5 Things Writers Get Wrong About Medical Care

I’m back and I’m here to talk about the nuances of sickfic.  Obviously there’s artistic license involved so I’m not gonna talk about disease processes but about those ever so important little background details.

1.  LOVED ONES ARE NOT ALLOWED IN THE ROOM DURING TREATMENT.  This mostly just goes for the critically ill but if your character is unconscious, or has undergone some sort of major trauma they will be told to go to the waiting room.  Use that to explore some really intense angst.  Trust me, it’s even more gut wrenching than watching the treatment.

2.  In hospital rooms, the machines don’t constantly beep.  The noisiest thing in the room would probably be a ventilator in the patient is intubated.  The only time the machines are supposed to make noise is when the vitals go above or below the establish limits, or when an IV pump is done infusing a medication.

3.  IV Access.  I’ve read a few fics where one character is a physician and is treating a character at home.  (Sherlock fic, I’m looking at you.)  Sometimes these treatments involve giving medications via IV at regular intervals.  No self-respecting medical professional is going to poke someone anew every few hours.  They will place an IV to do this.  Every time you access a vein you’re risking phlebitis, vein collapse, scarring and all that fun stuff.

Here’s a video demonstration of IV placement if you wanna see more about it.  (Though wtf using lidocaine for a measly 20G?)

4.  Seizures: they are much shorter than most people think.  Generally around 20-30 seconds, some up to a minute.  Any longer than that is somewhat unusual, though every person presents a bit differently.  When you pass the two minute mark is when you worry because during the whole seizure is not receiving oxygen.  Around 3-4 minutes is when brain death can begin if the appropriate care is not given.  Do not put anything in their mouths, and be sure to pad the head and put them on their sides.

 After a seizure, people don’t just magically come awake.  The brain “reboots” from the bottom up and this period of becoming aware is called a postictal state.  The first part of the brain to come back online is the “lizard brain” causing a fight or flight response.  Some people are very violent when still waking up, most just want to get away.  Generally the period is extreme confusion lasting 20 minutes or longer.  (Again varies from person to person.)

Partial Seizure progressing into Tonic Clonic

(The shouting is not from pain it is air being forced from the lungs due to contraction of respiratory muscles.)

5.  Pupillary reaction to drugs.  This is a big thing for me.  If your character is taking drugs know the physical signs!

Video of the details of the impact of drugs on pupil size.  Very short

Miosis:  Or pupil constriction.  Seen in opioid use.

Mydriasis: pupil dilation.  Seen in cocaine users, and any other stimulants such as meth.  Also known as “blown” pupils.  Blow out pupils are also a sign of severe head trauma.

In hospital rooms, the machines don’t constantly beep.  The noisiest thing in the room would probably be a ventilator in the patient is intubated.  The only time the machines are supposed to make noise is when the vitals go above or below the establish limits, or when an IV pump is done infusing a medication.

Again, if you think I got anything wrong, or have anything you want to add, please do!

A Copper Bedrail Could Cut Back On Infections For Hospital Patients

Checking into a hospital can boost your chances of infection. That’s a disturbing paradox of modern medical care.

And it doesn’t matter where in the world you’re hospitalized. From the finest to the most rudimentary medical facilities, patients are vulnerable to new infections that have nothing to do with their original medical problem. These are referred to as healthcare-acquired infections, healthcare-associated infections or hospital-acquired infections. Many of them, like pneumonia or methicillin-resistant Staphylococcus aureus (MRSA), can be deadly.

The World Health Organization estimates that “each year, hundreds of millions of patients around the world are affected” by healthcare-acquired infections. In the United States, the Office of Disease Prevention and Health Promotion in the Health and Human Services Department estimates that 1 in 25 inpatients has a hospital-related infection. In developing countries, estimates run higher.

Hospital bed safety railings are a major source of these infections. That’s what Constanza Correa, 33, and her colleagues have found in their research in Santiago, Chile. They’ve taken on the problem by replacing them, since 2013, with railings made of copper, an anti-microbial element.

