The Flushing Of Cannulas

Goose. Geese. Moose. Meese. Cannulas. Cannulae. Whatever!

Blood Extraction

Why throw away the first 10mL of blood when collecting it from an existing cannula? It’s because that portion is theoretically contaminated, such as by previous infusions.

Saline Flush

The purpose is, also theoretically, to keep the cannula open and working. Patent, as they say. That’s why this is recommended after giving IV medications or just periodically. Basically, after each use.

Not Water

Normal saline is injected, not water. This is because a pure water injection would lead to the water rushing into red blood cells, due to that trusty process of osmosis. This sudden water influx would make them explode.

Which, as you can imagine, would run counter to the usual hospital purpose of trying to heal people, not atomically bomb their bloodstream.

References

  1. Blood collection from intravenous cannula. (2019). Retrieved from https://vitualis.wordpress.com/2006/05/15/blood-collection-from-intravenous-cannula/
  2. Keogh, S., Flynn, J., Marsh, N., Mihala, G., Davies, K., & Rickard, C. (2016). Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients. Trials, 17(1), 348. doi:10.1186/s13063-016-1470-6
  3. Labos, C. (2019). Why can I taste saline and medications when they’re inserted into my IV?. Retrieved from https://www.mcgill.ca/oss/article/you-asked/why-can-i-taste-saline-when-its-injected-my-iv
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Differential Diagnosis Of Acute Abdominal Pain

Here’s a sordid acronym: BITCH.

Acute abdominal pain

  • Bleeding (haemorrhage)
  • Inflammation
  • Twisting (torsion, leading to ischaemia)
  • Congestion (obstruction)
  • Hole (perforation)

Bleeding

  • Ruptured AAA, ovarian cyst, ectopic pregnancy or abdominal organ
  • Leads to haemoperitoneum, meaning blood in the abdominal cavity

Inflammation

  • -itis of any organ in the abdominal area
  • Just think of the anatomy in the region to come up with possibilities
  • Appendicitis is the most likely surgical cause, while gastroenteritis is a common ailment of the masses

Twisting

  • Sigmoid volvulus
  • Torsion of gonadal structures (ovaries or testes)

Congestion

  • Things that involve blockage
  • Constipation
  • Intestinal obstruction, ureteric obstruction from renal calculus or urinary retention
  • Mesenteric ischaemia

Hole

  • Perforated gastrointestinal structure
  • Gastric or duodenal ulcers

So Money Guest Co-Host

I’ve been featured on So Money, a podcast by award-winning journalist Farnoosh Torabi.

http://podcast.farnoosh.tv/episode/ask-farnoosh-235/

She edited out the part where I explain that the triple application rejection was actually for KFC. But no worries! It wasn’t ever my ultimate dream to work in a chicken shop, so I wasn’t really cut. I guess she wasn’t impressed with that.

Here’s the summary.

Me: “It was such an important life tribulation! It was actually for KFC!”

Farnoosh: “I’m not familiar with KFC. Do you mean…Kentucky Fried Chicken?”

Me (too enthusiastically about this significant life setback): “Yes!”

Farnoosh (secretly editing that part out): “…”

She also edited the part where I accidentally said, “HELLO!” loudly and way too early because I thought she was done talking.

As well as the bits where we talked over each other awkwardly. There were a few of those. (She did leave in all the praise I had for her.)

How To Win Friends & Influenza doesn’t operate like that. It has more instances (two) of inserted laughter than removed content. The editing is focussed on audio quality and there are no advertisements or revenue aims.

But this was a fun So Money interview nonetheless, where we tell you how to manage your money. Except that you shouldn’t take any of this as financial advice, because it’s not.

Take your lawyers and slowly back away. No one needs to become hurt here.

Podcast 028: Adolescent Medicine With Dr Linette Gomes

Chronic diseases can strike people of all ages, from foetus to corpse (probably not inclusive). Adolescent medicine is what it sounds like: the branch of medicine that deals with adolescents, particularly when it comes to chronic diseases.

In this episode, Dr Linette talks about what adolescent medicine involves and the type of health practitioner it suits.

Podcast

About the guest speaker

Dr Linette Gomes is a paediatrician and adolescent medicine physician. She is currently appointed as a senior staff specialist in the Adolescent and Young Adult Medicine (AYAM) Unit of Westmead Hospital.

Dr Linette’s specialty is in the area of behavioural and developmental paediatrics. She has a PhD. in “Medical Expertise in the Management of Attention Deficit Disorder (ADHD) with Hyperactivity” from the Children’s Hospital Education Research Institute at Westmead Children’s Hospital.

Dr Linette was previously the Head of Paediatrics at Hawkesbury District Hospital. She continues to have a private clinical practice at Rouse Hill, where she sees younger patients with ADHD, Autistic Spectrum Disorders, learning difficulties and developmental delay. Her main interests and work are now in her staff specialist position at the AYAM unit, Westmead Hospital, where she hopes to make a valuable contribution in the years to come.

Outside her work, Dr Linette’s life revolves around her family and friends. She enjoys reading and travelling.

Music credits

Opening and closing themes by Lily Chen.

Important Facts For People Who Wear Lingerie And Have Kidneys

Issues With Breast Tissues

Bras haven’t been proven to be useful. One argument is that it’s more of a personal preference or even a fashion statement.

There isn’t much research on this front. But based on the limited evidence out there, bras  are more likely to be harmful if they’re the wrong fit. The nudists win again.

Renal Complications

DKA can lead to AKI.

DKA can lead to lactic acidosis, which can be associated with thiamine deficiency.

Thiamine deficiency less commonly involves vomiting, which can stain clothing. The nudists win again.

References

  1. Mills, D. (2016). Health Effects of Not Wearing a Bra. Retrieved from https://www.healthline.com/health-news/going-braless-wont-hurt-breast-health
  2. Why is BRA important?. (2016). Retrieved from https://smah.uow.edu.au/brl/bra/whyisbraimportant/index.html
  3. Prywes, M. Science Proves That Wearing Bras Is Bad For Your Health. Retrieved from https://www.lifehack.org/336735/science-proves-that-wearing-bras-bad-for-your-health
  4. Hunimed Web Team. (2017). The advantages and disadvantages of wearing a bra. Retrieved from https://www.hunimed.eu/news/advantages-disadvantages-wearing-bra/
  5. Orban, J. C., Maizière, E. M., Ghaddab, A., Van Obberghen, E., & Ichai, C. (2014). Incidence and characteristics of acute kidney injury in severe diabetic ketoacidosis. PloS one, 9(10), e110925. doi:10.1371/journal.pone.0110925
  6. Feenstra, R. A., Kiewiet, M. K., Boerma, E. C., & ter Avest, E. (2014). Lactic acidosis in diabetic ketoacidosis. BMJ case reports, 2014, bcr2014203594. doi:10.1136/bcr-2014-203594
  7. Moskowitz, A., Graver, A., Giberson, T., Berg, K., Liu, X., Uber, A., Gautam, S., … Donnino, M. W. (2013). The relationship between lactate and thiamine levels in patients with diabetic ketoacidosis. Journal of critical care, 29(1), 182.e5-8.
  8. Berkheiser, K. (2018). 11 Signs and Symptoms of Thiamine (Vitamin B1) Deficiency. Retrieved from https://www.healthline.com/nutrition/thiamine-deficiency-symptoms