Recently, I went along for the first time to do voluntary work at my local hospital. This was an introductory session to tell me what I was going to be doing when I come in in the future. I was shown around the hospital (it's fairly small) and was told I would primarily be helping on the rehabilitation ward, where I will be talking to patients and helping generally on the ward e.g. meals.
During this first visit I spent half an hour talking to a patient on the ward. She had been moved from a large hospital to this smaller one and told me about how she'd found the whole experience. This gave me the valuable experience of seeing how a patient reacts to the care they are being given. Sometimes the patient can still feel lonely and wish for more - this is where volunteers can help. This is something I hope to do a lot more of in the coming months!
The matron also taught me how to take blood pressure, pulse, temperature and measure oxygen levels. Within 2 hours of arriving at the hospital I had taken these readings on a patient and was told that during busy times I may be asked by the nurses to do this. This was a very hands-on experience that I really enjoyed and hopefully will be able to do more of in the future!
I plan to go back to the hospital at least once a week and hope to do more of what I've done already!
Wednesday, 21 November 2012
BioChem Labs
Recently I had the opportunity to visit the Biochemistry labs at a large hospital nearby. I saw all the various machines used to analyse substances, such as urine and blood samples. Although most of the machinery I did not fully understand, there were some more low-tech methods that I know about from school, such as chromatography. I saw how haematologists can view individual red blood cells and from this diagnose cases such as sickle cell anaemia and how the hospital priotised blood tests on how urgent they were (generally the tests from the ICU in the hospital were more urgent than samples from nearby GP surgeries).
Perhaps the thing I found most interesting was the toxicology lab. Here they analysed urine samples from local sessions aimed to help addicts with drug dependancies. From analysing the urine it is possible to see whether it has been spiked by the patient in an attempt to significantly reduce the proportion of metabolites from drugs present. One example is how the patients would spike their sample with methadone to make the metabolites of the crack cocaine less obvious.
I found the whole experience interesting, especially as I saw an area of a hospital I had not previously experienced and saw the science that goes on behind the scenes.
Perhaps the thing I found most interesting was the toxicology lab. Here they analysed urine samples from local sessions aimed to help addicts with drug dependancies. From analysing the urine it is possible to see whether it has been spiked by the patient in an attempt to significantly reduce the proportion of metabolites from drugs present. One example is how the patients would spike their sample with methadone to make the metabolites of the crack cocaine less obvious.
I found the whole experience interesting, especially as I saw an area of a hospital I had not previously experienced and saw the science that goes on behind the scenes.
Thursday, 11 October 2012
First Aid Teaching
After spending most of the last month sorting out UCAS and my Personal Statement, I have now applied to university!
Over the last few months, I've attended a few Red Cross training sessions. We were taught CPR, bandaging, recovery position and also how to react and help in a few other situations. The point of the scheme was to eventually have us teaching younger years First Aid.
On Tuesday and today (Thursday) in our PD sessions, we taught the Year 12s basic First Aid - recovery position, CPR and bandaging. Both times, we had fairly large groups (30+!) and were in a noisy environment (with other groups in the sports hall). My team consisted of 3 of us and we had 20-25 minutes to teach our peers these 3 potentially life-saving skills. Obviously we had to be fairly quick, but also engage the audience! We planned our session and decided each of us would do a demonstration of one type of First Aid (I did CPR with breaths) to the whole group, then we would split the group into 3 smaller groups (10 or so) and get them to do it.
I found the whole experience new and exciting, if a little challenging! We had to convey a lot of important information in a very short space of time (and so used "Golden Rules" for each method of First Aid). We also had to engage the audience and compete with a noisy and distracting environment. Generally, I found our groups responded well and I felt they'd learned something. Volunteers got involved and did CPR correctly on a Little Anne. Hopefully, I'll be able to get involved in future peer mentoring schemes with the Red Cross - it's possible in the future we will teach First Aid to other years or run sessions about HIV on World AIDS Day - I look forward to getting involved in this!
