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Broken Ribs: always assume a punctured lung

If someone has broken ribs, always assume they have a puntured lung(Pneumo-thorax) or blood seeping into the lung (Hemo-Thorax). Low oxygen saturation levels with tip you off with either condition. Anything below 90% is NOT normal and you should assume the worst, especially if the blood O2 level is in the 70-80s. Get help fast. Many people turn blue or a darker than normal gray shade in their faces and skin. Their skin is turning blue because it is grey/blue when your body is low on Oxygen/O2. Go to the Emergency Room right away. I had an old girlfriend that turned very blue (life threatening) from a really bad cough in the winter and turned a weird blue color in her face. Sure enough the doctors did emergency surgery to re-inflate her lung after 5 minutes of examination. Pneumo-thorax /Punctured lung can turn life threatening fast....get help, dont mess around.

Halodol: calms down violent and combative people

A very big and combative patient came in tonight and started throwing tables and beds around his room had to be restrained. To sedate him, he was given Halodol, a sedative, Ketamin-style drug, otherwise known as "Special K" on the street. It put him to sleep right away and we tied him down with 4-point restraints. The drugs worked well to calm him. He was maniac-depressive and went nuts once he entered the ER, talking would not calm him, even with 10 security guards around him.
Halodol is also given to animals to calm them, like horses. Pretty strong stuff in pure form.

Medical Charting Abbreviations

The ER is really fast paced, so slow charting is not tolerated. It is important to use shorthand and do it really fast. A male nurse showed me how to do some of it tonight both by computer and on paper.

Paid Tutoring

Since a lot of us are striving for high grades, I have been hired as a tutor at my school for$9.50/hour. I have been asked to tutor many different subjects (Chem,Bio,English, Basic Math) now that I'm at the intermediate level with most of my classes. Beginning students really need the help. Lectures are so fast and packed with students that if students have questions they can't ask anything, so they get lost immediately. Many students give up easily in this situation when they all they need is simple clarification actually.
  Fyi: the best thing you can teach anyone is confidence that they can do it. Constantly pepper your tutoring session repeatedly with praise telling them "you got it, good job, way to go...and others".....this is the biggest thing you can do for them. When students have questions they feel lost and stupid because they didn't get a subject right away like the rest of the class. Confidence reenforcement to create replies between you and the student is the BEST thing you can do.
   Tutor Tip: if you are rusty on the topic with a student, just ask another tutor to help you when they are free. Tell the student you are rusty or don't, rather than teaching them the wrong thing. Don't guess! It will make students mad at you, frustrated that you wasted their time in learning the wrong thing and have to relearn it again....better to say "I don't know this stuff to well. Let me get another tutor to help you" .Then sit in on the session yourself,2nd tutor, yourself and student to learn it yourself for next time. You'll become a great tutor yourself.

Summer Tutoring:
  Several of the multi-subject tutors are left on during the summer quarter to help out with the super fast summer classes. Many of them work apart time schedule about 17 hours/week. It is decent summer work doing what you already know. Many good tutors after graduation are hired staff too where I work. It is a good transition job after graduation while job searching.

Statewide E-tutoring Network:
  My state off Washington have a huge, statewide E-tutoring portal with tutor for every subject. This is another job that I was offered to do through some of my coworkers that do it already. It is another seperate area that you make money in. It is completely online through a portal and you can pickup additional work this way.
 
YouTube website: (make a following)
  Another thing that several tutoring coworkers are going to start is their own YouTube website with technical tutorials with several different subjects.

Hope these are some useful money making ideas.

Off to study myself

Reality of Studying

  If you are anything like me I am not the smartest guy in class, but I even out the difference by studying like crazy, reviewing material over and over again.
  This gets me the grades I need. I'm not above repeating a class either to boost my grade if necessary, especially math which is difficult for me.

  About your social life when you are pushing hard for high grades...my Pre-Med classmates said their social lives have suffered alot because of their dedication to studying, mine included.


 We all agreed that you have a tough choice: (Pick Two)

High grades
Sleep
Friends
** Pick TWO**

Unless you are superstar student wiz kid, you will have to study your butt off like me and not have much of a social life. Just reality of the Med School track.

Good reference book

This reference book explains many of the procedures that I see done in the ER weekly in detail.

The illustrations are good.

Take a look at the illustration on inserting a Central Line. Good stuff.

