#now i need to cover the one hospital(?) scene from the manga vol 5 because it actually wrote a cardiac emergency accurately!

[raposarealm]

A break from the disastrous Kimochi, because I feel like crap! And what better way to distract myself from feeling sick than to talk about a sick boy!

Not the Yuyoyuppe album, this but this specific scene from Axess I’ve meant to rag on for a while now, from Episode 50.

(A read more for minor spoilers, I guess. And also because this got hella long.)

You might remember this as being right after the final fight versus Dark Blues, and also after the stupidest stunt the egghead pulls all season, which lands him in the hospital. 

First off, I’m going to bitch about this shot for a second:

(Credit to @panningexe​ for these shots, by the way, because I physically cannot bring myself to rewatch Axess.)

(This would be a good time to add in a disclaimer: I’m not a nurse or other medical professional, I’m a pharmacy technician who still doesn’t have her license in this state because I’ve been too busy to take the PTCB test. I did some preliminary research for the stuff beyond the pharmaceutical aspect, but most of that was just ‘stuff I learned from my mother who was an RN 20 years ago’. Take the finer details with a grain of salt, and please correct me where I’m wrong.)

Series never get medical things right, but, shockingly, that IV line is correctly set up. Taping down the extra line isn’t usually done from what I’ve seen, but it’s not wrong. Tangled lines are more of a danger, as long as the taped lines there are still loose enough to not impede the flow rate. But. You want me to believe this is a patient in critical condition, in a hospital in a large city, in the future, and all you have to regulate flow rate is a roller clamp?

But Rapo! you say, clamps can be used along with other regulators! Yes, but, lemme direct you to this other shot from the same scene:

It’s harder to see here, but: there really is just that one roller clamp and the drip chamber built into the line (which doesn’t really regulate drip rate well on its own.) Yeah, those work just fine, but they’re harder to use, and are therefore more prone to human error. Hospitals are already phasing them out, like, in real life. 

There’re two LVP bags (Large Volume Parenteral bags, large amounts of sterile fluid used usually for regulating essential bodily functions,) on the stand there. If I remember the episode correctly, Enzan was out of commission for multiple days following his dumb stunt, but I don’t remember how long he was unconscious. 

Quick rundown of some common LVPs for context: Normal Saline contains sodium chloride (usually 0.9%, but treatment of severe dehydration and NPO/’Nothing By Mouth’ patients often receive 0.45% instead,) is used on nearly everyone who’s admitted to the hospital, since it’s used to help with dehydration, and especially on critical patients and those with blood loss (and is sometimes co-administered with blood products.) Also containing sodium chloride with other compounds are Ringer’s Solution and Hartmann’s Solution (also called Ringer’s Lactate.) Both contain other electrolytes (calcium chloride and potassium chloride are pretty standard, for instance,) but Ringer’s Solution contains sodium bicarbonate in place of sodium lactate (hence “lactated” Ringer’s.) When high sodium is a risk, such as with renal impairment or some chronic conditions, or when a patient’s body is especially acidic, such as suffered with sepsis, then Ringer’s or Hartmann’s may be used in place of saline. (Source because it’s long.) Lastly, Dextrose 50% in water, usually abbreviated to D5W, can be used when the body is malnourished. Note that these might have to be switched around depending on the SVPs (’Small Volume Parenteral,’ or just normal medicine that’s injected or otherwise administered parenterally) given, e.g. nitroglycerin and norepinephrine, medicines used in cardiac emergencies, can’t be used with Hartmann’s. 

Side note over. Anyways, there’s only two bags present on the stand there, and the line’s only attached to one. Sometimes LVPs can be used to keep an IV line open while no medicine is being administered, but. This is, again, an unconscious, critical patient. From the first picture, we can see bandages on both Enzan’s hand and head, which I’ll guess are probably burns from the forced Fusion attempt (he was holding the PET and smacked into Blues head-on.) Burns are one of the worst things to treat, as they’re excruciating for the patient. Plus, there’s a chance that said head-on impact could’ve cause some head injuries. Why isn’t he on pain medication? A conscious patient can take medication orally, but that’s kinda hard to do when someone’s out cold. Burns carry significant risk of infection, too, and IV anti-infectives are often injected into the LVP bag directly, or ‘piggy-backed’ onto the IV line, which requires them to be placed on the stand higher than the LVP so that gravity pulls the piggyback medicine into the main line. I don’t see a connector on that line, but I suppose the medicines could have been injected directly. However, due to the manufacturing of that type of bag, there’d be a stopper on it to keep sterility, which maybe it’s there, but I don’t see it.