In other news, I've managed to secure a placement in a Biochemistry Lab in a hospital. I'll be going there tomorrow and hope I'll learn a lot about research methods in hospitals. I'm also starting volunteering at my local hospital soon, which will involve seeing and talking to patients. I look forward to both of these exciting opportunities!
Over the last few months, I've attended a few Red Cross training sessions. We were taught CPR, bandaging, recovery position and also how to react and help in a few other situations. The point of the scheme was to eventually have us teaching younger years First Aid.
On Tuesday and today (Thursday) in our PD sessions, we taught the Year 12s basic First Aid - recovery position, CPR and bandaging. Both times, we had fairly large groups (30+!) and were in a noisy environment (with other groups in the sports hall). My team consisted of 3 of us and we had 20-25 minutes to teach our peers these 3 potentially life-saving skills. Obviously we had to be fairly quick, but also engage the audience! We planned our session and decided each of us would do a demonstration of one type of First Aid (I did CPR with breaths) to the whole group, then we would split the group into 3 smaller groups (10 or so) and get them to do it.
I found the whole experience new and exciting, if a little challenging! We had to convey a lot of important information in a very short space of time (and so used "Golden Rules" for each method of First Aid). We also had to engage the audience and compete with a noisy and distracting environment. Generally, I found our groups responded well and I felt they'd learned something. Volunteers got involved and did CPR correctly on a Little Anne. Hopefully, I'll be able to get involved in future peer mentoring schemes with the Red Cross - it's possible in the future we will teach First Aid to other years or run sessions about HIV on World AIDS Day - I look forward to getting involved in this!
In other news, I've managed to secure a placement in a Biochemistry Lab in a hospital. I'll be going there tomorrow and hope I'll learn a lot about research methods in hospitals. I'm also starting volunteering at my local hospital soon, which will involve seeing and talking to patients. I look forward to both of these exciting opportunities!
Monday, 3 September 2012
Medication
It's been a while since my last post. Since April I've had exams, gone back to school, started my new role as Head Boy, been starting UCAS applications and choosing universities and also had Biology Field Trips to Aberystwyth and the Galapagos! It's definitely been a busy Summer, so the blog was put on the backburner for a bit, but hopefully now I'll be able to make regular posts again!
I was thinking about all the various different things I could post about, and decided I'd look into the medications I have experience with and what they're used for. All of these I have used through my work with Mencap, so some are used to treat fairly similar conditions e.g. Epilepsy.
N.B. In each case, the medication I've dealt with is put with its brand name on the left and the generic name on the in italics.
Keppra - Levetiracetam
This is a medicine used to treat Epilepsy - either myoclonic, partial or generalised seizures. Levetiracetam helps control electrical activity in the brain and so helps reduce the chance of having seizures. Different doses of this medication are available and in some cases the doses increase over time.
Levetiracetam has numerous side effects, both affecting the body and mind. Some examples include eczema, vomiting, diarrhoea, mood changes and thoughts about suicide.
Imodium - Imodium
Imodium is used to treat diarrhoea. It works by slowing down the muscle movements in the gut, which increases the total time in the gut so more water is absorbed, meaning the stools are firmer and are passed less frequently.
Side effects range from common, including constipation and nausea, to uncommon and rare, which includes hypersensitivity reactions (e.g. anaphylactic shock) and coordination problems.
Phenytoin - Phenytoin
Phenytoin is used to treat a variety of different conditions, such as pain, neurotic pain and epilepsy. In my experience the medication has been used to treat epilepsy. Phenytoin is used to treat partial or generalised seizures by helping control the electrical activity in the brain, and so like Keppra helps control seizures and so is anticonvulsant. Like Keppra, the dosage of Phenytoin is gradually increased to control the condition.
Unlike the two medications above, Phenytoin does interact with alcohol and so cannot be taken with alcohol. There is a huge range of drugs that may interact with Phenytoin and so cannot be taken in conjunction, such as Vitamin D, warfarin, diazepam and doxycycline.
