Clear!

And the Countdown Begins...

2006-07-16T22:54:00.000-04:00

Move-in day at UVA is coming up (August 19th) so I now have that to be looking forward too. I've been saving my money to last me through the upcoming year. Orientation is now also done with and I've registered for my engineering classes. I've decided also that I'm going to take the EMT-Intermediate class, or at the very least, the EMT-Enhanced class at the first chance that I can safely do so.

I'll post more later, I just got off from work. Take care.

Bravomedic out.

"Ditch Medicine"

2006-06-03T09:44:00.000-04:00

I guess I'll start of this post with my usual apology for not having posted in a while. School for the past two months has been a nightmare with AP and IB exams going on (and the last minute preps for them that our teachers give us. I wouldn't necessarily just call it supplemental work, that word is too benign; it was more like a forced march). Now that these exams are over though there's nothing else to do (this hold especially true for seniors) and so we eagerly await the next two weeks in the hopes of suturing closed this part of our lives. In my case, I have mixed feelings- I'm going to miss the friends I've made in high school and my accomplishments, I have no regrets about anything I've done. On the other hand, I'm ready to move on and hopefully come one step closer to med school.

As far as college goes, I'm thinking I might decide to switch over to chemical engineering with a minor in BME at UVA. I bought a textbook on organic chemistry which I plan to read this summer (we'll see whether or not that happens- it probably won't).

Yesterday was our "senior trip," in which the senior class went to a large park. Some of us brought water guns. I formed a fire team which we will designate as "Bravo" consisting of Adam, Will, and myself. Bravo's mission was to locate and take out (well, soak) an enemy civilian which we will designate as "Echo" (hey there Emily!). On the first encounter, Echo was spotted taking the point and heading east-bound on one of the trails. This trail happened to intersect another trail where a large tree was found. As Echo rounded the trail we opened fire. She can slap pretty hard and thus we were forced tactically to fall back. We then lost contact with Echo and had to decide on which direction they went. Deciding that they were again heading east-bound, Bravo team took one of the higher trails which would cut off the east-bound trail and give us plenty of time to dig in. After about twenty minutes of marching we reached the engagement zone. An unarmed scout (Will) was then deployed to find the target. An enemy fire team found us first though and proceeded in our direction. We fired a few cover shots and then were forced yet again to make a tactical fall back (12 against 3 are not good odds). Thankfully the enemy fire team consisted of drama students and thus did not pose any real danger (as it could not exceed the speed of 2 mph and even with that would be forced to sit down and rest). Having again lost the target we moved to the base camp (where the buses were) as this is where the target would have to come eventually. Sure enough, the target arrived about 20 minutes later and the mission was completed (at the cost of my arm after being slapped repeatedly).

As for the title of this thread, Ditch Medicine is a book by Hugh Coffee which describes the role and procedures of the PHCP (pre-hospital care provider) in a combat zone, thus it kind of relates to the story above (though no casualties were sustained). It's actually a very good book and describes basic surgical procedures (including wound debridement) and small wound care/repair, needle thoracocenteses, chest tube thoracostomies, IV therapy, advanced airway procedures, amputations, burns, psychological support, nutrition, and anaphlyactic shock. I would thoroughly recommend it to anyone interested in combat medicine (or EMS).

Stay safe everyone,
Bravomedic out.

Valedictorian

2006-04-26T16:01:00.000-04:00

They announced class ranks today and there was a ceremony for the top 20 in the class. I was announced as valedictorian for my senior class. Things are looking up for me now, I was also voted "most likely to succeed" for the senior superlatives.

My mom is also going to allow me to take my EMT-Intermediate class in college in addition to my regular engineering classes at UVA. I can't wait, I'm really excited about the EMT-I class.

I went out with my friends today for lunch. Apparently another friend had said, "You three are going to lunch together today? Are you insane?! If that restaurant blows up there goes the [insert high school name here] Brain Trust!" Okay, well I found it funny.

My AP Biology class (all eight of us) took a practice AP Bio exam. I thought it was pretty easy but we shall see what the results are.

