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Swine flu
Posted: 06 May 2009 06:57 PM   [ Ignore ]   [ # 46 ]
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Yeah, but at my age I can’t recall them at will; only when the topic comes up and triggers my memory. smile

First, go to your local Indian food store and ask to buy about a pound of citric acid crystals.  Fill a measuring cup half full of household ammonia.  Put in one drop of deep red wine.  It should give you a very light blue color.  Now start adding citric acid crystals very slowly, with stirring.  As soon as the blue color fades, you have a relatively neutral solution of ammonium citrate.  This is fairly decent for minimizing blood and rust stains on clothes.  Another approach is to rinse out as much stain as possible, squeeze dry, saturate the area with straight liquid laundry or dish detergent and work it in.  Then just throw the garment, etc. in with the rest of the dirty clothes and let it sit until you do your next wash. This works well for grease stains.  Tomato stains are really nasty, but flushing with rubbing alcohol first then using the detergent usually does a decent job.  Alcohol also works on some felt pen and most ball point stains.

Rust on tools:  Mechanical abrasion is best, a toothbush loaded with kitchen cleanser usually helps.  Then rinse the toothbrush and load with citric acid crystals and scrub the remaining rust.  After you’ve removed as much as possible, rinse with ammonia (acid promotes new rust) to neutralize.  Dry thoroughly, then wipe with salad oil, and wipe excess off. 

Occam

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Posted: 07 May 2009 04:05 AM   [ Ignore ]   [ # 47 ]
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Occam sure is handy to have around! I’m writing those tips down.  grin

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Some people can read War and Peace and come away thinking it’s a simple adventure story. Others can read the ingredients on a chewing gum wrapper and unlock the secrets of the universe.    - Lex Luthor

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Posted: 08 May 2009 10:13 AM   [ Ignore ]   [ # 48 ]
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asanta - 05 May 2009 03:05 PM

Even the flu won’t warrant a visit to the ED( where you will expose everyone who has not yet had it) unless you are very ill. Going anywhere when you are ill and contagious, unless necessary, is common courtesy, and will go a long way to contain the virus. I can’t understand why people think every illness should be a cause to run to the doctor to spread the ‘love’ around!

I imagine that on the first day that someone has a symptom, a
sniffle, a slightly sore throat, an aching joint… that their
first reaction will not be to stock up on a week’s worth of food
for their coming illness.  Wouldn’t they be contagious on that
first day, so their trip to buy food would be risky to others?
If they have a helper, a caretaker, a partner of some sort,
then that could avoid this issue but not everyone has someone
else helping them, that person offering assistance but risking
infection.  Is there an appropriate way to respond to that very
first symptom?  If not, then when should a person stock up to
prepare to isolate?  Should they normally always try to keep at
least a week long stock of food?  Are there any special protections
that a caretaker should do, beyond ordinary hygiene like washing
after contacting the ill person?

So on the second day, they know that they are a victim of
an infection, but what bug is it?  Could this kill them two
days from now?  Will they just have to tough it out without any
effective treatments, hopeing for the best?  They are frightened,
confused, searching the web for information trying to avoid the
thousands of junk web sites…  what’s a victim of a microbe,
a microbe with a drive to infect and survive, supposed to do?
Call a doctor, visit, isolate, keep searching the web for the
libraries that offer full books online, or what?

Preperation and education is going to be better than reacting
after an infection.  So where are some good sources to help the
general public prepare, if any?

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Posted: 08 May 2009 03:05 PM   [ Ignore ]   [ # 49 ]
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The flu is spread by droplets and hand contact. If you sneeze, sneeze into your sleeve, if no sleeve, cover your nose with something else. Wash your hands frequently and especially after sneezing, using either soap and water or an alcohol based substance. As for visiting a doctor; use common sense, if in doubt, call your health care provider.

If you can hold down liquid and if you are making urine, and are taking analgesics as needed for comfort (it will NOT eliminate your fever—just make you more comfortable), if you have no underlying health problems, ESPECIALLY cardiac and/or respiratory you will probably be okay. Call your health care provider for instructions and advice. As always, if you feel it is an emergency, call 911. LOL

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Posted: 08 May 2009 03:06 PM   [ Ignore ]   [ # 50 ]
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Jules - 07 May 2009 04:05 AM

Occam sure is handy to have around! I’m writing those tips down.  grin

I am too!!!  grin

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Posted: 10 July 2009 09:58 PM   [ Ignore ]   [ # 51 ]
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I just read this on CNN:

Last week, health secretary Andy Burnham warned that by the end of August, around 100,000 people will be affected with the virus every single day.

gulp

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Posted: 10 July 2009 10:05 PM   [ Ignore ]   [ # 52 ]
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George - 10 July 2009 09:58 PM

I just read this on CNN:

Last week, health secretary Andy Burnham warned that by the end of August, around 100,000 people will be affected with the virus every single day.

gulp

lavate las manos as much as possible, and don’t touch your face with your hands when you are out and about. Purell is your friend! It is beginning to hit hard among my co-workers, although no one has had a serious case yet. It seems to only hit hard if you are already chronically ill, much like any other flu. It seems to be an average flu for now. Remember that in an average year, about 36,000 people die of the flu!

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Posted: 11 July 2009 08:02 AM   [ Ignore ]   [ # 53 ]
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George - 10 July 2009 09:58 PM

I just read this on CNN:

Last week, health secretary Andy Burnham warned that by the end of August, around 100,000 people will be affected with the virus every single day.

gulp

I think his estimate may be overly pessimistic. For what its worth we were seeing 8-10 cases of culture verified swine flu/week 3-4 weeks ago. This past week I only saw one. If the trend keeps up then the pandemic may be finally on the wane. Contrary to media reports however this has been a very mild flu. Most of my patients have been back to work in two or three days.

Asanta is correct. Wash your hands. If you do so frequently you will eliminate 99% of the source of transmission. And she gave good advice about sneezing as well. Sneeze any place except into your hands. The perfect place to sneeze is on to the floor, but if you find that unacceptable (or have family and coworkers who walk on their hands)  your elbow/sleeve is the next best thing.

[ Edited: 11 July 2009 08:06 AM by macgyver ]
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Posted: 11 July 2009 05:13 PM   [ Ignore ]   [ # 54 ]
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There is much talk about a big flu comeback in the fall with the cooler weather. I read the first doses of vaccine should be available in mid October. This will be good for those with compromised immune systems, pregnant women, elderly (especially in nursing homes where it’s easily transmitted) and other vulnerable people. However, the people lining up in a panic for the shots will probably be healthy 20-somethings. Remember the flu vaccine shortage a couple years back? Suddenly, those who NEVER had a flu shot were going to great lengths to get one! Supply and demand? I picture the same thing happening this fall, especially if supplies of H1N1 vaccine are very limited, even just initially.

I wouldn’t mind getting the vaccine for my boy - I usually get him a flu shot every year anyway. And we have a nurse who brings flu shots to our office each fall, so I’ll probably get my “usual” fall shot too. But if supplies are limited for some reason, it should go to those who need it most first. We can wait.

Funny - the shot knocks me on my ass for one day - every time! I wake up the next morning feeling awful. I must have quite an immune reaction to it. But that’s OK I know that just means it’s working! Others in the office say “Oh it gave me the flu, I’m never getting it again.” I try to explain that it wasn’t the flu, it was just the body’s reaction to the shot. The REAL flu would make you feel like crap for days, not just one day! I will gladly take the one lousy day and some Advil, over the real flu any time.

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Some people can read War and Peace and come away thinking it’s a simple adventure story. Others can read the ingredients on a chewing gum wrapper and unlock the secrets of the universe.    - Lex Luthor

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Posted: 11 July 2009 05:25 PM   [ Ignore ]   [ # 55 ]
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I always get a flu shot and make sure my family gets one too. Most of the nurses I work with refuse to get it because ‘it gives them the flu’. I don’t think they know what a real flu is!! I work with a lot of nurses who believe in woo. In my previous unit where we did a lot of research and had a lot more autonomy, there was much less woo! I think that is because in the pedi ICU we demanded rationale behind any new technology, and treatments, and taught the new nurses these critical thinking skills. In the neonatal unit where I work now, we have very little autonomy and much of what the attendings order make NO sense to me and they complain to the manager when I ask for the rationale behind their orders…the nurses there are used to doing as they are ordered and don’t ask questions.

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Posted: 11 July 2009 07:01 PM   [ Ignore ]   [ # 56 ]
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Asanta, I’ve noticed the same thing. I don’t know if a case of “a little knowledge is a dangerous thing”.  I think most RN’s get just enough training to do their job, but not enough to really understand the basic science and reasoning behind the things they are being asked to do. The result is that they substitute a good scientific understanding of the process with their own interpretation of what’s happening and they end up coming to a lot of the same erroneous conclusions that the average lay person does but with an undeserved confidence in their conclusion.

