#med ask

HAPPY NEW YEARS TO U ALSO BELOVED!!! aight so quick facts for ya

very much so! but before that rq:

paracetamol is an analgesic and antipyretic (pain reliever and fever reducer respectively), its otc here but it varies i think.

its not an nsaid (non steroidal anti inflammatory drug) unlike say ibuprofen. tis just acetaminophen. which is why u can safely take paracetamol on an empty stomach no problem but its not recommended to do the same with ibuprofen bc it irritates the stomach and on the long term can cause ulcers, gi bleeds and what have you.

paracetamol tablets come in several strengths, from as low as 80mg for kids to the maximum single dose of 1000mg.

now an overdose can go two ways; either too much at once or too much in a day:

the max amount of grams in a single dose is 1000mg/ 1g.

the max amount of grams in a day shouldnt exceed 4g in adults.

so if i took a 1000mg tablet today im not allowed to take another till at least 4 hours and cant have more that 4 tablets in total all day

if i took 2 of the 500mg tablets the same thing goes lol. point is u can play around with the numbers. fics b having me pulling out my dusty calculator and doing maths lmao it happens. anyway

if for whatever reason an overdose happens the first thing we need to know is how much was taken. an extra tablet wont be as bad as 10 yk? theres more maths in medical school than i like but oh well

not to get into the nitty gritty of pharma lol but paracetamol is broken down in the liver, therfore too much runs the risk of hepatoxicity (chemical/ drug induced liver damage), which can lead to acute liver failure.

why acute and not chronic? bc this is a one time thing so to speak; the overdose happened now it wasnt years into the making (like late stage alcoholic liver disease that can lead to liver failure)

anyways acute liver failure is a medical emergency

treatment should be started immediately/ asap even if the symptoms havent kicked in yet. the anitdote is acetylcysteine btw

there are key symptoms of liver damage/ issues in general that include jaundice (yellowing of the skin) abdominal pain (self explanatory lol) and disorientation/ confusion due to whats called hepatic encephalopathy which is medical for liver -> brain problem lol

other symptoms include swelling (when proteins get out of whack body fluids do too.

have i mentioned yet that it depends on the dose but also the person in question? people are extremely different and their metabolisms and mutations if present can reflect in really funky ways when it comes to biochemical pathways etc :3

anyway back to the topic on hand lol

what characters in the media typically portray wrongly and folks irl sadly copy wrongly is what a suicide via overdose actually looks like

paracetamol may be a pain killer but overdosing on it is far far from painless. be careful out there pls

recovery and potential complications depend on the dose and how fast treatment was delivered. so thats for u to decide

but liver transplants will be needed to survive if the damage is extensive or irreversible enough.

the antidote i mentioned can save the liver if administered within a window (8 hours afaik), but if massive enough the od can still damage the liver despite the antidote (or if the pt comes after 8 hours)

the determining factor here are the liver cells, are they alive, can they be saved, have they passed the point of no return etc

based on that too recovery time is determined as well as treatment options or needs

the liver as u know is famous for its regeneration (granted its healthy and the loss/ removal isnt expansive lol) so u can imagine how severe the damage must be to need a full transplant bc its past saving :'(

Hey! Thanks so much. So I answered this exact question before so I’ll paste what I wrote back then!

I’ve always wanted to be a doctor ever since I was young (at least since 6 years old, it was definitely one of the first career choices I ever wanted to do, regardless of how hard it is in reality to get in). My initial reasons for it at the time was of course, influence from my parents (my dad is a doctor and so I could see what he did), and I used to be really obsessed with learning about the human body. My dad would bring home all of these medical models of the heart and stuff, and I would display them on my bookshelves (now thinking back, wtf 7y/o Jade??? that’s honestly so weird) and I would read these little ‘Charlie Brown’ encyclopedias of the human body (basically, super dumbed down for kids). Sometimes I’d play at being secretary at my dad’s surgery just for fun, though know I realised the other workers probably got super pissed at me. I just really loved learning about it for the science part.