I shall post more later tonight, but for now I'm going to sleep.

Stay safe everyone,
Bravomedic out.

Happy Easter!

2006-04-16T09:47:00.000-04:00

Happy Easter!!!

A man was blissfully driving along the highway, when he saw theEaster Bunny hopping across the middle of the road. He swerved to avoidhitting the Bunny, but unfortunately the rabbit jumped in front of his carand was hit. The basket of eggs went flying all over the place. Candy, too. The driver, being a sensitive man as well as an animal lover, pulledover to the side of the road, and got out to see what had become ofthe Bunny carrying the basket. Much to his dismay, the colorful Bunny was dead. The driver felt guilty and began to cry.
A woman driving down the same highway saw the man crying on the sideof the road and pulled over. She stepped out of her car and asked theman what was wrong. "I feel terrible," he explained, "I accidentally hit the Easter Bunny and killed it. What should I do?" The woman told the man not to worry. She knew exactly what to do. Shewent to her car trunk, and pulled out a spray can. She walked over tothe limp, dead Bunny, and sprayed the entire contents of the canonto the little furry animal. Miraculously the Easter Bunny came to back life, jumped up, picked upthe spilled eggs and candy, waved its paw at the two humans andhopped on down the road. 50 yards away the Easter Bunny stopped, turnedaround, waved and hopped on down the road another 50 yards, turned, waved,hopped another 50 yards and waved again!!!! The man was astonished. He said to the woman, "What in heaven's nameis in your spray can?" The woman turned the can around so that the mancould read the label. It said:
"Hair spray. Restores life to dead hair. Adds permanent wave."

Money!

2006-04-13T12:23:00.000-04:00

I had my Target interview today and I got the job. I am now a Pharmacy Technician/Cart Attendant/Cashier. I'm happy though that I now have a job. It pays off to be a valedictorian and going to UVA because it helps to distinguish you from the rest. My base pay rate begins now at $7.00 an hour. Yay for me! I think I shall go on a spending splurge and buy some more books. Yesterday I went book shopping and bought (let me get out the list):
-Weiten's Psychology: Themes and Variations
-Study Guide for Weiten's Psychology
-Single Variable Calculus (already had the class but couldn't resist buying it anyway)
-Mosby's Clinical Manual of Health Assessment
-Mosby's Health Assessment (different book from above)
-C++ Interactive Course

I have been augmenting my medical kit further by adding a 4" elastic wrap (ACE wrap type) and a roll of 3" Coban gauze (self adhering). The bag is getting fairly large now and I need to find a way to reinforce the bottom of it which leaves me one of two options: a) stick a piece of cardboard down into the bag (not very aesthetically pleasing) or b) sew a piece of foam into the bottom. I think I'll also spray the bag with a waterproofing compound. Again, I shall post pictures when I am done constructing the bag.

In Other News:

Antibiotic, Telithromycin, Can Help Some Asthma Patients
'According to an international study of 278 patients in 70 centres, an antibiotic called Telithromycin reduces asthma symptoms and enhances lung function. Researchers also found that the drug improved recovery times.'

Stay safe everyone,
Bravomedic out.

Fortune Cookie

2006-04-12T13:33:00.000-04:00

Salvete omnes,

I went to a Chinese restaurant the other day and ordered my usual- beef fried rice. I don't even have to really order anymore, the waiter just walks over and asks, "The usual?" to which I give my nod and off they go to fix my food. I also get my egg drop soup featuring my favorite protein (and yours too) albumin and is a major protein component of your blood plasma. Albumin functions to maintain the osmotic transmural pressure differential which ensures proper mass exchange between the blood and the interstitial fluid when at the capillary level. It also serves as a transport molecule for certain hormones and some metal ions. But that has nothing to do with fortune cookies, so moving on to fortune cookies, I received mine and it said "You will reach the highest possible point in your business or profession." Sounds good to me, looks like I'm on my way to Chief of Trauma Surgery (one day anyway, hehe). I do like the sound of that. Heck, lets add Chief of Trauma Surgery/Associate Professor, that sounds even better.

