#respiratory rate monitoring

[artisticdivasworld]

Breathing Easy: A Comprehensive Guide to Helping Patients with COPD

Living with chronic obstructive pulmonary disease (COPD) can be challenging and overwhelming for both patients and their loved ones. COPD is a progressive lung disease that affects millions of people worldwide and can significantly impact their quality of life. However, there are various strategies and treatments available to help patients manage their symptoms and breathe easier. In this…

[17yearcicada]

today's random memory that's haunting me: book i read in middle school where a girl initiated a sexual situation by asking the guy to guess what color her bra was. i don't remember the name of the book so i will never get closure on that scene i don't think

[reasonsforhope]

"A team of researchers at Washington University in St. Louis has developed a real-time air monitor that can detect any of the SARS-CoV-2 virus variants that are present in a room in about 5 minutes.

The proof-of-concept device was created by researchers from the McKelvey School of Engineering and the School of Medicine at Washington University...

The results are contained in a July 10 publication in Nature Communications that provides details about how the technology works.

The device holds promise as a breakthrough that - when commercially available - could be used in hospitals and health care facilities, schools, congregate living quarters, and other public places to help detect not only the SARS-CoV-2 virus, but other respiratory virus aerosol such as influenza and respiratory syncytial virus (RSV) as well.

“There is nothing at the moment that tells us how safe a room is,” Cirrito said, in the university’s news release. “If you are in a room with 100 people, you don’t want to find out five days later whether you could be sick or not. The idea with this device is that you can know essentially in real time, or every 5 minutes, if there is a live virus in the air.”

How It Works

The team combined expertise in biosensing with knowhow in designing instruments that measure the toxicity of air. The resulting device is an air sampler that operates based on what’s called “wet cyclone technology.” Air is sucked into the sampler at very high speeds and is then mixed centrifugally with a fluid containing a nanobody that recognizes the spike protein from the SARS-CoV-2 virus. That fluid, which lines the walls of the sampler, creates a surface vortex that traps the virus aerosols. The wet cyclone sampler has a pump that collects the fluid and sends it to the biosensor for detection of the virus using electrochemistry.

The success of the instrument is linked to the extremely high velocity it generates - the monitor has a flow rate of about 1,000 liters per minute - allowing it to sample a much larger volume of air over a 5-minute collection period than what is possible with currently available commercial samplers. It’s also compact - about one foot wide and 10 inches tall - and lights up when a virus is detected, alerting users to increase airflow or circulation in the room.

Testing the Monitor

To test the monitor, the team placed it in the apartments of two Covid-positive patients. The real-time air samples from the bedrooms were then compared with air samples collected from a virus-free control room. The device detected the RNA of the virus in the air samples from the bedrooms but did not detect any in the control air samples.

In laboratory experiments that aerosolized SARS-CoV-2 into a room-sized chamber, the wet cyclone and biosensor were able to detect varying levels of airborne virus concentrations after only a few minutes of sampling, according to the study.

“We are starting with SARS-CoV-2, but there are plans to also measure influenza, RSV, rhinovirus and other top pathogens that routinely infect people,” Cirrito said. “In a hospital setting, the monitor could be used to measure for staph or strep, which cause all kinds of complications for patients. This could really have a major impact on people’s health.”

The Washington University team is now working to commercialize the air quality monitor."

-via Forbes, July 11, 2023

-

Holy shit. I know it's still early in the technology and more testing will inevitably be needed but holy shit.

Literally, if it bears out, this could revolutionize medicine. And maybe let immunocompromised people fucking go places again

Also, for those who don't know, Nature Communications is a very prestigious scientific journal that focuses on Pretty Big Deal research. Their review process is incredibly rigorous. This is an absolutely HUGE credibility boost to this research and prototype

[darlingdarkly]

New Year, New You Part 5

Johnny “Soap” MacTavish x f!reader

Personal Trainer AU

4.5k words

CW: dubcon!, dark fic, dark content, obsessive behavior, dirty talk, explicit language, E rated, NSFW, smut, 18+, mature themes

Part 1, 4, 6

Johnny realizes he’s obsessed, that’s what makes him different. An insane, deranged person doesn’t know what they’re doing, doesn’t actually see the boundaries they’re crossing. Completely oblivious to the downward spiral they’re on, but Johnny can see it, he knows he’s losing the battle with himself.

