on the condition and not based on the objective benefit or the quality of life.

Suggestions for Good Palliative Care Services in Future  

Different parameters and suggestions should be developed for good palliative care services in future to meet the scarcities and needs. A framework can be formulated for good and effective palliative care to meet the challenges. A comprehensive and centered approach is need of the time to meet future challenges of palliative care patient as mentioned below:

  • Develop effective information practices among staff and patients palliative care units.
  • Need to conduct specific research in palliative care.
  • Provision of basic elements based on community initiative as a group.
  • Avoid over sighting of therapeutic options without the consent of the patient palliative care unit.
  • Avoid decisions regarding end of life and develop aggressive directions.
  • Advance documented directions should be present in palliative care units.
  • Careful documentation should be exercised for effective goals in palliative care units.
  • Need to develop correlation between assessment by staff and patients at the time of admission.
  • Use specific and advance instrument for better correlation and staff ratings in palliative care units.
  • The implementation of the framework by assessment questions, guiding principles, and strategies for interpretation of framework suitable for the local needs of the community.
  • Appointment of competent facilitators for identification and development of essential resources both material as well as inspiration for the expansion of palliative care network.
  • Provision of initial leadership to start the building process, and keep liaison with the key stakeholders.
  • Facilitator should be accountable for getting the community group together and creating awareness palliative care.
  • Evaluation of guidelines to maintain and construct good services.

Medical sign

Role of Palliative Care in Residential Aged Care Services

For implementation of customised care planning for residents who are dying in aged care units, some programs were written like “Palliative Care Quality Resource Guide” known as toolkit. This toolkit provides help to assist health care providers to apply the National Palliative Standards and helping improved quality service to end of life care. More comprehensive study is still required to develop a mechanism for dying in sophisticated manner. Nurses need to acquire skills and knowledge for retrieving professional development by workshops and seminars. Skilled professionals working in palliative care units are another choice of learning for nurses (Allen et al, 2008).

Conclusion

History of palliative care showed that people living in remote areas are facing comparatively more problems than modern urban areas. This study emphasised that prevailing conditions in palliative care units in Germany are far below than United States and United Kingdom. Palliative care has been developed across Australia in variable ranges and ways by healthcare professionals working in general practice settings, hospitals and clinics. A framework can be formulated for good and effective palliative care to meet the future challenges.

 

 

References 

Alex Brooma, Emma Kirby, Phillip Good, Julia Wootton , and Jon Adams,(2013), ‘The art of letting go: Referral to palliative care and its discontents’, Social Science & Medicine, Vol. 78 pp. 9-16.

Brown, R., Dunn, S., Byrnes, K., Morris, R., Heinrich, P., & Shaw, J.(2009),‘Doctor’s stress responses and poor communication performance in simulated bad-news consultations’,  Academic Medicine, Vol. 84,pp. 1595-1602.

Carole Willard (1999), ‘Caring for patients and relatives: an appraisal of palliative care philosophy European’, Journal of Oncology Nursing, Vol.3,No.1 pp. 38-43.

Kate White, David Wall, Linda Kristjanson,and Edith Cowan University(2004),‘Out of sight out of mind: reframing remoteness in providing palliative care in remote Australia Collegian’, Vol. 11,No.4,pp.29-33

Lukas Radbruch, Gabriele Lindena, , Martin Fuchs,KarlNeuwöhner, FriedemannNauck and  Schulenberg, , and Working Group on the Core Documentation for Palliative Care Units in Germany, (2002), ‘What Is Palliative Care in Germany? Results from a Representative Survey’,Jr. of Pain  & Symptom Mgm., Vol. 23 No. 6 pp.471-487.

Mitchell, G. (2011), ‘Palliative care in Australia’, The Ochsner Journal, Vol. 11,pp. 334-337.

Sonia Allen, Ysanne Chapman, Margaret O’Connor, and Karen Francis, (2008), ‘The evolution of palliative care and the relevance to residential aged care: Understanding the past to inform the future’, Collogian,Vol.15,pp.165-171.

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Introduction

The profession of Nursing – approbated as one of the key roles of health care sector- is focused on providing a wide range of health care services to individuals, their families as well as to the community as a whole. Florence Nightingale, an English nurse who was serving during the Crimean War, had laid the foundation for the professional nursing through her famous book titled “Notes on Nursing”.

The duties and responsibilities of nurses diverse across different countries and in specialties, thus defining ‘nursing’ is quiet challenging. Among other definitions, International Organization of Nurses defined that is “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.”

NUrse cartoon image

Services of a nurse

The service of nurses witnessed in wide range of settings; starting from hospitals to home visits and also places such as schools, home for elders, military camps, cruise ships, free-standing clinics and pharmaceutical research companies. Even the scope of practice of nurses spread from assisting other health care workers to a certain level of prescriber authority. The key factors on which nursing profession emerged or can be categorized are their role, knowledge and attitude.