In other news:

Stem Cell Research News- Stem Cell Transplants Improve Recovery In Animal Models For Stroke, Cerebral Palsy
http://www.medicalnewstoday.com/medicalnews.php?newsid=41331

'A single dose of adult donor stem cells given to animals that have neurological damage similar to that experienced by adults with a stroke or newborns with cerebral palsy can significantly enhance recovery from these types of injuries, researchers say. Using a commonly utilized animal model for stroke, researchers administered a dose of 200,000-400,000 human stem cells into the brain of animals that had experienced significant loss of mobility and other functions. The stem cells used in the study were a recently discovered stem cell type, referred to as multipotent adult progenitor cells, or MAPCs. '

Biology/Biochemistry - Don't Hold Your Breath: Carp Can Manage Without Oxygen For Months-
http://www.medicalnewstoday.com/medicalnews.php?newsid=41326

'Article Date: 12 Apr 2006 - 5:00am (PDT)How long can you hold your breath? Scientists at the University of Oslo have recently discovered how the Crucian Carp, a close relative of the goldfish, is able to live for months without oxygen. The researchers hope that understanding how some animals cope with a lack of oxygen might give clues as to how to solve this problem in humans. "Anoxia related diseases are the major causes of death in the industrialized world. We have here a situation where evolution has solved the problem of anoxic survival millions of years ago, something that medical science has struggled with for decades with limited success", says Professor GÃ¶ran Nilsson who will be presenting his latest results at the Annual Meeting for the Society for Experimental Biology on Friday 7th April [session A9]. The researchers have found that this extraordinary fish can change the structure of its gills to avoid becoming anoxic. In addition its blood has a much higher affinity for oxygen than any other vertebrate, and it makes tranquilizers and produces alcohol when oxygen supplies are limited. These mechanisms allow the fish to survive for days or even months without oxygen depending on the temperature, whilst still maintaining physical activity. ### '

Stay safe everyone,
Bravomedic out.

Sallying Forth

2006-04-11T13:46:00.000-04:00

Salvete omnes,

I'm on spring break here and you know what that means (or at least you teens know what that means)- that's correct. It's that time of the year when we must emerge from our caves and sally forth into the great unknown that is the summer job search. I'm looking at Kroger and Target (but I don't think the local Target is hiring). We shall see though. If I don't get a job with either then I shall just have to find another job at one of the greenhouses. Volunteer jobs just don't provide the same level of income that being a grocery store clerk does. I had to abandon the idea of getting a job as an EMT because I'm under 18. I had to abandon the idea of becoming a medical assistant because I am capable of independent thought. Oh well, at least I shall be able to read my Principles of Anatomy and Physiology or Clinical Cardiac Electrophysiology during the dead time. Wish me luck!

In other news, I gained a CME credit hour from the Department of Defense for sitting through one of the lectures for combat medics. I was very impressed and I did learn some things from it. It was well worth the hour spent and I'll go to more in the future.

Time to go to mentorship now.

Stay safe everyone,
Bravomedic out.

Plant Biology

2006-04-08T23:10:00.000-04:00

Guess what I get to spend my Spring Break working on...That's right! An AP Biology packet! Sadly the packet is on plant structure and growth- easy stuff, but boring beyond all belief. I mean, memorizing the endodermis in a plant and its various functions is only but so much fun.

I hope everyone is having a good break (for those of you who are out now) and I hope that everyone has a happy Easter! I asked the Easter Bunny for medical supplies! I do hope I get them, the kit can always use more supplies. What I really need is an oxygen tank and regulator, but I don't think that is going to happen (I didn't even ask bother asking for one). I also asked for some classical music CDs.

Right now I'm practicing for world domination by playing the classic game, Colonization. One can never start too early these days. I have also signed up for my orientation day at UVA to meet with my advisor on course registration. I might take 18 credits for the semester in an attempt to get some of my medical school prerequisites out of the way.