It’s that damn Fitbit. It was an impulse buy, he saw it, saw the opportunities it created and jumped on it. It didn’t matter the price, money was no object, he’d buy you five more in five different colors if that’s what you’d like. It was the dilemma it created for him that did him in. It gave him 24/7 access to you, unrestricted, unsupervised looks into your life at any given time that he just couldn’t get any other way.

He checked in on you constantly, almost ridiculously often, sometimes he couldn’t stand five minutes between opening the app. He’d scroll aimlessly through his social media only to switch back to it. He tried putting his phone in his locker while he worked out but just after warm ups he’d cave and go retrieve it.

It was the closest thing he could get to shrinking himself down and climbing up on your shoulder, a fly in every room you’ve ever entered. It only provided him the most basic of information, your vitals, heartbeat and respiratory levels, your stress levels and location, but it was enough, just to know you were breathing halfway across town put him at ease.

He wished he’d altered it before he gifted it to you, plant a bug in it so he could hear you all the time, just the sound of your voice would be enough to make the hours between sessions pass by faster, make them more bearable. But he’d been in such a hurry to give it to you, to see your reaction, be more in tune with you that he’d passed up on it, it just simply would take too long.

He contemplated sneaking into your apartment in the night, using the cover of darkness to infiltrate your home, sneaking back into your room and planting it then, he’d even have the opportunity to watch you sleep, but there was always the risk of waking you up and while you hadn’t called the police the first time you’d discovered he’d been in your house that might become a different story if he did it in the dead of night, while you were actually home.

He’d been in your house, many, many times. Typically between your commute to work and your break for lunch when it was most unlikely for you to come home for anything, plus he always had the app to tell him if you doubled back for something, like last time. He’d hidden in your shower as he listened to you unlock the door, come back to your bedroom and grab whatever it was you’d forgotten.

He waited for you to turn off your street and continue on to your job before he came out, lying down and stretching out on the expanse of your sheets as he watched you make it to work safely. This became a routine for him, a guilty pleasure he found himself indulging in more and more often.

At first he resisted, he really tried not to but then he found himself on your block, and then in front of your place and then inside. Like clockwork it’d become a part of his routine, he’d wake up, monitor you through the app as you woke up. He’d text you good morning, always leaving you baffled on how he knew precisely when you were awake every single time without fail. You’d do your morning routine and leave for work, then he’d head over. He’d always catch sight of you turning off the street as he came up the other end, timing it just right so he could watch you turn the corner.

He’d been in all your drawers, raiding through your panties and thoroughly examining your vibrator. He’d been through your bathroom, looking through all your soaps, shampoos and creams. He’d been through your closet, looking at all your clothes and imagining you in all of them, like a little doll he was playing dress up with.

He was very careful to put things back just as they were, so his intrusion would continue to go unnoticed and he could continue his secret excursions into your home. He just wanted to know you as completely as he could, to be a better trainer to you, to know those things that maybe you’re too shy to tell him.

If that made him a bad person then so be it. He could live with that if it meant being able to perform above and beyond for you. It was these circumstances, these chain of events that led up to him seeing you walking through the gym with Jason that perhaps pushed things into motion, this extreme sense of closeness that made his emotions take the wheel and his anger blind his better judgment, a catalyst in this chemical equation that had blown things out of proportion.

He was particularly hard on you that day, trying to push you a little farther than you’d been performing and it had left you tired and sore. You had just finished the cardio portion of your session, coming off the treadmill and lacing your fingers together behind your head, trying to catch your breath.

Johnny took down your time and used the app to capture your vitals and stats while you recovered. “Did good lass, makin’ steady progress.” When he looked up from his phone you were rubbing soothing circles into your lower back with a pained grimace on your pretty face. “What’s wrong, hen?”

You shook your head and tried to downplay it but he wasn’t fooled so easily and he pestered you about it until you caved and told him. “I’m just a little sore is all.” He hovered around you, pulling on each arm and massaging each of your legs, insisting on a thorough check for any injuries.

You begrudgingly let him, but insisted you were fine and just needed a little rest, but his mind was already filling up with ideas. He could take you home, draw you a nice hot bath, of course he’d have to climb in with you and wash you, he wouldn’t want you to strain yourself, get you all nice and soaped up, really work those muscles of yours and give them some relief, then maybe you both could find a little release in each other.