Phenytoin also has numerous side effects, some of which include dizziness, headaches, rashes, tremors and suicidal tendencies. Status epilepticus can also occur if this medication is stopped abruptly.
Lacosamide - Lacosamide
Lacosamide is used to treat partial epilepsy. Like most of the other medications it is available in tablet form or oral solution. Again the dosage may be increased over time. Interestingly, this medication may interact with Phenytoin and Midazolam, but can be used in conjunction if the prescriber thinks the benefits may outweigh the risks.
Again this medication has many side effects, which can include rashes, balance problems, double vision or rarely hallucinations.
Buccal Midazolam - Midazolam Hydrochloride
Midazolam can be used in a variety of ways including treating insomnia, convulsions and as a sedative. In my experience, Buccal Midazolam is used to stop convulsions in prolonged tonic clonic seizures or during status epilepticus. I've never actually had to administer Buccal Midazolam, although I am trained to. This medication interacts with grapefruit juice and so cannot be taken with this fruit juice as it increases the amount of midazolam in the blood. As midazolam should only be taken in the lowest amount to avoid dependence, this is not recommended.
Midazolam Hydrochloride can cause a range of side effects: aggression, rashes, vomiting, cardiac arrest and respiratory depression.
Rectal Diazepam - Diazepam
Diazepam is used in a variety of ways - for aggression, alcohol dependence and withdrawal, epilepsy, anxiety and more. My experience of Diazepam has been with rectal diazepam in order to stop prolonged tonic clonic seizures or status epilepticus. Again, although I have been trained to administer this drug, I have never actually had to. Alcohol and smoking, along with other drugs, such as Phenytoin, can interact with this drug, so taking these as well as Diazepam in not recommended.
Side effects of Diazepam are numerous and can include nausea, jaundice, gastrointestinal problems, tremors and even psychological problems and behavioural changes.
I was thinking about all the various different things I could post about, and decided I'd look into the medications I have experience with and what they're used for. All of these I have used through my work with Mencap, so some are used to treat fairly similar conditions e.g. Epilepsy.
N.B. In each case, the medication I've dealt with is put with its brand name on the left and the generic name on the in italics.
Keppra - Levetiracetam
This is a medicine used to treat Epilepsy - either myoclonic, partial or generalised seizures. Levetiracetam helps control electrical activity in the brain and so helps reduce the chance of having seizures. Different doses of this medication are available and in some cases the doses increase over time.
Levetiracetam has numerous side effects, both affecting the body and mind. Some examples include eczema, vomiting, diarrhoea, mood changes and thoughts about suicide.
Imodium - Imodium
Imodium is used to treat diarrhoea. It works by slowing down the muscle movements in the gut, which increases the total time in the gut so more water is absorbed, meaning the stools are firmer and are passed less frequently.
Side effects range from common, including constipation and nausea, to uncommon and rare, which includes hypersensitivity reactions (e.g. anaphylactic shock) and coordination problems.
Phenytoin - Phenytoin
Phenytoin is used to treat a variety of different conditions, such as pain, neurotic pain and epilepsy. In my experience the medication has been used to treat epilepsy. Phenytoin is used to treat partial or generalised seizures by helping control the electrical activity in the brain, and so like Keppra helps control seizures and so is anticonvulsant. Like Keppra, the dosage of Phenytoin is gradually increased to control the condition.
Unlike the two medications above, Phenytoin does interact with alcohol and so cannot be taken with alcohol. There is a huge range of drugs that may interact with Phenytoin and so cannot be taken in conjunction, such as Vitamin D, warfarin, diazepam and doxycycline.
Phenytoin also has numerous side effects, some of which include dizziness, headaches, rashes, tremors and suicidal tendencies. Status epilepticus can also occur if this medication is stopped abruptly.