Compared to other health care providers, nurses must possess traits that help them get on with people by communicating effectively, being empathic and patient. Further, they require standard level of education followed by a clinical training as well as legal recognition (through registering as nurse practitioners at different levels) in performing their role. The ability to be efficient and self controlled in decisive situations, problem solving skills, right attitudes, same careful attention on each individual without any prejudice and the willingness to work any time shift during the day are some of the ingredients of a professional nurse.

Working environment of nurses

In modern world, a serious scarcity of nurses reported in many countries. One of the major reasons is the poor work related environment. Lucia et al (2009) highlighted the fact that nursing professionals are overloaded with work due to shortage of nurses. The high ratio between nurses-to-patients and the number of tasks handled by a single nurse resulted in cognitive work load. A high incidence of musculoskeletal disorders (MSDs) reported among nursing professionals due to long working hours and demand for handling multitasks with frequent interruptions.

The United Kingdom, USA, Australia, France, Germany, Canada and Ireland are some of the leading developed countries that attract the largest numbers of migrant nurses in their health sector in bridging the employment gap. Between 1995 and 2000 Australia received 11,757 nurses from various other nations. More than 10,000 foreign nurses were accepted to enter the United States, while 1998 to 2002, United Kingdom admitted 26,286 foreign nurses. The American Hospital Association reported 168,000 open positions in 715 US hospitals and 126,000 (75% of total) positions were vacant for registered nurses (Kline, 2003).

Challenges and rewards in working abroad

Nurses having opportunities to work overseas are two-fold; those who work in developed countries with advanced technical environments and in remote areas with less facility under local & international development organizations. There will be many more motivation factors for nurses to work abroad such as better standard of living, higher salaries, good climate conditions, and the experience of working in different culture in another country.

Kline (2003) depicted the fact that both push and pull factors resulting in nurse migration. On one hand, nurses migrate due to the desire of developing their professional skills and knowledge that would not be achievable in their current position or the country. On the other hand, nurses are attracted to countries with higher standards of living, personal safety and better wages compared to their native countries.

The reality of nursing abroad could be very different from what it first appeared.  Though there are many personal rewards and development opportunities in the profession of ‘abroad nursing’, many challenges and risks also involved in the work. Every day across the world, humanitarian aid activities take place in many locations where there are potential risks of serious accidents and life losses for aid workers. These include exposure to war torn areas, exposure to natural diseases, risk of travelling unsafe routes, and also threat of sexual abuse, abduction or permanent disability.

Nurses are supposed to work long hours that doubles the risk of developing a cancer. Charles (2013) concluded the potential risk of breast cancer among shift-working nurses, based on research conducted among total sample of 2313 women in Canada. UK health authorities introduced a compulsory test of HIV for all foreign health staff recruiting in the country, after discovering 10 South African nurses with HIV positive(Stubbings et. al.2004).

There is a great concern of the possibility for exploitation of foreign nurses. Brubaker (2001) stated that hospitals in Washington have paid less salary to overseas nurses that were less than those paid to comparable US nurses. Foreign nurses are excluded from jobs in leading facilities and tended to fill entry level positions as they are not US origins. (Brown et al, 1998)

The job satisfaction and perceptions among current nursing professional would set the trend for future generations to enter in to the profession. In a survey conducted among Registered Nurses, 36% of respondents claimed that they would not recommend nursing as a career option for young people (Charles, 2013). In another study, Stubbings et. al. (2004) reported that 25% of nurses actively discourage someone from going into nursing.

Even though there are many risk factors involved in abroad nursing, many find it as a life changing experience to gain many personal rewards to their life. At the same time it will add an extra value to the country that they are working for. Migrant nurse is a good source for knowledge transferring. The knowledge experiences and health practices which brings from the native country can be merged with the existing county health care facilities and finally go to a better methods or well organized health services.

With the developed skill set of abroad nurses will be extremely resourceful in terms of having direct impact on individuals and communities. While providing the healthcare services there are chances to experience the culture of an international locale. Exposing to traditions and customs as well as rituals and believes of a foreign country will be added benefit.

Most of the time nurses who are working for humanitarian organizations, recruited for under development countries suffering from many issues. Personal skills and attributes some of less tangible benefits can be absorbed from abroad nurses to develop those poorly resourced communities while paying them high salaries.

The effect on receiving countries is positive in that countries receive skilled nurses who can enter the workforce with minimal preparation to fill critical shortages. On an average day, the UK uses 20,000 temporary or agency nurses to fill shortage positions in hospitals, costing the NHS $1,235 million USD a year ( Stubbings et al, 2004;Kline,2003).

