BushyFromOz

i actually thought this topic would get more replies than it has

Tough to change a culture when there are so many who go out of their way to avoid work.

Change comes from the top down and that is what it will take here.

what the organization i work for needs... unfortunately its easier to just blame your employees for having a bad culture that apparently starts from the grass roots level

Sounds like there is a underlying issue with the organizations culture

Thanks mike. does anyone have experience with the mosby book?

In the topic... suggestions?

Cheers

Hey!

Anyone using propfol for combative patients and whats your experince?

Chris

Sweden.

conrad murray......

Midazo-slam is our drug oif choice. 100mcg/kg to a max of 10mg and a total of 4 doses..... generally make for a compliant patient

I think the main thrust of the post was about milliequivalents<->mmol conversion, and has already been answered in detail. I just wanted to add that the expression of solution concentrations as percentages is a little different.

A 1% solution is by definition 1g in 100ml. It has nothing to do with millequivalents or molarity / molality. So a 0.9% sodium chloride solution, is 0.9g of sodium chloride with water added to a final volume of 100 ml.

You could do the math and convert this to a molarity, in which case you have 154 mmol of Na+, and 154 mmol of chloride. But, this is particular to 0.9% NaCl. If you were to make 0.9% dextrose, for example, you'd have a different molarity.

[(9g / 100ml ) / (58.44 g/mol)] * (1000ml / 1L) * ( 1000 mmol / 1 mol) = 154 mmol/L

(Here 58.44 g/mol is the molar mass of sodium chloride. Use something with another molar mass, e.g. CaCl2, and the answer will be different).

I realised the mess up after i posted the question, but the edit function had dissappeared by then, but thanks for the heads up bro

i don't get the "tastier freedoms" comment.... you were in the military so more people could eat snacks or something?

No worries mate. It wouldn't matter if you were doing it for the hell of it. Unfortunately, all of the systems of measurement are rather arbitrary and we often run into the problem of different systems and dimensions being used. Imagine my horror when somebody stated a patient's blood sugar was 6 for the first time in front of me only to follow it after my reaction with "what, 4-8 feeling great."

Yeah. Nearly everything ive seen is in SI units, so either grams or mol/mmol, so the mEq really threw my head into a spin.I cant imagine why anyone here is using nanograms for troponin when nearly everything is done in mmol... must have got a discount on whatever machine the are using as it was one of those iSTAT type things.

This is the problem with the text books i have, nearly all uUS based so using measurements that are i am unfamiliar with, its like having to use a shity socket set when all you have is metric but your nice sidchrome gear is in imperial

So I can toss mine in the garbage when it arrives?

Well yeah, if you want... of course you could keep it yourself. Sorry kat, someone beat you to the punch.

I feel kinda bad now

I am not sure what you are asking? H2O + CO2 is not a proper reaction. For a proper reaction, you need to identify the environment (often aqueous in biochemistry), the reactants, the products and ideally, a balanced equation with proper stoichiometry would be the proper way to write said reaction.

Fundamentally, you have to change the oxidation state of an atom for an reaction to be considered a REDOX reaction. An acid-base reaction involves acids and bases, but the confusion only confounds as there are several acid-base theories. The Bronsted-Lowry, Arrhenius and Lewis are the top contenders with significant amounts of overlap and subtle differences. Additionally, some use what is called the strong acid definition.

Believe it or not im just doing this for the hell of it. 2 things lead me down this confusing path, one was getting a patients troponin level a few days ago in ng/dL, the other was doing some work on action potentials and all principle cations and anions being given in mmol except calcium which was in mEq's - and i didn't have a clue what that was.

The C02 + H20 thing was a reference to the hasselbach equation. The solution would be blood plasma and ive always know it to be a decomposition, the bicarb to carbonic and hydrogen i know is catalyzed by an carbonic anhydrase enzyme. I was just wondering if the bicarb to water / c02 was also a redox?

Youve answered my main question in you first post anyway bro, much appreicated

Brilliant, i wonder how many people read that awesomeness. For some reason i knew chbare would be the guy who chimed in

Sorry for al the questions, i can learn this stuff provided i re-write it in bush-a-nese... but if i ask this stuff at work people look at me like i have 2 heads, and seeley, stephens and tate is leaving me with more questions than answers.

I get it though, mostly

I understand the mEq/L relation to moles of electrons or hydrogen in redox and acid base

What i dont get is which ion are involved in acid / base or redox reactions. I know what an acid, base, oxidisation and reduction reaction is but i dont understand if the mEq of a substance is related to hydriogen or redox

So with the Ca++ example you gave, 1mmol of Ca++ is equal to 2mEq of Ca, but is this for 2mmol of hydrogen for 1mmol of Ca++ or 1 mmol of electrons?

