Reading Comprehension

Now, the same commenter, "seeingdouble," has recently posted a new comment on my blog in which she states that I did not answer her question about being certified. Check again.

So I have a new lesson today for her on "Reading Comprehension." Enjoy!

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I just got back from duty- 24 hour shift! Woohoo! Glad that's over. Nothing major, just your routine transports. I had a few patients that were friends of mine, thankfully they weren't seriously hurt.

I spent the day with my biomedical engineering mentor. We went over the electrospinning process and I read part of the textbook on tissue engineering. Pretty interesting stuff. Basically, what an electrospinner does is make cotton candy (but out of collagen, or whatever substance you want to use). First, though, you have to refine the collagen from a source, such as rat tails, and this process takes a while. Then you mix the collagen with an aqueous solution and load it into a syringe. You charge the needle (giving it a positive charge of, I think, 28000 volts) and then you place a metal rod a few inches in front of the needle which is connected to a ground. The syringe is then depressed at a constant rate and as the solution shoots out of the needle, the base evaporates (it's very volatile) and you are left with a fiber that wraps around the metal rod. This same process can also be used with a different protein, fibrinogen, and used to make gauze that can be used as an instant bloodstopper. It's pretty cool.

Right now I'm being forced to read "All the King's Men" for my AP English class. I'm really getting tired of reading these stories. Is it really so bad that I refuse to think that America and its democratic-republic is evil? I'm tired of reading about political agendas.

Stay safe everyone,
Bravomedic.

Exams

Yeehaw! Exam week is finally over! I really think that this has been the most stress-free week of my entire life though. I had to take an exam (midterm) for AP English (Literature), AP Biology, AP Statistics, AP Latin (Literature), and AP US History. I thought they were all pretty easy *knocks on wood*.

In further news, in 6.5 months I'll be going off to UVA! I can't wait, and the major that I'm planning on seems so cool (biomedical engineering). A lot of people have asked what biomedical engineering actually is and what it does so I will use that as a topic in a future post.

It's nice to know that the job also has a future. At UVA, a job fair is held for employers to come and try to recruit students. There are so many employers that UVA actually has to turn some down. At least I know that when I graduate, even as an undergrad, I'll have job security.

I have also noticed one of the recent comments on my blog. It was great, my station and I got a good laugh out of it. We printed it out and it now proudly hangs on the "wall of stupidity," so congrats "seeingdouble," you're actually known for something. Now, normally I would not justify such inanity by commenting on it but I will make an exception this time. Perhaps she truly does not understand in which case I will point out the error in her ways.

First of all, I did complete the required courses and I am a registered/licensed EMT. Now here comes the kicker, "Anyway, getting your own jump bag together seems like a bit of a waste of time. If you are working on a box, they'll have the supplies you need." So you think that I'm going to put together a jump bag to carry into duty on an ambulance that already has a jump bag? Amazing. I'm going to let you in on a little secret. Throughout much of the country are these regions known as "rural" areas. It can take anywhere between 20-30 minutes for a truck to get to the scene. Thus it's important for emergency medical care to reach the scene sooner. That's where a personal jump bag comes into play. I'll review what can happen in even 10 minutes, in case you don't realize how important this is:

-A patient in an MVA has stopped breathing- without being ventilated, within 10 minutes, this patient will go into cardiac arrest and become brain dead; needless to say, there's no coming back from that.
-MVA patient/unresponsive patient/altered LOC- needs help maintaining an airway; it doesn't matter if the patient is capable of breathing on his own if he doesn't have a patent airway
-MVA patient/assault victim is cut in the throat- an occlusive dressing and bleeding control will keep this patient from having an embolism or exsanguinating.
-A diabetic patient has overdosed on insulin or forgotten to eat- Glutose (glucose paste) can be given to keep the patient from becoming totally unresponsive so that he can be transported to the hospital and have D50W administered. This saves the patient from the complications (brain damage, organ damage, etc.) of hypoglycemia.
-A patient overdoses on a drug/poison that would normally cross the stomach membrane barrier rather quickly- Charcoal can bind to this poison and help prevent it from being from being absorbed into the organism.