Copper definitely wipes out microbes. “Bacteria, yeasts and viruses are rapidly killed on metallic copper surfaces, and the term “contact killing” has been coined for this process,” wrote the authors of an article on copper inApplied and Environmental Microbiology. That knowledge has been around a very long time. The journal article cites an Egyptian medical text, written around 2600-2000 B.C., that cites the use of copper to sterilize chest wounds and drinking water.

Continue reading.

Photo: A copper bedrail can kill germs on contact. (Courtesy of CopperBioHealth)

anonymous asked:

Do you know anything about hospital release procedures? I wanted to write a short story with someone waking up in the hospital after passing out for a few days, and I don't know anyone with hospital experience. How long do they hold the person? Does release take a bunch of paperwork? Can they be out of there the day (or night) they wake up? Does it need a doctor's oversight?

I think it will depend a little on what country your character is in and the severity of the health issue. Since I live in the UK - and have done for my whole life - I can only give you advice based on our NHS procedures. We do have private hospitals of course, but none I’ve ever had the privilege to use.

My source for this is a family member who has worked in hospitals for a large portion of their life.

The first port of call generally is the Accident & Emergency ward. One thing we need to establish is whether or not your character has been unconscious for days before admittance, or falls unconscious and remains in that state for a few days after they were admitted into A&E. I’ll separate this advice out to make it easier for you to jump to whichever part is relevant.

Unconscious for days in hospital

So, your character has been brought to A&E unconscious by ambulance or whoever found them in that state. 

It’s important here to know whether the character has a loved one/relative/friend with them at the time, or whether they are completely alone. If they have someone with them who visits regularly during the period of unconsciousness, then investigations into next of kin will be much easier for the hospital to carry out. Otherwise, the hospital will have to use whatever personal items the patient has with them to try and establish any points of contact/next of kin. We’ll get to the importance of finding a next of kin in a moment.

Anyway, your character is on the A&E ward, trolley-ed up, and will be seen - in an NHS hospital - depending on their priority in relation to other patients who are already on the ward. Since the character is unconscious, they would be considered a high priority - the staff will need to know if your character can a) breathe unaided, and/or b) is suffering any kind of severe head injury/brain damage.

The type of tests that might be carried out on the character include blood tests, x-rays and brain scans to establish why they’re unconscious and what can be done to get the patient responsive again. An A&E ward generally isn’t equipped to carry out brain scans and x-rays, so the patient would need to be taken on their trolley by a porter to wherever they’d need to be.

Bear in mind that paperwork is a huge thing for hospitals - everything that happens to this patient will be documented in several places, and goes through a hierarchy of people. So to keep it basic, things run through the doctor here. They will decide what needs to be done for the patient, the nurses carry out these duties, for example: the doctor decides a blood test needs to be done, the nurse takes the blood and sends it off, then receives the results and passes them onto the doctor.

Anyone admitted to a hospital is always seen by a doctor - nurses don’t make the decisions here.

So after all of this has happened, your character wakes up and they need to get out of their pronto. Let’s say for argument’s sake, they wait for a nurse to come and attend to them. For the moment, we’ll leave out the idea that they’re on a drip or hooked up to monitors.

Generally, hospitals can’t force you to stay under their care, but if you do insist upon leaving, you have to sign a form which basically says that you take full responsibility for yourself once you walk out of the doors. If there is a troubling problem with your character, then it would be likely for doctors/nurses to at least try and persuade them to stay if they believe they need the care and attention.

If the person is adamant that they’ll be leaving, and their tests are generally okay and not anything major, the paperwork procedure can take at least a few hours. The doctor will also likely try to initiate some sort of follow up, such as requesting the character to return for an appointment on x-date at x-time.

In this case, it is possible the character could leave on the exact day they wake up, but the paperwork procedure would be lengthy and if there are any serious concerns, the doctor will try their very best to get the patient to reconsider their choice to leave.

Unconscious for days before going to hospital

So for this example, your character has already been unconscious for a while and for whatever reason has only made it to A&E in time for them to wake up. The same kind of tests might still be carried out, but if, for example, blood tests and scans came back okay without any immediate problems to be seen, the character can self-discharge. This also requires a form of course, and it depends on which tests have been carried out and whether or not the doctor feels it’s okay to let them go.

