Malignant hyperthermia escape room

Significant bradycardia and escape rhythms can flow; a low hematocrit increases blood flow by decreasing vis-be caused from the stimulation of vagus nerve. Arterial hypo- cosity. Hypothermia decreases neuronal metabolism and tension can result from pontine or medullary compression. reduces CBF, whereas hyperthermia has the opposite effect.May 13, 2022 · Immediate treatment of malignant hyperthermia includes: Medication. A drug called dantrolene (Dantrium, Revonto, Ryanodex) is used to treat the reaction by stopping the release of calcium into muscles. Other medications may be given to correct problems with a balance of the body's chemicals (metabolic imbalance) and treat complications. Oxygen. monster breakout indicator mt4 Escape rooms are a popular recreational activity in which participants are closed into a room, then presented with a storyline and a series of problems and challenges. If all problems are solved within a fixed timeframe, the participants "win" and are released from the room; if not, they "fail" the challenge. letter to tenants regarding security cameras Make Malignant Hyperthermia Training Memorable Participating in an MH escape room is a fun and effective way to learn emergency response protocols. Positioned to Prevent Wrong-site Surgery uber eats paypal Malignant hyperthermia. It is an anesthetic crisis that has been drilled into our heads since training. It is mostly unpredictable and rare—an individual anesthesia provider may see it once in her/his lifetime or not at all. It is scary because of its rarity and because of its high fatality rate unless recognized early and treated appropriately.comfort; environmental factors (e.g., room temperature); ... Malignant hyperthermia is a rare, life-threatening heredi- ... escape rhythms.malignant hyperthermia due to anesthesia SUSCEPTIBILITY to malignant hyperthermia (MH) is viewed as a pharmacogenetic trait dependent on exposure to inhalational anesthetics. 1, 2 Outside of the operating room, individuals susceptible to MH are usually asymptomatic. bradley elementary lunch menuNov 19, 2015 · Chapters cover drills ranging from medical emergencies such as cardiac arrest and malignant hyperthermia, to non-medical emergencies such as an active shooter and evacuation of a medical... Mar 25, 2022 · The Malignant Hyperthermia Association of the United States (MHAUS) [ 46 ], Ontario, Massachusetts, and Tennessee require that facilities that stock succinylcholine have dantrolene available within 10 minutes of identifying a suspected MH crisis, and stock at least 700 mg (a 10 mg/kg dose for a 70 kg patient) on site. -may also be triggered by stressors such as vigorous exercise and heat MH produces what clinically? 1. rapid increase in body temp 2. acute loss of control of intracellular calcium regulation 3. uncontrolled increase in SM metabolism 4. extreme acidosis 5. severe rhabdo the temperature increase seen in MH must be what to be considered MH? corsair 31 trimaran for sale Nov 19, 2015 · Chapters cover drills ranging from medical emergencies such as cardiac arrest and malignant hyperthermia, to non-medical emergencies such as an active shooter and evacuation of a medical... Immediate treatment of malignant hyperthermia includes: Medication. A drug called dantrolene (Dantrium, Revonto, Ryanodex) is used to treat the reaction by stopping the release …Browse the shownotes for No Agenda Show 1330: Cattle-lyst Converter.Today's ICU #OnePager is about 5 #toxidromes that cause hyperthermia: sympathomimetics anticholinergics serotonin syndrome neuroleptic malignant ... how to start the downswing correctly Author: James W Chapin, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF more... History and Physical Examination Malignant hyperthermia (MH) may occur either in the operating room (OR) or in...When the disorder was first formally described, the dramatic and unusual feature of the reaction was an elevation of body temperature to levels incompatible with survival—107-109°F or higher—in medical terms, hyperthermia. Since 80% of patients diagnosed with the disorder died, it was a malignant disorder, hence the name. 1996 lincoln town car lighting control module Hyperthermia is defined as a body temperature greater than 40 C. Several conditions can cause hyperthermia. In sepsis, the immunologic reaction to the infection most often manifests as a fever. Some toxic ingestions and …This review discusses the potent inhalation agents as the principal triggers and evidence that the modern agents, desflurane, sevoflurane, and isoflurane, can cause florid MH reactions in the same way as halothane but also are associated with reactions whose onset is delayed for several hours into anaesthesia.Outline the treatment of malignant hyperthermia. Summarize the role of the