But wait, there's more, "If you are planning on happening upon an accident and playing hero, I doubt you'll need that big *** bag of supplies." [Edited to remove curse words for people that are more intelligent than that.] There are more emergencies than just trauma calls; kindly see above.

Here comes the funny part (again), "I'll have to check with my husband, but as a EMT-B I don't think you are allowed to administer glucose and charcoal without the supervision of a EMT-I or P." Maybe you should leave the thinking up to people that are capable of it, okay?

EMT-Basics do not operate under the licenses or supervision of Intermediates or Paramedics. EMT-Bs, Is, and Ps, all operate under the license of a medical director (who is an MD). I hate to tell you this, but not only can I administer glucose and charcoal, but my medical director has also given me permission to administer: epinephrine (in an IM injection), nitroglycerin, oxygen, aspirin (ASA), and albuterol (via nebulizers which are kept on the truck).

Thanks for the comment, "seeingdouble." It was a great opportunity for an educational case!

Jump Bag- Part II

Howdy again everyone,

I'm getting slammed this week as the semester closes. I've had to complete several AP biology labs, take two AP Bio tests (covering metabolism, respiration, photosynthesis, and biochemistry), finish several essays for AP biology, take an APUSH test on Reconstruction with included Document Based Question (DBQ), as well as several write-ups for my mentoring. Ah, I'm glad I work well under pressure. In fact I usually can only function effectively under pressure. I love the stress.

I'm still getting the stuff together for my jump bag but I really haven't had a chance to yet. I need to still order some gauze and cravats; you know, consumable medical supplies. My supply list of things that I will place in the bag includes:

Trauma:
-8 Rolls of 3" Gauze
-20 4"x4" Dressings
-4 Occlusive Dressings (medium size)
-2 Rolls of 2" Tape
-1 Bottle (500 mL) Sterile Saline
-5 Cravats
-1 Pair of Hemostats
-50 Bandages (assorted sizes)
Airway/Breathing:
-1 Adult BVM (bag valve mask)
-1 Set of Oropharyngeal Airways (Oral Airways)
-1 Set of Nasopharyngeal Airways (Nasal Airways/Nasal Trumpets- this is a maybe)
Medical:
-1 Bottle of Activated Charcoal
-2 Tubes of Glutose (glucose paste)
-1 Obstetrics Kit
-1 Glucometer Kit (Glucometer, lancets, test strips, alcohol prep pads, etc.)
Diagnostics:
-1 Adult Blood Pressure Cuff
-1 Stethoscope
-1 Penlight
-1 Wind-up Watch
Miscellaneous:
-2 Medium-sized Notepads
-4 Patient Care Charts and Tracking Information
-1 Cell Phone

I will post pictures as soon as I get the thing set up. Keep in mind that this is not all of it, just things that I remember off the top of my head.

I figure I'll keep it in my car and also keep it in the dorm when I go off to college. I also have an iron-on star of life which I might put on the bag so that it is more identifiable.

Will post more when I have time.

Keep safe everyone,
Bravomedic out.

Jump Bag

Watch out everyone, I just received a new jump bag!

The other day at the rescue squad we were all given duffle bags. I already have one duffle bag for my clothes so I decided to turn it into a jump bag for myself to keep with me. The duffle bag is really nice, its dimensions are 24" x 12" x 15" which gives me a whopping 4320 cubic inches. It also comes with a shoulder strap for those extra heavy loads and it has reflective stripes on the side of it. There are also pockets on the sides which allow me to categorize some of my supplies (such as diagnostic equipment, wound care, personal protective equipment, etc.).

I'm thinking about making some modifications to the bag however. Here's my list of things to be done to it:

-Reinforce the bottom of the bag; the bag's underside is kind of flimsy and I really want it to hold some form when I start to put things inside of it, I also want the bottom reinforced so it won't get torn up.
-Internal frame- I was thinking about adding some kind of internal frame like they put on hiking backpacks so that the jump bag will hold more of a form.
-Cargo netting- I'm going to add some cargo netting on the inside of the main section of the bag so that I can place certain things (such as non-rebreather masks, supply tubing, and extra supplies) into more categorized areas and just so that the bag is all-around more organized (read, I don't want the jump bag exploding when I open it).
-More reflective strips on the side- I think the bag needs more reflective strips on the side...I don't like the idea of getting hit by a car while helping someone on the side of the road.