Pick Teachers Wisely

Be very careful which professors you take.

At community colleges, the deans are mostly concerned with their own skin. Reason being that most community college students are transitory for less than a year. The profs will stay around longer than you, so their attitude toward you as a student is that of contempt. They truly don't care whether you pass or ace a class.

More on this topic later. 

Platelet Rich Plasma Therapy

Platelet Rich Plasma Therapy
  A super shot of your body's own healing white blood cells, Plasma, healing factors injected right where you need them. Amazing regrowth and super low inflammation.

  http://www.youtube.com/watch?v=2yyrzuUQjzU&feature=related

Allan Mishra, MD-inventor of PRP technique
  http://www.apexprp.com/

Using PRP for Heart Attack Therapy to regenerate the heart:
   http://www.bioparadox.com/

DaVinci- Robotics Surgery Machine

DaVinci- Robotics Surgery Machine

   http://www.davincisurgery.com/?id=it&gclid=COyXiM_CmaoCFQhzgwodUVoQxg

3-D Vision Surgery !! Sweet

3-D Vision Surgery !! Sweet

   http://cnettv.cnet.com/3d-operating-room/9742-1_53-50003367.html

My father in the ER

My family got a real scare when my dad drove himself to the local hospital ER complaining of severe chest pains. In his pain filled state of mind, he immediately drove himself early in the morning to the ER even though 3 other people were at the house around him and available for an emergency.
  This was a really stupid move for him or anyone in that people are known to have secondary heart attacks on the way to a hospital, crash their cars and die on the side of the road. This was a really stupid move on his part......mind you he has 4 college degrees. Knowledge of facts does not automatically make you wise.
  Our entire family gave him a stiff "talking to" about safety and his own welfare while he we had his captive attention in his hospital bed.
   Turns out later that he was ok,but still scared the craps out of our family with his behavior. Duh!
  I gave my parents the grand tour of the ER since I worked there....small world.

Organic Chem- Level 2 Help Book

My O-Chem help book arrived today.

Medical Mission Work Overseas

I am a big advocate for people to travel overseas, outside their own country and open their minds culturally. Especially nurses and docs. It will change your life completely.

Here are some great medical mission programs around the world.

Doctors Without Borders:
   involved in every war torn, poor country / natural disaster your can imagine. They are heavily involved in Africa, Asia and recently the Indonesian Tsunami and Haiti. They are the frontlines of the medical field overseas literally, in many war zones.
   www.doctorswithoutborders.org

Mercy Ships:
  A huge floating surgical hospital on a cruise ship (300 rooms) that travels to cities all along West Africa. Amazing medical organization. Performed more 20,000 surgeries for the world's poorest for free. All volunteer crew, who pay for themselves. Long and short-term volunteer shifts.
    www.mercyships.org

Habitat for Humanity: International
  www.habitat.org

ER Coffee: make it first!

First thing you should do when you arrive to volunteer in the ER is make good, strong coffee for the staff that is just starting their shift. They need it and dearly appreciate it.
  Ask if they have a bag of special brew they want made. Nurses are picky and always have a secret stash of "Good Stuff" hidden in a cabinet. Ask around...there is at least 2 nurses per shift that are coffee freaks and only drink good stuff. In a paper towel, mark down the time "Brewed fresh @ 1830, Fri, Godiva Blend". Everyone will love it and snatch it up in minutes...makes them really happy and you score major bonus points as a volunteer.
Good coffee at beginning of there shift makes people really happy.....simple pleasures.

  I recently brought in some good tea and made fresh brewed iced tea + splenda and it was a huge hit. They drank 2 gallons in 10 minutes...now that is fast...wow!

Exotic Jobs in Hawaii

Ever wanted to live in a sunny place like Hawaii?

You need to look into Travel Nursing or Locum Remind for Doctors. There are many head-hunting agencies that will actively find jobs for you anywhere you want to live. These are temp positions that are short term for you to kick the tires on a local area and feel it out before commuting long term.

Global Medical Agency.
   Www.gmedical.com

LAM Associates Physician Search:  
   Www.mdopenings.com/hawaii.html

Ultrasound: 2 kinds

There are 2 kinds of ultrasound:

Vein ultrasound- for sticking people properly with needles and IV drips, shallow ultrasound. Ask a head nurse or EM tech to show you how to use this...very handy and helpful when putting needles in correctly. Great for use on senior patients and drug users when you can't find a vein visibly.

