Volume 26 Number 1
By Frank Hubbell, DO
What is activated charcoal for?
Activated charcoal is used to treat certain types of ingested poisonings as well as in water purification filters to remove toxins and unwanted tastes.
How does it work?
Activated charcoal works by having a large surface area and being highly absorptive. After absorbing and binding the poison in the stomach and small intestine, thus, preventing it from being absorbed into the system, it will then pass out of the digestive tract along with the feces.
How is it made?
Charcoal is finely ground and heated in the presence of oxygen. This causes the charcoal to become very porous, increasing the surface area of the charcoal and creating a large number of traps that will absorb and hold other compounds, especially poisons.Read More»
Volume 26 Number 1
Critical Care Check List
By Frank Hubbell, DO
The Big Idea is that, occasionally, significant life-threatening injuries do occur, and when they do, we have to be able to quickly react to them. The last time that we did a review article on these life-saving skills was in 2007.
The life-saving, critical care skills are not used nearly as often as the more common non-critical care skills. The vast majority of the time our patients are conscious, coherent, and can tell us exactly what happened, when it happened, and where it hurts. They usually have only one primary injury, and it is rarely life-threatening.
Because of this, our critical care skills tend to get a little dusty. It is well worth it to every once and a while to take the time to blow off the dust and polished these skills.
What follows is a concise, step-by-step review list to help practice and remember these life-saving skills, so they will come to mind when they are needed. For life-saving skills to be effective, the life-threat has to be recognized quickly and dealt with effectively. Time is of the essence, but it is also equally important not to miss anything.
To make this task as efficient and accurate as possible, it is best to use a step-by-step list, trying to avoid any detours that will only result in confusion and the possibility of missing a critical step and diagnosis.
These are the Principles of Rapid Critical Care Evaluation for Detecting and Managing Life-Threats:
Change in Level Of Consciousness – CVA, diabetes
Shortness of Breath – asthma, chocking, anaphylaxis, pneumothorax
Chest Pain – acute coronary syndrome
Shock – hypovolemic, neurogenic, cardiogenic, obstructive
RAPID CRITICAL CARE EVALUATION:
(aka the primary survey)
This rapid action sequence proceeds once the SCENE IS SAFE.Read More»
Gordon Giesbrecht, PhD is a professor of thermophysiology and the Director of the Laboratory for Exercise and Environmental Medicine at the University of Manitoba. He has authored over 100 articles on cold physiology. An excellent speaker and educator, considering the number of times he has been intentionally hypothermic, he also has a great sense of humor. He has been known to refer to the Alaskan Panhandle as “ U.S. occupied British Columbia.”
WMN: Was there an event in your personal life, or education, that sparked your interest in what happens to the human body when it begins to cool below our normal core temperature?
GG: Well, in the late 1970’s and early 80’s I was a wilderness instructor in the Rockies. Mountain climbing, rock climbing, white water canoeing, ski touring and stuff like that, and getting cold, or staying warm I should say, becomes very important when you are pursuing those activities. Then when I returned to Winnipeg to do a Masters at the University of Manitoba I found a physician named Gerry Bristow who was willing to provide medical oversight while we actually made people hypothermic. I didn’t think we would be able to do that and when I found out I thought I’d died and gone to heaven.
WMN: Dr. Hamlet has postulated for years that growing up in a cold weather environment changes how a person reacts to getting cold and their attitude about cold weather. In essence, if you grew up where it gets cold you more aware of the real dangers and less likely to be frightened of the cold. Do you share that assessment?Read More»
ISSN-1059-6518 Volume 25 Number 6
Mild TRAUMATIC BRAIN INJURY (mTBI) – CONCUSSIONS
By Frank Hubbell, DO
For years we rode our bicycles without helmets, played touch or flag football without helmets or padding, climbed, paddled, skied and did all sorts of sports without worrying about a little bump on the head. But, it would appear that modern medicine, moms, and coaches have uncovered some potentially major problems associated with a simple head injury known as a concussion.
Any bump or blow the head that damages the brain is referred to as a traumatic brain injury (TBI). A TBI is an injury to the brain that disrupts of the brain’s normal functioning . TBI is referred to as mild if the loss of consciousness or changes in level of consciousness are brief. TBI is considered severe if the changes or loss of consciousness are extended.
Traumatic Brain Injury Stats:
There are 1,700,000 TBIs per year in the USA.
75% of TBIs are concussions or other forms of mild TBI.
Causes of TBI:
Falls – 35.2%
Motor Vehicle Accidents – 17.3% (largest % of deaths – 31.8%)
Struck by/Against – 16.5% (largest cause of TBI in children – 25%)
Assault – 10%
Unknown/other – 21%
Helmets and TBI:
90% of fatal bicycle accident victims were NOT wearing a helmet.
Motorcycle accidents – greater chance of severe TBI and death if the driver or passenger were NOT wearing a helmet.
21% of TBI are sports-related in children and teenagers.
#1 cause of sports-related death.
85% of head injuries (TBI) are prevented by helmets.
A concussion is the most common form of TBI. A concussion occurs when the brain has suffered a biomechanical injury, a direct force has been applied to the head, causing functional rather than structural changes of the brain, in other words a disruption of normal functioning of the brain. What this simply means is that the individual has the symptoms of a head injury, but all diagnostic imaging, xrays, MRIs, and CTs of the head are normal. The insult to the brain is on a physiological, cellular level, rather than creating gross anatomical changes.Read More»