interprofessional team in the evaluation and treatment of malignant hyperthermia. Stop the triggering agent. Call for help. Administer dantrolene 2.5 mg/kg until the reaction subsides up to a maximum of 10 mg/kg. Increase ventilation to lower end-tidal CO2. saturn square moon transit forum Malignant hyperthermia is a condition that's often triggered by certain anesthesia drugs and can be life threatening. The condition impacts an estimated 1 in every 100,000 adult surgeries and 1 ...2 Nov 2010 ... This late hyperthermia should also be identified and treated. ... prognostic accuracy of malignant EEG patterns appears to be less reliable ...Malignant hyperthermia is a rare condition that causes a fast rise in body temperature when someone with the disease receives general anesthesia. Contact Information Erica McKnight 336-716-7194 [email protected] Wake Forest Baptist is 1 of only 3 civilian sites in the US to offer the gold-standard biopsy test for MH susceptibility. fox river resort map Mortality from malignant hyperthermia in the United States was 16.9% in 2001 and 6.5% in 2005, but it is characterized by high morbidity. Therapy is based on suspension of the triggering agent...Prepare for Malignant Hyperthermia Outside the OR. June 6, 2021. When two malignant hyperthermia (MH) cases occurred outside their operating room in a short time, the Advocate Aurora Health System (the system has facilities in both Wisconsin and Illinois) Corrective Action/Preventive Action (CAPA) team, the team set out to analyze and improve their response to this life-threatening anesthesia ...Mar 25, 2022 · Assistance in diagnosing and managing an MH crisis is available from the Malignant Hyperthermia Association of the United States (MHAUS) hotline at 1-800-644-9737 in the United States (00+1+209-417-3722 outside the United States). An acute management protocol can be found on the MHAUS website, at www.mhaus.org. steam deck desktop mode resolution The game play in this room involves minimal scavenger hunting and requires more deductive problem solving like our other escape rooms.MHAUS recommends that a full complement of dantrolene be available to administer at the anesthetizing location (e.g., operating room) within 10 minutes of the ...Chapters cover drills ranging from medical emergencies such as cardiac arrest and malignant hyperthermia, to non-medical emergencies such as an active shooter and evacuation of a medical...Jun 06, 2021 · Prepare for Malignant Hyperthermia Outside the OR. June 6, 2021. When two malignant hyperthermia (MH) cases occurred outside their operating room in a short time, the Advocate Aurora Health System (the system has facilities in both Wisconsin and Illinois) Corrective Action/Preventive Action (CAPA) team, the team set out to analyze and improve their response to this life-threatening anesthesia ... What is malignant hyperthermia? Malignant hyperthermia (MH) is a rare inherited autosomal dominant disease. It causes a life-threatening condition in susceptible horses triggered by anesthesia drugs (such as halothane, isoflurane, and succinylcholine), and occasionally by stress or excitement.Malignant hyperthermia is a rare inherited disease that causes rapid onset of extremely high body temperature associated with muscle rigidity and muscle injury in people exposed to certain types of anesthesia. It often occurs in the operating room during surgery, or in the recovery room. bus blue anchor What is malignant hyperthermia? Malignant hyperthermia (MH) is a rare inherited autosomal dominant disease. It causes a life-threatening condition in susceptible horses triggered by anesthesia drugs (such as halothane, isoflurane, and succinylcholine), and occasionally by stress or excitement.Malignant Hyperthermia. Perioperative and perianesthesia team members can help patients by being knowledgeable of the risks of malignant hyperthermia and its signs and symptoms, by implementing evidence-based care, and by educating patients and families about MH. This module provides that information.Hyperthermia is defined as a body temperature greater than 40 C. Several conditions can cause hyperthermia. In sepsis, the immunologic reaction to the infection most often manifests as a fever. Some toxic ingestions and … lamont coleman Chapters cover drills ranging from medical emergencies such as cardiac arrest and malignant hyperthermia, to non-medical emergencies such as an active shooter and evacuation of a medical...Significant bradycardia and escape rhythms can flow; a low hematocrit increases blood flow by decreasing vis-be caused from the stimulation of vagus nerve. Arterial hypo- cosity. Hypothermia decreases neuronal metabolism and tension can result from pontine or medullary compression. reduces CBF, whereas hyperthermia has the opposite effect.Nov 19, 2015 · Chapters cover