Abdominal Ultrasound-deep depth, internal ultrasound for your stomach and bones, internal organ inspection. Only the doctors will likely know how to use this. Make a good relationship with them first before you ask them on this one.

CAT Scan/MRI techs: befriend them

Make friends with the CAT scan tech.

You can learn a ton from them. Find one that is open to teaching you while they work. It is very repetitve so most are very receptive to teaching you. Their hands fly over the keyboard as they work.

Ask them to show you kidney stones and heart clogging plaque inside the heart....it will shock you! ...and make you wanna change your diet asap.

Photos of patients or Conditions

Never take photos of patients in the ER.
You are breaking HIPPA privacy laws and will get booted out of the hospital. Look up what they have on the internet if you wanna reference it.

Good Reading List

Some good books I have enjoyed reading.

Working in the ER- Emergency Room

I recommend everyone who is serious about medicine: nursing and medical students alike, to volunteer in the EMERGENCY ROOM. Proper work hard and have fun. It is never boring and docs/nurses are really on top of their game, sharp, no nonesense people. They hump and work hard and fast. Everyone helps out too even if they don't like each other. The ER is a completely different culture than the rest of the hospital. Teamwork is super key and you cam feel the support from everyone there. Few people are slackers, unlike other depts in the hospital. It is busy and fun and I personally learn a ton there. I volunteer on a busy Friday night on purpose to get in on the big rush. It is always busy and I force myself to learn 2-3 new things everyday I go in which I write down and keep in a binder. Never stand around or lean on counters...people notice. Look busy and treat it as a real job, like the professional you are going to become. Hospitals will hire you as paid staff if you are a volunteer that humps his/her butt and works their tail off.

Organic Chemistry Help

Everyone I have talked to has said that you MUST put in the time to commit to learn Organic Chemistry well. This being said, find a tutor and an upperclassman that rocked the class for advice.

Several people recommend this Quick Tips study book, Level 1 and 2 are good. See photo.

Volunteering in ER: "Say I don't know"

Make sure to say "I don't know what that this?" If an EM Tech, nurse or doctor ask you to get something you truly don't know what it is, then don't guess! They will show you later on and train you. In a pinch, you must be able to get it right away. Better to err on the side of caution that be overly cocky and leave them hanging.

This will be a big strike against you if you return 15 minutes later with the wrong thing....no,no,no..don't do it.

An experienced EMT applauded me when things got crazy with a patient crashing with low blood pressure and asked me to grab supplies outside the room but I didn't know what it was. The patient had a heart problem and would have had a serious blood pressure drop while I was searching for the item he asked for. The EMT in the room went out to get it. After stabilizing the patient, the EMT showed me later on what and where the needed supplies were.

Volunteer Shadowing

In my quest for medical knowledge, I ask head nurses and many different people at the beginning of my shift if I can shadow them.

"Do you mind if I shadow you tonight"...ask them when they are standing at ease at their station, bumbing around or not busy. At my hospital they always say yes to me.

Befriend the ER Secretary

Make friends with the ER secretary/charge nurse in the middle of the ER section by saying "Hi " every night and asking "Do you need anything?" ...OR....."If you do need something, let me know."
They always need help fetching something because they are required to grab the phone lines. They can't leave or walk away; but you can. They often need to hunt down a particular person out of reach. They will begin to rely on you for this task and you will stay constantly busy because of it.
  ALWAYS ASK the charge/training nurses if they need help with anything. They always need help with something if they are walking quickly. the speed of their walk should tell you how busy they are. Match their step as they go into a patients room and just be available to help...say,"Can I help you?"

  You can become a valuable asset to them as you make yourself available to and become their righthand assistant. You will learn a ton from them just by watching and shadowing them around.

Learn something every night

I force myself to learn something every night.
Write down 2-3 things you learn about every night.
The first couple of weeks you need to learn the names of the medical supplies that you are restocking. I took my smartphone a photographed all of the supplies just to remember what they looked like and officially called names.

Medical School Journey of Kit

This blog is about my journey to get to medical School.

I was inspired to write my own blog having read others that are on the same journey as myself. They gave lots of helpful tips especially about Organic chemistry Tip books.

I will post things I learn on the way there in my journey.

Kit