impactednurseは、祝日！彼は日本の旅行に出発する2週間です。彼は非常に失われ、混乱doesntの知って、 1つの単語として彼は日本のです。
彼は相撲を訪ねて試合を期待し、キャッチで野球の試合を、多くの寺院を訪問します。
彼は考えていないが、緊急事態局です。
今すぐ別れを告げるためです。
イアンです
To decode the above message….. cut and paste into Google Translator. I think my original message has gained a little extra flavour in the translation.
Anyway… you will get the grist of it.
A paper published today by the Australian Strategic Policy Institute raises more than a few concerns regarding Australia’s ability to manage a large scale disaster.
Since September 2001, 10 billion dollars has been poured into our counter terrorism preparedness, while only 500 million has been spent on disaster preparedness.
The authors of this paper outline both the psychological and structural complacency now effecting our ability to prevent, respond and recover from large scale man-made or natural disasters.
This week is international midwives and nurses week.
Our hospital is celebrating with awards and foyer displays recognizing the significant achievements of these very special people.
Flying in front of the hospital entrance, large flags proclaim the event.
Unfortunately someone has accidentally hung them upside down.
Now, hanging a flag upside down is an internationally recognised distress symbol.
A picture pregnant with metaphor? Ill let you be the judge.
Every year at about this time the workload on our emergency departments begins its annual crescendo to a crisis. Public demand climbs as we enter the winter months.
Our emergency departments begin to list as we take on the cold winter wash of snotty sneezes, and ice-slip fractures, of croups and pneumonias and truculent viral spread.
Our corridors ring to grand overtures of aromatic baritone vomiting and exaggerated re-telling of sports collisions.
The very young and the very old lay skittled in our waiting rooms.
Hospitals have little capacity to meet the surge, and patients pile up in our emergency departments. They wait for a nurse. They wait for a doctor. And if they are really unlucky, they wait for a hospital bed.
Resources within the emergency departments are invariably stretched like frayed strands of bungee rubber.
Welcome to the bulge 2008.
A) People who turn the steering wheel to change lanes and then flip the indicator as their hand passes by it.
So the first flash of their indicator occurs after they are at least 1/3 of the way across the lane. I really hate that.
B) Mothers who let their kids jump up and down on the front/back seat of their cars unrestrained, whilst they are driving along with their mobile phone glued to their ears. I really hate that.
C) People who combine A & B. I really hate that.
D) People who endlessly complain about things that get up their noses all the time. I mean, I really, really hate that.
OK then. In a collective effort to unobstruct those impacted airways. Pick out two things that are really getting up your nostrils and wipe them over the comments.
Here at impactednurse.com we are happy to remain smugly add free in that holier than thou sort of way. But we will make an exception here to plug the site of a mate of mine. Mick the paramedic has recently set up Gear247.
Gear247 sells the sort of stuff that gets a hopeless gadget tragic such as myself all flustered and excitable.
From LED Lenser Tactical Focus Flashlights to Littman’s Classic II Stethoscopes to the ultimate Mother’s Day Gift of a Tick Removal Pen . This site has the goods.
Besides its my Birthday in a couple of days, and that flashlight sure looks cool.
Having problems remembering all those values and formulae?
A little rusty with your Advanced Cardiac Life Support algorithm?
Child is fitting, dont know what to do?
Well look no further. Presenting the impactednurse Pocket Cheat Sheet. Simply download this pdf file and print it out.
Then….. following the included instructions, simply fold and snip yourself a nifty pocket reference guide. Be the envy of all your friends.
[ Alternatively, you can pop over to Pocket Mod and design your very own version. ]
The man seated in the middle of this photo is Commodore Roger Boyce who we cared for several months ago following a motorcycle accident.
He sustained closed head injuries, bi-lateral pneumothorax, 12 fractured ribs and a fractured clavicle. The helicopter crew slid him across onto our resuscitation bed like a large broken pizza.
I was privileged to be a part of the resuscitation team that danced all over Commodore Boyce that night. And when we were finished with him, there was a whole lot of others queued to dance on him a whole lot more.
We put him back together. But we did not save his life. That happened much earlier.
Shortly after his accident, two girls stumbled upon the scene to find the Commodore crumpled, and cyanosed with an obstructed airway. Fortuitously these girls had completed a First Aid course and were able to safely open his airway and perform basic life support until help arrived. A simple act that gave him back to his family.
Had they been a few minutes further away or had they not known exactly what needed to be done, he would be dead.
Every year hundreds of average people, mumbling along, minding their own business, find themselves suddenly thrust into a situation where they stand across the intersection between another persons life and their death. The ultimate challenge slapped across their cheeks. Quick. Do you know what needs to be done?.
Clearing an airway, performing CPR, stopping bleeding. All simple things that anyone can easily learn. Simple things that may save a life.
Providing effective and sustainable chest compressions during cardiac arrest CPR can be a real challenge. It is without doubt physically draining, and even in seasoned medical staff you still see a lot of ‘TV CPR’ with the upper body and bent arms bobbing furiously up and down…..and not much at all happening down at the business end.
For a while now we have been trailing the Zoll AutoPulse automated cardiac compression device in our department.
The AutoPulse consists of a backboard containing the battery, electronics and a mechanical drive shaft. The drive shaft effects the chest compressions via a disposable chest strap.
This machine means business, and delivers a high energy circumferential chest compression that verges on explosive.
Note to myself: if you place the straps too low, say over the stomach for instance, the device will expunge the patients entire gastric contents skywards in a floor show that makes the Mentos and Diet Coke performance look decidedly ho-hum (but that’s another story).
The Australian Medical Association (AMA) today released a position paper on the management the growing impact that methamphetamine use is having on our emergency departments. Currently there are estimated to be approximately 73,000 dependent methamphetamine users in Australia. And the number is rising. In comparison there are approximately 45,000 regular heroin users.
Methamphetamine-induced psychosis is of particular concern to the medical profession. Out of every ten dependent users, around three will experience a psychotic episode in any one year, with paranoia and hallucinations being prominent clinical features….
…Many of those who are agitated or psychotic are also heavily intoxicated with alcohol, increasing the risks of aggression towards staff and creating clinical management challenges. Presentations related to amphetamines are typically of high acuity, result in prolonged length of stay in the Emergency Department, and consume considerable resources A third require sedation and intensive nursing, medical and security inputs to manage them safely
:: AMA::
You can read the position paper in full here.
I have written about the challenges we face managing these patients here.