In the US, agency nurses can earn $50 per hour or $104,000 per year. Nurses who work as traveling nurses can earn $75 per hour or $156,000 per year (Gamble, 2002). The cost of employing foreign nurses is a much less expensive method of filling vacant positions. One hospital in Kentucky recently recruited 50 nurses from the Philippines at the cost of $300,000, which was roughly what the hospital paid for agency nurses for 1 month (Brown, 1998).

Abroad nurses are truly impacted by the developed, industrialized countries and there are many learning opportunities for them. Before returning back home they are able to develop and sharpen their skills. The medical case and extreme circumstances that nurses may come across in host countries prepare them to   overcome obstacles, handle emergencies and tackle challenges.

Working abroad often produce unique challenges as many underdeveloped, impoverished regions without adequate running water or electricity – sense candle light may use to deliver a baby or stitch wounds.

Hibbert (2003) mentioned to the “First trip of many for volunteer nurse”, in the Australian Nursing Journal article about the prevalence of ‘jiggers’ (a type of parasitic flea) burrow under the skin.  He further stated that   cutting jiggers from under the skin of locals is not something nursing courses taught, but a challenge that volunteer nurses face.

The sign of health care

Conclusion

All things considered, there is no doubt that the duties and responsibilities of nurses working across different countries and in specialties are quite challenging. They have to face a lot of challenges during their work. Though, they got personal rewards and development opportunities but risks are also involved in their work. They gain experiences and health practices which brings from the native country can be merged with the existing county health care facilities and finally go to better methods or well organized health services.

 

 

References 

Brubaker, B (2001), ‘Hospitals go abroad to fill slots for nurses; wide pay gap exists between US foreign workers in D.C. area’, The Washington Post, June, pp. A.1.

Charles, S (2013), ‘Nurses working night shifts at greater breast cancer risk’, ‘Viewed 23 August 2013 <http://www.ncah.com.au/news-events/nurses-working-night-shifts-at-greater-breast-cancer-risk/1820/>.

Donna S. Kline., (2003),’Push and pull factors in international nurses migration’, Journal of Nursing Scholarship.Vol.35, No.2, pp.107-11.

Gamble, D (2002), ‘Filipino recruitment as a staffing strategy’, Journal of Nursing Administration, Vol.32, No. 4, pp. 175-177.

Glaessel-Brown, E. (1998), ‘Use of immigration policy to manage nursing shortages’, Journal of Nursing Scholarship, Vol.30, pp. 323- 327.

Hibbert, R (2003), ‘First trip of many for volunteer nurse’, viewed 24 August 2013.

< http://www.nursewithoutborders.com/how-volunteer-nursing-overseas-can-cultivate-your-career-2/2103/>.

Liz Stubbings and Janet M. Scott, (2004), ‘NHS workforce issues: Implications for future practice’, Journal of Health Organization and Management, Vol. 18, No.3, pp.179 – 194.

Lucia, PR, Otto, TE. and Palmier, PA, (2009), ‘Chapter 1 Performance in Nursing’. Reviews of Human Factors and Ergonomics, Vol.5, pp. 1–40.

 

 

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Cars! We sure do love them. Sleek sedans, tough SUVs, royal limos, fast sports cars – all of us have different choices and different reasons for those choices, too. And who fulfills our desires of owning one? Well, a car manufacturer. And if it is a popular one like Mercedes Benz – not only do we get what we desired for but much, much more than that. Innovation works like an inspiration for them, and the result? Well, we all know that quite well; cars, vans, coaches and buses that speak of satisfaction and excellence.

Classic Mercedes

Classic Mercedes

History
The success story of the Mercedes-Benz brand is a long one. It all started with the Mercedes from Gottlieb Daimler’s Daimler-Motoren-Gesellschaft in 1901 and the Benz Patent-Motorwagen from Karl Benz in 1886. But it was not till 1926, that the two brands merged to form the Daimler-Benz company that manufactured the first cars under the Mercedes-Benz brand name. And there was no looking back from that point. From the 1930s, the brand focused on the manufacturing of the 770 model that attained quite popularity in Germany during the Nazi period. It was not simple craze that saw so many buyers of this model, including Hitler himself. The cars could run at 160 kmph or more, contemporary chassis with independent front suspension and much more. Ever since, the company has been into innovations to make the driving experience better for all the automobiles it manufactures.
Iconic automobile models since inception
The SSK model in 1926; a racing car of the age.
The Großer Mercedes or the 770 model in 1930.
500K in 1934
260 D in 1936, known to be the first diesel car.
The 170 model in 1936.
The W125 Rekordwagen in 1938.
The 320A in 1939, ideal for military use.
The Adanaeur Mercedes in 1951.
The Ponton models in 1953.
The 300SL Gullwing in 1954.
The 190SL in 1956
Fintail models in 1959.
The 220SE Cabriolet in 1960.
The Grand Mercedes in 1963.
The 239SL Pagoda model in 1963.
S-Class of 1965.
300SEL 6.3 in 1966.
The W114 models in 1968.
C111 models in 1969.
W107 350SL in 1970.
450SEL 6.9 models in 1974.
The first station wagon from Mercedes- W123 in 1977.
The first turbo diesel by Mercedes – 300SD in 1978.
The G-Class and 500SEL models in 1979.
190E 2.3–16 models in 1983.
300SL and 500SL in 1989.
500E in 1990.
600SEL in 1991.
The C-Class models in 1993.
C43 AMG in 1995.
7.3 V12 and SL73 AMG models in 1995.
SLK in 1996.
The M-Class and A-Class models in 1997.
CLS-Class and SLR McLaren models in 2004.
GL320 Bluetec, BlueTec E320, R320 Bluetec, ML320 Bluetec versions in 2007.
The SLS AMG in 2010.
The CLA-Class of 2013.
Bicycles and Formula One cars
After much success with the cars, Mercedes-Benz moved on to the production of bicycles and presently manufactures the Trekking Bike, Trailblazer Bike, Fitness Bike and the Mercedes-Benz Carbon Bike models.