drills ranging from medical emergencies such as cardiac arrest and malignant hyperthermia, to non-medical emergencies such as an active shooter and evacuation of a medical... range rover tdv6 engine removal 1 Mar 2019 ... Malignant hyperthermia is an inherited condition that occurs in ... and risk entrapment when they cannot escape from the trunk or vehicle.What is malignant hyperthermia? Malignant hyperthermia (MH) is a rare inherited autosomal dominant disease. It causes a life-threatening condition in susceptible horses triggered by anesthesia drugs (such as halothane, isoflurane, and succinylcholine), and occasionally by stress or excitement. band saw saw mill Malignant hyperthermia is a condition that's often triggered by certain anesthesia drugs and can be life threatening. The condition impacts an estimated 1 in every 100,000 adult surgeries and 1 ...We were planning on removing the anesthesia machine from the room for starters. Sedative, opiate meds, propofol, and local anesthetics are all safe. Most of us wouldn't actually remove the machine but would "prepare" it by washing out inhalational agents in the circuit and removing vaporizers or by using the adsorbing filters that reduce ...Abstract. Malignant hyperthermia is a rare condition that occurs in susceptible patients exposed to triggering anesthetic agents. It is associated with a high mortality rate if not recognized immediately and treated appropriately. A 52-year-old man presented to our clinic 2 days after an assault for management of jaw pain.Malignant hyperthermia is defined in the International Classification of Diseases as a progressive lifethreatening hyperthermic reaction occurring during general anaesthesia. Malignant hyperthermia has an underlying genetic basis, and genetically susceptible individuals are at risk of developing malignant hyperthermia if they are exposed to any of the potent inhalational anaesthetics or ... craigslist pittsburg ks 1.Introduction. The molecular regulation of intrinsic death process, often referred to programmed cell death (PCD), determines the malignant transformation and therapeutic responses of carcinomas , .The long-standing viewpoint of apoptotic death as the standard PCD mechanism has been changed according to up-to-date researches , , .Pyroptosis, another lytic …This training allows for hands-on practice, as well as to practice clinical procedures, communication and teamwork in a realistic, high-tension scenario. Malignant hyperthermia (MH) is a potentially fatal, inherited disorder usually associated with the administration of certain general anesthetics and/or the drug succinylcholine. retake drug test reddit Whether you’re looking for a Character Theme or Escape Room party or just a good old fashion movie night with yummy popcorn, we’ve got it. Our Private Party Rooms will Make Your … ashton method taper Whether you’re looking for a Character Theme or Escape Room party or just a good old fashion movie night with yummy popcorn, we’ve got it. Our Private Party Rooms will Make Your …Assistance in diagnosing and managing an MH crisis is available from the Malignant Hyperthermia Association of the United States (MHAUS) hotline at 1-800-644-9737 in the United States (00+1+209-417-3722 outside the United States). An acute management protocol can be found on the MHAUS website, at www.mhaus.org.Browse the shownotes for No Agenda Show 1330: Cattle-lyst Converter.the story of malignant hyperthermia began dramatically on april 8,1960, when a 21-yr-old engineering student at the university of melbourne, victoria, australia, sustained compound fractures of his right tibia and fibula when he was hit by a car while walking to his lectures at the university. 1 he was taken to the casualty department of the … game wii Malignant hyperthermia causes muscles to contract uncontrollably and is the only disease caused by anesthesia. People at risk for developing malignant hyperthermia should …When the syndrome of malignant hyperthermia was first noticed by the world during 60s, the rate of mortality was about 80%. The increasing awareness of syndrome with resultant in earlier diagnosis and treatment markedly reduced the mortality to 28% during 70s. With the introduction of the dantrolene, the rate of mortality reduced to 7%.We were planning on removing the anesthesia machine from the room for starters. Sedative, opiate meds, propofol, and local anesthetics are all safe. Most of us wouldn't actually remove the machine but would "prepare" it by washing out inhalational agents in the circuit and removing vaporizers or by using the adsorbing filters that reduce ...An inherited hypermetabolic syndrome, MH, once triggered, causes sustained skeletal muscle contraction that can lead to severe hyperthermia, left ventricular failure, brain damage, organ failure, disseminated intravascular coagulation, cardiac arrest, and death. Recognizing symptoms early and discontinuing anesthesia promptly are imperative. 