Monday, January 04, 2010

Inflammation

I'm dealing with some of that as I write this post. All because my face hurts.

And no - it's not because someone punched me or I fell on it. I have a sinus infection. Went to see my PCP this morning to get looked at for it, and I got in to see his Nurse Practicioner instead. Not a problem - I've known her for quite a while and she's quite good. Her assessment skills are better than those of some docs that I know, in fact. Anyway, my suspicions were confirmed by her, and she prescribed Amoxicillin and Flonase for the inflammation. Told me that I'm probably looking at 2-3 days more misery before I start to feel better. I expected her to say that, in fact; it usually takes a couple of days for anti-biotics to do their job. Then you have to stay on them for a while so that they get all of the nasty bacteria out of your system. And some of them have undesirable side effects. Knowing this from personal experience, I am generally much more careful now about what I am prescribed, and I make sure that whatever I've been given is going to do what is intended.

So now I'm at work in Goffstown, doing what I have to so that I can stay warm, and just generally making sure I don't do much. I really don't want to go out on any calls if I don't have to, simply because it's cold. Really cold here, in fact. The temperatures are sitting in the mid-teens, but at least the wind has died down. That's a blessing in itself.

Worked in Boston on Saturday, and on the overnight we had a rather challenging transport. At 0230 we got sent to Logan Airport - in a snow storm with low visibility and high winds - to pick up a patient coming in from Mexico with third-degree burns over 60% BSA (or "body surface area"). A 12 year-old female, got too close to some pyrotechnics that caught her clothing on fire. Burned her legs, arms, and abdomen. The difficult part of the transport was getting this child off of the aircraft; she came in on a Gulfstream with a physician, a flight medic, and her mother. The doctor's English was quite good, the medic's was decent, but the patient and her mother spoke virtually no English. So communicating was tough. In addition, it was extremely cold and quite windy, and no person should have had to be out on an open tarmac with the conditions as they were. We really had to hustle to get this girl off of the plane and loaded aboard the ambulance as quickly as we could just because it was so nasty outside.

She went to the Burn Center rather than to Children's. That makes sense - after all, where else can you get top-notch care at virtually no cost? And the people there are quite good at what they do. Because of that, I'm inclined to believe that this young girl has a chance at a good recovery. At least I hope she does...

Yesterday Martha and some of Kerry's friends put on a baby shower for her. I was quite surprised at the number of people that showed up. Pleasantly, of course, but I was blown away at the number of people that can be shoe-horned into an area that is maybe 800 square feet. There were probably 25-30 people in the rooms (living room and kitchen area) at one time, and everyone seemed to have fun. I know Kerry did. And - it's a testament when you know who your friends really are. I think Kerry got to see some of that yesterday.

I have to get back to work; I'm putting a class together on Rehab at a Fire Scene that's going to include some pathophysiology of Carbon Monoxide exposure as well as some familiarization to one of the devices Goffstown Fire uses to assess patients who have exposure. The device, a Massimo RAD-57, allows measurement of Oxygen Saturation as well as Carbon Monoxide saturation; it will do either one. Bear in mind that it's a tool and at least can give a baseline or a reference point. I would think a more accurate measurement would be from an arterial blood gas measurement, usually on someone who's gotten really seriously exposed.

When I was in Paramedic school a number of years ago we had a patient who was brought into the Emergency room with a big case of CO poisoning. It was a suicide attempt; this person apparently had been given a diagnosis of a terminal illness of some sort not long before this happened. He went into his work shed and started up his lawn mower. Left it running. Probably thought he'd die a peaceful death. As it was, a member of his family found him, and he ultimately ended up in a Hyperbaric chamber. And I was tasked to monitor him during the dives.

It was actually really interesting, and I learned a lot about how Hyperbaric chambers work. And the patient did survive. How long he lived after the fact is something I was never able to find out.

To be honest, I'm glad I don't know.

2 comments:

Sandi said...

I was so surprised that you stopped by my blog! Gotta question....what is "Manch Vegas"? We passed through Logan Airport on many an occasion in the years when my husband did a lot of overseas travel. It was a busy place! You are lucky it was not as cold as it is here. Temp is sitting at -2 and headed lower tonight. Glad I don't have to go out in this cold! I had no idea when I offered to do Bible Study at my house this Tuesday that it would save me from having to head out into the cold! I can't even breath when it's this cold!

Susie Hemingway said...

Probably a bit late with this but a very old recipe for sinus infection, is to boil up some beetroot (I presume it's still called beetroot in America) strain and cool the juice, and then sniff up the nostrils. I know it sounds awful and it is messy |( maybe better to do it sitting in the bath or shower) but a very old country recipe and my Grandfather used this and swore by it. Hope you're better soon Walt