I know a lot of nurses who have avoided this trap and really have a good understanding of what they are doing but unfortunately they seem to be the minority. I think this is always going to be a problem though when you have a training program that provides the information you need to do your job but not the depth of information you need to understand the “why” behind your job.

Jules, you’ve got a good head on your shoulders. I wish all my patients understood vaccines as well as you do. By the way, hows the new camera working out?

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Posted: 11 July 2009 08:29 PM   [ Ignore ]   [ # 57 ]
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Since I had good solid cases of the flu (in addition to the normal colds) about a half dozen times between the ‘40’s and early ‘60’s, I’ve made sure to get the flu vaccination each year ever since it was available.  I must have lucked out because I’ve never had any reaction at all to the shots in all that time. 

As far as nurses go, I’ve found that whenever I was in the hospital, carrying on a pleasant conversation with them and asking a few questions pretty quickly tells me whether they know what they are doing.  Only a few times have I had to ask that they get the doctor for me rather than doing or continuing with a procedure.  Although some of them may not be too knowledgeable, they are almost all really trying very hard to help the patient and do the best job thay can, and I respect that.

Occam

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Posted: 11 July 2009 08:54 PM   [ Ignore ]   [ # 58 ]
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That’s true. In teaching hospitals, especially in the ICUs, the nurses have a LOT of autonomy. When I would be in charge at night, I could take steps in an emergency and start some orders BEFORE calling the doctor to wake him/her up and get the orders covered..i.e. Xrays, lab draws. If I called the doctor WITHOUT taking the obvious steps first, my reputation would have suffered!! You were expected to understand what was going on and take steps on your own while you were waiting for the MD to show up from the sleep room. Waiting for the doc could have meant a much poorer outcome. In the unit where I now work, our doctors practice their own sort of woo. They make diagnosis where I can’t find any studies supporting their claims (and they won’t do studies either). When these infants are discharged, I correctly postulated that the out patient pediatricians took them immediately OFF all of the (over)prescribed meds. The docs get VERY annoyed with me, because they have not had anyone—especially a nurse asking for proof of efficacy. Nurses who do not work in teaching hospitals usually have very little autonomy. I have worked in teaching hospitals for most of my career for this reason. The unit I work in is NOT a teaching unit.

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Posted: 11 July 2009 08:58 PM   [ Ignore ]   [ # 59 ]
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macgyver - 11 July 2009 07:01 PM

Asanta, I’ve noticed the same thing. I don’t know if a case of “a little knowledge is a dangerous thing”.  I think most RN’s get just enough training to do their job, but not enough to really understand the basic science and reasoning behind the things they are being asked to do. The result is that they substitute a good scientific understanding of the process with their own interpretation of what’s happening and they end up coming to a lot of the same erroneous conclusions that the average lay person does but with an undeserved confidence in their conclusion.

I know a lot of nurses who have avoided this trap and really have a good understanding of what they are doing but unfortunately they seem to be the minority. I think this is always going to be a problem though when you have a training program that provides the information you need to do your job but not the depth of information you need to understand the “why” behind your job.

Jules, you’ve got a good head on your shoulders. I wish all my patients understood vaccines as well as you do. By the way, hows the new camera working out?

I love the new camera, thanks! And I’m liking that new padded crumpler bag to carry it in, also. I’ll try to PM you a couple of shots, if the file size isn’t too big.

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Posted: 12 July 2009 07:40 AM   [ Ignore ]   [ # 60 ]
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Science-Based-Medicine recenly had a post on the difference between a scientific and a medical education, which helped me to better understand wwhile so many of my colleagues, even though they are doctors, don’t see to understand the logic of evidence-based medicine, how to properly interpret a research article, and so on, and why they are so susceptible to woo and anecdote. I think, as macgyver points out, this is a big part of the problem with nursing as well.

And as asanta indicates, the culture of a particular institution can encourage, or suppress, the efforts of individuals to think critically and scientifically. One of the vets I work with was an RN in the ICU for 10 years before going to vet school, and she was lucky to have worked in some places that expected her to know what she was doing and watch out for nonsense from the doctors, especially the new ones. We take the same approach with our nurses, and the experienced ones regularly challenge, in a polite way, the doctors to rationalize orders they don’t understand. This bugs some of the newer, and more insecure docs, but it’s saved my behind more than once, and FWIW I can’t imagine wasting the talent and energy of good nurses by not allowing them to use what they know to help the doctor treat the patient.

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