Mercedes
Also, Mercedes-Benz has been known for participating in the Formula One races and also providing other teams with engines specifically designed for the purpose.

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Following are ADR 13/00 Standards/Australian Design Rules for Vehicles after amendment, in due consideration of Vehicle Standard (Australian Design Rule 13/00 – Installation of Lighting and Light Signaling Devices on other than L-Group Vehicles).
The content of the aforesaid rules are sub divided into various categories such as:
1. Name of Standard used
This Standard relates to the Vehicle Standard (Australian Design Rule 13/00 – Installation of Lighting and Light Signaling Devices on motor vehicles except for L-Group Vehicles) as per year 2005.
2. Commencement
Its commencement begins immediately from the succeeding day of its registration.
3. Scope
The laid out bullet points in the rule book of Australian design suggests all the necessary requirements for the frequency and mode of installation of light signaling devices on motor vehicles except for L group vehicles.
4. APPLICABILITY AND IMPLEMENTATION
This national standard is applicable to the design and manufacturing of vehicles in dependence on what kind/ type of vehicles are been manufactured.
By and large the types are- moped 2 wheels, moped 3 wheels, passenger cars, motor tricycle, heavy and light omnibus, trailers (further sub divided into the categories depending upon their weight) etc. All of these vehicles must adhere to this standard by following at least one of the below mentioned clauses:
(a) There are a series of guidelines stated in the upcoming sections of Exemptions and alternate procedures inclusive of another segment that narrates supplementary general requirements, Individual requirements and disparity to the requirements for lamps in appendix A.
(b) One among the many alternatives talked about in clause 9.
• Exemption and Alternate Procedures
Well by and large scope of the contract, its approval, any further alterations and adjustments in it, chargeable penalties for non- conformity of production activities, its control etc are exempted here. Furthermore, production is almost never opted for discontinuation and communication at every level for approval and disapproval of various kinds of contracts on signaling of devices are pursued in accordance to the regulation no 48.
Many a times, depending on what type/ model of vehicle in particular is being talked about, there are certain bullet points one would be made familiar with if needed that would come under a few more exemptions too. for instance all those vehicles that have filament headlamps attached to them would not call for a-
• dipped beam’s vertical orientation
• leveling of headlight
• the procedure for its measuring.
Similarly there are many more provisions kept aside on the use of cornering lights, rear end lights, fog lamps etc, each of which would be confided with you if considered necessary.

SUPPLEMENTARY GENERAL REQUIREMENTS

• Installation of extra lights in the automobile when the one previously fitted fail to comply with the entire system.
• Guidelines are mentioned for the installation of these too, one should adhere to them while bringing about this change.
• They should be fitted when the installation of before lamps are non- accessible to the bare eyes and hence mostly irrelevant.
• In addition to this, driving lights should be installed too. Their installation by and large depends on what kind of light exactly does one hopes to obtain as the final output.
For example, white light is obtained by main/ dipped beam headlamp, along with reversing and front fog lamp.
Similarly, lights in the rear end of an automobile use a standard red color lights to signal the various working of the automobile, like application of brakes, use of reverse gears etc.
In case of retro lights that are non triangular shaped, the color amber is aimed to be lit at its read end. It is generally grouped or takes up a part of the light emitting surface in common with rear end lamps, for a synchronized lighting system.

Unless stated in particular the various lights should be used in the same combination following the cliché rule as it is tried and tested. Alterations in their position, electrical connections and basic orientation should be kept at minimum to avoid unnecessary complexity.

