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Me Medical Medical News

Airplane Medical Kit

Because of the comments to the post about the doctor on the airplane, I wanted to do a follow up. So let’s first talk about what is in the medical kit on a commercial aircraft. The FAA requires an AED, and a medical kit that contains the following items:

The most common inflight medical events are:

  • Gastrointestinal/Nausea (31%)
  • Neurological, such as fainting or seizures (26%)
  • Respiratory (7%)
  • Cardiovascular (5%)
  • Dermatological (5%)

My wife was on an aircraft flying from JFK to Heathrow where there was a death in flight. The flight attendants cleared out the back row of the plane and put the body on the seats, covering him with a blanket. That is where he stayed for the remainder of the flight.

I myself have been on two flights were there were medical issues. In both cases, the flight crew called for medical personnel. I wasn’t going to volunteer, but no one else did, so I raised my hand. The FA brought me a radio headset that was connected to the airline’s on call doctor, who consulted with me and we agreed upon a course of action.

The first was a moderate allergic reaction (urticaria, wheezes, pruritus) on a flight from Orlando to Boston. The passenger got himself 50mg of IV diphenhydramine and some inhaled albuterol. He was fine and slept the rest of the flight.

The second was on a flight from Las Vegas to Orlando. It was a guy who was having himself an anxiety attack. He was hyperventilating and complaining of shortness of breath, chest pain, along with numbness and tingling to his fingers and lips.

The reason for it was hilarious. He had gotten married to his fiancé (a white woman) while in Vegas. He was Puerto Rican, and was dreading his mother’s reaction when he told her that he had married a woman (who wasn’t Puerto Rican) that his mother hadn’t even met yet. If you know anything about Puerto Rican mothers, you would know that they are much like Italian mothers. He had every right to be afraid.

Anyway, I told the doctor that his vitals looked good and I felt like it was an anxiety attack. The doctor agreed. I traded seats with his wife for about half an hour and talked him down. Once he felt better, I went back to my seat. An hour later, his wife came and got me a second time. During that second visit, his wife told mine that I was a very patient and nice man.

That’s it for my aircraft stories.

Categories
Humor Medical

We’re Doing Science

Scientists have announced that animals can breath through their anus. I can believe it, because the left has been talking out of their ass for decades.

With that in mind, I am working on a new first aid class. It’s still in the early stages, but I will let you know when I have more.

No, not like that…

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Medical

Childhood Development

When a child is very young, from birth to about 18 months, their first attraction is to their primary caregiver. The secondary caregivers are added to that, and the child remains firmly bonded to those caregivers until about 9 years of age. This early childhood bonding is important, because that is how children learn about trust: a parent being loving while caring and nurturing the child teaches them to trust. That the parent doesn’t “spoil” the child by over coddling also teaches the child a healthy mistrust that is important to a child’s development. If a person learns to trust others too much, then wind up in unhealthy, dependent relationships and never learn self reliance.

Anyway, the child at age 9 has learned a healthy balance between trust and mistrust, and soon this develops into a sense of independence that allows them the confidence to begin exploring relationships outside of the family.

At that point, children become attracted to (not in a sexual way) same sex peers (usually same sex peers, but there are some exceptions- think the traditional tomboy who played baseball with the boys) who are outside of the household. They begin to emulate those peers, children their own age, plus or minus a year or two. This learning behavior is a normal part of childhood development, and is driven by the fact that humans are social animals.

We emulate the behavior of other humans so that we can enter societal groups and not be outcasts. This normal attraction to same sex friends has been called the “normal homosexual phase.” Homosexual in this case not referring to an erotic, sex driven attraction, but to an emulation of those who would become a child’s social peers. Those of you reading this who are boys might remember this as your “girls are icky” phase. These are the days of summer camps, fishing with your best friend, or girls playing house and dolly. Skipping rocks, making mudpies, and playing pickup games of baseball. This is when children learn traditional societal roles and responsibilities.

There are adults who use this phase as an opportunity to confuse children. It is during this phase that children begin to form friendships and a sense of their role as it relates to the society in which they live. Those adults who want to take advantage of this have a narrow window of opportunity, because beginning about two years later, children begin to show the first signs of sexual attraction to the opposite sex. It is during this “normal homosexual phase” that children are most easily groomed into being confused about their role and can be swayed into accepting a nontraditional role such as transgenderism or homosexuality. The formative years from about 9 to 12 or so is when children form their sense of who they will become. It would be easy for a manipulative adult to convince a child that his deep friendship for his same sex best friend is really some sort of homosexual attraction of a more erotic nature, rather than of a developmental nature.

Children who are emotionally, sexually, and mentally abused or those who receive emotional trauma during these formative years are those who go on to experience mental health issues as adults. This is why allowing teachers to push these alternative roles upon children in the age groups from Kindergarten through seventh grade is so damaging to children.

This is also why there are teachers who are fighting so hard for access to children in this age group. It is access to young children that allows them to build the next generation of adults with misaligned emotional and psychological compasses.

Categories
Medical

Medicines to keep on hand

One thing that people who prepare for emergencies frequently overlook is medicine for “routine” medical problems. There are a couple of over the counter medications that I consider to be essential. When you are in a situation where medical care is not readily available, these medications can literally be lifesavers.

Acetaminophen: This one is good for pain and for control of fever.

Benadryl: This drug is good for allergic reactions, and also works well as a sedative and sleeping aid.