Lacosamide - Lacosamide
Lacosamide is used to treat partial epilepsy. Like most of the other medications it is available in tablet form or oral solution. Again the dosage may be increased over time. Interestingly, this medication may interact with Phenytoin and Midazolam, but can be used in conjunction if the prescriber thinks the benefits may outweigh the risks.
Again this medication has many side effects, which can include rashes, balance problems, double vision or rarely hallucinations.
Buccal Midazolam - Midazolam Hydrochloride
Midazolam can be used in a variety of ways including treating insomnia, convulsions and as a sedative. In my experience, Buccal Midazolam is used to stop convulsions in prolonged tonic clonic seizures or during status epilepticus. I've never actually had to administer Buccal Midazolam, although I am trained to. This medication interacts with grapefruit juice and so cannot be taken with this fruit juice as it increases the amount of midazolam in the blood. As midazolam should only be taken in the lowest amount to avoid dependence, this is not recommended.
Midazolam Hydrochloride can cause a range of side effects: aggression, rashes, vomiting, cardiac arrest and respiratory depression.
Rectal Diazepam - Diazepam
Diazepam is used in a variety of ways - for aggression, alcohol dependence and withdrawal, epilepsy, anxiety and more. My experience of Diazepam has been with rectal diazepam in order to stop prolonged tonic clonic seizures or status epilepticus. Again, although I have been trained to administer this drug, I have never actually had to. Alcohol and smoking, along with other drugs, such as Phenytoin, can interact with this drug, so taking these as well as Diazepam in not recommended.
Side effects of Diazepam are numerous and can include nausea, jaundice, gastrointestinal problems, tremors and even psychological problems and behavioural changes.
Friday, 13 April 2012
Blood Tests and other things!
I recently had a blood test to test for any sign of infection after being bitten (thankfully there's no infection!). My GP referred me for a Full Blood Count and although I couldn't get a printout of my results, I thought it'd be interesting to find out what different types of blood test there are! So here goes:
Because of the substances in blood, blood tests can be used for a wide variety of things, such as assessing organs and checking for infections. Genetic screening for conditions, such as cystic fibrosis can be done with a blood test as well, as the blood is a source of DNA.
Full Blood Count
These are the most common type of blood test and while they cannot normally give a diagnosis on their own, they are useful in testing for certain conditions, a few of which are listed below:
These are mainly used for Diabetes to check the sugar levels of a patient. There are kits that can be used at home to check glucose levels say, before and after a meal, to ensure they are the right sort of values, so as to minimise the risk of any harm being caused due to hyper or hypoglycemia. Through my work with Mencap, I've been privileged enough to see this type of blood test multiple times. It involves taking a tiny pinprick of blood from the finger.
Gene Test
Samples of DNA can be assessed to look for gene mutations that cause conditions, such as haemophilia, where the blood doesn't clot properly and cystic fibrosis, where mucus is secreted into the lungs.
Chromosome Test
This is used when a professional suspects genetics may have caused an abnormality, but are unsure of which gene is involved. In a chromosome test, the professional can examine the chromosomes directly. By looking at the number of chromosomes (there should be 23 pairs) and their shape, it may be possible to detect the genetic abnormality causing the condition. For example, if you looked at the cells of someone with Down's Syndrome, instead of a pair of Chromosome 21s, you would find 3 (hence Trisomy 21). Chromosome testing is often used where patients (often children) have developmental problems with no apparent cause.
Genetic Screening
This is used when no symptoms are present, but is to check for the possibility of conditions, such as the screening during pregnancy for Down's Syndrome and sickle cell anaemia. Huntington's disease is a genetic disorder that often reveals itself in later life. If a family member has developed Huntington's, you may wish to find out if there's a risk of you developing the disease.
There's so much to look into in blood tests, and these are just a few. I hope to look into this further soon and maybe even into Blood Groups etc, but for now I think I'm going to call it a night! Too much revision and research is making my brain go numb!