I've also started stocking up the kit. I'll post more about that later. So what do you guys think? What suggestions do you have for a jump bag?

Stay safe everyone,
Bravomedic

Summer Job

Howdy everyone. I hope you are all doing well.

I'm currently scouting out jobs for summer employment before I go off to UVA. There are a couple of ambulance services that are hiring EMT-Basics (which I am now by the way). The problem is probably going to be my age since I'm under 18 (just turned 17). However a lot of physician's offices are trying to recruit me because they need medical assistants (big time RN shortage around here).

We had four MVAs last duty and not a single transport. On one hand I'm glad they weren't serious enough that they would require transport, but on the other hand I enjoy transporting patients. I feel sorry for one of our patients who took a brand new Corvette right through a chain link fence. Scratched the car to pieces and destroyed the light covers. I don't know how the driver managed to do it. I suspect some alcohol involvement though.

Medical News:

How Mental Stress May Raise Heart Disease Risk

'Most people believe that stress plays a role in heart disease. A study published in the latest issue of Psychophysiology finds that large rises in blood pressure during mental stress are associated with higher levels of activity in the regions of the brain associated with experiencing negative emotions and generating physiological responses in the rest of the body. The research suggests that exaggerated activity in the cingulate cortex during mental stress may generate excessive rises in blood pressure that may place some individuals at a greater risk for heart disease. Most of what is known about the brain and its links to stress and heart disease has been taken from research on animals. This study on humans used functional magnetic resonance imaging (fMRI ), a non-invasive technique for imaging brain activity. While they were inside an MRI scanner, twenty healthy men and women performed a computer task to create mental stress that, consequently, increased their blood pressure. This allowed the researchers to correlate simultaneous changes in blood pressure and brain activity during stress. This study is published in the current issue of Psychophysiology.'

I don't stand a chance then...

DinB DNA Polymerase Is A Key Player In DNA Repair

'A quarter century after they discovered it, researchers have identified the job of one of the most common DNA-damage response proteins. The enzyme has puzzled scientists because it is present in nearly every organism, which suggests that it is crucial to life, and yet, in laboratory experiments, its function has remained a mystery. The discovery suggests that the enigmatic enzyme known as DinB DNA polymerase is specialized for proficient and accurate replication of a particular kind of damaged DNA, reports Graham Walker, an HHMI professor at the Massachusetts Institute of Technology, and his colleagues in the January 12, 2006, issue of the journal Nature. HHMI professors are leading research scientists who received $1 million grants from the Institute to bring innovative teaching to the undergraduate classroom. DNA is assaulted daily by toxic chemicals, metabolic byproducts, sunlight, and other forms of radiation. Most of the nicks and dings are quickly fixed by the cell's fleet of precision DNA repair processes, which can surgically excise and replace a faulty section. '

The sad part is that I understand that and understand the processes going along with it...

Holiday Update

Well, I hope everyone had a merry Christmas and a happy new year!

I got a ton of books for Christmas including "The Making of a Surgeon in the 21st Century," "Bedside Manners," and "Principles of Anatomy and Physiology." They're really great books, thanks Mom and Dad! And yes, I'm well aware that books are supposed to be underlined but oh well.

In other news I transported a patient with suspected meningitis at the rescue squad. I so called that one, the rest of the crew thought I was just being paranoid until the physician confirmed my suspicions. The guy had a fever of 101.7, generalized headache, his neck was sore and he couldn't touch his chin to his chest. He was also photophobic, classic signs of meningitis. I'm still sterilizing everything I own. I really hope those N-95 respirators work.

I also just created a new forum at http://medicus.z42.us/index.php
Check it out, I hope you like it. I'd like some input on it and hopefully you'll become a user. It's meant for discussing medical topics and all aspects of patient care.

I was also thinking about creating another forum that's more of an RPG (role playing game for you non-techies) where you follow different patients around and make decisions on their care. Let me know what you think about this too and if you'd be interested.

I'm out, I'll post some more later, stay safe,
Bravomedic.