Is weather a it is a redox reaction dependent on the compound being broken / formed? H20 + C02would be a redox reaction?

whethar the conversions are right... i cant ask the next bit without this being right

crazy crazy crazy topic, i know (well not really) because it all comes back to my complete incompetence when it comes to hasselbachs acid/base equation, so feel free to correct my stupidity. Also, i was transporting a patient a few days ago who had a troponin measurement done in nanograms per decilitre for some reason so i am really bloody confused

1 mol of an elements is equal to the elements atomic weight

1 mol of a compound is equal to the sum of the atomic weight of the elements in the compound

1 mmol is 1 mol/ 1000 (or 10-3 if your into it) or 1 thousandth

1 umol is 1mol / 1000000 (or 10-6) or 1 millionth

1 nmol is 1mol / 1000000000 (or 10-9) or 1 billionth

In solution it is expressed as a concentration of 1 mol of the compound per litre pf solution? so .9% saline is .9% of 1 gram (mol) of NaCl??

Hydrogen because of atomic weight of 1 (close enough) can be expressed in milligram, micrograms or nanograms

I gave up on the mEq to mmol conversion because i get lost on why the mEq doubles when its missing electrons form the valence shell and makes no sense to me becuase it looks like you double to molecular weight to overcome the lack of 2 electrons which makes no sense to me.

Phew... im tired.....

Terrificle

I have a copy hot of the press... take yourselves out for a beer and ill pay you back next time i see you all

oh gawd, can we not do this again?

:bonk: :bonk: :bonk: :bonk:

ok, my trip to the library was a bust. in order to get the article I had to either be a KU Med student or needed to be dating a doctor or a med student and I'm not pretty enough or rich enough.

My advice, find a doctor at the hospital of your choice down where you are at. Next ask them if they could check their library if they have a subscription to the Lancet. Then if they will be so kind to do a lancet search for Jennett as author and 1974 as year of publication and that will pull the article up. If the library has a subscription to the Lancet then the Library should be able to get the article printed out for you for no charge.

The librarian at the KU med center was being a bitch and was following the policy strictly. Maybe if I went to the UMKC medical school library they might be more lapse but I'm not sure if you want me to expend that much effort for this.

I will if you want. I'm in between projects and sort of out of work so it's not a big deal for me.

Let me know what you want me to do.

I even went to the link I supplied and it wont even show me the purchase article button anymore.

Hey ERDOC or Doczilla, could you maybe help Bushy out?

Youv'e done too much already, thanks for your effort bud.

I have a hard copy of the document on the way, it should be in my hands by Tuesday. I can then fax, scan, or mail it to you.

Scan would be good. I reallly appreciate your help guys

I will make a trip to the ku med center library tomorrow to see if they have a copy that far back. if so Ill make a copy and get with you to send you via email

Sent from my SPH-D710 using Tapatalk 2

Thanks man

I love this joint

thanks guys. I can find plenty of places where they want to slug you 30-50 bucks to get it but i was hoping someone may already have a legitimate "freeware" type copy, particularly given its age

Thanks to the people who PM'd me, much appreciated

Hi kids

I have exceptionally weak google fu at times and it seems this week is one of those weeks

I have been trying to find a copy of jennett and teasedle's (??spelling) article on GCS published in the lancet in 1974. If anyone has an electronic copy or a link to a full text article they could PM me i would be very grateful. I have been looking for some time without success

Thanks

What does COPD stand for?

What is asthma?

Why does chronic asthma not fit?

See i dig that, but when i get to the differences between the obstruction from emphysema and the obstruction form asthma clearly there is a difference in the physiology. Damage to alveolar septal wall / acini / parenchyma in emphysema than asthma, so to me asthma and chronic bronchitis are far more similar than asthma and the "broad" name of COPD.

Whihc brings me to the next crazy idea.... perhaps its emphysema that is the odd on out here

Thanks mate, much appreciated

HI Kids

Check it, but my question is regarding the A- of the diagram above.

Its giving me the concentration of A- in micromoles which i get, but the description of what te cations actually make up A- actually is, although it is the sum of intracellular cations that the plasma membrane is impermeable to, it doesn't tell me what they actually are. My best guess is protein monomers and phospolipids.

My texts are vague on this

Ay ideas? Surely thers a Chem guru in here??

cheers

Wow, still the same issues?

Humanity sucks

Yes you can do a make you feel good show and pat yourself on the back, BUT in the end it was a useless attempt at trying to reverse a fatal injury.

A case in point : high speed motor vehicle crash. When I arrived on scene there were folks trying to do CPR on the driver. I made everyone stop and look at the scene. The drivers brain matter was all over the house into which he had crash landed.

They felt good because they could say " We did everything possible?

In reality they abused a corpse and screwed up a crime scene.

edit to add

Injuries incompatible with life is a term that needs to be thought about..

Not all injuries with high mortality are incompaitble with life.

In this case exsanguination, PEA, cardiac tamponade or any other aetilogy you can come up with that involves penetrating thoracic trauma is not unmanagable, and not all penetrating trauma is going to skewer your ticker, or obliterate your left ventricle

Your making a lot of assumptions about underlying tissue/organ damage that you most likely can't see.

The example of your MCA and brain matter everywhere is not a real apples to apples comparison

just sayin