6th gen 4runner Today's ICU #OnePager is about 5 #toxidromes that cause hyperthermia: sympathomimetics anticholinergics serotonin syndrome neuroleptic malignant ...The homepage to search for a model or part. Our DIY how-to guides and videos to find repair instructions. The Water Filter Finder for refrigerator water filters.Prepare for Malignant Hyperthermia Outside the OR. June 6, 2021. When two malignant hyperthermia (MH) cases occurred outside their operating room in a short time, the Advocate Aurora Health System (the system has facilities in both Wisconsin and Illinois) Corrective Action/Preventive Action (CAPA) team, the team set out to analyze and improve their response to this life-threatening anesthesia ... bronx police department What are the signs of malignant hyperthermia? They can include: Severe muscle rigidity or spasms. Rapid, shallow breathing and problems with low oxygen and high carbon dioxide. Rapid heart rate. Abnormal heart rhythm. Dangerously high body temperature. Excessive sweating. Patchy, irregular skin color (mottled skin) What is the first symptom of MH?T here are several ways to ensure your staff is properly trained to handle a malignant hyperthermia emergency. Making them sit through yet another annual in-service or having them read dry educational materials would certainly get the job done, but creating an MH escape room would make the training memorable, challenging — and a lot of fun. gamecube homebrew apps Malignant hyperthermia (MH) is an uncommon pharmacogenetic disorder of muscle induced by exposure to suxamethonium and all the volatile anaesthetic agents. It is characterized by hypermetabolism, muscle rigidity and muscle injury. AETIOLOGY MH susceptibility is inherited as an autosomal dominant condition with variable penetrance.clark1984 - Read online for free.17 Des 2019 ... Malignant hyperthermia (MH) is a rare but life-threatening surgical ... “SBT in the OR is more realistic than it is in a training room,” ...Sylvia Walters never planned to be in the food-service business. In fact, before she started Sylvia's Soul Plates in April, Walters was best known for fronting the local blues band Sylvia Walters and Groove City. longhorn mountvolume setup failed for volumeSigns and symptoms of malignant hyperthermia may vary and can occur during anesthesia or during recovery shortly after surgery. They can include: Severe muscle rigidity or spasms Rapid, shallow breathing and problems with low oxygen and high carbon dioxide Rapid heart rate Irregular heart rhythm Dangerously high body temperature Excessive sweatingUse this guide to help you formulate nursing interventions for a hyperthermia nursing care plan and nursing diagnosis.. Hyperthermia is defined as elevated body temperature due to a break in thermoregulation that arises when a body produces or absorbs more heat than it dissipates. It is a sustained core temperature beyond the normal variance, usually greater than …Immediate treatment of malignant hyperthermia includes: Medication. A drug called dantrolene (Dantrium, Revonto, Ryanodex) is used to treat the reaction by stopping the release of calcium into muscles. Other medications may be given to correct problems with a balance of the body's chemicals (metabolic imbalance) and treat complications. Oxygen. swing dance calendar More than a million books are available now via BitTorrent. For more information about this format, please see the Archive Torrents collection. infp stalking Malignant hyperthermia (MH) is a rare, inherited disorder of skeletal muscle that presents as a hypermetabolic response triggered by halogenated anesthetics, succinylcholine, or both. The...Mortality from malignant hyperthermia in the United States was 16.9% in 2001 and 6.5% in 2005, but it is characterized by high morbidity. Therapy is based on suspension of the triggering agent... savage b22 chassis Through the Development of a Malignant Hyperthermia Simulation in the Operating Room. Journal of Continuing Education Nursing. Nov 1;51(11):523-527. ... Escape rooms can help to build key skills within your team, such as collaboration, communication, decision making, and-may also be triggered by stressors such as vigorous exercise and heat MH produces what clinically? 