He was drawn from his plans by an ear piercingly loud squeal from behind him. It made the hairs on the back of his neck stand at attention and dread seep deep into his bones. He knew that squeal. “Johnneeeeeee!!!” He turned in time to receive the full push of her ample breasts in his face as she jumped up and onto him, he caught her but only because she’d caught him off guard, he would have been more than happy to let her drop straight to the floor.

He pried her off in time to stop her lips from reaching his face, where they were headed for a peppering of excited kisses. The woman in his arms was an old client of his. She was well off, extremely bubbly and the epitome of annoying. She also happened to be madly in love with him and to top it all off she was the gym owner's daughter, which in turn made him unable to ever be rid of her so long as he worked here.

You stare at the scene before you, a bit bewildered and his eyes snap to yours, swimming with an emotion you can’t quite identify, it’s when the conversation starts you realize it was actually a mix of shock and panic.

“I’m back! Are you happy to see me? I missed you! Did you miss me?” A rapid series of questions she doesn’t even wait to hear a response for before she’s firing out another. He starts to speak when she speaks over him. “Who’s this?” And the look on her face is of a toddler who’s been given a present only to open the box and not like what he sees, unfiltered, completely crystal clear disgust.

He physically moves away from her to draw you closer, tucking you under his arm possessively. “This is mah new client.” You give her a warm smile and introduce yourself, though it’s clear she neither cares enough to remember it nor introduce herself.

She ignores you completely and looks back to Johnny. “I came because I’ve been cleared and we can start back our sessions.” He rocks back on his heels and his mouth twists into an unsure grimace. “The doctor was very clear Olivia, you need time to heal.”

She walked up to him and pokes a manicured finger into his toned chest, response dripping with confidence. “Actually mister, I got cleared for regular exercise yesterday, so long as we don’t play too hard.” She turns to you with a sly smile, like she’s going to impart some great secret that you were just dying to hear. “This one tends to get a little handsy with his teachings.” She winks and you just stare at her blankly as Johnny shifts foot to foot impatiently the whole time, clearly uncomfortable.

The first chance to get a word in edgewise he starts to speak. “Olivia, can I talk to you privately?” She beams with enthusiasm. “Already trying to get me alone, I see. Let’s go.” Johnny turns to you with serious eyes. “Dinnae go anywhere, I’ll be right back.” And then he’s gone, his shadow a fit blonde in a tight pink tracksuit.

You stand by yourself a moment before your feet begin to protest and you pick up your gym bag and find a little bench out of the way to sit down and rest.

You sat patiently for ten minutes, but ten turned into twenty and twenty turned into thirty and you felt yourself actually drifting off as you sat in the busy gym and waited for Johnny’s return. Your legs were tired and you still had to walk home. You were rubbing at your screaming calves when a shadow was cast over you.

You looked up to see a man, a very strong, handsome man standing over you. Where Johnny was uniquely attractive, defined features and jutting imperfections coming together to create an unconventionally attractive image this man was the opposite. You’d seen him a hundred times in every mildly attractive man you’d ever passed on the street.

He was handsome, yes. His perfect white teeth, tanned skin and trimmed hair said so and you started to wonder if maybe they all went to the same dentist and tanning salon as some kind of job requirement. But he was also easily forgettable, the kind of face that would make you blush in passing if your eyes locked but one that you couldn’t quite recall later on in memory.

He introduced himself as Jason and said he worked at the gym as a massage therapist. You do remember vaguely reading in the pamphlet that they had massage therapists on staff but you had just assumed that meant by appointment or something. You should have known better though because you’d originally assumed the personal trainers worked the same way and Johnny had certainly not made an appointment to train with you.

“I can see you’re a little sore, am I correct?” You gave him a polite smile and tried to give him the same run around you’d given Johnny but it seemed you just lost your knack for being a convincing liar somewhere along the way because he didn’t take your word on it either.

“I can help you out with that if you’d like.” And before you can even give a reply he’d reached out and grabbed your leg, lifting it and began pressing into the meat of your sore calves with his thumbs and it was like magic, you instantly melted into his grasp and he smiled as he hooked you and began to reel you in.

“Oh yeah, so much tension in these calves, no wonder you’re in pain.” And then he stopped and the magic was gone and you took a deep breath, holding in the urge to frown.