As I got older (like…Year 5/6? So about 11-12 y/o) I really enjoyed participating in charity and fundraising events- I loved (and still do) helping others in any way I could. In doing a lot of this service stuff from a young age/into my later high school years, I feel (hopefully!) that I have the empathy to look after patients, it just seemed like the most perfect job to me. I genuinely feel like since I’m privileged with health/prosperity/opportunities in life that other people don’t, I should give back in any way I can. I was able to do something where I could mash my love for anatomy and helping others together. (Super cheesy, I know). I’m also an extroverted person, and enjoy working around and interacting with people- Medicine gives me the opportunity to meet new people every day, whether it be colleagues or patients.

ooh the only thing i know about it is that its associated with cross reactivity? and that iirc kelly (life with my rainbow on yt) has oas :]

cross reactivity btw is when the immune system thats allergic to substance a flares up in response to substance b even tho a and b arent the same. famous example from my textbooks lol is the cross reactivity between penicillins and cephalosporins; 2 different classes of antibiotics that are in the same category of beta lactams. anyway

inchrestingly enough oas is limited to the oral cavity and throat whereas alleriges are typically systemic manifestations of a percieved antigen by the body. stomach acid breaks down whatever the body is over reacting to so it doesnt go further than that

from what ive just read its triggered by stuff that resembles (to the body at least) pollen, but what does any of this mean practically? well it comes down to the severity of the allergic reaction in question; fruits and nuts being mildly annoying to eat or minimal flare ups requiring antihistamines arent the same as the worst case scenario of going into anaphylactic shock (the one that needs an epi pen). hives and nausea id say are smack down the middle? lol

genuinely honest- id treat them as i would anyone else lol.

first thing of note is that ones religion or nationality etc isnt part of the patient profile (info i obtain from the patient as part of the history taking), the only thing i can think of that is within the bounds of the clinical encounter is travel history (crucial for conditions with endemic areas but also other things. tis a routine question)

second is if ur asking for like a war trauma surgery situation where id theoretically be on the front lines and like an idf soldier is somehow on my operating table; my policy (in line with medical ethics) is that if i wont help i wont harm. ill decline treating if theres anyone else willing to do so. conflict of interest is a valid reason to refuse care

so i'm writing some fanfic where the characters get into a plane crash and have to survive on their own with limited medical supplies/knowledge (the characters are age 12-15 but some of them have first aid knowledge to an extent) and i have some Questions (if u don't mind me asking)

(before i start this is SHAMELESSLY inspired by the greys anatomy season 8 finale where the plane crashes)

can you use fire to cauterise open wounds to stop bleeding? or would that just bring further complications?

can you use safety pins as makeshift staples (if you loop them so the skin shuts properly)

the only character who knows how to properly suture needs sutures to stop bleeding out, is it realistic for him to instruct the two other least injured people to suture him up (he can't use his hands) without blacking out from pain?

injuries the characters have: (what is the treatment protocol for each of these?)

one character gets her leg broken with bone exposed (eventually it has to be amputated)

one dislocates his shoulder

one person's hand gets stuck in the debris

someone gets debris in her stomach

one person just has superficial wounds

one character gets debris stuck in her leg

they all have heavy bruising and scrapes as well but those are treatable

things the characters do know how to do:

tie a makeshift tourniquet (advice: do not practise tying tourniquets on yourself because it's quite painful)

suture (one person)

insert a needle into someone's veins (same person)

apply compression bandages to stop bleeding

other super basic stuff (apply plasters, tie an arm sling, etc)

the very basics of cauterising a wound

supplies they have:

tranquiliser guns (limited, and the tranq guns are suited to taking down dinosaurs but they work on humans too)

hand sanitiser and rubbing alcohol (limited)

two basic first aid kits with needle and thread

a knife

cloth to use as bandages and tourniquet material

oxygen (from the plane)

possibly an iv drip???

matchsticks (limited) to make fire to sterilise things and to heat the knife for cauterisation

debris from the plane for splints

food and water (limited)

also how does one put a dislocated joint back into its socket? particularly the shoulder?

sorry if this is super long and for asking so many questions lol. feel free to answer whenever :) and it's completely fine if u don't know (duh) i can research myself but i am sure you're more accurate than a search engine

hope u are having a wonderful day <3

beloved hiiii :D

oooh exciting!! ngl i havent watched any medical shows lol so i dont have any pop culture knowledge (the writing in said shows isnt always the most accurate as u probably already know lol) BUTT tis a famous trope/ au setting so lets see what we got >:)

(also ofc??? love answering ur questions and stuff in general!! and if i dont anything we can always learn together XD)

disclaimer i will be freestyling these okay i dont have any experience in trauma surgery lol but heres what i do got right off the bat:

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aight first off cauterisation is indeed used to stop severe bleeding *when all other means have been used* and an open flame is definately not the way to go for tha (burns can be extremely dangerous and a. cause fluid loss and b. increase the risk for nasty infections that can lead to sepsis and death)

instead id suggest heating up metal (like a scrap from the aircraft or sum) via the fire and then applying it to the wound :3