INDIVIDUAL REQUIREMENTS
These are set of guiding principle complementary to the requirements of the above points. It ‘s not mandatory to install an extra lamp in an automobile but when done they are strictly advised to follow the below rules. We enlist the major ones in particular to keep the bullets points concise and easily comprehensible.
• External cabin lights are prohibited for all vehicles in general except those which are more than 2100m wide. Even then, their installation is optional, if someone chooses to opt for it, they should be placed at the front at horizontal/ vertical angle with any sort of electrical connectivity. Albeit, their number should not go beyond 5 in totality.
• Side marker lamps are places on vehicles 7.5 m long and 2.1 m wide with an outward orientation placed in pair at both the front and the read end of the car and one in the center with any electrical connectivity that suits the user the best.
• Driving lamps: These are not mandatory on motor vehicles and trailers are totally prohibited from using them. No individual specifications are mentioned for them in particular except for that their number should vary in between 2-4 and should be fitted in adjacent to the headlamps.
• Cornering lamps
These are restricted for their usage on trailers and are allowed for installation on other vehicles if their demand is called for. Special guidance for their position as to where they would be located on an automobile is listed in here. For vertical position their height should not surpass the main beamed lights, for length the light giving off surface of the cornering lamp should not surpass the bonnet of the vehicle by 2meters at the maximum. Last but not the least, they should be place in pair, one at each side at the width. Much has been said about its geometric visibility layout too, such as the primary axis of photometry should not directly fall on the surface of the road. Also cornering lamp should be placed at the right end of the longitudinal axis passing through the center of reference at whose other side is in perfect alignment with this
part of the vehicle.
• Similarly guidelines for installation of each additional light such as fog lamps, indicators, reverse lights are mentioned too with slight variations to the above mentioned protocols.

ALTERNATIVE STANDARDS.
These state that the technical needs of any of the editions of the contract book in entirety at present or in future should comply with the technical requirements of the stated standards at every point.
Further for vehicles under the NC category are required to have a headlamp ranging in between 559 meters to 1372 meters (when measured from the lamp’s center to the ground).

Adhering to all the rules mentioned above, would lead you to the signing off of the final agreement which reiterates the use of different types of light placed at different part of an automobile in excruciating detail. Going through it might seem like boring trite job but one needs to hop through the contract to the major points that interests them. Read the guidelines for the one which you are intending to use and overlook the rest for a quick, pain less procedure.

Thanks for taking the time to read the blog hope you enjoyed it enjoy?
automotive-lighting.com.au
David Smith
[email protected]

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Before we start if you have any doubt then contact auto-electrician, this article is for your pleasure only and does not replace a trained professional.

If you have encountered some trouble with your headlights then there is nothing much to panic about, we have come up with simple, easy to follow instructions that would guide you through the entire process, make you capable enough to change it on your own, saving those extra bucks in your pocket from splashing it on a fleet of black and white crusaders. After all taking care of your darling automobile has always been “your” thing to do.
Let’s begin with the process that would empower you to provide the power of sight to your car!

Step 1: Take a quick look at the anterior part of your car.

Step 2: Locate the bulb holder. Safely open the hood covering it with great care. Once that is out you could see the bulb holder at the back of the headlight, out of which three wires are coming out of a trapezoid shaped plug.

Step 3: Slide off the wiring harness, you could see the three wires entangled at a the base of the headlamp in a either a plastic catch, a screw cap or a metal clip.
In case of plastic catch, push down the little lever you see on the top of a plug, on applying the pressure the gently pull the same so that it slides off.
In case of a screw cap, simply unscrew it by rotating the clip anti clockwise.
For the last one, the metal clip- just pull it in the upwards direction against the gravity of the earth and it would pop open. At any of these points, be careful how you handle these little equipment’s, dropping them off would call for another thing to do such searching for the part in the engine ay we’ve all been there it’s one hell of a task.

Step 4: Recognize which type of bulb is to be fitted inside it. Usually no big tools in specific are needed to replace or fit a new bulb.

Step 5: Take off the wasted bulb from the socket. After taking the wire out of the way doing that shouldn’t be that big of a task. Much precaution should be taken while handling the bulb once it’s out of its packaging. Always use a tissue or a clean rag to hold it, because any oil/sweat of your palm may lead to damage the piece prematurely, reducing its life to a considerable extent.

Step 6 : Now holding the bulb from it upper end, insert it at the back of the headlight, till it is grabs a firm hold in the socket. Look for yourself to confirm that is in there for sure, a clear line alongside the holder would confirm that it is fitted evenly.

Hence these were the simple steps whose execution requires a little of your time and effort with nothing more to ensure a good working headlight again. Be it a installation of new headlight or the replacement of an old one the procedure is the same.

• Different types of automotive lights
There are many lights in totality that constitute the entire automotive lighting in an automobile apart from the main headlamps. While headlamps can be segregated mainly under two types:
(a) Standard headlamps
These are also known by the name low, meeting or passing beam that gives out illumination of moderate intensity, providing enough for a proper vision and at the same time not overdoing it to cause any kind of glare.
(b) HID headlamps.
These are mainly used in luxurious cars such as Audi, Mercedes, etc that provide for an higher intensity light giving a better vision to the driver of the car but often injurious for other people on the road. Usually one has to go through the rules and regulations book for getting legal permission to install these. Other additional lights are:

1. Cornering lamps
With an intention to provide extra illumination for the way ahead, these are placed just adjacent to the main headlamp. They may or may not burn steadily depending upon their wiring on how the manufacturer wants them to work like.