I shall post more later tonight.

Valete omnes,
Bravomedic.

Funny Joke

2006-04-05T21:49:00.000-04:00

So a friend IMed me about UVA:

Mufasa: Look, Simba. Everything the light touches is your campus. A student's time here at UVa rises and falls like the sun. One day, the sun will set on your time here.
Simba: What about that dark, shadowy place?
Mufasa: That is e-school, Simba. It is forbidden; You must never go there.

That's funny! I'm in the forbidden place! Woohoo!

Just wanted to post that. Now back to bio...

Bravomedic out.

What Happened to America's Pattons?

2006-04-02T22:59:00.000-04:00

Today I'm going to deviate from my normal course of topics. Normally I go on about medical topics but tonight I'm going to make the rare exception.

I'm tired of the liberal press crying over the deaths of five Iraqi civilians by insurgents. That part would not normally bother me, it's just the way the press tries to turn the blame around and does not place it on the insurgents, but instead tries to pin it on American troops. I don't know how, but they always do. I don't know how the "reporters" (if that's what you can call them) can sleep with themselves at night. Now lets look at the contrast, when American troops are killed, it barely makes two sentences in the news and when it does, it's to go on about how all of Iraq hates us. Disgusting, when in fact very few of the people in Iraq actually hate us, they love us, we just have the occasional insurgent who wants to ruin the people of Iraq's one chance at democracy. But using the liberal way of thinking we go from 10% of the population disliking us somehow equals 90%. I guess that's why they're reporters, they couldn't do math so that shut off every other field.

Now this brings me to my question...what ever happened to the Pattons of America? Has our wealth really made us this spineless and weak? Since when did it become cool to be a pansy? What is wrong with today's society? Teens are squirting out kids faster than rabbits. I blame the parents. Why can't they raise more Pattons? If World War II were to occur today I'm pretty certain that we would eventually be speaking German because the press would be attempting to undermine the American defense. Half of America (especially the adolescent population) would still be thinking that we have no right to defend ourselves because war is "never justified". What a joke. What happened to the Pattons of America?!

Why don't we have people that say things like:

"May God have mercy upon my enemies, because I won't."

"Wars may be fought with weapons, but they are won with men. It is the spirit of men who follow and of the man who leads, that gains the victory."

And my personal favorite:

"It is foolish and wrong to mourn the men who died. Rather we should thank God that such men lived."

May there be better days ahead for all of humanity. At the risk of using another cliche, keep fighting America, anything worth having is worth dying for.

Good luck people,

Bravomedic out.

Patient

2006-03-29T20:38:00.000-05:00

Howdy everyone,

Duty is coming up this Friday. Last week I had a syncope (fainting) patient. Blood sugar was 121 (normal). No history of hypertension. Blood pressure confirmed this...in fact he was hypotensive with a BP of 94/68 (if that). Pulse rate was slightly elevated at 94 and a decreased SPO2 at 89% on the pulse ox. Respirations were 12 and normal. No further information available. No medical history at all actually except for arthritis (and he's 84 years old!!!). Astounding. I placed him on a NRB (non-rebreather mask) at 10 liters per minute (lpm) and kept him on the monitor. The transport was uneventful and the SPO2 rapidly rose to 95% and pulse decreased to 82. Currently the reason for the syncope is unknown as we have not received any feedback from the ER. It could've been a cardiac related problem which he was probably monitored for a recurring event. Blood labs would've been interesting to see too. I'll try to find out from the ER. By the way, the patient reported no numbness or chest pain/discomfort. Anyone else have any possible ideas? Cardiac origin seems to be the most likely.

In other news, a stroke magnet is available for free as well as information to educate the general public. I would recommend that you sign up for one here and stay informed. Time = brain. WebMD also has some basic guidelines for detecting a stroke which can be found here. We actually use some of the same tests in order to help us make the diagnosis (or prehospital provider diagnosis). Read up, it might come in handy some day.

Stay safe everyone,
Bravomedic out.