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assuming u mean the surgical staples: yes and no? lol obv since this is an emergency there is little space to be picky abt equipment, so honestly safety pins would work ig but i think theyd keep coming loose (oh the agony)

i messed around with one of mine just now and the line that locks into the head (?) is pretty straight so i kinda doubt itll be able to like close flesh the way one imagines it to but its literally fiction lol we can suspend our belief far more than this. as long as its closed properly go for it lmao i give u my blessing XD

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yeah sure!! since the patient is awake and aware enough to be able to assess and give instruction i see no reason as to why not lol.

btw in case of an amputation or extremely severe bleeding id recommend using a tourniquet (lots of tutorials online!) to compress the artery and minimise the bleeding :D (ooh maybe u can use the cautery thing here too)

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OMG I READ THE FUTURE AHA (my condolences) okay so the amputation will be at the knee level (which afaik is the hardest kind of amputation to perform joint wise lmao. good luck with that) presumably. theyll need a tourniquette as mentioned above, very sharp knife or something to hack away at the flesh and tendons (very tough) and ligaments around the knee socket (even tougher i think). and lots of bandages for the stump

now had they recieived the needed medical attention i doubt theyd need to go up to the knee (there are shin level amputations) but since theyre kids and all alone with no guide or anything idk if theyll be able to save the lower leg bones or even cut though them if they could (i doubt med supplies include saws lol) so yeah thats my reasoning at least.

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dislocation is a relatively easy fix (compared to everyhting else lol) but it depends on where the humerus (arm bone) is:

based on which kind of dislocation the direction of pull is determined, but again relatively simple no blood no mess

there are a few maneuvers/ techniques u might want to look up like hippocratic and spaso/ reverse stimson (both for anterior btw)

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a hand getting stuck i assume means impaled? oof thats going to hurt. well broken hand bones are pretty rough to deal with in the wild, since all bones need proper realignment to avoid further pain and complications when the body heals itself (did u know that if a fracture heals wrong they have to break it and reset it? yeah.) so im not sure honestly ig it depends on what u have in mind for them

again not too sure what stomach means exactly; are her guts poking out? just bleeding from scratches? depends on what ur going for!! lmk btw and feel free to send more asks ill look up and find what we need to know :D

impaled leg i take it? as the above u need to know what condition shes in exactly like arterial puncture probably means severe bleeding and death honestly, lmk what u have in mind!!

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superficial wounds need cleaning and patching up, sometimes if theres like unclean areas of said wounds they need to be scraped off (debridement) esp if theres like scraps or dirt or anything on the wound. what fun!

again for the cautery i think an open flame would heat up the knife much faster than a match lol (also they need to be preserved. also also they wouldnt last long enough i think)

unforch yes; the human body in my years of learning thus far has proved to be really good at parkour'ing between extremes lol, in this case sedentary lifestyles or limited activity for whatever reason on the long run makes it harder to bounce back to pre fatigue levels of activity bc the body gets used to a certain state and is a bit of a bitch to change (a famous example iirc would be folks who for example lose weight quickly and the body can interpret it as oh no somethings gone very wrong and does everything it can to gain the weight back, hence why maintaining ones weight is harder than the change itself. or so i know) anyhows

(my friend needs it for her fanfic)

(tbis: traumatic brain injury and my main reference is this nih article)

AIGHT SO heres both an overview and what i assume ur fren wants to know for whump purposes lol:

WHAT IS TBI: brain injury caused by a mechanical force, be it blunt trauma or a penetrative object (like a bullet or bone fragments)

CAN TBI BE PSYCHOLOGICAL? NO!!! a traumatic brain injury can result of course in psychological damage or stress that leads to ptsd for example, but by definition tbi is a physical injury.