2. Spot lights
These are more of an accessory provided to some special cars used for specific purposes such as hospital emergency vehicles, sheriff cars, fire brigades etc. They are more of signal lights with special sirens, mounted at the top of the vehicle.

3. Brake light
These are found at the rear end of any automobile, which glows bright red at the application of brakes (usually brighter than the headlights). When seen from a distant, the drivers preceding the front vehicle anticipate that the car is decelerating to either stop or run on a slower speed, accordingly they can maintain a safe distant from it to avoid any kind of collision.

4. Reverse lights
These are installed in a car with the same purpose as that of brake lights. Constituting a part of the rear end signaling/ warning devices, the reverse lights are present to give off illumination when the car is in the reverse gear, moving backwards than forward. Doing so the vehicles that are behind us are warned beforehand of the vehicle’s rearward motion and readjust/ realign themselves accordingly to make way for each other in order to keep away from any kind of crash.

5. Rear Fog lamps
These came into use quite later after the introduction of the above mentioned lights, concepts of whose are widely gotten on the wrong end of the stick and misrepresented.
So far as the manufacturer’s understanding states, fog lights are provided as an aid for driving in extremely foggy/ rainy weather where the standard visibility of the driver reduces to a great extent because of the unfavorable conditions in the surrounding nature. Ideally these are available in mono colors mostly yellow, characterized by long range, and lessened dispersion. The objective is to let others know that you are on the road too, so as to escape from the constant honking which mostly gets on the nerves of both you and the surrounding people. One would be surprised to know that certain countries do have laws about their installation and usage. As far as India is concerned, there are no laws under anyone’s knowledge for how to, when and where are these supposed to be used.

6. Indicator
These are small lights placed both at the front and the rear end of the car, in all four corners that are used for signaling when a car is about to take a turn. In earlier days the driver was manually supposed to hit the indicator button and turn them on or off but know the sensors in the car use the smart technology to turn them on/off on their own.
Just as standard color for stop lights used universally is red, similarly indicators are that of yellow color.

7. Glove Box
This is a closed compartment available like a mini drawer in inside of a car for the passengers to use the available space for storage of miscellaneous items. You will often find a small lamp inside, triggered by a switch.

8. Headliner
This is a composite substance that is used in the making of the roof of the cars to give them a foam backing. They comprise of multi-layered coating of different materials that together bring stiffness look and feel in the inside of the car. Depending on your car you may have a dome light, map light, courtesy light (rear seats).

9. Doors
Some doors have lights at the bottom which are great for warning other motorist at night the door is open. They operate on a pressure switch.

Whatever your lighting need we aim to provide it for you.

Thanks for taking the time to read the blog hope you enjoyed it enjoy?
automotive-lighting.com.au
David Smith
[email protected]

Australias car lighting supplier trade, wholesale and consumer

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Headlights are one of the most important components of any automobile; every driver realizes its importance and the usefulness as it’s not just a little something attached to the anterior end of the car. It’s more of a necessity that empowers the person to access the power of its sight and drive carefully after the sun sets down, because no matter how skilled of a driver a person is the skill needs a source of light to guide them through the ways for a happy and a safe strolling. Sure use of better headlights also gives the entire structure of a car a classy edge like the ones used in ludicrously expensive, luxurious cars but the bottom fact always lies in the importance of the purpose that it serves.
Following is a guide that serves two purposes:
(a) To help the buyer familiarize with the various types of headlights present in the market and their plus and minus points, their functions, so that the buyer could conclude by him as to which one suits them the best.
(b) it also sheds some light in the area of their installation, the lightning technologies making oneself efficient enough to bring about a change so minute on its own. You don’t need to run endless chores to a mechanic to do a basic job as this one for you.

What’s a headlight?
A headlight is also known by the name of “headlamp” that is fitted in the bonnet of the car to shed light on the way ahead after dusk or in any situation when there’s poor visibility say when there’s immense dense fog, cloudy rainy seasons etc. It hence enables one to see through things clearly and ensures a safe journey ahead. A factor that should be kept in mind while selecting them is that they should be of moderate intensity because a low intensity light wouldn’t provide proper illumination and a high intensity light could provide a string glare and hence temporary blindness to drivers coming from different side of the road.
The use of headlamps was first introduced during the late 1880’s, in its original form they were fueled by acetylene or oil. With advancement in technology with a gradual shift in era, electric headlights were introduced in 1898 by the Electrical Company of Hartford, Connecticut with the prime motive of providing the Columbia Electric car with an optional accessory.
Now to provide additional knowledge in consideration of the same, headlights constitute mere one part of the entire automotive lighting system of a vehicle like cars, truck, van etc others may include indicators, stop brake lights etc located at different places in a automobile.