Free CPR Classes

2006-03-26T13:18:00.000-05:00

The AHA (American Heart Association) will be offering FREE CPR classes throughout "CPR Week" which is on April 1st-8th. I encourage you all that aren't already certified to sign up at your nearest location and participate. It's well worth it and will put your mind at ease (at least somewhat). If you enjoy the class then consider taking a first aid class or even a first responder class. You might even consider going into an EMT class someday (make an informed decision though and do a ride along first before you invest the time in it).

For more information on the free CPR class go here or call 1-877-AHA-4CPR .

In other news, I have duty today at the squad. Maybe we'll get something tonight (not that I am hoping for it, because that comes at the expense of others) since the last few duties have been really quiet.

Stay safe everyone,
Bravomedic out.

CPR Guidelines

2006-03-25T21:40:00.000-05:00

Salvete omnes,

As you may or may not know, CPR protocol has changed according to the American Heart Association (AHA). New guidelines can be found here. I would recommend reading it and refreshing yourself with the topic. I would also recertify as soon as possible.

I went book shopping today and bought a few books including:
-Fundamentals of Logic Design by Charles H. Roth- Electronics book that covers...guess what...logic design! Basically this covers the digital circuits that we know and love today.

-The Ancient World by Scramuzza and MacKendrick- Comprehensive guide to the classical world.

-The Republic by Plato- A discussion by the philosopher Plato about the meaning of nature and justice as well as the ideal state and ruler.

-The Ancient World by Pareti, Brezzi, and Petech- Part of a series on the history of mankind. This particular book discusses the ancient world in reference to religion, politics, economics, and historical events.

-The Limits of Medicine by Edward S. Golub, Ph.D.- This liber (Latin for "book") discusses how medicine evolved when science actually became part of medicine a mere 150 years ago. Golub argues that we need to change the way that we look at noninfectious diseases (such as cancer, heart disease, and Alzheimer's) which cannot be attributed to a single cause as can be done with many infectious diseases and therefore there may not be that "magic bullet", not a single one anyway.

I also bought some medical supplies today including some 3" elastic gauze (wrap), a 3" self-adhering gauze roller, and a pack of 4x4" dressings. I also bought a few dextrose tablets for diabetics (raspberry flavored).

To give you an idea of what I'm up against, I'll bore you with my school schedule. Currently I'm working on my AP US History (APUSH) review project. This is going to take a while (try days), but it is a great review. I also have a 27 weeks review test (2.5 hours long) in APUSH which is basically a series of essays as well as a quiz on the recent material (on the same day). I have a few neurology chapters to read for AP Biology. At least that's one thing I can look forward to. I then have to answer a packet on the material. In AP Stats I have a few problems to do and then a test on Wednesday. In AP English I have to read my weekly 300 pages of literature (I'm currently reading The Things They Carried by Tim O'Brien). In Electronics II, I have a quiz on counters using flip-flop circuits including D, J-K, and S-R flip-flop inputs. In AP Latin V I am translating the "Amores" by Ovid. I think that sums it up. There's probably more that I'm forgetting, but it helps me to see it all written out. Wish me luck!

Take care everyone,
Bravomedic out.

Educational Lesson Part II

2006-03-24T09:52:00.000-05:00

Salvete omnes,

Today I will post another educational lesson for my loyal reader, and everyone's favorite fool, seeingdouble. "Seeingdouble" recently left me a nice little comment:

"Darlin'... I hate to break it to you but my reading comprehension is not the problem. The NREMT requires you be at least 18n yeaers old, which you are admittedly not, therefore you are NOT certified. It's a damn shame anyone believes your [explicit word removed]. www.nremt.org, go ahead, check for yourself."

Anyone who writes "Darlin'" but if you're going to cite a source...you should at least make sure that the source that you give doesn't prove you wrong...

