Toiletries

Apparently there is this meme going around, where bloggers let their audiences know what they read, when they get "down to buisness". It all started with a certain Lissa, of which until today I have never heard of. She started sharing the reading material she has lying around in her bathroom and then tagged other people to follow suit. Kinda weird, but I'll bite. It would seem the trend caught on and now even I got tagged by InsomniacMedic. So here it goes.


I've never been a big fan of reading on the toilet. There was a time when I prolonged the stay on the porcelain throne to enjoy a good read, but in the flat I've now been living in for the past five years the bathroom is just to narrow an uncomfortable to actually relax and stay for a while. Nowadays I tend to do my number two and get out of there as soon as I can. Also my legs tend to fall asleep and that is something I'd rather not have.

I've always found it fascinating how people, men in particular, take their time and enjoy the peace of their own WC and read while doing their thing. Some friends of mine will spend up to an hour in there. Yes, some even take their laptops in there and thanks to WiFi surf the web or catch up on emails. Talk about efficiency... I never quite got the hang of that concept and I'm quite happy with getting out of there rather quickly.

On occasion, when I do decide to read little, I will thumb through a copy of "RETTUNGSDIENST" (lit. "EMS" in German), a German EMS publication. There are a handfull lying around within arms reach. The only thing I do on a regular basis is play with my mobile phone. Check twitter and facebook, look for apps on the Android Market Place, write the occasional text message or email. That's about it. I do not, however, blog from the bathroom, just in case you are wondering...

Something I will always do when I'm at home, however, is smoking. I know, I know.... ewwwww. Maybe it's because it masks the smell, maybe... well, to be honest, I don't know exactly why. I just enjoy to light up a fag when I'm on the dumpster. Don't judge me!

When I'm at work however I will regularly (and by regularly I mean every now and then, not 4 times a shift...) disappear with a news paper or some sort of catalogue in my hand. Whatever I can grab will do. That way my 15 minutes get me up to speed on current events, news and/or product offers. I always found this rather odd, because I know a lot of my colleagues can't relax when they're at work, for fear of the impending doom of the next alarm. Some even choose not to go number two at all while they're at work. Doesn't bother me though... strangely enough.

So yeah, I got a little carried away and now you more than you ever wanted to know about me. But you had to ask didn't you?


I shall tag the only one that apparently reads my blog and hasn't been tagged so far:

The MICT Student

Your move!

Improvements in pain scoring

In modern medicine there are breakthroughs happening left and right on a daily basis. A new and improved pain scoring technique especially developed for emergent care provider, both pre-hospital and in an ED setting, will now help improve accuracy in pain management and will make the old 1 to 10 visual analogue scale superfluous.

Introducing the

CRAP Score - Cynical Real Alternative Pain Score

CRAP Score = (OPS+AF) x (SC)x (EC)

OPS = 10-point pain score (Old Pain Scale)
AF = Adjustment Factor (see below)
SC = Story Credibility
EC = Exam Credibility

For LPT (Low Pain Threshold) patients; calculate CRAP score:

• If the patient reports their pain as being more than 10 on the conventional 10-point pain scale, subtract 1 point for every point over 10. If a patient claims their pain is 12, subtract 2 points and start with an 8.
  

• For every visit the patient has had to your a&E in the past 12 months claiming a "chronic" or "undiagnosed" painful condition subtract 1 point.

• Every time the patient says "ow" when you push on a non-painful or uninjured area of their body, subtract 1 point.

• For every claimed allergy to a non-narcotic pain relief medication, subtract 1 point.

• If they are wearing sunglasses/wrist-splints/neck-brace/insist on wheelchair/lying down, subtract 1 point.

• If they have tape or ECG lead residue on their body from a prior hospital exam, subtract 2 points. (Waive the wheelchair/neck-brace penalty is the patient is registered with a disability)

For HPT (High Pain Threshold) patients, you add to their reported pain score:

• If a spouse or family member forced them to come in, add 1.

• If patient history shows that every A&E visit for a painful condition related to something torn, broken, ischaemic or perforated, add 2.

• If they have no allergies add 1.

• If they are tachycardic (racing heart) or hypertensive (high blood pressure) add 1.

• If they have visible major injuries they may be in shock and won't feel the true pain till the endorphins wear off

Worked example 1
Young guy/gal goes to A&E for the 7th time in the past year for migraine (-6) reporting his headache as 12 on a 10 point scale (-2). He claims to be allergic to 5 over-the-counter pain meds (-5). He has been to A&E 5 times in the past year claiming other painful ailments e.g. back pain, belly pain, but tests found no disease or injury (-5). He is in the examination cubicle eating crisps/choccy and yelling into his mobile phone. He claims his migraine is a killer. When his abdomen is pressed he claims it is tender (-1), but he hadn't noticed due to the migraine being so bad.
CRAP score = (10 -6 -2 -5 -5 -1) x (0.5) x (1) = -4.5.
Even without Story Credibility of 0.5 and Exam Credibility of 1 that's a CRAP score of -9.

Worked example 2
Limping guy/gal is taken to A&E by spouse, but reports "fuss about nothing" and pain score of 4. Blood pressure and heartbeat are increased (+1). They've taken a couple of aspirin. Examination finds torn ankle ligaments, probable fractured tarsals plus fluid retention around ankle plus abrasions to forehead and forearms. Patient states s/he fell on icy pavement. Patient history over several years shows 3 previous visits for fractures/torn ligaments/open wounds requiring stitching.
OPS + AF = (4 +1 +1 +2) = 7
Even without a Story Credibility and Exam Credibility, that's a CRAP score of +8 and they've sustained real damage.

Found on Dragonqueen's Site, all credits go to her.

How to make a fool of yourself...

It's a painfully slow friday night. Something that doesn't happen very often. While your average week-end night is fun-filled with back to back calls related to alcohol, fighting and domestic issues, we were just sitting at our station trying to figure out how to pass the time.
Somewhere around o-dark-thirty dispatch sent us to post in a different call area. The streets were strangely calm. My partner and I didn't speak much, as we were both tired. As we were driving through a residetial area something in the road we had just passed caught my eye. Something just didn't seem right. I put the rig in reverse and backed up to the last intersection. We both looked out the window and saw a BMW in the middle of the road and two people lying on the pavement in front of it, around them a group of people. It appeared as if something bad had happened. Maybe the BMW ran them over?
I quickly turned the rig around and made my way to the scene. But something still didn't feel right. My mind was telling me that something was wrong, but I couldn't quite put my finger on it. My partner called it in on the radio.

As we pulled up to the crowd of people, they looked up and saw us, surprised as if we shouldn't be there. I rolled down the window and before I could ask what had happened one of the bystanders asked "Do you need to go through? Do you need us to move?". A little startled I asked him what happened. Now he had a real confused facial expression "what do you mean, what happened?". And before I could answer, I realized what was going on. "Film set?" "Yep..." "Ok, never mind then".

Turns out we had parked in the middle of a running film set. I don't know they were filming and didn't get the chance to ask, as we got out of there as fast as we could and told dispatch to disregard. We laughed the rest of the way and felt pretty dumb not have realized it sooner.