1. rapid increase in body temp 2. acute loss of control of intracellular calcium regulation 3. uncontrolled increase in SM metabolism 4. extreme acidosis 5. severe rhabdo the temperature increase seen in MH must be what to be considered MH?During the surgery, he develops malignant hyperthermia (MH). Methods: Learners are to identify the signs of MH, including tachycardia, hypercapnia, muscle rigidity, and renal …Abstract. While usually occurring as an operating room emergency, malignant hyperthermia can appear postoperatively on a medical-surgical unit. If unrecognized and/or untreated, malignant … list of oil and gas companies with email addresses Malignant hyperthermia (MH) was first described by Denborough in 1962 when deaths were occurring during and immediately (within 24 hours) following the administration of anesthesia medications. The common denominator in these patients was sudden and critical increases in body temperature.Definition Malignant Hyperthermia (MH) is an acute pharmacogenetic (autosomal dominant) disorder, which develops during or immediately after the application of general anaesthesia involving volatile agents and/or depolarising muscle relaxants. The disorder is as a result of a defect in calcium channel regulation in the muscle cell.Outline the treatment of malignant hyperthermia. Summarize the role of the interprofessional team in the evaluation and treatment of malignant hyperthermia. Stop the triggering agent. Call for help. Administer dantrolene 2.5 mg/kg until the reaction subsides up to a maximum of 10 mg/kg. Increase ventilation to lower end-tidal CO2.Malignant hyperthermia. It is an anesthetic crisis that has been drilled into our heads since training. It is mostly unpredictable and rare—an individual anesthesia provider may see it once in her/his lifetime or not at all. It is scary because of its rarity and because of its high fatality rate unless recognized early and treated appropriately. massey ferguson gc1725mb problems In preparing for critical events, simulation is a powerful teaching tool to maintain or further develop skills and prepare the team to function well when seconds count. Malignant Hyperthermia (MH) is one of these serious events that can happen in the operating room (OR).Escape rooms are a popular recreational activity in which participants are closed into a room, then presented with a storyline and a series of problems and challenges. If all problems are solved within a fixed timeframe, the participants "win" and are released from the room; if not, they "fail" the challenge. asia ferguson body If given these drugs, people at risk of malignant hyperthermia may experience a rapid increase in heart rate and body temperature (hyperthermia), abnormally fast breathing, muscle rigidity, breakdown of muscle fibers (rhabdomyolysis), and increased acid levels in the blood and other tissues (acidosis).Abstract The abnormal increase in intracellular Ca++ in malignant hyperthermia (MH) is well documented, but the link between the increased Ca++ concentration and high temperature remains speculative. We investigated the possibility that the Ca (++)-induced change in the state of cell membranes may contribute to the temperature elevation.Malignant hyperthermia is a genetic life-threatening disease that results in an uncontrolled release of calcium that causes the body to go into a hypermetabolic state. It’s triggered by the administration of volatile anesthetic agents or succinylcholine, which is a depolarizing muscle relaxant. substitution and elimination worksheet with answers 2 Nov 2010 ... This late hyperthermia should also be identified and treated. ... prognostic accuracy of malignant EEG patterns appears to be less reliable ...11 Feb 2022 ... Escape to Simulation: How a COVID-19 Escape Room provided Interdisciplinary ... Malignant Hyperthermia Simulation Training in Operating RoomMalignant hyperthermia is a rare inherited disease that causes rapid onset of extremely high body temperature associated with muscle rigidity and muscle injury in people exposed to certain types of anesthesia. It often occurs in the operating room during surgery, or in the recovery room. avengers fanfiction peter bipolar Significant bradycardia and escape rhythms can flow; a low hematocrit increases blood flow by decreasing vis-be caused from the stimulation of vagus nerve. Arterial hypo- cosity. Hypothermia decreases neuronal metabolism and tension can result from pontine or medullary compression. reduces CBF, whereas hyperthermia has the opposite effect.Though rare, the death of a patient due to malignant hyperthermia is tragic for the family and the operating room staff. Malignant hyperthermia causes complications in 1 in 100,000 surgical procedures in adults and 1 in 30,000 surgical procedures in children (MHAUS, 2021). Though uncommon, when considering the 234 million major surgical ...Malignant hyperthermia is a rare inherited disease that causes rapid onset of extremely high body temperature associated with muscle rigidity and muscle injury in people exposed to certain types of anesthesia. It often occurs in the operating room during surgery, or in the recovery room. Malignant hyperthermia susceptibility (MHS) is an autosomal dominant disorder. Most individuals