The NREMT merely certifies you. It does not license you to be an EMT. Only a state can license you. Just because you are an NREMT does not make you an EMT because a the National Registry is merely a certification agency, it cannot give you a license because it has no jurisdiction to do so. To quote your source, seeingdouble:

"The NREMT certifies individuals by issuing a certification. The NREMT does not issue a license or permit to work. EMTs must have a state license or state certification to work." - http://www.nremt.org/about/mission_statement.asp

Thank you for yet again proving my point about your inaptitude in the field of reading comprehension.

I am licensed by my state and therefore I am an EMT. When I turn 18, I merely have to pay the fee for National Registry certification because I am already a licensed EMT and thus have passed all of my tests.

Thanks again for the comment seeingdouble. I always get a kick out of stupidity. From your previous comments in the past which have all been incorrect and demonstrate your education, or lack thereof, I believe you should leave logic to people that have two neurons to rub together.

I apologize to everyone here who is intelligent for having to sit through that. Now we can move on. I'm sure you've read in the news that there is a growing concern about TB resistance to both first, and second line antibiotics. A fact sheet can be found at http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35815. I hate to be the one to say it, but antibiotic resistance kind of goes with the territory. If you give out the medication and people use it, the bacteria will eventually build up an immunity to it. It's called natural selection. There are only two ways to stem the tide either a) cut down on antibiotic use (which I would not consider in TB patients) or b) start researching new antibiotics and hold them in reserve for extreme cases.

The American Thoracic Society (ATS) and World Health Organization (WHO) have released new guidelines for the treatment of tuberculosis:

'Led by the American Thoracic Society (ATS) and the World Health Organization (WHO), a consortium of international health agencies today published on the World Wide Web the first International Standards for Tuberculosis Care (ISTC). "The purpose of the ISTC," said Philip C. Hopewell, M.D., who co-chaired the committee that produced the standards and who is a past president of the ATS, "is to establish a widely accepted level of care that all practitioners, public and private, should achieve in managing patients who have, or are suspected of having, tuberculosis." '

Stay safe everyone,
Bravomedic out.

Blood Circulation

2006-03-23T19:37:00.000-05:00

Howdy there,

I hope everyone is doing well. As you may or may not know, I look at my blog stats to see what people have been coming to my site for, in an effort to serve my readers. I have noticed that recently people have been coming to my blog looking for the general path of blood as it circulates throughout the body so I will post on that tonight.

Circulation of blood, as the name says, doesn't begin at a specific point because it is a circuit. It is constantly flowing in a circle, so I will arbitrarily begin with the right atrium. The right atrium receives unoxygenated blood from the vena cava and then contracts, forcing the blood through the tricuspid valve into the right ventricle. The right ventricle then contracts forcing the blood through the pulmonary valve and on into the pulmonary artery (the only artery in the body that carries unoxygenated blood; an artery is just a vessel that carries blood away from the heart). The pulmonary artery carries the blood into the lungs (the capillaries in the alveoli) where the blood becomes oxygenated. The newly oxygenated blood is then carried back to the heart via the pulmonary vein (conversely, the only vein in the body that carries oxygenated blood; veins merely carry blood back to the heart) and then enters the left atrium. The left atrium then contracts forcing the blood through the bicuspid (also known as the mitral) valve and on into the left ventricle. The left ventricle then contracts and forces the oxygenated blood through the aortic valve and on into the aortic arch (which leads into the aorta) where the blood is pushed into the systemic circulation. After flowing into smaller arteries, then arterioles, capillaries, venules, and then into the veins, the now unoxygenated blood (it has already delivered oxygen to the tissues) flows into the inferior and superior vena cavae which return the blood to the right atrium where the circuit continues all over again.

I hope this helps.

Good luck students!
Bravomedic out.

aPWV

2006-03-22T09:52:00.000-05:00

Salvete omnes,

Yesterday I went to a biomedical engineering seminar on aortic pulse wave velocity (aPWV) and how it measures aortic stiffness. It also covered the value of this test in the diagnosis of cardiovascular disease. Two methods of determining the aPWV are under research and includes using an MRI or an ultrasound and then matching the results up against the EKG (specifically the QRS complex since that is what creates a pulse, the QRS complex indicates the depolarization of the ventricles). The advantages of using one of the above methods is that it is both noninvasive and relatively cheap.