WHAT DOES TBI DO/ WHAT DOES IT LOOK LIKE? fantastic question, well it depends on what part of the brain is affected;

quick anatomy lesson lmao: the brain as u know is divided into hemispheres (right and left). the brain as a whole is divided into lobes as well (in this case the blues greens yellows and reds). so far these categories are all structural/ directional; we havent yet gotten into what they do.

if i say temporal lobe (green stuff. i know its says occipital but trust me bro i know what im talking about. also u can look it up lol) thats where the temple is! hence the name, and it recieves auditory (hearing) information bc thats where the ear nerves enter :3

anyway u see those numbers? well each one is an area. and we had to learn each damn one lmao :') anyhows these areas are functional; they tell me what they do, therefore any damage to an area affects this brain function.

like in the case of stroke patients (a stroke is a blood clot, and if the body is unable to deal with it for whatever reason and it continues to block the blood flow to the brain, cells will begin to die of hunger, bc the blood carries the stuff it needs as well as takes out the wastes. anyway if an area dies its like a skill is being erased. ofc theres like a window of time where the damage is reversible, ill get into that later)

take area 22 for example, were still in the temporal lobe btw, it contains part of whats called wernickes area, and its in charge of language comprehension. damage to area 22 results in whats called wernickes aphasia (aka receptive aphasia) wherein the patient faces difficulty in comprehending, recieving, language. they can still speak of course, but their speech is referred to as word salad; theyre fluent but cant be understood.

tldr; where the individual recieves (?) the tbi and how expansive the damage is determines what brain function is impaired or lost.

ill leave reading the symptoms/ presentation of tbi for u :3

WHERE ARE THE BIG MEDICAL WORDS: im getting to it omg. injury is a very broad term that holds the capacity for a million categories and subcategories, but going with the article above with what i hope is the most relevant for u lol:

diffuse axonal injury: if u have ever seen a generic nerve it looks like a tree and the axon is the trunk and its job is to relay electrical impulses (fun fact look up saltatory conduction i beg u pls its so cool). injury to the axon fucks all of that up. its the most common kind of tbi and the damage itself as u can imagine interferes with communication withing the nervous tissue.

slight tangent but impulses/ messages can be chemical or electrical, so in the case of dai and axonal damage it can release said chemicals (neurotransmitters like acetylcholine) that makes everything worse :')

concussion: needs no introduction lol and ranges from mild to severe. the idea is that a crowbar to the noggin does diffuse damage.

haematoma: prefix haem- means blood and suffix -oma means tumor/ swelling. hence haematoma is a collection of blood outside the vessels it should be in. a cranial haematoma is just one inside the skull (and there are several types depending on where/ which layer its in. long story) which is dangerous bc it squishes the brain and that hurts like hell i can imagine but most importantly the increased pressure makes it harder for blood to move around which may result in seizures (abnormal brain electricity), comas, and possibly even death

contusion: basically a brain bruise. the difference between a concussion and a contusion? surface area and severity; contusions are more local/ precise and more severe bc the brain tissue is like actually bruised, whereas a concussion is more spread out. ig u can think of it like jam on toast; the more u spread it out lol the less sharp it tastes? idk if anyone can explain it better pls be my guest XD

rapid movement (like in a car accident) that leads the brain to do the dvd logo bounce™ within the skull (its floating btw in a fluid, part of its job is shock absorption. physics my dudes <3) btw is a whole thing bc if the brain bounces both the front and the back can be bruised (double whammy fr) but i wont bore u with more details fjdks

secondary stuff: can be a follow up to the og injury, more gradual, kinda like how u recover from an initial shock and then the pain hits u like a bag of wet mice (wait what).

im running out of brain juice forgib me so ill just list a few of the mentioned causes; infections, low blood pressure/ oxygen flow due to injury, hydrocephalus (fluid build up in le brain), seizures and more.

BRAIN STUFF: heres probably what every whump writer has looked up at least once lmao:

the brain peaces out when oxygen supply is cut off. depending on how long u can hold ur breath (athletes and smokers have very different lung capacities for example) theres an upper limit ur body can take. after that u pass out. (ofc the concentration of oxygen and timing blah blah are all factors that determine the trajectory of events but who wants to do the math lol)

a few minutes of oxygen deprivation later the cells start to die of starvation. the brain is a very oxygen hungry organ, but with the right treatment the individual can regain consciousness and recover brain activity and function. BUTT

theres a cut off point here as well, up until now the damage is reversible, however after i think the 4 (?) minute mark le cells start to die for good. there is no replacing what dies, bc nerves dont regenerate or divide (some do tho but not the ones here).

the damage a stroke does is essentially cutting off the oxygen supply in an organ or to the tissue. if it goes on too long regardless of where it is in the body some damage is permanent (gangrene for example is really advanced cell death due to a lack of blood flow (among other things) and an infarct/ stroke can cause it.

anyhows i mentioned wernickes area in the case of a stroke and how depending on how severe the damage is (how big the clot was and how long it took between the injury and the intervention) the potential complications but also the treatment plans/ options are determined.