Beyond the basics....

[STARMedic]

If anyone is interested I would like to start a thread related to the Medical and Trauma related emergencies that you as Shop Owners, Artist's, Apprentice's and Customer's may encounter inside and outside the shop, and what you can do to provide the fallen person with a better chance not only for survival but for complete recovery as well.

Some of the Medical Emergencies I could forsee would be:

Diabetic Coma
Diabetic Ketoacidosis
Seizures
Allergic Reaction
Anaphylaxis
Hypotensive Crisis
Hypertensive Crisis
Cardiac Arrest
Respiratory Arrest
Altered Mental Status
Drug Overdose

Some of the Trauma Emergencies I could forsee would be:

Fractures of Extremities related to falls inside and outside the shop in the immediate area
Other fractures of major bone groups secondary to the above
Uncontrolled Hemmorhage
Traumatic Brain Injury secodary to non specific Trauma
Pneumothorax
Hemothorax
HemoPneumoThorax


There are probably numerous other things that I have left out, and anyone is encouraged to mention other things they feel relevant......

Anyone interested in talking Emergency Medicine?

Bruce

[gremlin]

always interested in learning something new bruce, fire away!

[Rickyboy]

I am all eyes and ears!! Bruce.. I also can respond with facts as well as I am in the medical field.

[gremlin]

hey bruce got an emergency question for ya, will My A.E.D. work on the cat? if not Im in trouble when the wife gets home :oops:

[Rickyboy]

Gremlin, The cat has 9 LIVES!!! lol

[lowshovel1]

I, would like some education in that area,thanks

[STARMedic]

Just wanted to let everyone know that I havent forgotten about this topic I started, Ive just been up to my ass in work, and gettin to sling some ink. Also had a surprise directoral audit and review for my board certification in November....

Im puttin it together in word and will paste into here when I get a chance....

Thanks in advance,

Bruce

[gremlin]

here is a hypothetical question for the resident medics,
Everyone knows its not good practice to tattoo someone under the influence of anything.
However. I can pretty much tell when someone has been drinking, or when some one has smoked a little weed, or taken a bunch of ephedrine (I tell them im booked for the night but if hey want to make an appointment and come back tomorrow ill work them in)

What I would like to know is about the tale tale signs of the other drugs such as heroine, coke, crack, extascy,meth etc...those drugs didnt got popular in my neck of the woods untill recently, long after i left the wild party scene, and the next generation took over where we left off. (hey im in small town georgia and those didnt get here untill about 7 or 8 years ago) so I really havent been around folks under those influences and would like to know what to look for.

[ink_freak]

i ve noticed that alot of ppl on that stuff usually have abnrmal facial movements like they r chewing on something and look wired

[EvilOfTheNeedle]

people on estasy mostly have very big pupils and some chew as if having gum in there mouth but not all do this..they also talk ALOT, take deep breaths thru the nose and fidgit. you will know someone has taking e's as soon as you see them trust me, they nearly always have a bottle of water too and some vicks nasal spray.

as for herion just look out for the needle marks! and there eyes are rolling in the back of there head..pretty much like a drunk.

[voodoo]

Bruce,why dont u put a little test up her on stuff we should know and some that might b a little more advanced?

[STARMedic]

OK, to address Grem's Q's first....

Drugs and what you may see...

Classed Narcotics:

Codeine, Fentanyl, Heroin, Opium, Dextromethorphan, Hydromorphone, Oxycodone, Oxymorphone, Methadone, Meperidine (Demerol), and Morphine

Central Nervous System depression (slow sluggish response, lethargy) Pinpoint Pupils, slow and possibly labored respirations, hypotension (decreased blood pressure) pupils may in some instances be dilated and sluggish, whereby excitement and stimulation (shining a light in them) may precipitate tremors.....(meaning hit the dilated pupil with light and the eye will jitter usually up and down.

Classed Sympathomimetics:

Aminophylline, Ephedrine, Ritalin, Amphetamines, Caffeine, Khat, Cocaine, Methamphetamine, and Dopamine

Central Nervous System excitation, seizures, hypertension (high blood pressure), hypotension in the concomitant use of caffeine with other drugs, and tachycardia (Heart rate above 100).

People in a withdrawl state may have any of the following.

Diarrhea, large fixed pupils, hypertension, tachycardia, insomnia, lacrimation, muscle cramps, restlessness in the presence of uncontrolled yawning, hallucinations, visual and auditory disturbances, cocaine withdrawl sometimes causes severe depression.

Ive noticed that meth heads tend to click and grind their teeth, crack heads tend to have severe occular deviances and cant fix or focus, x heads tend to be hyperthermic and restless, fidgity. (Hyperthermic is hot skin, sweaty, feverish)

The bottom line is that most of the above need to be dosed with narcan or flumazenil, and dont need any new ink so much as they need definitive care.


A good way to determine heart rate is by using the first two fingers, placed on the inner arm anywhere from 2-4 inches back from where the base of the thumb meets the arm, once youve located the artery by feeling the pulsation, you can count, some people prefer counting the number of beats in 60 secs but you can count the number of beats in 30 secs and multiply by 2 or count number of beats in 15 secs and multiply by 4.

A rule of thumb for when I dont have time to look at a watch is:

One, Two, Thre, Four, Five.....in rapid succession means the HR is above 100 and is tachycardic

One, and Two, and Three, and Four, and Five....with just enough time to sound out the "and" means the HR is usually between 80-100

One annnnnnd....Two annnnnd......Three annnnnd......Four and.......usually shows a HR between 60-80......

Anything slower than 60 is considered Bradycardic, anything faster than 100 is considered tachycardic.

HR doesnt necessarily mean much some people live with HRs below 60 and above 100 all the time......but I do believe that some of the things taught us in Emergency Medicine apply to the everyday operations within this industry.

"Sick people generally look sick"......

If you have someone sit down in the chair and they just dont look right, they may be in a bad way.....all the above can give you clues to suspect something isnt quite right, and maybe should recommend that they come back when they are better....

This is in no way meant to say that you should or shouldnt tattoo people who come in and dont look right, hell they may just be fugly.....I can only decide what or who is right to be sitting in my chair, not yours....

Hope this helps...

Bruce