Again, it is possible the character can leave on the very day they awake. It might be a little quicker than the previous scenario, but not by much I would imagine.

As for next of kin, it’s important because some medical procedures (namely operations) require a form of consent. If your character is unable to give that consent, the hospital would then look for the next available person who could give it to them (if they felt the procedure absolutely integral to the patient’s health). Naturally, any type of complicated procedure or operation would only add time onto the character’s stay, as they would then have to recover from anesthetic, etc.

Tl;dr your character might be able to get out on the day they wake up, but it would take several hours before a doctor would allow it. 

Leaving without following procedure

Say the character knows waiting for a nurse/doctor will only impede them and they decide to leave of their own accord… It is possible… but probably not very easy to go unseen. The nurses/doctors on that ward would know of your character as a patient, and even though they likely wouldn’t have time to stand guard over them, they wouldn’t turn a blind eye if they saw this person wandering through the corridors unaided.

Also, a good thing to remember: if your character has been fitted with an IV, yanking it out of their arm will cause a significant amount of bleeding… so they would essentially be wandering the wards, bloodied and maybe a little disorientated in a hospital gown, which would alert a passing medical professional straight away.

Additionally, if they have been hooked up to any kind of monitors, they will react loudly to being forcibly removed, which would alert the attention of the staff on the wards. Leaving during the day would probably be more difficult than leaving during the night, as the wards will be busier and lots of people, including patients, are awake.

In an NHS hospital, the patient - after their brief stay in A&E - would be transferred to a ward with other patients on it. In a private hospital, it is likely they might get their own room, but this all depends on how many beds are available, etc.

So leaving secretly or on the day they wake is entirely feasible, but not without its challenges, Anon…!

Note that all of this information here is very vague… if possible, try and find someone who might have more in-depth knowledge about this, or read books around the subject where you can. Someone else on Tumblr might also see this and correct where I’m wrong, or add in their own two cents, so it’s worth keeping an eye on the notes section!

I hope this helps. Best of luck.

- enlee

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"Ever been so depressed it felt as if every nerve ending in your body was exposed, red, and raw?"

Gene-Swapping Plasmids Aid Antibiotic Resistance in Hospitals

Bacteria appear to be swapping antibiotic-resistance genes through mobile pieces of circular DNA called plasmids, and this exchange may be contributing to the alarming rise of antibiotic-resistant bacteria in hospitals. To understand how these plasmids move between bacterial species in a hospital setting, Karen Frank, Tara Palmore, Julie Segre and colleagues spent two years taking environmental samples and surveillance cultures from over one thousand patients at the National Institutes of Health Clinical Center. Over this two-year period they identified 10 patients who harbored carbapenem-resistant bacteria. Using a relatively new technology called long-read genome sequencing to decode and compare plasmid genomes, the NIH team discovered that plasmid-carrying bacteria are exchanging antibiotic-resistant genes in the biofilms of sink drains. However, they do not have any evidence of transfer of bacteria from the sink to any of the patients. The authors note that patients who carry the bacteria may not be sick, but can still pass carbapenem-resistant bacteria onto others. The study offers evidence that plasmid transfer in healthcare settings is likely aiding the increase in antibiotic-resistant bacteria.

Read more about this research from the 17 September issue of Science Translational Medicine here.

[Image courtesy of Darryl Leja, NHGRI/NIH. Please click here for more information.]

© 2014 American Association for the Advancement of Science. All Rights Reserved.

THIS IS AN ANIMATED SHORT That I made about doctors and medicine and stuff. It is a comedy. Even though it may seem like it is trying to make a big profound point, the main thing is the humour…..I think. I didn’t try and make some satire of healthcare or the NHS, I just came up with some silly ideas and made them into a cartoon inspired by multiple visits to the doctor that were getting me absolutely nowhere. Some bits are loosely based on experience but most is just made up for giggles. If you see some deeper meaning, then that’s great, it’s different for everyone, and who knows what my subconscious is throwing at me when I am writing ideas down… if you just see a bunch of random meaningless crap, that is fine too - I see that when looking at lots of art. I just made it for you all to watch. Nothing else.

watch it here

Do you know what I don't get?

TV Shows/Movies where the couple is lying together in the hospital bed?