He gently set your leg down and sat down next to you, close enough for you to smell his spicy aftershave and feel the warmth of his minty breath as he spoke. “Let me take you back to the table. Five minutes that’s all I’m asking and you’ll feel good as new. I promise.” You think about it, you were supposed to wait for Johnny but he really was taking forever and you really were a bit sore. “Come on, it’ll be quick.”

So you get up and follow him, chasing the glorious sensations of his magic hands on your aching muscles. Johnny watches from across the gym, his hands have turned into fists and his brow is furrowed. He watches you follow after Jason and disappear into the massage rooms and he can feel his cool begin to slip.

You follow him to a set of rooms, he picks one, knocks once on the door and enters. Following him inside you see a scarcely furnished room. Two tables are the only furnishings to speak of. One, off to the side has towels, bottles of water and a radio covering the surface. The one in the middle of the room is padded and looks comfy.

He instructs you to undress and lie down on the table but you refuse, not quite comfortable enough with the situation as it is, you still feel in the pit of your stomach like you’re doing something wrong. He tells you that the clothes will mitigate the massage and just get in the way and then leaves, leaving no room for argument. You pull your sweats down your legs but opt to keep your panties on.

You lie down on the table and cover yourself with the towel he’d provided, grumbling at the minute size of it as it came to rest just below the swell of your ass. You lay there feeling uncomfortable in your own skin and wonder how long he’ll give you before he comes back but you don't have to wait very long.

You hear the click of the door open, a slight pause and then you hear it shut, by the sound of the footsteps on the carpet you knew someone had entered but they’d yet to announce themselves and it made you a bit uneasy. Jason had been chatty enough before but now he’d fallen silent.

There was a pregnant moment of silence and you were right on the verge of speaking up when you felt hands on you, warm, strong. They began at your calf, smooth firm passes that had you holding your breath. It really did feel just divine, you had no idea how much tension had built up, all that running and exercising had made your new muscles sore and taut. You sighed as they moved down your leg and eventually down to your feet.

You tried hard to keep quiet but the way he was rubbing your feet let little moans escape your lips, quiet timid sounds but sounds nonetheless. The silence was peaceful but held an uneasy quality you still couldn’t shake. The warm hands left your feet and you all but whined at the loss of contact. You felt them once more on your lower thighs, grabbing handfuls of your flesh and kneading them carefully.

They rose higher and higher to a point you thought increasingly inappropriate. You found yourself suddenly thinking about Johnny as crazy as that was, it didn't make it untrue. You felt like maybe you were crossing some kind of line, you weren’t together but you weren’t not together either. Did casual sex make you off limits to other people? It was a boundary you as of yet hadn’t discussed because honestly your whole relationship was mostly undiscussed. He’d picked you seemingly at random and decided you were his new client, no questions, exchanges or substitutions.

But it wasn’t like you were fucking Jason, he was just helping you with your sore muscles, he’s a massage therapist, it’s literally his job. You thought about what he’d said to you last. “Dinnae go anywhere, I’ll be right back.” But he’d taken so long and Jason seemed so nice, he really just wanted to help, he could tell you were uncomfortable.

The roaming hands ghosted over the swell of your ass and skirted right up against your panties. You began to rise from the table and say something when a familiar voice broke the silence and a hand pushed you back down onto the table with force. “What did I say, bonnie?”

“Johnny! I-“ You tried once more to rise from the table but a stubborn hand pushed you back down again. His voice came again, harsher this time, almost angry. “What did I say?” You felt a lump in your throat but swallowed it down, now seemed like the time for answers, not silence. “Don’t go anywhere.”

“Aye, so ye can listen?” You lifted your head off the rest and turned it to the side, feeling a flush of shame under his heated gaze. “Johnny, wait I can explain.” You halfway hoped he’d cut you off and save you the trouble of trying to explain yourself but to your surprise he just waited to hear what you had to say.

He continued to massage you through your schpiel and it was making it hard to articulate what had happened in a way that didn’t make you sound in the wrong and pathetic all wrapped in one. You finished with Jason coaxing you into the massage room and sat unmoving but pliant under his working fingers. He hummed and seemed to consider your story for a moment and you felt it eating as your nerves in every second of silence he made you endure.

“We need tae have a talk, hen.” He flipped you over and pulled you down the table with a harsh yank and you made a surprised little yelp at the sudden movement. Now your ass was on the edge, legs dangling over the side as he slotted himself between your thighs. You stared up into his blue orbs silently, trying to read him but you couldn’t get a feel for anything other than an uneasy calmness that could potentially mean anything.