Different Types of headlights:
All the headlights irrespective of their inbuilt features share the common function of being the source of illumination, what differentiates them from one another is the type of bulbs that they use to provide the light. Majorly there are three types of bulbs used in a headlight- halogen, xenon and LED.
Halogen Headlamps
Also known as tungsten halogen, it is an incandescent light that constitutes of small part of halogen along with iodine or bromine, together they create a combination of the halogen gas and tungsten that gives birth to halogen cycle re-depositing evaporated tungsten on above the filament, increasing its life and intensity. These are best if one needs a source of high luminous efficacy, working at higher temperatures.

Xenon Headlamps
These are a specialized type of lamp that discharges gas and electric lights that generates light on passage of electricity through ionized xenon gas at great pressure conditions. Final result obtained is a white light coming out of it very similar to the natural sunlight, one can call it to be the latter’s masquerading counterpart. The bulbs have their use in various fields such as in projectors used in movie theaters, torches, and of course headlights etc.

LED Headlamps
The abbreviation of “LED” stands for “Light Emitting Diode.” It is a semiconductor diode that emits light when voltage is applied to it, usually the quality of light depends upon the temperature, a low temperature results in a better source of light than at higher temperatures, and hence it kind of becomes mandatory to maintain a relatively stable temperature for a constant light output. The range of these lights are small, not too penetrating in nature, apart from headlights its used in abundance in manufacturing of Diwali lights as its miniature size help it to come in different shapes and sizes.

Which is Best to use : Halogen, Xenon, or LED Headlamps

This is a tough call, it actually depends on the consumer as to what are its needs and priorities and what kind of light suits him best in his interest. Following are few bullet points that’ll bring out the advantages and disadvantages of Halogen, Xenon and LED:
1. Halogen
Advantages:
• Perfect to use if one needs bright white light as the final output.
• It is durable and has a long lifespan.
• If damaged, the cost of replacement are highly reasonable.
Disadvantages
• Too much of unnecessary heat is generated, loss of which means loss of energy for the entire system .
• It is highly reactive and hence rigorously mixes up when brought in contact with other substances.
• Needs to be handled with great precaution, inability to do so could lead to serious injuries.
2. Xenon
Advantages
• Offers better illumination with much more clarity.
• Provides for better efficiency
• Consumes less power and hence is a little more cost effective.
• More durable than Halogen headlamps.

Disadvantages
• Initial cost of investment is high. Not used in cheaper cars.
• Often come in high intensities that causes to much of glaring effect leaving the people coming from the other end partially blind for a few seconds, while driving this could lead to major accidents also it causes too much of a strain in the eyes of the other drivers.

3. LED
Advantages:
• It consumes to less of a power for an efficient, proper working.
• Energy consumption is low by LED lights. They can run on a low voltage.
• Available in small sizes, hence more versatile. Can be made available in the market in all shapes, designs and sizes.
Disadvantages:
• They are more expensive, mostly used in making of luxurious cars.
• It non-deliberately tends to produce extra heat that hampers both the quality of final light being produced and of course the loss of energy.
• More and extra efforts have to be made to maintain them at relatively constant temperatures, so as to obtain good lighting.
All in all, it is widely accepted that headlights in an automobile is as crucial as the engine itself. Its importance has been recognized by and large by every automobile manufacturing company. Limited by the budget constraint or the need restraint one can opt for any of the above lights by carefully weighing each of its pros and cons. The answer is not tough to decide. One just needs to have a clear mind with a clear insight as to what are they finally expecting.

So to answer the question which is best, all have advantage and disadvantage but hopefully this article will allow you to make a more informed choice.

Thanks for taking the time to read the blog hope you enjoyed it enjoy?
automotive-lighting.com.au
David Smith
[email protected]