Also, can we take a look at the rest of the room? WHY ARE THE MONITORS OFF?!!? The only time you shut those things off are when you take someone off life support. That’s why hospital halls are filled with those annoying ‘bing’s -- those monitors have to be there. You never know when someone who looks stable suddenly become tachycardic. You never know when someone’s IV line fell out and now they’re not getting the medicine they need. You get the point. Not only are those monitors not connected to Enzan there, they’re not even on! For God’s sake, the closest he has to a monitor right there are Anetta and Netto standing next to him! 

As side not that I don’t know how to work into the rant, I’d say I’m surprised he’s not on oxygen, not even the nasal cannula you’d see in every soap opera episode that takes place in a hospital. I had one of those in for a sleep study, for God’s sake. But, since this is a medical device that I wasn’t actually taught about because my class sucked, I’ve now been informed that cannulas aren’t used unless the patient shows explicit difficulty breathing, but doesn’t require intubation (endotracheal tube, AKA tube down the throat,) or mechanical ventilation (partial or complete respirator.)

It’s nearly 1am and I’m done ranting, but TL;DR, if I lived Akihara, I’d have sued this hospital by now.

[recentanimenews]

Bookshelf Briefs 7/30/18

Dead Dead Demon’s Dededede Destruction, Vol. 2 | By Inio Asano | Viz Media – If the sight of Oran’s drooling face on the cover of this volume doesn’t inform you that this is one of those weird manga titles, nothing will. That said, for a manga about aliens infiltrating the Earth, and the Earth’s rather violent response to this, there’s a lot that’s grounded in reality here. The gang’s friend Kiho is dating a guy, which puts her on the outs with the rest of her (single) friends, and also causes friction when her boyfriend turns out to be a bit fond of conspiracy theories. Possibly my favorite scene in the volume is when the girls all go to their friend Ai’s house and met her four identical siblings… and one goth guy who calls himself the Black Knight, which meets Oran’s immediate approval. A lot of fun. – Sean Gaffney

Laid-Back Camp, Vol. 3 | By Afro | Yen Press – We’re still working on the characterization of anyone not named Nadeshiko or Rin, but for the most part the third volume will please readers who enjoyed the first two, as it combines chatter about camping with the camping itself—though honestly, Rin’s driving to get to the camp ends up occupying most of the time. Sadly, a trip with Nadeshiko is turned into a solo trip because she gets a cold, but on the bright side we may finally be luring Rin’s eccentric friend Ena to go along on the next trip. The long-term plotline seems to be to get Rin to be interested in camping with other people… but it’s certainly a long term project, as we’re three volumes in and we haven’t seen a group effort yet. Next time? – Sean Gaffney

My Boy, Vol. 2 | By Hitomi Takano | Vertical Comics – As with the previous volume, I recommend skipping the afterword. If you do, then My Boy continues to be a touching story of a young woman who’s got a newfound family in a young neglected boy. The problem here is that Mashuu already HAS a father and brother, and her hanging around with him all the time is inevitably going to be seen as creepy at best. One scene, where Mashuu can’t contact his brother, has Satoko going into his home and the entire scene has you holding your breath waiting for something horrible to happen. It still, may, in fact, especially now that her coworker is noticing the attention she’s giving Mashuu. I don’t like him. The manga is very good, though, and so far is avoiding obvious pitfalls. – Sean Gaffney

Sacrificial Princess and the King of Beasts, Vol. 2 | By Yu Tomofuji | Yen Press – We return to the adventures of the most earnest sacrificial princess ever. Last time I mentioned that I felt the author might have grown up reading Fruits Basket, and that feeling hasn’t gone away—Sariphi isn’t quite as shiny as Tohru, but she still tends to try to overdo it in order to avoid disappointing anyone. In this case, though, it almost leads to her death. Fortunately, she’s gaining more allies in this book, as we meet her friend Amit, an alligator woman with a big heart, and the phoenix she summons, which is both adorable and hilarious—he needs to be animated so that I can hear his accent. Shoujo fans will enjoy this cute fantasy romance. – Sean Gaffney

