medgremlin @ medgremlin @lemmy.sdf.org

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Joined

2 yr. ago

The drug most commonly implicated in acts of violence (particularly domestic violence) is alcohol, and there's ads for that plastered all over the damn country. The violence associated with "hard" drugs like heroin or cocaine is usually tied to their acquisition or sale. Alcohol is the one that causes violence via consumption, and it's one of the only drugs that its withdrawal can very easily kill you. Opiate withdrawal sucks, but it's typically not lethal.

They are entirely different drugs with different mechanisms. Taking too much paracetamol/Tylenol/acetaminophen is extremely dangerous for your liver and dosing instructions should be followed exactly. Prolonged use of ibuprofen or other NSAIDs can lead to gastrointestinal ulcers and kidney damage, so only take it for as long as you have to. They both have instructions to take a dose every 6 to 8 hours, so if you're in significant pain or you have a really bad fever, you can alternate them every 4 hours. For example, paracetamol at 8am, ibuprofen at noon, paracetamol at 4pm, etc.

Also, be careful of "cough" or "cold" medicines like NyQuil/DayQuil, because they usually have paracetamol/Tylenol in them and that counts towards the daily dose limit.

Something I've seen at some restaurants (ranging from casual to Michelin star) is the increasing prevalence of mocktails. If you mix non-alcoholic ingredients with the same kind of style and objective as mixed drinks, you can make some really tasty stuff.

If you're still looking for resources (particularly if you are needing non-religious resources) a lot of health systems have outpatient programs and support groups for various substance use disorders, so that would be a good place to look. Depending on how severe the problem is, presenting an open and non-judgemental front regarding medical intervention and medication use can help reduce the stigma of getting chemical help for a chemical problem.

Unfortunately, the medications that help with alcohol withdrawal are somewhat dangerous in their own right and need to be fairly tightly controlled. Delirium tremens (the shakes) from withdrawal are usually managed with benzodiazepines like Valium for emergent use and Ativan for prolonged control. The other main maintenance drug for alcohol withdrawal is Librium, and that one is also a benzodiazepine. It would be amazing if there were safe OTC options, but because of the serious damage alcohol does and the dangerous nature of withdrawal from it, it really needs to be closely medically managed. Opiate withdrawal sucks....alcohol withdrawal can very easily kill you outright.

I'm always rather disheartened when I talk to people about the expectations placed on residents in the American medical system because a common response is to say that it doesn't matter and they deserve it because they're going to be doctors making a good salary soon enough. I'm in my second year of medical school now, so residency's a little ways off, but I can't help but think that people will think of me as spoiled and entitled for pushing back against the 80 hour work weeks that are normal in residency.

Interestingly, the recurrent laryngeal nerve is looped around that way because the structure of the nerve grows in before the structures of the aorta and other large vessels fully grow in and orient into their correct position, so the nerve ends up looping around them.

I've been in enough futile codes that I hope there isn't any consciousness beyond the "lights out" point. Especially since most of the codes I participated in were in a pediatric hospital. It doesn't matter that the brain shut off more than half an hour ago...you just have to keep doing compressions and pantomiming the code until the parents consent to calling it. I've seen it get dragged out an extra 45 minutes past where the physician would have called it because the mom didn't want T.O.D. called until after the dad got to the hospital from work. It's better with adults, but not by much. There's only been a handful of times where caving in the sternum was actually worth the destruction involved.

Having worked in ERs...nah. People can be pretty damn dumb sometimes.

That is specifically mentioned in the article as well as delineation of state versus federal crimes in regard to presidential pardons.

I don't think it's something that should be shortened. It's dehumanizing.

"A person affected by substance use disorder". Or " people with addiction disorders". Addiction is an illness that people sometimes have, but it should never become a descriptor of who or what they are.

Yes, the AP tests are standardized at the national level.

I've worked in ERs before, and there is more to this story that the article sidestepped quite neatly. Most ERs these days are filled to capacity with dangerously low staffing ratios, and the general public's definition of an "emergency medical condition" and the medical definition of an "emergency medical condition" are very different. Some nights I've worked, we had people with chest pain and a cardiac history wait in the lobby for 5+ hours because there were no beds available and their EKG was mostly okay for the time being. A big contributor to this problem is a lack of mental health resources which results in ERs losing beds for up to weeks or even months at a time to hold psych patients that have nowhere to go. It is heartbreaking when we had to turn away people who mostly needed a social work consult...but when there's two doctors and twelve nurses for a 40 bed ER and 2 out of 3 resuscitation bays are in use for active codes, there just isn't anyone or any resources available to help someone who isn't actively dying.

The inpatient side isn't a lot better. Skilled nursing facilities and rehab centers are increasingly rare and increasingly expensive, and the hospital can't keep a patient forever if they don't meet criteria for hospitalization. The nice thing about inpatient is that they get to enforce their staffing ratios so that each nurse only has so many patients to handle. In the ER with EMTALA, it doesn't matter that a nurse is caring for 6 patients (3 of which are waiting for an inpatient hospital bed, and 1 is waiting for an ICU bed....), that nurse will have to take on another critically ill patient that is stuck on a bed in the hallway if that's all that's available. The inpatient problem exacerbates the ER problem, and then you have people stuck in the lobby for 12+ hours before there's a physical space for someone to see them, that provider's capacity to take on another patient notwithstanding. It's a true crisis and it's only going to get worse until the full healthcare system (i.e. all the non-ER parts) are as accessible and available as needed.

People die from malnutrition and exposure in America as well.

It can be administered up to a couple weeks after exposure. It's a very slow virus.

I've been enjoying the main storyline of the current WoW expansion.

Most of my time as an EMT was as an ER tech in a peds hospital and kiddos are astonishingly good at getting all kinds of fluids all over the place.

Numbers 1 and 4 are just baffling to me. Blizzard's strengths have always been (or at least previously were) game balancing and writing interesting stories with compelling and complex characters. Overwatch 1 was a departure from the writing front, but Overwatch 2 seems to be where they just chucked it all out the window.

Personally, when I'm doing direct patient care, I want as much of me covered as I can tolerate. Like, yes, it sucks horrendously doing CPR in full isolation gear, but I'd rather have that than have fluids touch my skin anywhere.