He sinks to his knees in front of you, and as his lips come level with your pussy you automatically shift to close your legs, you weren’t exactly comfortable with him nose and eye level with your sex at the moment, you didn’t feel fresh and clean after the strenuous workout he’d put you through. He tuts and slaps your thigh, it stings and you cry out as he pries them open again. “Can strip fer Jason but cannae keep yer legs open fer me.”

You gawk for a moment and start to speak but the look he gives you from between your legs demands silence. It is impossible for you to be any wetter, not a dry patch to speak of on the gusset of your cotton panties. It doesn’t help that he’s speaking directly to your soaked slit, the heat of his breath against it making gooseflesh erupt over your skin. “I leave the room fer twenty minutes and ye run off with the first man ye see.” You get a bit offended at this and try to protest which earns you another slap, this one right over your pussy, his fingers landing firmly on your clit, making you yelp and you finally decide it’s in your best interest to shut up for the moment.

“When ye became mah client ye became mine.” He reached up and settled a hand on your thigh, rubbing circles with his thumb into the soft skin, lovingly and gentle, a stark contrast from his previous slaps. “Every inch of ye is like my portfolio, the accumulation of my work and ye were gonna jus’ let him touch ye. Rub his greedy fuckin’ mits all over ye.”

You wanted to say something, express the discomfort that had plagued you, the guilt you’d felt following after him but then he leaned forward and licked up your clothed slit with the flat of his tongue and any sensible thought you may have had evaporated. He reached your clit and sucked hard, making your mouth drop open and a choked cry of his name fall from your lips, you cringe expecting more penance for the outcry but he seems to not mind your little outburst and only pulls away to keep talking.

“This body I’ve worked and toned and pushed is mine, I’m yer trainer and I’m the only one who gets tae touch ye.” You feel his hand leave your thigh and then the pads of his fingers find your clit and begin to rub it, slow firm circles that make your toes curl and his mouth latches over your hole, sucking your juices directly from the source through the fabric of your panties. Your hand finds purchase in the locks of his hair as you buck into the euphoria of his hot mouth.

The room is filled with moans, loudest of all his, vocal to the extreme as he frenches your slit with what can only be described as perfervid avarice. You feel your climax mounting and he must know because he slows down, granting you just the lightest touches over the top of your clit as he licks and sucks at pussy from over your panties like a ravenous dog.

You beg him for more, plead with him for that extra bit to push you over the edge, that last bit of friction you so desperately need but he seems not to even hear you, mumbling incoherently into your pussy while he ignores you completely.

But he must have heard you because he finally addresses you, his voice thick with lust. “So wet, lass. Is it fer me or was it fer him?” He pulled his mouth away from you and the absence of his touch was nothing short of agonizing, you could feel your release slipping from your grasp. “You Johnny! Please! I’m sorry! You were gone for so long with her and left me all by my-“

He pulled his fingers away from your clit, leaving you with nothing and you let out a frustrated huff as he looked up at you, his mouth glistening in the soft light of the room as his lips turned up in a smirk. “Lass, were you tryin’ tae make me jealous because you were jealous of Olivia?” Your brows furrowed in confusion. “What? No I-“

He stopped you with a hearty laugh and you scowled as you found your quickly fading release far from funny. “Why did ye nae just say that, hen? All this fuss jus’ cause ye thought ye’d have tae share me, aye?” You start to correct him but then his mouth falls over your clit and his fingers push as far into your pussy as the fabric will allow and you find you don’t give a fuck what he believes so long as he doesn’t stop.

He builds you back up in earnest, driving you steadily towards release and your moans are now a constant stream of sound flowing from your lips. His head is buried between your thighs as his fingers ravage your clit relentlessly. You’re right on the edge of your climax, so close to falling apart.

“Johnny! I’m close!” He pulls back, fingers slowing their maddening pace. “I need tae hear ye say it, hen. Tell me who ye belong tae.” He leans up and suckles gently at your clit, tongue sliding over it in lazy passes as you try to clear your fuzzy head. “You Johnny! I belong to you! Please! Please let me come!”

He hums into your soaked panties, pushing vibrations against your clit as his fingers probe as deep as the fabric will allow but it must not be enough for him because he peels them away from your body and pushes them to the side, groaning as he slowly pushes two thick fingers into your pussy, raking them in and out as his tongue snakes out and finds your bare clit, circling it with the tip of his tongue.

