OT: How cold is Barrow?

Discussion in 'Digital Cameras' started by Dudley Hanks, Feb 19, 2014.

  1. Dudley Hanks

    Eric Stevens Guest

    Are you really trying to say that after driving into a tree at 60mph
    you would not be concerned about whip lash?
     
    Eric Stevens, Feb 28, 2014
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  2. Dudley Hanks

    Savageduck Guest

    Warfarin is an anticoagulant used to reduce the risk of thrombosis. It
    will do nothing to prevent fibrillation of any sort. If you are using
    Warfarin regularly and if you had internal injuries, you would have
    been vulnerable to internal bleeding and shock.
     
    Savageduck, Feb 28, 2014
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  3. Dudley Hanks

    Tony Cooper Guest

    Well, they actually wouldn't be concerned with "whiplash". That's not
    a medical term, and it is usually used to describe the result of neck
    distortion.

    And, it's not really to prevent injury; it's to prevent *further*
    injury. The backboard and the C-Collar are put on in case the victim
    has damage - like a broken neck - and movement would aggravate that
    damage.

    I had the unfortunate experience of seeing my daughter arrive in an ER
    strapped to a body board with a C-Collar in place after being in an
    auto accident where she was the passenger of a car that had been
    T-boned on the passenger side.

    She did not have any neck or back injury from the accident, but the
    condition under which she was removed from the vehicle dictated the
    use of the backboard.

    I happened to be near the hospital when a friend in the car behind the
    car my daughter was in called me to tell me my daughter was on the way
    to ER. I beat her there.
     
    Tony Cooper, Feb 28, 2014
  4. Dudley Hanks

    PeterN Guest

    One of the many problems hospitals in the lower 48 face is that too many
    people use the ER instead of a local practitioner. There has been a
    steady growth of ambulatory care centers, that offer walk-in services at
    reasonable rates. The charges for an ER visit often start at $1,500 and
    up, which most insurance companies really pay. /These same carriers
    would only pay significantly less than twenty percent of that for a
    visit to a local doc, or an ACC. Since these ER visits serve as a high
    profit center the hospital will not refer them to a lower cost facility.
    Don't get me started on the waste and outright stupidity in our health
    care system. And don't you righties dare bme Obamacare. This has gone on
    for more than fifty years.
     
    PeterN, Feb 28, 2014
  5. Dudley Hanks

    Eric Stevens Guest

    I don't know, but suspect the arrangement was an accident of history
    based on aadecision in the pasat about where they could site the CAT
    scan. The department has had a major addition and accompannying
    reorganisation and from the UURLs Savageduck gave us the other day,
    the arrangement and equipment of the ICU is quite different.
    That's what tends to happen in New Zealand which is one reason why
    accident victims brought in by ambulance follow a different path.
     
    Eric Stevens, Feb 28, 2014
  6. Dudley Hanks

    Eric Stevens Guest

    In this case it was clearly labelled ICU.
     
    Eric Stevens, Feb 28, 2014
  7. Dudley Hanks

    Eric Stevens Guest

    I avoided the ER and went straight to the ICU.
     
    Eric Stevens, Feb 28, 2014
  8. Dudley Hanks

    Eric Stevens Guest

    As I told you, a needle was inserted in my vein but nothing was
    connected to it until I got to the hospital.
     
    Eric Stevens, Feb 28, 2014
  9. Dudley Hanks

    PeterN Guest

    On 2/28/2014 3:24 AM, Floyd L. Davidson wrote:

    Last summer I was T boned by a drunken cop, so badly that the Lexus was
    probably totaled. (It was a loaner my care was being serviced.)
    Although I was fairly groggy, I know they didn't put an IV in my arm.
    They did so in the ER, just to give me fluids.
    I was alert enough to tell one of my friends, who as also in the car, to
    watch my camera, lenses and tripod.
     
    PeterN, Feb 28, 2014
  10. Dudley Hanks

    PeterN Guest

    If you are satisfied, so be it.
     
    PeterN, Feb 28, 2014
  11. Dudley Hanks

    Eric Stevens Guest

    But there is a risk of blood clots forming in the heart which, if they
    break away, can give rise to stroke. The warfarin is to minimise the
    risk of clot formation.
    Hence the administration of vitamin K which restores normal clotting
    function.
     
    Eric Stevens, Feb 28, 2014
  12. Dudley Hanks

    Savageduck Guest

    Correct, and that has nothing to do with protecting against
    fibrillation as you stated earlier.
    Not quite, but it might help reduce internal bleeding in a marginal situation.
     
    Savageduck, Mar 1, 2014
  13. And now we see that they in fact did do exactly that. It didn't
    seem significant to Eric at the time and he didn't remember it,
    or any details.

    It is perhaps the most significant single treatment the EMS crew
    provided.

    The IV was used... guaranteed.

    Stroke or a myocardial infarction. Both a of course deadly.
    The fact is that Warfarin is commonly prescribed for people with
    atrial fibrillation.

    Incidentally, atrial fibrillation is another major cause of
    fainting spells of the type described by Eric. Between atrial
    fibrillation and dehydration it's pretty obvious the low
    measured BP was not the "cause", but just another symptom of his
    medical condition.

    As for that "unused" needle in the arm, it was used. Normal
    saline most likely, but with a MedicAlert bracelet indicating
    potential heart problems they probably ran D5W.
    The effects of a blood thinner, and in particular one like
    warfarin, are not all that easy to reverse quickly. There is
    little point in administering Vitamin K on scene as opposed to
    at the hospital under a doctor's direction and using lab tests
    on blood chemistry as a guide. It has very little immediate
    effect, so delaying for an hour has no significant benefit.
     
