161–170 of 201 posts
I was half-dozing on a Southwestern flight when a stewardess came on the PA system calling for any physician to identify themselves. I spoke up, and the crew directed me toward the back. They already had this incredible medical kit opened in the aisle. I mean they had everything ....ACLS drugs, defibrillator, suction, a complete mini-pharmacy, and what looked like a few plastic-7 wound and/or trauma kits at the least…
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I'm assuming the patient wasn't a racehorse? If I had a dollar for every time a dermatologist or podiatrist tried to be 'helpful' on an emergency scene... I could probably buy a coffee at Starbucks... The same goes for 'nurses.' If an ER nurse wants to help out, that's great. Invariably though, it's a nurse at a nursing home or dialysis center... I don't mean to imply these folks aren't skilled professionals, but pre…
On the other hand, it's good to have anyone step in to lend a hand, instead of standing back like sullen sheep.
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http://en.wikipedia.org/wiki/Tycho_Brahe#Death
Now I have something to be paranoid about and will be going the bathroom as much as possible.
I was half-dozing on a Southwestern flight when a stewardess came on the PA system calling for any physician to identify themselves. I spoke up, and the crew directed me toward the back. They already had this incredible medical kit opened in the aisle. I mean they had everything ....ACLS drugs, defibrillator, suction, a complete mini-pharmacy, and what looked like a few plastic-7 wound and/or trauma kits at the least…
Would not they check the passenger list for Dr's first? I remember being told that this was an occupational hazard for Phd's that you might be assumed to be a MD Dr.
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Beyond a certain capacity the bladder is no longer contractile and must be catheterized to urinate. Happens every day in the OR or PACU.
Really? What happened before modern medicine? I'm not being snarky: I believe you.. but a burst bladder would be lethal without access to modern medical knowledge. That seems like a epic fail by evolution.
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Actually, no idea why I grabbed onto morphine in that discussion. Our protocols call for vecuronium, atropine, etomidate, succinylcholine. However, we do also use fentanyl if indicated to deal with tachycardia and ICP. One other thing I noted in the original article was bemoaning the lack of pulse oximetry, "to assess if patient was exchanging oxygen". Treat the patient, not the number. If your patient is in respirat…
If I was the patient I would love to hear that my oxygen levels were normal and that I am not at any risk of dying any time soon. I would say treating the patient should include first measuring how urgent it is. Additionally if you panic you can easily imagine having trouble breathing, or that your trouble breathing is worse than it actually is. I have experienced this first hand when just relaxing removed most of my…
My dad, an electrical engineer, was once on his way back from a conference with a Concorde flight full of other EEs. In the air, the stewardess asked, "Is there an engineer on board?" Everyone responded enthusiastically. She was forced to clarify, "Is there an aeronautical engineer on board," to disappointment all around. I must admit, some secret part of me always hopes I'll be in a situation on an airplane where th…
I must admit, some secret part of me always hopes I'll be in a situation on an airplane where they need an emergency perl script written On a flight from Sydney to Vancouver earlier this year, the in-flight entertainment system on my plane was broken. I spoke up: "Hi, I have a doctorate in computer science and I know a bit about these systems... want me to take a look?" I was surprised when they agreed, brought me up…
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It's a little surprising to me they didn't even attempt CPR.
Out of hospital CPR has very slim survival chances. Being on a plane will result in at least 30 minutes of CPR even before an ambulance can take over. Chances on surviving that are extremely low. Therefore I can see why the doctor on the plane decided not to perform CPR. I have a medical degree myself btw.
Having no medical training, I know how to perform CPR and was able to resuscitate him to get to the local hospital and then to Methodist in Indy. Every doctor attributed to him living past 30 minutes to my efforts .
Outlook looked somewhat good for the short term, but the longer he was in ICU his chances worsened. Due to longer term massive organ failure, he passed on 12/12/12. My dad was Wilbur Harold Crawley III: automotive, electrical, and acoustic engineer.
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Opioids are rarely in RSI. RSI uses a sedative and a paralytic. The sedative is almost always a benzodiazapine, and occasionally a dissociative or hypnotic sedative like ketamine or etomidate. Morphine would be a _very_ poor choice for a sedative in an RSI protocol.
Actually, no idea why I grabbed onto morphine in that discussion. Our protocols call for vecuronium, atropine, etomidate, succinylcholine. However, we do also use fentanyl if indicated to deal with tachycardia and ICP. One other thing I noted in the original article was bemoaning the lack of pulse oximetry, "to assess if patient was exchanging oxygen". Treat the patient, not the number. If your patient is in respirat…
There are a few extremely important caveats with pulse oximetry. PulseOx is useless if your patient isn't perfusing their periphery well (either due to hypothermia, or shock). You also need to consider that it only measures the percentage of hemoglobin that is bound to _something_, that something could just as easily be carbon monoxide. The other commonly overlooked issue is that certain types of lights (fluorescent lights are the worst offender) play havoc with pulseox meters. Your average fluorescent light will happily sat in the mid-80's. Be sure to cover the finger (or toe) that the sensor is on with something opaque.
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#1 would probably be asking for a pilot. There have been a number of tests on simulators, and pilots licensed for smaller aircraft have a surprisingly low chance of being able to land a commercial jet.
That said, pilots -- or even non-pilots -- can actually do fairly well landing a large aircraft as long as they're being talked through the process by someone experienced. See http://mythbustersresults.com/episode94