Ibuprofen: This is a non steroidal anti inflammatory. Anyone who has ever been in the military will tell you that this drug is used by them for everything from headaches to broken bones.

Immodium: Diarrhea is a killer because losing fluids and electrolytes can be dangerous. In a survival situation, take some as soon as the second incident of liquid bowel movement occurs.

Meclizine: This one is sold under many brand names. It’s good for mild nausea and can prevent vomiting. Like diarrhea, vomiting causes a loss of fluids and electrolytes that can be life threatening. It’s best to take this as soon as you feel queazy. If you wait until you are vomiting, it may be too late. Just remember that it can make you drowsy.

I’m sure that there are others I have forgotten. I am open to suggestions on what you may feel is essential.

Categories
Medical

First aid

Yesterday at the blogshoot, we did a bit of training on gunshot wounds. Several people in attendance asked me to do a post on the contents of a first aid kit. Let me start by saying that the way paramedics can tell the new guy from the experienced medics is in the amount of gear they tote around. Medics, fishermen, and gun owners have a trap that they commonly fall into, and that is the tendency to buy tons of gimicky crap when it comes to equipment.

Remember that serious trauma is first and foremost a surgical emergency. Trauma patients don’t need a tricked out first aid kit- they need a trauma surgeon. All they need you to do in the field is keep them alive and prevent them from furthering their injury until they can get on the operating table. So with that in mind, I take a minimalist approach to trauma first aid equipment. Please see the end of this post for disclaimers and conflict notice.

First aid kits that are filled with bandaids, sting ease, and other supplies are not good for this sort of work. Sure, I have one of those in the car, but band aids are not going to do you any good with a serious injury. Likewise, don’t get one that has suture kits and everything else, because you aren’t gonna need that and will likely screw it up anyway. Remember: simple. minimal. Stay in your lane.

The basics:

A pair of trauma shears. Most often used for cutting off your victim’s clothes. Don’t bother with the ones that have built in carabiners, bottle openers, glass breakers, or any of that other nonsense. You will likely throw these out once they are soaked in blood, so don’t waste a lot of money on a tricked out pair.

A compressed space blanket. Trauma patients need to be kept warm. After you treat them, wrap them in one. I used to keep the back of my unit heated to 90 degrees for trauma patients. Since we can’t do that, a space blanket is a great way to help with that.

A couple ( 2 or 3) packs of gauze soaked with a clotting agent. QuikClot is best, any of the other commercial alternatives (Celox for example) are acceptable. Many doctors will trash talk QuikClot, but every time one has told me that, the only reasons they can give are anecdotal. The plural of anecdote is not data.

A quality tourniquet. I prefer the CAT. Try to get one with the NSN number printed on it, that way it is more likely to be MilSpec and not a Chinese knock off.

A nasopharyngeal airway with a pack of KY to aid insertion.

An Israeli combat bandage. I like these because they can also be used as an ACE bandage, or (in conjunction with a triangular bandage) to stabilize arm/shoulder injuries, and other uses. Use your imagination.

A Hyfin Chest seal.

A pair or three of exam gloves.

If you don’t want to assemble a kit piece by piece, this is a good one. I just throw out the cheap tourniquet, then add a CAT, a Hyfin kit, and that handles most of what you will need in an emergency.


I follow the CoTCCC (Committee on Tactical Combat Casualty Care) Guidelines (see below) very closely and have designed trauma kit around them. All of the trauma treatment training I conduct is based on those guidelines.

Tactical Combat Casualty Care (Pronounced “T-Triple C”) is a set of guidelines developed by USSOCOM (United States Special Operations Command) to properly train non-medics to deal with the preventable causes of death in the field. With that in mind, remember that the single most important piece of gear that you have is the knowledge that you carry in your head. Seek out and get some training. Do not attempt to do any of this or use any of this stuff without knowing what you are doing.

Supporting documentation from the National Association of EMTs:

Basic Management Plan for Care Under Fire

  1. Return fire and take cover.
  2. Direct or expect casualty to remain engaged as a combatant if
    appropriate.
  3. Direct casualty to move to cover and apply self-aid if able.
  4. Try to keep the casualty from sustaining additional wounds.
  5. Casualties should be extricated from burning vehicles or buildings and moved to places of relative safety. Do what is necessary to stop the burning process.
  6. Airway management is generally best deferred until the Tactical Field
    Care phase.
  7. Stop life-threatening external hemorrhage if tactically feasible:
  • Direct casualty to control hemorrhage by self-aid if able.
  • Use a CoTCCC-recommended limb tourniquet for hemorrhage that is anatomically amenable to tourniquet use.
  • Apply the limb tourniquet over the clothing clearly proximal to the
    bleeding site(s). If the site of the life-threatening bleeding is not
    readily apparent, place the tourniquet “high and tight” (as proximal
    as possible) on the injured limb and move the casualty to cover.

Disclaimers and conflicts:

I have no financial conflicts to disclose, other than the fact that I do make money for training people in various aspects of trauma and medical care. I do not have a financial stake or interest in any of the products mentioned or linked in this post.

This post is not a substitute for training, knowledge, or does it imply that you should practice any of the techniques on this page without the necessary training, experience, and clinical judgement to apply these techniques. The writer assumes no responsibility for anyone who attempts to practice any of the actions on this page without first receiving training in the use or application of any of the procedures mentioned on this page.