    Floyd L. Davidson, Mar 1, 2014
  14. I'm absolutely saying they put you on the backboard and used a
    C-collar to prevent injury. As Tony indicates, that might be
    further" injury, but primarily it is to prevent an initial
    injury.

    One of the problems with the use of a C-collar is patients may
    automatically assume it means they have a broken neck, and to
    many people that means "I am going to die!". The typical tactic
    to counter that is to watch the patient after the C-collar is
    applied, if their pulse starts pounding and their eyes get
    big... Someone who is really stern looking and sounding takes a
    pointed finger and literally pounds on the front of the C-collar
    (it works better with a Philadelphia Collar that is solid), at a
    rate of about 1 per second, hard enough to shake the patient,
    and tells them the collar is to protect them from an injury they
    don't have.

    That usually convinces them it's true, because they know that
    wouldn't be done to anyone about to die of a broken neck! :)
     
    Floyd L. Davidson, Mar 1, 2014
  15. Dudley Hanks

    PeterN Guest

    Both can be deadly. Either can leave the body devastated. Both my wife
    and I had strokes, and were fortunate. Neither of us had more than
    minimal residual effects. My wife has a limp, and I will slur words when
    tired. I firmly believe that it was only as a result of prompt medical
    intervention that our outcomes were as good as they were. In my wife's
    case, I demanded that she be taken to a center where she could be
    diagnosed and treated immediately. The doc at the first ER said she
    didn't have a stroke, but would confirm the following day when a med
    tech would arrive. It was a major battle to get her into a decent
    hospital, which I won. On her arrival at the ER there the neurologist
    took one look at her and confirmed my suspicions. Three days later I
    took her home. In my case I insisted on going as soon as I felt some
    numbness in my arm, and some blurry vision. I was home in four days.
    About five years ago I had a very minor MI, as a result of which I now
    wear a defibrillator.
     
    PeterN, Mar 1, 2014
  16. Dudley Hanks

    Savageduck Guest

    ....but it does little to prevent fibrillation, it does protect from a
    potentially fatal thrombosis which might result from the alternating
    arrhythmia and stasis of fibrillation.
    That would be the classic ischemic attack.
    It is one of those procedures which is pretty much SOP, but again, we
    are talking of a situation in NZ where there are possible differences,
    but I couldn't think why there would be. There are a whole bunch of
    good reasons to start an IV ASAP and few to delay it.
    Hence my remark.
     
    Savageduck, Mar 1, 2014
  17. Peter! I'm astounded, because that is a *very* astute observation.

    You have separated the "outright stupidity" of the *health care
    system* from the actions required by the various components,
    such as hospitals and other health care providers, to deal with
    it.

    Going all the way back to before Hillary Clinton's efforts at
    the start of President Clinton's first term, efforts to correct
    the system have been fought by the right wing of the Republican
    Party.

    What President Barack Obama has accomplished by passing and
    putting into effect the Affordable Healthcare Act, aka
    Obamacare, will go down in history as one of the most
    significant improvements to American life in many generations.

    In the US there is little doubt that we do have the best
    "medical care" available in the world. The best medicine, the
    best doctors, the best facilities. We have one of the worst
    Health Care Systems to provide access to that medical care! Our
    infant mortality rate and our longevity rate is a clear
    indication of just how poorly out health care system works.
     
    Floyd L. Davidson, Mar 1, 2014
  18. Note that "ICU" means "intensive" and "care". Not diagnosis, not
    stabilization, not surgery either. And the "intensive" part means
    this isn't for watching people with a runny nose.

    But the main point is that an ICU is a place to monitor a patient
    and where nurses provide continuing care. An ICU is nurse intensive,
    and doctor bare.

    And ER is where patients are stabilized. Typically the only other
    place a patient might go without being stabilized is to an OR, but
    they try to avoid that too.

    It doesn't sound as if the door was labeled correctly for the use
    it was given at the time. The other alternative is that this is
    just one more of *your* assumptions, and isn't strictly valid.
     
    Floyd L. Davidson, Mar 1, 2014
  19. I don't believe you.

    You are telling me the people who transported you were incompetent,
    and that is very very unlikely. It is much more likely that you
    were not very observant. Since we already know you didn't see or
    understand much of what happened...
     
    Floyd L. Davidson, Mar 1, 2014
  20. Dudley Hanks

    Savageduck Guest

    In the case of my wife's second brain bleed, which was 14 years after
    the first one. She had in general terms a ruptured AVM (Arteriovenous
    Malformation), in her case a ruptured cerebral angioma. After she was
    stabilized at our local ER/Trauma center, she was transported 30 miles
    South to San Luis Obispo as there was no neurosurgeon immediately
    available, or on call at our hospital, only a neurologist.
    In her case she went straight from ambulance to OR, as the surgical
    team was waiting for her.
    All the diagnostic work and initial stabilization was done at the
    Trauma Center, and the neurologist had communicated with the other
    hospital and neurosurgeon. That resulted in a long stay in ICU another
    two weeks in a DOU (direct observation unit) and 6 weeks in a rehab
    unit, and about 30 months of out-patient physical therapy.

    The billing for that came to well over $500K, my out of pocket expenses
    ran $3,800. The joke was that she would have to sleep with her head in
    a safe as she now had a $500K head.
     
    Savageduck, Mar 1, 2014
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