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In the childhood years of any individual, everyone dreams of owning an automobile of their own, just as your darling first bicycle in school days these become the new obsession when one moves past the teenage years. Maybe it’s the years long waiting to buy this baby that accounts for so much of love towards the machine or mere a hobby to act all mechanical in order to check up on its basic parts to ensure its well being, either ways I am of the opinion that such a hobby is an healthy exercise.
Car maintenance is very crucial to ensure that your machine runs a long life, new as ever, free from minor troubles that hamper its smooth working and not to mention dodge some of the possibilities of any future bigger car problems. Usually, this car maintenance technique has a very wide ambit where one is supposed to occasionally check on the engine oil’s- replace them on time, replace the dirty filters, clean the carbonator, check for any loose wiring, ensure if brakes and all are working fine or not etc. Together in a whole regular check on such small factors can help your vehicle evade the probable fiascos of engine failure or complete breakdown of normal functioning in the near future. It’ll be surprising to know that vehicles these days constitute of an internal clock that reminds the owner of the car to go run a maintenance check on it, if not this the owner manual, or your service dealer draws out a scheduled time table as to how frequently is your car scheduled for periodic maintenance check up. This is usually an hassle free thing to do, if you have even an iota amount of technical person living inside of you, you can bring about the minor check up procedures on your own, else dropping of the vehicle in the near service station is not too much of an herculean task either. Depending upon what part of it is reanalyzed the duration for such maintenance drive can vary from a few hours to a few days.
We in particular cater to your lighting bulbs accessories that are indispensible in the working of an automobile. Additional components in the car such as headlights, indicators, fog lamps etc together make up the entire automotive lighting system which acts like the eyes to the machine. Without them it is almost impossible for a driver to drive off on the road after the sun sets down. Hence for a safe, hassle free driving it is necessary to have a good source of light that provides for just the right amount of light in just the right amount of intensity to illuminate the path ahead. All in All, the point that could be drawn out after mentioning its importance is that in among the many spare items accessories that are maintained by the owner of the car, spare bulbs are an equal must for dreadful times.
This site hence solely provides for the source that would recognize your needs, help you identify what exact type of what bulb is it that you need for your various components of automotive lighting and then help you buy them in the most reasonable costs. Customers intending to avail the services can either contact our service providers or us in particular to meet their demands.
We present to you an assortment of all types of bulbs most commonly used in wide variety of automobiles, such as halogen bulbs, xenon bulbs and LED lights use in headlamps, indicators, rear end lights etc. It is to be noted that most of these products are available with replaceable bulbs except for LED lights. They have to be replaced entirely if damaged.
Furthermore we provide for replaceable transformers for products that work on low voltage to help they run efficiently without exerting too much pressure on your car battery in the long run.
Hence you are just a few clicks away to end your search on quality products for your beloved car.

Some additional terms one should familiarize itself with for ensuring better safety measures:
A safe future one road is not much of a distant dream in today’s era than it feels so. Sure, the number of accidents reported in a year is arising at an alarming rate but the manufactures and technology worldwide is spreading its ambit to ensure the non- happening of such misfortune events. They thus have come up with technologies and parts that address to every teeny tiny trouble of yours eradicating all the probable problems emerging from poor night vision, bad weather etc.

1. First Aid Kit
As simple as they may sound, they hold a much more crucial importance in the extra spare accessories of the car. If by any bad chance of fate there may occur a accident the first aid kit helps one to provide the victim of the accident with a first quick addressal to its wounds, thus minimizing the loss of blood and additional problems arising from it. A customized form of such first aid kit permits you to look after the needs of your own family immediately in times of need. Following are a few items that are a “must to have” in the box which would cater to all kinds of injuries of a minor to major accident:
1. a range of adhesive bandages
2. safety pins
3. adhesive tapes
4. Antibiotics (prescription only s4 medication)
5. If your are on regular medication keep a supply ensure rotate stock and keep in date.
6. Chlorhexadine / Normal saline for cleaning the wound
7. Antiseptic cream and washes
8. Cotton Balls
9. Scissors
10. Pain relievers
11. Nsaline and betadine sprays that relieves of the wounded area of pain. etc

2. Mobile Phone Emergency charger
Just like we need oxygen to breathe, similarly i think Cell phones in today’s era also work as a life support system for many. Yeah, no kidding, the increased dependency on it is impossible to ignore or overlook at, hence to keep this life support system working incessantly one can opt for keeping a highly compact, functional, portable mobile charger within their car and carry it as an additional accessory in times of need for charging your cell phone anywhere you want and at anytime.
These are made up of in such sizes that fits up most of the mobile phones pins and also require minimum amount of storage area for their own placement. It can be operated on a simple battery power of your car most efficiently giving one a peace of mind to stay connected to the rest of the world at all times when gone away on a long journey to someplace.

3. High visibility clothing
These are clothing formed out of a florescent material with additional reflective tapes that highlights you automobile on the road at all times, be it the day time or the night hours.
Doing so it is ensured that other passerby vehicles can easily trace your car and make way for it as they both move further down on the road on their final destination.
Talking on logical terms the ultraviolet rays of the sun react with the fluorescent colors to make it appear more brightly enhancing its visibility during daytime. At night the mere material of the fluorescent is capable of shining with its own color evident enough to be spotted from a long distance.

4. Flashlight in a car
Suppose the battery of your car dies in the middle of a journey a flashlight in such a case can come in handy to locate the different spare part accessory you have maintained in your car and then utilize them to make it run again. It provides for a temporary yet reliable source of light energy when every other source is shutting down.

Thanks for taking the time to read the blog hope you enjoyed it enjoy?
automotive-lighting.com.au
David Smith
[email protected]

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