Fignewt345

Is there an easy way to tell D from L?

I don't know of any simple way of distinguishing between the two in everyday uses. Glucose synthesis can be achieved by photosynthesis in plants, and anabolic reactions (gluconeogenisis) in plants, animals (e.g. liver) etc. The glucose synthesized naturally will be in the form of d-glucose. Therefore, am I safe to assume readily available means of testing is not normally needed?

Does the difference between D and L potentially effect humans?

Our metabolism is stereoselective, and l-glucose is not broken down in glycolysis. l-glucose does have laxative effects and some studies have shown it to be a fairly benign and safe pre-colonoscopy laxative. A quick search revealed some studies on the effects of l-glucose and increased memory in rats (along with other monosaccharides), but I did not come across any widely published reports on the effects of l-glucose in humans. However, an anomer derivative of l-glucose can have the opposite effect on the langerhans islets beta cells in the pancreas by stimulating insulin release. So giving this form of l-glucose sugar may actually have the opposite effect compared to traditional d-glucose treatments. I am unsure of the prevalence of this form of l-glucose, so I can't say if this is a real danger.

However, I'm always willing to be surprised if you got any more information for us.

So, let's start off with a very common one. Why do we call glucose, dextrose? Is there in fact something special about dextrose? Is all glucose the same? What is a primary difference? Trust me, understanding this concept will go a long way in helping you understand how it applies to other medications.

Why do we call glucose, dextrose?

Because dextrose is one of the two forms of glucose.

Is there in fact something special about dextrose?

Yes, dextrose (dextrose monohydrate, or dextroglucose) is by far the more common and the only form of glucose our cells can use for glycolysis.

Is all glucose the same? What is the primary difference?

No, both forms of glucose (the other being the rare levoglucose which is normally not naturally occuring) may have the same molecular formula and molecular sequence, however their structures are different in that they are basically mirror opposites of one another. They have opposite molecular configurations.(enantiomers)

http://www.askoxford.com/asktheexperts/faq/aboutgrammar/laid

Which is correct: 'a person was laid on the table' or 'a person was lain on the table'?

People are often perplexed about this group of words. The important thing to remember is that there are two quite separate verbs involved. Lay is the present tense of a verb whose basic meaning is 'place something in a more or less horizontal position', with the past tense and participle laid. Lay is also the past tense of the verb lie; while lain is the past participle. So the proper use is:

Lay

Please lay it on the floor (present tense)

She laid the book on the desk (past tense)

They had laid it on the floor (past participle)

Lie

Go and lie down (present tense)

She went and lay down (past tense)

The body had lain in the field for some time (past participle)

and in the example it must be was laid on the table.

"Laid" is not the correct use.

Since the action of the patient you are describing has already been completed, you can use the past participle. (You are not describing the past in the present tense.)

In your case I believe lain would be correct. Maybe to avoid confusion you can remove "down," since to lie on the couch is to lie down on the couch by definition. IE "Upon returning to the room staff discovered that the patient had lain on the couch and was twitching."

It sounds strange and foreign. A lot of proper English does.

There is a lot of tangible knowledge and skill to be learned on transfers, and those skills and knowledge translate to better 911 care and ability.

Shouldn't your education teach you all this before you go out and attempt to learn it all while already working?

In many current systems becoming a well-rounded provider may require you to work many different levels and certifications to get the whole picture. But it just seems it is best to educate providers to that level before sending them to do their job, especially in this career. This is where we should concentrate our efforts towards changing EMS, don't you agree?

Sorry if I sent this thread down a different road.

You're right, I did jump the gun a bit. I'll revise: educating all prehospital providers to the highest level of medical care, based on medical theory, not step-based levels of skills, is the best way.

Piecemeal education, having every level operating on it's own and then stacking them upon each other, is not efficient, or effective.

No other medical profession operates that way. They may have increasing levels of autonomy as they move through the programs (such as MDs), but it is all emcompassing and designed toward one goal, the highest level of education and medicine in their field.

I never stated it was the “best” way; I simply stated that the reason we do things here, and many other places, is because it “works”. Is it the best way? Maybe, maybe not, but I never said it was.

No, it doesn't work because thousands of patients each year are not getting the optimal level of professional, prehospital medical care at the hands of providers not educated to the paramedic level.

But you are right, you never stated it is the "best" way. The best way would be having all providers educated at the highest level of prehospital medicine.

Denying patients the highest level of care based on what has always been done in the past is NOT the "best way."

Thermal energy from the electrical burn destroyed large amounts of internal tissue. This heralds coagulation necrosis and tissue edema, allowing the build-up of fluids in possibly multiple areas, causing compartment syndrome. Since the path of the circuit appears to pass from upper extremity to lower, any and all tissues within the abdominal and thoracic cavities , and of course the extremities, should be suspected to have received thermal damage.

http://www.emedicine.com/med/TOPIC2810.HTM

I suggest taking lots of practice tests like you've been doing, and to look at those tests to find which areas you are weaker in. Then study those weak areas (but don't forget about the others entirely), until you feel more comfortable. The new CBT national registry analyzes which questions and subjects you miss, and may give you more questions from that subject area. It's probably a bit more complicated than that, but that's how i studied for it.

In general however, no one can really tell you the right or wrong way to study. Do whatever you feel is most comfortable and has worked for you in the past. Just make sure you understand the material and that it sticks to you. But I always find getting a good sleep and plenty of breakfast always helps.

"You guys like to live on a pedestal and you crave public worship."

His entire article is about as fair, balanced, and comprehensive as this line is in his reply...

I love how this writer and writers with similar views love to clump a person with EVERY person in a certain profession.

On the joking side, we should perform a study to see how many writers and columnists may have substance abuse problems... and report any findings we have as an epidemic and a plague to society.