In other news, I've recently done 1:1 caring for a client with Angelman's Syndrome. This involved me being paired with him in a club nearby. His parents drove us in the car and speaking to them and seeing the client at home showed me a new side of living with learning disabilities that I had not seen before. Speaking to his parents about the activities he likes, how he often communicates and how his condition was first diagnosed (what was initially thought of as febrile convulsions turned out to be Epilepsy and Angelman Syndrome) on his first birthday made me think about coping with conditions in a home setting, rather than just a work. It also made me think more about the cuts to the public sector, and services that many people locally use, such as Mencap.
Because of the substances in blood, blood tests can be used for a wide variety of things, such as assessing organs and checking for infections. Genetic screening for conditions, such as cystic fibrosis can be done with a blood test as well, as the blood is a source of DNA.
Full Blood Count
These are the most common type of blood test and while they cannot normally give a diagnosis on their own, they are useful in testing for certain conditions, a few of which are listed below:
- A low red blood cell count may be due to anaemia (iron deficiency)
- A high red blood cell count can indicate problems with the lung or kidney.
- A low white blood cell count can indicate problems with the bone marrow, such as leukaemia.
- A high white blood cell count can indicate some sort of infection in the body, as white blood cells are part of the immune response and so deal with infections.
These are mainly used for Diabetes to check the sugar levels of a patient. There are kits that can be used at home to check glucose levels say, before and after a meal, to ensure they are the right sort of values, so as to minimise the risk of any harm being caused due to hyper or hypoglycemia. Through my work with Mencap, I've been privileged enough to see this type of blood test multiple times. It involves taking a tiny pinprick of blood from the finger.
Gene Test
Samples of DNA can be assessed to look for gene mutations that cause conditions, such as haemophilia, where the blood doesn't clot properly and cystic fibrosis, where mucus is secreted into the lungs.
Chromosome Test
This is used when a professional suspects genetics may have caused an abnormality, but are unsure of which gene is involved. In a chromosome test, the professional can examine the chromosomes directly. By looking at the number of chromosomes (there should be 23 pairs) and their shape, it may be possible to detect the genetic abnormality causing the condition. For example, if you looked at the cells of someone with Down's Syndrome, instead of a pair of Chromosome 21s, you would find 3 (hence Trisomy 21). Chromosome testing is often used where patients (often children) have developmental problems with no apparent cause.
Genetic Screening
This is used when no symptoms are present, but is to check for the possibility of conditions, such as the screening during pregnancy for Down's Syndrome and sickle cell anaemia. Huntington's disease is a genetic disorder that often reveals itself in later life. If a family member has developed Huntington's, you may wish to find out if there's a risk of you developing the disease.
There's so much to look into in blood tests, and these are just a few. I hope to look into this further soon and maybe even into Blood Groups etc, but for now I think I'm going to call it a night! Too much revision and research is making my brain go numb!
In other news, I've recently done 1:1 caring for a client with Angelman's Syndrome. This involved me being paired with him in a club nearby. His parents drove us in the car and speaking to them and seeing the client at home showed me a new side of living with learning disabilities that I had not seen before. Speaking to his parents about the activities he likes, how he often communicates and how his condition was first diagnosed (what was initially thought of as febrile convulsions turned out to be Epilepsy and Angelman Syndrome) on his first birthday made me think about coping with conditions in a home setting, rather than just a work. It also made me think more about the cuts to the public sector, and services that many people locally use, such as Mencap.
Thursday, 29 March 2012
Epilepsy
I was in another training session for First Aid (with the Red Cross) today and we were discussing causes of unconsciousness and talked about Epilepsy. After a friend suggested to me and as I've had a fair bit of experience dealing with Epilepsy, I decided it would be my next post! As there's so much to say about Epilepsy, I'll focus on my experiences with epilepsy, but will provide basic information about other types.