Here is a quote from a Medscape article titled, "Aortic Pulse Wave Velocity" which is from the The American Journal of Geriatric Cardiology which explains the basic hemodynamic concepts involved:

"In the absence of widely used noninvasive aortic blood pressure measurements,[3] PWV may be an available method to evaluate the status of central arteries. During systole, the contraction of left ventricular myocardium and the ejection of blood into the ascending aorta acutely dilate the aortic wall and generate a pulse wave that propagates along the arterial tree at a finite speed. This propagation velocity constitutes an index of arterial distensibility and stiffness: the higher the velocity, the higher the rigidity of the vascular wall and the lower the distensibility.[3]
The pressure pulse generated by ventricular ejection is propagated throughout the arterial tree at a speed that is determined by the elastic and geometric properties of the arterial wall and the characteristics (density) of the contained fluid (blood). Since blood is an incompressible fluid and is contained in elastic conduits (arteries), the energy propagation occurs predominantly along the walls of the arteries and not through the incompressible blood. Thus, the properties of the arterial wall, its thickness, and the arterial lumen diameter are the major factors influencing PWV. The relationships between PWV, transmural pressure, wall tension and distensibility have been formalized in many mathematic models. In most of them, the arterial segment studied is considered as a tube either with a thin or a thick vascular wall. Inside this cylindrical tube, there is a positive relationship between the change in pressure and the change in volume (V). The latter is usually expressed per unit length and then evaluated in terms of changes in diameter or radius, considering the length of the tube as constant. In such conditions, PWV may be defined according to the Moens-Korteweg and the Bramwell and Hill equations.[3]"

Okay, well I thought it was interesting anyway...you all probably didn't. Hopefully you read the above article and learned something anyway though. If you are interested in reading the rest of the article, you can go to http://www.medscape.com/viewarticle/443202 .

Stay safe everyone,
Bravomedic out.

Summer Jobs

2006-03-20T09:47:00.000-05:00

Salvete omnes,

Right now I'm looking for summer employment. No one will hire an EMT under the age of 18, so I'm kind of stuck under the given situation. I've applied so far to CVS as a pharmacy technician. I'm not sure when, or even if I will, hear back from them. It's nice to have burning money, I mean, savings for when I go off to college. Look, pictures!!!

The first picture is of the Rotunda while the second one is a picture of part of one of the engineering buildings during winter. I can't wait!

In other news, I've been asked to teach a virtual class on "Basic Medical Skills" at the "Virtual University". I'm almost done with the first lesson on anatomy and physiology. I'll make the course notes available here as I create them.

I also had my physical Friday as well as the PPD test (to check for TB exposure). Today I have to go back and have it looked at by the occupational health center. There isn't a bump so it looks like I'm in good shape.

I made a couple of textbook purchases this weekend including:

Mosby's Clinical Nursing - Preview Here - This book is going to be fun to read- over 1800 pages!!! I can't wait! (And no, there is no sarcasm there.)

An Introduction to Genetic Analysis

Time to go back to the salt mines. I'll post more later.

Stay safe everyone,
Bravomedic out.

Ride Along

2006-03-10T20:10:00.000-05:00

Salvete omnes,

I would like to apologize (again! I know...) for not posting more often. I've been very busy between school, rescue squad, and various projects for school. This week I had to wire several IC chips on a breadboard for a digital LED display board. I first had to figure out the message that I wanted, then I had to draw out the K-maps for it and simplify the Boolean expression, which needless to say, is not so fun. It turns out that the project required 10 IC chips (7404, 7408, 7411, 7427, 7432) as well as a 555 timer. That was an absolute nightmare and to make matters worse, the teacher didn't allow us to wire the breadboard normally. We had to make each wire flush to the breadboard and at perfect 90 degree angles (which kind of ruins the point of a breadboard). I keep seeing wires everywhere now, I must be hallucinating.