School of Horns, Vol. 1 | By Mito Aoi | Yen Press – We’ve seen an endless amount of magical academies in the last few years, but there’s always room for more. This one has students divided up based on the horns they have on their heads—each type determines the magic. Our hero is half-human, so his horns are smaller than the other students (does this remind you of anything?), but in addition his powers seem to mess with others, meaning he’s a strange fifth type of magic user. Yes, it’s the old “bullied kid ends up being the really special one” story, but the main reason to read this is the slowly developing relationship between Eru and Rihito, who are sort of Deku and Todoroki-esque. This didn’t reach out and grab me, but it’s certainly pleasant enough. – Sean Gaffney

Shojo FIGHT!, Vol. 4 | By Yoko Nihonbashi | Kodansha Comics (digital only) – The fallout from the Kokuyodani team’s participation in volleybetting is going to be long-lasting, it seems. Part of their punishment involves living at the school for a month and undergoing intense training (including fasting, which supposedly “cures any illness”) and practice games against teams that believe the worst rumors. After one of these, Neri has a major attack of the angst and runs off, but after a good talk (and more!) with Shigeru, she seems finally on the verge of overcoming her past trauma, and actually tells Inugami and Odagiri what happened with her old teammates and lets herself enjoy volleyball again. And now that she seems to be on the road to better mental health, there’s enough time to give several other characters a bit more fleshing out in this volume, which is very welcome. I really enjoy this series. – Michelle Smith

Takane & Hana, Vol. 4 | By Yuki Shiwasu | Viz Media – There’s a lot less snarking in this book, but maybe I’m getting used to the fact that this is never going to match the hilarity of its start. What it does do is develop both the plot and characters—Hana is not quite ready to admit she has romantic feelings for Takane, but she’s getting there. Meanwhile there’s a new secretary at Takane’s business whose job it is to try to break them up—unfortunately, he’s a nice guy at heart, and his heart isn’t really into this, especially when Hana does not back down immediately. And lest you forget that Hana is in high school (and believe me, that is the premise), there’s a culture festival! Maids! Butlers! Cross-dressing! And Takane, being a giant ass. Which is what I’m here for. – Sean Gaffney

Toriko, Vol. 43 | By Mitsutoshi Shimabukuro | Viz Media – Toriko has finished, and it goes out the same way it’s always been—the food love is so much more interesting than the fighting. The first half of the book wraps up the fighting, including even giving the hapless Zongeh a part to play, but honestly I was ready to skip to the back half, where Toriko and his friends indulge in his Full-Course Meal, all prepared by Komatsu and HIS friends. There is also Toriko and Rin’s wedding, but again, I wonder if that was suggested by editorial fiat to avoid having the series seem too gay—the manga is all about the relationship between Toriko and Komatsu, and everything else is secondary. In the final pages, they even go off on a sort of honeymoon together. In space. – Sean Gaffney

Wake Up, Sleeping Beauty, Vol. 5 | By Megumi Morino | Kodansha Comics – Having whisked Shizu away from the hospital, Tetsu heads for his grandfather’s place by the beach, whereupon many revelations ensue. There’s a lot here that I didn’t expect to learn until the next (and final) volume, including the truth of what happened to Tetsu’s mom and why he’s been so desperate to earn money. What’s even better is that not only do readers learn these things, but so do Tetsu’s father and sisters, and everyone resolves to work harder as a family so that no one member feels the need to sacrifice everything for the sake of the others. There is one thing they don’t know, though, and it was such a great surprise that it makes me want to reread earlier volumes for hints. I’ll miss this series once it’s gone, but I bet the conclusion will be great. – Michelle Smith

Yuuna and the Haunted Hot Springs, Vol. 3 | By Tadahiro Miura | Seven Seas – This continues to be a title that you should only read if you are a teenage boy in search of something to get you horny. That said, I’m not that market at all, and I’m still reading it. I think it’s simply that compared to other series in this genre, I find it more tolerable—especially its lead, who continues to not be the standard Keitaro clone who plagues this sort of title. In fact, most of the girls spend more time fondling each other than they do the lead—and no, that doesn’t mean there’s any hints of yuri. These girls all want Kogarashi. But as with my last review, I will admit that Yuuna is a good series for those who want harmless comedic fun and like huge breasts. – Sean Gaffney

By: Michelle Smith