Epilepsy is a complicated condition - once again one not fully understood. Sometimes damage to the brain is detected and this is believed to cause the seizures (or "fits"). This is Symptomatic epilepsy and an example would include a lady who had become epileptic after suffering head trauma (a patient who's consultation I sat in on while on Work Experience). However in other cases, epilepsy occurs with other conditions, such as learning disabilities (all my other experience dealing with epilepsy comes under this category). The learning disability hints there is some sort of brain damage, however no brain damage can be found. This is Cryptogenic epilepsy. In many cases, no obvious cause for the seizures can be found - that is, no brain damage. Seizures occur when neurones in the brain are disrupted, which causes the electrical impulses to cause the seizures.
There are many types of epilepsy. These are divided up into Partial and Generalised Seizures. The type of seizure depends on how much of the brain is affected. In Generalised Seizures, most or all of the brain is affected and, not surprisingly, in Partial seizures, only part of the brain is affected.
Partial Seizures
Partial seizures can be simple or complex. In simple partial seizures, the person will be conscious throughout the duration of the seizure, and so will remember it. In complex seizures, the person is unconscious for the seizure and can display unusual behaviours.
Generalised Seizures
There are 6 types of Generalised Seizures: Absences, Clonic, Atonic, Tonic Clonic, Myoclonic and Tonic. My experiences so far have involved Absences and Tonic Clonic seizures - so I'll focus on these in a minute. In Myoclonic jerks, the person experiences twitches as if being electrocuted. When these jerks persist and the person usually becomes unconscious, then they are experiencing a Clonic seizure. In a Tonic seizure, your muscles suddenly contract, which can cause you to fall over. In an Atonic seizure, the muscles relax, causing the person to fall to the ground.
Absences are very common and are seizures I have witnessed multiple times! During an absence, the person loses consciousness and appears to be daydreaming (which is why a lot of the time these seizures are missed). During a seizure, the person will not respond and will stare into space. Clients I work with who experience absences don't respond to name or any sort of visual stimulus (e.g. waving a hand in front of their eyes), have dilation of the pupils, cyanosis of the lips and can drop their head into their chest and blink rapidly. These seizures have also appeared to cause sudden changes in behaviours and the mood of the client, however do not always. When an absence occurs, the general approach is to quietly call their name until they come back round, especially as they can be disorientated after an absence.
Tonic Clonic seizures are what most people commonly associate with an "epileptic fit" and it is the most common type of seizure in people with epilepsy. Contractions and twitches cause the person to fall to the floor and jerk. This can involve banging their head, biting (it has been known for a person to bite their tongue very hard during a tonic clonic) and jerking their arms and legs. These normally last for up to 5 minutes, but vary depending on the person. In my experiences, they have lasted between 1 and 4 minutes. After a Tonic Clonic seizure, the person is normally fairly tired and will lay down for 10-45 minutes to recover. During a seizure, it is important to remove as many hazards as possible (without putting yourself in danger). Examples of this may include moving furniture to avoid the person causing injury to themselves or removing any objects that could cause injury. If possible, some people also put a soft object, such as a pillow, underneath the person experiencing the seizure's head in an attempt to prevent damage from repeatedly banging their head of the floor. Common drugs to be administered for Tonic Clonic include Diazepam (either rectally or through injection) and Buccal Midazolam (squirted onto the inside of the cheeks in the mouth). Thankfully, I've never had to administer either of these so far!
Status Epilepticus is where the person remains unconscious from a seizure for more than half an hour. This can be a single seizure or multiple (clusters). Medication is normally administered when this occurs or and ambulance is called as there is a risk of brain damage from a prolonged seizure.
While there is no cure for epilepsy, some people do seem to "grow out" of this condition. Most people learn to cope with it and the effects on their lives vary. For example, depending on your last seizure, you may or may not be eligible for a driving licence. AEDs (Anti-Epileptic Drugs) are prescribed to try to lessen the frequency of seizures.
There are multiple triggers, many of which are more common than the stereotypical "flashing lights" (photosensitive epilepsy), such as stress, blood sugar levels, dehydration and lack of sleep.
