Emedinews:Insights on Medicolegal Issues:Immediate first aid may stop serious poisoning and may save life

If breathing and the heart stop, the person will die within a few minutes unless first aid is administered at once. Here is an action list. Each step is explained in more detail below the list. Start with the first step and follow each step in the order given. Act as quickly as you can, but stay calm.

• Check if the patient is conscious try to make the patient wake up. Shout "Are you all right?" and gently shake the shoulders, but take care not to make any injuries worse. Pinch the skin on the neck and watch the face. A patient who is just sleeping will wake up, but an unconscious patient will not.
• Open the airway. The airway is the tube through which air passes from the mouth and nose to the lungs. If it is blocked the patient cannot breathe and air cannot get into or out of the lungs. A patient who cannot breathe will die within 4 minutes. In an unconscious patient, the tongue may block the throat and the airway.
• Make sure the airway is open and air can get down the throat. Place the patient on his/her back. Tilt the head back and lift the chin up with the finger and thumb of one hand on the bony part of the chin, while pressing the forehead back with the other hand. This will open the airway and stop the tongue blocking the throat.
• Check whether the patient is breathing after opening the airway; quickly check whether the patient is breathing. Look for the belly or the chest moving up and down. Feel the chest moving up and down. Feel the patient's breathe on your cheek. Listen for breath sounds. Put your ear close to the patient's mouth. Use all four checks. Remember that the chest may move up and down even when the throat is completely blocked and air cannot get to the lungs.

Emedinews:Makesure:The patient missed her last dose of hepatitis B vaccine as she was out of station at 6th month.

Situation: The patient missed her last dose of hepatitis B vaccine as she was out of station at 6th month.
Reaction: Oh my God! Why was the vaccine not given between 4–6 months?
Lesson: Make sure that all patients are given the complete vaccine regimen. The correct regimen is 0, 1–2 months and 4–months.

Emedinews:Inspiration:The wooden bowl

A frail old man went to live with his son, daughter-in-law and a four-year old grandson. The old man’s hands trembled, his eyesight was blurred, and his step faltered.

The family ate together every night at the dinner table. But the elderly grandfather’s shaky hands and failing sight made eating rather difficult. Peas rolled off his spoon onto the floor. When he grasped the glass often milk spilled on the tablecloth.

The son and daughter-in-law became irritated with the mess. “We must do something about grandfather,” said the son. I’ve had enough of his spilled milk, noisy eating, and food on the floor. So the husband and wife set a small table in the corner. There, grandfather ate alone while the rest of the family enjoyed dinner at the dinner table. Since grandfather had broken a dish or two, his food was served in a wooden bowl. Sometimes when the family glanced in grandfather’s direction, he had a tear in his eye as he ate alone. Still, the only words the couple had for him were sharp admonitions when he dropped a fork or spilled food. The four-year-old watched it all in silence.

One evening before supper, the father noticed his son playing with wood scraps on the floor. He asked the child sweetly, “What are you making?” Just as sweetly, the boy responded, “Oh, I am making the bowl for you and mama to eat.” The four-year-old smiled and went back to work. The words so struck the parents that they were speechless. Then tears started to stream down their cheeks. Though no word was spoken, both knew what must be done. That evening the husband took grandfather’s hand and gently led him back to the family table. For the remainder of his days he ate every meal with the family. And for some reason, neither husband nor wife seemed to care any longer when a fork was dropped, milk spilled, or the tablecloth soiled.

Children are remarkably perceptive. Their eyes ever observe, their ears ever listen, and their minds ever process the messages they absorb. If they see us patiently provide a happy home atmosphere for family members, they will imitate that attitude for the rest of their lives. The wise parent realizes that every day those building blocks are being laid for the child’s future. Let us all be wise builders and role models. Take care of yourself, and those you love, today, and every day!

 Source: http://academictips.org/blogs/the-wooden-bowl/

Emedinews:Makesure:A patient with LBBB in ECG developed acute pulmonary edema.

Situation: A patient with LBBB in ECG developed acute pulmonary edema.
Reaction: Oh my God! Why was the underlying low cardiac functions not suspected?
Lesson: Make sure all patients with LBBB undergo echo to rule out ejection fraction. This may not be true for RBBB.

Emedinews:Inspiration:Puppies for sale

An Inspirational Story

A store owner was tacking a sign above his door that read “Puppies For Sale.” Signs like that have a way of attracting small children and sure enough, a little boy appeared by the store owner’s sign. “How much are you going to sell the puppies for?” he asked. The store owner replied, “Anywhere from $30-$50.”

The little boy reached in his pocket and pulled out some change. “I have $2.37,” he said. “May I please look at them?” The store owner smiled and whistled, out of the kennel came Lady, who ran down the aisle of his store followed by five teeny, tiny balls of fur. One puppy was lagging considerably behind.

Immediately the little boy singled out the lagging, limping puppy and said, “What’s wrong with that little dog?” The store owner explained that the veterinarian had examined the little puppy and had discovered it didn’t have a hip socket. It would always limp. It would always be lame. The little boy became excited. “That is the little puppy that I want to buy.” The store owner said, “No, you don’t want to buy that little dog. If you really want him, I’ll just give him to you.”

The little boy got quite upset. He looked into the store owner’s eyes, pointing his finger, and said, “I don’t want you to give him to me. That dog is worth every bit as much as all the other dogs and I’ll pay full price. In fact, I’ll give you $2.37 now, and 50 cents a month until I have him paid for.”

The store owner countered, “You really don’t want to buy this little dog. He is never going to be able to run and jump and play with you like the other puppies.”

To this, the little boy reached down and rolled up his pant leg to reveal a badly twisted, crippled left leg supported by a big metal brace. He looked up at the store owner and softly replied, “Well, I don’t run so good myself, and the little puppy will need someone who understands!”

- Author Unknown

Emedinews:Insights on Medicolegal Issues:How can the firearm discharge residue on hands of accused be collected by the doctor?

Nitrate and nitrite residue may be found on medical examination and can be recovered from the skin by occlusion in a layer of melted paraffin during medical examination. Another test for skin residue involving paraffin as the collecting medium is for metallic elements in trace amounts, which result from primer residue. The analyses are made with neutron activation by ballistic expert.

•        The test is known as the ‘dermal residue test’ or ‘paraffin glove test’. The important factor is to place the responsibility of interpretation of results in the hands of the forensic scientist, not the doctor

•        Atomic absorption and x–ray dispersive energy spectrometry methods are also useful in identifying and quantifying metallic residues from weapon firing.

•        Currently, a screening technique is used to check the hands, clothing and other objects where circumstances warrant the examination. The main element examined for is lead, which appears to originate chiefly from the primer composition

•        Swabs are taken from appropriate areas on small clean cotton cloth squares moistened with a few drops of 1% lead–free hydrochloric acid and air dried.

•        A few drops of reagent are applied to the swab area on the cloth which is again dried. If the lead is present it is indicated by the development of a characteristic purplish–blue color.

•        The interpretation of such results should be left to an experienced examiner as positive results do not necessarily prove the subject fired a gun nor a negative result wholly precludes the firing.

Emedinews:Makesure:A patient died after receiving 30 ml IV KCL bolus.

Situation: A patient died after receiving 30 ml IV KCL bolus.
Reaction: Oh my God! Why was KCL given as bolus?
Lesson: Make sure that IV KCL is not given at a rate of more than 10 mEq per hour.