diagnosed with MHS have a parent with MHS, although the parent may not have experienced an episode of MH. The proportion of individuals with MHS caused by a de novo pathogenic variant is unknown.If Malignant Hyperthermia is suspected in Recovery Room. As above but also consider chest X-ray, blood cultures and cranial CT depending on the clinical picture. When the Diagnosis of Malignant Hyperthermia is made. Declare an MH emergency; Call for Anaesthetic assistance; Hyperventilate with 100% O2 (3-4 x normal minute volume ) 6r80 transmission filter malignant hyperthermia what is it? also known as mh or hyperpyrexia it is a rare, genetic autosomal-dominant and life threatening disease. it is a hypermetabolic disorder of skeletal muscle which is a true emergency in the or. it is a biochemical chain reaction response “triggered” by commonly used general anesthetics and the paralytic agent …Malignant Hyperthermia Unit Room 8.32A Level 8 Clinical Sciences Building St James’s University Hospital Beckett Street Leeds LS9 7TF. Email: [email protected] Contact Numbers. Direct Line: 0113 20 65270 Fax Number: 0113 20 64140 Emergency 24 hour Hot-Line: 07947 609601The homepage to search for a model or part. Our DIY how-to guides and videos to find repair instructions. The Water Filter Finder for refrigerator water filters.Sep 29, 2022 · Malignant hyperthermia is a life threatening condition that needs to be treated immediately. If left untreated, it can lead to: cardiac arrest brain damage internal bleeding failure of other... pendleton brand Adherence to watchful waiting practices was low in the emergency room (5.7%) ... Management of Patients Susceptible to Malignant Hyperthermia: A Surgeon's ...Malignant hyperthermia is diagnosed based on signs and symptoms, monitoring during and immediately after anesthesia, and lab tests to identify complications. Susceptibility testing. Testing to find out if you're at increased risk of malignant hyperthermia (susceptibility testing) may be recommended if you have risk factors.May 17, 2019 - Explore lexly sanchez's board "MH " on Pinterest. See more ideas about malignant hyperthermia, operating room nurse, nurse.Nov 04, 2022 · in this work, a collaborative nanotherapeutic strategy is implemented in a two-dimensional (2d) silicene-based nanosystem, which simultaneously loads cisplatin (ddp), for inducing synergistic pyroptosis and photonic hyperthermal nanotherapy. 2d silicene nanosheet, as an excellent candidate of photothermal-conversion nanoagent and drug-delivery … harley circuit breaker wiring ABSTRACT: Malignant hyperthermia is a rare, life-threatening clinical syndrome of hypermetabolism involving the skeletal muscle. In susceptible individuals, this reaction is triggered primarily by exposure to volatile inhalational anesthetic agents and succinylcholine (a muscle relaxant). kroger check stub Jan 05, 2021 · CRACKING THE CODE Staff members team up to answer questions that provide the combination they need to unlock the escape room's box. | All photos are by Julie Blakeley. T here are several ways to ensure your staff is properly trained to handle a malignant hyperthermia emergency. Making them sit through yet another annual in-service or having them read dry educational materials would certainly get the job done, but creating an MH escape room would make the training memorable, challenging ... Page 3 of 15 Title: Malignant Hyperthermia Document #: 6489 Issuing Authority: BP Clinical Programs/Chief Nurse Executive, Administration Last Revised Date: 11/29/2019 Version Number: 2.1 (Current) DISCLAIMER: This is a CONTROLLED document.The most current version is in electronic format on the BCHS intranet site. year round resort jobs with housing florida Disorder of skeletal muscle. A defect of the sarcoplasmic reticulum causing an increased concentration of intracellular calcium. Hypercalcemia causes the muscle to contract and become rigid. Accelerated cellular process that increases oxygen consumption and production of carbon dioxide and heat resulting in metabolic acidosis and hyperkalemia.Prepare for Malignant Hyperthermia Outside the OR. June 6, 2021. When two malignant hyperthermia (MH) cases occurred outside their operating room in a short time, the Advocate Aurora Health System (the system has facilities in both Wisconsin and Illinois) Corrective Action/Preventive Action (CAPA) team, the team set out to analyze and improve their response to this life-threatening anesthesia ...Malignant hyperthermia (MH) is a rare life-threatening condition that is triggered by commonly used anesthetic medications. Early recognition and treatment is essential to improve survival rates, and being prepared for an MH crisis can decrease clinical response time and the associated morbidity and mortality with the disease. static caravans for sale tenby