Epilepsy is a complicated condition - once again one not fully understood. Sometimes damage to the brain is detected and this is believed to cause the seizures (or "fits"). This is Symptomatic epilepsy and an example would include a lady who had become epileptic after suffering head trauma (a patient who's consultation I sat in on while on Work Experience). However in other cases, epilepsy occurs with other conditions, such as learning disabilities (all my other experience dealing with epilepsy comes under this category). The learning disability hints there is some sort of brain damage, however no brain damage can be found. This is Cryptogenic epilepsy. In many cases, no obvious cause for the seizures can be found - that is, no brain damage. Seizures occur when neurones in the brain are disrupted, which causes the electrical impulses to cause the seizures.
There are many types of epilepsy. These are divided up into Partial and Generalised Seizures. The type of seizure depends on how much of the brain is affected. In Generalised Seizures, most or all of the brain is affected and, not surprisingly, in Partial seizures, only part of the brain is affected.
Partial Seizures
Partial seizures can be simple or complex. In simple partial seizures, the person will be conscious throughout the duration of the seizure, and so will remember it. In complex seizures, the person is unconscious for the seizure and can display unusual behaviours.
Generalised Seizures
There are 6 types of Generalised Seizures: Absences, Clonic, Atonic, Tonic Clonic, Myoclonic and Tonic. My experiences so far have involved Absences and Tonic Clonic seizures - so I'll focus on these in a minute. In Myoclonic jerks, the person experiences twitches as if being electrocuted. When these jerks persist and the person usually becomes unconscious, then they are experiencing a Clonic seizure. In a Tonic seizure, your muscles suddenly contract, which can cause you to fall over. In an Atonic seizure, the muscles relax, causing the person to fall to the ground.
Absences are very common and are seizures I have witnessed multiple times! During an absence, the person loses consciousness and appears to be daydreaming (which is why a lot of the time these seizures are missed). During a seizure, the person will not respond and will stare into space. Clients I work with who experience absences don't respond to name or any sort of visual stimulus (e.g. waving a hand in front of their eyes), have dilation of the pupils, cyanosis of the lips and can drop their head into their chest and blink rapidly. These seizures have also appeared to cause sudden changes in behaviours and the mood of the client, however do not always. When an absence occurs, the general approach is to quietly call their name until they come back round, especially as they can be disorientated after an absence.
Tonic Clonic seizures are what most people commonly associate with an "epileptic fit" and it is the most common type of seizure in people with epilepsy. Contractions and twitches cause the person to fall to the floor and jerk. This can involve banging their head, biting (it has been known for a person to bite their tongue very hard during a tonic clonic) and jerking their arms and legs. These normally last for up to 5 minutes, but vary depending on the person. In my experiences, they have lasted between 1 and 4 minutes. After a Tonic Clonic seizure, the person is normally fairly tired and will lay down for 10-45 minutes to recover. During a seizure, it is important to remove as many hazards as possible (without putting yourself in danger). Examples of this may include moving furniture to avoid the person causing injury to themselves or removing any objects that could cause injury. If possible, some people also put a soft object, such as a pillow, underneath the person experiencing the seizure's head in an attempt to prevent damage from repeatedly banging their head of the floor. Common drugs to be administered for Tonic Clonic include Diazepam (either rectally or through injection) and Buccal Midazolam (squirted onto the inside of the cheeks in the mouth). Thankfully, I've never had to administer either of these so far!
Status Epilepticus is where the person remains unconscious from a seizure for more than half an hour. This can be a single seizure or multiple (clusters). Medication is normally administered when this occurs or and ambulance is called as there is a risk of brain damage from a prolonged seizure.
While there is no cure for epilepsy, some people do seem to "grow out" of this condition. Most people learn to cope with it and the effects on their lives vary. For example, depending on your last seizure, you may or may not be eligible for a driving licence. AEDs (Anti-Epileptic Drugs) are prescribed to try to lessen the frequency of seizures.