Like do you not understand that tubes exist?

IVs? Heart monitors? Oxygen cannulas? Feeding tubes? Etc.

Do you not understand that you would be lying on these tubes?

And that doing so would cause various things to beep?

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According to surveys by the Department of Labor’s Bureau of Labor Statistics (BLS), there are more than 35,000 back and other injuries among nursing employees every year, severe enough that they have to miss work.

Nursing assistants and orderlies each suffer roughly three times the rate of back and other musculoskeletal injuries as construction laborers.

In terms of sheer number of these injuries, BLS data show that nursing assistants are injured more than any other occupation, followed by warehouse workers, truckers, stock clerks and registered nurses.

The number one reason why nursing employees get these injuries is by doing their everyday jobs of moving and lifting patients.

Hospitals Fail To Protect Nursing Staff From Becoming Patients

Photo credit: Talia Herman for NPR, (x-ray) Daniel Zwerdling/NPR

Nobody wants to read about a sick child.

AKA: The problem with this new romanticized-illnesses genre.

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Nobody wants to read about a sick child.

Nobody wants to read about a child puking.

Nobody wants to read about a child with tubes in their arms, mouth, nose, etc.

Nobody wants to read about a child waking up at midnight as the nurse loudly enters the room to check on their vitals.

Nobody wants to read about a child with pale, clammy, skin…with greasy hair…with a hospital gown that’s barely clinging to their shoulders…because with everything going on, they don’t really give a damn about what they look like

Nobody wants to read about a child losing control of their bladder or bowels

And I guarantee that by now, at least ¾ of the people reading this are uncomfortably squirming

Because nobody wants to read about it

And nobody wants to read about a child questioning if they’re going to be okay

Nobody wants to read about a child experiencing wave after wave of nauseating pain, but when the nurse points to that chart with the scale on it, the child weakly replies that it’s only a 7/10.

Nobody wants to read about the child who has been through numerous surgeries, numerous diagnoses, numerous doctors…

Nobody wants to read about a child who spends more time at the hospital than at school

Nobody wants to read about a child who’s dying…

And so we don’t.

We don’t read stories about them.

We don’t even write stories about them.

Instead, we write romanticized stories about illnesses

Where patients become friends and teenagers fall in love and families come together

Where hospitals look like an Ikea showroom

Where miracles happen every day

And if you like those stories…

That’s fine.

But as you’re all reading/watching these romanticized tales, there are children out there – real children – whose real stories are going to be untold.

Because nobody wants to read about them

anonymous asked:

~~URGENT~~ Please Momma, sombody I don't know what to do!! I've been sick for a long time and the test results came back and I have cancer and its really really really bad. The only thing I have from my family is insurance, no support or acknowledgement or anything and my friends up and left because they don't want to "catch it" please I am so scared and I don't know what to do. My doctor says I don't have more than a year and I don't want to die alone. Oh god please I am so scared!!!

 Darling, what your family is doing is disgusting

 You cannot “catch” cancer. It is not contagious. Educate your friends and and family if you must, but if they’re going to leave you in your hour of need, it sounds like you need new friends, dear.

 M.O.D.’s aunt had cancer when he was very young, and his uncle had it a few years ago. His family members had always been by their side when they needed them. 

 Find Cancer Support Groups in your area, or even find ones online. Talk to your doctor, and please, PLEASE take care of yourself.

 You can get better, we all believe in you.

In The Moment part 5

Author: Hannahc56

Word Count: 1, 862

PART ONE PART TWO PART THREE PART FOUR

A/N: Geez guys!! So happy you guys like this so sorry it took forever to write this…

—————-

You left Dean behind you and took little steps towards the kitchen. You sniffled a few times, pushing back the tears that were behind your E/C eyes. You took a seat on the cold wooden bench and ran both hands through your hair. You pushed your hair behind your ears and tapped you foot on the old tile beneath you. You took in a few deep breaths. It was only amount of time before- A deep moan was heard a few doors down the hallway and you clamped your hands against your ears. Squeezing your eyes shut, you tried to block out any noise that pointed towards Dean. But a thin cardigan can only block out so much. A light wail echoed in the hallway and a shiver ran through you. 

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