Archive for October 28th, 2004

I thought the dead woman was hit with a much bigger projectile, so I didn’t look into this:
CodeBlueBlog: CSI MEDBLOGS: HOW DID BOSOX FAN DIE?

…The reason trauma to the globe does not cause death can be derived from standard evolutionary principles. Surely if this mechanism (direct blow to the globe) were fatal, our eyes would have developed behind calcium cages; however, the solution evolution worked out was to create a relatively closed-pressure chamber (the retro orbital space) with thin walls so that any backward-directed force on the globe would “blow out”? one of the thin surrounding walls rather than direct the force posteriorly to the central cerebral structures. So by teleological reasoning, the woman shot in the eye with an exploding pepper ball should not have died.

That’s the real news story here.

I agree, and I’ll bet the City of Boston regrets taking full responsibility for this death so quickly (that’s why I noticed and then dismissed this, the rapidity of the Municipal mea culpa).

I have yet to see someone hit with anything short of a bullet in the eye who expired. This can be because: a) they died before they were sent to the ED (doubtful, but cannot be completely dismissed), b) I haven’t seen everything (possible), or, c) it doesn’t happen (most probable). Elsewhere in my blog I have x-rays and CT’s of a person with a nail through their eye that was non-fatal. I don’t for a minute believe that a paintball striking the eye can cause death. I understand the kinetics are different, but having now thought about it, I don’t for a minute think that this Police projectile caused this death.

My request/demand to the City of Boston: Let’s see the autopsy results, and answer the question. Then this either rests, and I eat my words, or we know Something Else Happened. Given that this is the death of a civilian at the hands of the Police, this is a reasonable and rational request.

Interesting question, and many thanks to CodeBlueBlog for pointing it out. Let’s all hope there’s a public answer.

via Blogborygmi

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Well, brought on by this, that’s my inferred conclusion from this:

Conclusions: Interns made substantially more serious medical errors when they worked frequent shifts of 24 hours or more than when they worked shorter shifts. Eliminating extended work shifts and reducing the number of hours interns work per week can reduce serious medical errors in the intensive care unit.

and backed up by this:

Conclusions: Eliminating interns’ extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.

OK, so maybe it doesn’t say they should emulate ED docs, exactly, but it makes sense to me. I wouldn’t want an ED doc who’s been up for 36 hours making my TPA decisions, and ED docs, though thought to be not too bright by the rest of the medical staff, are smart enough not to work themselves to death and to avoid the hospital whenever posiible (this excludes the sub-genus meetinglover, who lives at the hospital anyway).

Funny, I watched my dad work shifts throughout my adolesence, and said to myself “I’m going to be a professional, so I don’t have to work shifts”. And then I went into Emergency Medicine. Shifts Until Retirement.

via Kevin, MD

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