There are multiple triggers, many of which are more common than the stereotypical "flashing lights" (photosensitive epilepsy), such as stress, blood sugar levels, dehydration and lack of sleep.
Tuesday, 13 March 2012
Co-amoxiclav + other things!
This week I had an incident at work where a client showed extremely challenging behaviour and ended up biting me badly on my shoulder. I went to the minor injuries and was prescribed anti-biotics for a week to help prevent any infections. Since I hadn't heard of "Co-amoxiclav", I decided to look it up and see what I could find:
It's an anti-biotic in the Pencillin group and is used to treat many infections, including infections in the abdomen, kidneys, urinary tract, sinuses and more. It is a combination of Amoxicillin Trihydrate and Potassium Clavulinate. Like many anti-biotics, it works by interfering with the cell walls of bacteria, and causes holes to appear in the bacteria, causing them to die because they can't control the substances moving in and out of the cell (such as the cytoplasm). Like most medicines, there are side effects of Co-amoxiclav, such as diarrhoea, vomiting, dizziness and jaundice. Thankfully I haven't experienced any of these, but they can occur after finishing the course of anti-biotics!
Another thing that interested me this week was in Biology, where my teacher ended up getting side-tracked onto talking about high tension pneumothorax. This can be caused by several things, but he focused on small punctures of the lung, rather than the other types that can happen in the elderly and smokers or due to large punctures, such as a broken rib, stab wound or gunshot wound. His example was how some people's lungs can have a pinprick puncture when taking off in an aeroplane, due to the changes in pressure (where the volume of air increases/decreases depending on whether you're ascending or descending). This tiny puncture means that air from inspiration can enter the pleural space (chest), but is stopped from getting back into the lung. Essentially, the space outside the lungs fills up with air and can cause difficulties for breathing and circulation. My teacher also said how the windpipe is forced to the other side of the body by the air. It can become life-threatening and needs intervention immediately. This is done by essentially letting out the air from the pleural space with a valve-like mechanism.
I've also started reading another book called "Bad Science" by Ben Goldacre. It's really interesting so far and exposes all the fakes and frauds in big pharmaceutical companies and really emphasises how we can be made to believe anything through statistics.
It's an anti-biotic in the Pencillin group and is used to treat many infections, including infections in the abdomen, kidneys, urinary tract, sinuses and more. It is a combination of Amoxicillin Trihydrate and Potassium Clavulinate. Like many anti-biotics, it works by interfering with the cell walls of bacteria, and causes holes to appear in the bacteria, causing them to die because they can't control the substances moving in and out of the cell (such as the cytoplasm). Like most medicines, there are side effects of Co-amoxiclav, such as diarrhoea, vomiting, dizziness and jaundice. Thankfully I haven't experienced any of these, but they can occur after finishing the course of anti-biotics!
Another thing that interested me this week was in Biology, where my teacher ended up getting side-tracked onto talking about high tension pneumothorax. This can be caused by several things, but he focused on small punctures of the lung, rather than the other types that can happen in the elderly and smokers or due to large punctures, such as a broken rib, stab wound or gunshot wound. His example was how some people's lungs can have a pinprick puncture when taking off in an aeroplane, due to the changes in pressure (where the volume of air increases/decreases depending on whether you're ascending or descending). This tiny puncture means that air from inspiration can enter the pleural space (chest), but is stopped from getting back into the lung. Essentially, the space outside the lungs fills up with air and can cause difficulties for breathing and circulation. My teacher also said how the windpipe is forced to the other side of the body by the air. It can become life-threatening and needs intervention immediately. This is done by essentially letting out the air from the pleural space with a valve-like mechanism.
I've also started reading another book called "Bad Science" by Ben Goldacre. It's really interesting so far and exposes all the fakes and frauds in big pharmaceutical companies and really emphasises how we can be made to believe anything through statistics.
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