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Showing posts from September, 2017

Week 6. EtOh = Alcohol

In honor of the weekend (and no invisible planet hitting us today), here's a really-quite-serious, "How drunk are you?" quiz based on how pickled your brain feels (loosely adapted from Table 38-1 in Lehne's Pharmacology for Nursing Care, 9th ed.)


1. Increased confidence? Euphoria, decreased inhibitions? Congratulations, the alcohol has reached your frontal lobe. Blood alcohol approximately 0.05%.

2. Loquacious? Judgement altered? Your frontal lobe continues to be affected, and you are now at or past the legal limit of intoxication, 0.08%.

3. Tremors? Involuntary body movements? Reduced attention? Your parietal lobe's been breached. 0.15%.

4. Reduced motor skills? Slurred speech? Parietal lobe conquered at 0.2%.

5. Altered perception? Double vision? The occipital lobe's getting pickled, 0.25%.

6. Altered equilibrium? There goes your cerebellum. 0.3%.

7. Feeling apathetic? Inert? In a stupor? Really shouldn't continue, because you're down to the diencep…

Week 5. Drsg = dressing

Wounds must heal from the inside out, the ruptured skin one's largest organ.

Wound care: to change dressings, carefully loosen the tape around margins. Moisten if dressings stick during removal, then assess and measure the damage, including size, color of tissue present, amount and type of exudate and color. There may be tunnels, undermining, necrosis, awe-inspiring and terrifying geological formations of the flesh, craters and caverns, deep vale all the way to white bone. Irrigate with 0.9% saline, or tears, if you like.

Actually, no crying into open wounds, because maintaining a sterile field is imperative for healing. Never turn your back, either. Pack gauze, cover, tape, box method.

And if the gruesome, bone-in-the-middle wound doesn't kill one, one's GPS might try to kill her by repeatedly sending her back to the same spot, barking, "turn left," (into oncoming traffic), over and over again. She might survive, but the P. sennae butterflies liquified against h…

Week 4. IM = intramuscular

So many things are skin deep. Beauty, blemishes, piercings, skin itself. An intradermal injection done correctly: bleb on half a hot dog, tiny yellow bubble on the hefty cake of human flesh or adorable meat cupcake. If you were vaccinated for TB as a child, no more skin tests for life. (It's radiation from chest x-rays for you every two years instead.)


Almost always, the vaccination is worth the risk. Protect your child, protect the immunocompromised, achieve herd immunity.

But we can't vaccinate for everything--not the unexpected, the accidental. Sometimes an old ampule explodes in one's hands, all glass shards and beads of blood, a symbol of something specific in one's life shattering into a hundred pieces, embedding tiny crystals in the skin, the clenched towel insufficient to stop the bleed. Sometimes the hurt is too deep, subcutaneous, intramuscular, all the way to the heart. (The heart's mostly muscle, too.)

But it's no use worrying every time an ambulanc…