As for the title of this post, I have a friend that is about to do a ride along tomorrow. That's going to be interesting. She wants to be a doc too, so it'll be a good experience for her at least. I have absolute confidence in her.

I'll post more later. Right now it's dinner time!

Medical News:

Coffee Consumption Linked To Increased Risk Of Heart Attack

'Individuals who have a genetic variation associated with slower caffeine metabolism appear to have an increased risk of non-fatal heart attack associated with higher amounts of coffee intake, according to a study in the March issue of JAMA.

It is not clear whether caffeine alone affects the risk of heart attack or whether other chemicals found in coffee may be responsible. Caffeine is metabolized primarily by the enzyme cytochrome P450 1A2 (CYP1A2) in the liver. Variations of the gene for this enzyme can slow or quicken caffeine metabolism. Carriers of the gene variant CYP1A2*1F allele are "slow" caffeine metabolizers, while individuals with the gene variant CYP1A2*1A allele are "rapid" caffeine metabolizers.

"In summary, consistent with most case-control studies, we found that increased coffee intake is associated with an increased risk of nonfatal MI. The association between coffee and MI was found only among individuals with the slow CYP1A2*1F allele, which impairs caffeine metabolism, suggesting that caffeine plays a role in the association," the authors conclude.'

Stay safe everyone,
Bravomedic out.

Biomed

2006-02-22T10:43:00.000-05:00

Howdy everyone,

Things have been really slow around here lately. I haven't had a single decent call in a long time; just the usual routine transports. Oh well, I guess no calls are good calls.

I invited a friend of mine to do a ride along sometime in March so that should be interesting. I always get a kick out of the look that the novices have on their face on the first ride along. I'm not sure how she's going to react to it. Some take it easy and seem to be rather stoic about it, but the vast majority "freak out" and become really panicky. I'm going to opt for that latter with her.

The jump bag is still under construction. I'll have to have it fully ready before I move off to college. Again, I'll post pictures when I'm done.

I also went to my biomedical engineering mentorship which I really enjoyed. I have a few ideas for my engineering topic when I go for my undergrad which I can't wait to start. We also went over a presentation on electrospinning and the effect of various concentrations of collagen (actually in this case gelatin was used) on fiber size and pore diameter. That was actually pretty interesting. I want to make my own one day so that I can use it to make the blood clotting bandages. That would be useful.

Well, I'll get back to work now. Stay safe everyone,
Bravomedic out.

It's Finally Over...

2006-02-05T12:00:00.000-05:00

I got my report card back yesterday. The semester is officially over now which means that our class ranks are set in stone and guess what that means! I got all As! This means that I am now, officially the valedictorian of my senior class. Woohoo!!! I'm so happy. All of the late nights staying up to do my homework and studying has finally paid off. It's finally over. It's nice to be the valedictorian because you know that in the future you have the bragging rights to tell your kids and grandkids that.

Sadly enough though, senioritis has not set in on me. I'm still going to stay up late (as I will probably end up doing tonight) to finish my homework. I would just feel bad if I didn't do my best in everything anyway because of my conscience. But at least it still takes a load off of me in terms of stress because I don't have to worry about my rank anymore.

In other news, I'm still working on my jump bag. I haven't done much to it recently since I haven't had any time. I did order a free Foley catheter and that's on the way in the mail (hopefully) which I will put in the bag. For those of you that don't know what a Foley catheter is, consider yourself lucky. It's a tube with a balloon on the end of it that you push into the urethra to guide it into the bladder upon which you inflate the balloon. It's used for monitoring fluid output and for allowing patients to urinate when they otherwise cannot. Now aren't you glad you asked?

Well, I'm out. Back to the salt mines.

Stay safe everyone,
Bravomedic out.

Reading Comprehension

2006-01-30T18:53:00.000-05:00

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!

---

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

2006-01-27T12:36:00.000-05:00

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

2006-01-19T23:03:00.000-05:00

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

2006-01-14T21:02:00.000-05:00

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

2006-01-12T10:30:00.000-05:00

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...