It’s all it takes to throw you into a hard orgasm, thighs clenching around his head as you ride out the bliss, hands white knuckling the table. He kept kneeled between your thighs, lapping up every drop of your arousal that leaked out and dragging you towards a second release. “Johnny stop! I can’t take it anymore!” You tried pushing his head away futilely, but he wouldn’t budge, drunk on you and determined to stay.

After a few more protests as he stuck his tongue all the way inside you before pulling out and lapping up the entirety of your poor abused slit he finally abated and pulled back, relenting. Your legs shook as he stood and helped you redress and you only got them to a wobble on the walk to the door.

He talked as you walked, all about the progress you’d made and the few refinements he had planned to make to your regimen but as you rounded the corner to the desk Olivia spotted the pair of you and ran up, interrupting him with a new barrage of questions and chatter. He answered her questions as simply as possible and kept trying to redirect the conversation back to you but she kept chiming in, clearly frustrated but not about to give up so easily.

You reached the desk and he turned away from her and addressed you directly. “Dinnae worry about yer homework, I know yer sore and I want ye rested and well fer our session tomorrow.” He leaned forward and whispered in your ear. “Dinnae worry about her either, I’m as much yours as ye are mine.” He bit your earlobe and tugged on it, earning a shiver from you and a scowl from Olivia.

He turned away from you and walked back towards a fuming Olivia. You came up to the kiosk and signed out when a brand new screen popped up where the “See you tomorrow!” screen normally prompted. It was a mini survey on your Baliquinox experience and a little notice at the end. Your two week free trial was up.

You looked back towards the main body of the gym where Johnny had just been but he was gone and with nothing else to do, you turned and exited the building, starting your walk home.

[oneshotnewbie]

If you come back soon could I pretty please request an Amelia (greys) one shot where the reader is her girlfriend and is brought to the ER in critical condition as Jane Doe but as soon as Amelia sees her she’s hysterical and all she wants to is reasure and hold the readers hand! YOU WOULD MAKE MY QUARANTINE SO MUCH BETTER I LOVE YOUR WORKS SM

Authors note: So... um... I know I waited so long to post this request but... I HAVE MISSED IT IN MY INBOX FOR SO LONG AND WHEN I FOUND IT TWO DAYS AGO, I WROTE IT IMMEDIATELY! I am so sorry. I hope you're still out there somewhere recognizing your request and reading it ♥

ᕚ---ᕘ

The hustle and bustle of the emergency room echoed through the cold hallways as the double doors were pushed apart to make way for the ambulance crew and their critical patient. The vehicle's red and blue lights cast flickering shadows on the walls, while the howling sound of the approaching accident conveyed to hospital staff the urgency of the situation.

The paramedics, with serious faces and rustling uniforms, wheeled the gurney into the emergency room. An unknown woman lay on the stretcher, pale and motionless, only the shallow rise and fall of her chest showed any life. A white sheet covered her completely, and her blood-stained hair stuck damply to her forehead. The slow, monotonous beep of the portable monitor accompanied every breath.

Dr. Hunt, the emergency physician in charge, immediately rushed to the bed. His expression was professional, but the depth of his gaze betrayed some concern. The nurses and also Dr. Keppner rushed to help the team take over.

"What do we have?" Owen asked as he looked over the medical file one of the paramedics handed him. "Unknown female person, middle-aged, found unconscious in a park, presumably after an attack. Stabbed in the chest and abdomen. We cannot say any more. No identification and no indication of possible previous illnesses."

The paramedics quickly explained the course of events, how they found the patient and what first aid measures they had taken. The information was relayed with the precision of a well-trained team, but uncertainty about who the woman was and what had happened to her hung in the air.

While Hunt and Keppner began checking vital signs, the unknown woman was wheeled into an examination room. The nurses exchanged hand signals and quietly instructed each other on the next steps. The background noise is a chaotic orchestra of clanging instruments, murmuring conversations and the beeping of medical equipment.

April Keppner leaned over the patient and began a thorough examination. She checked the pupillary reaction, palpated the pulse and analyzed the respiratory rate. The monitors showed unstable readings and the two doctors' facial expressions hardened. A quick look between the two revealed that they were worried.

"We need a CT scan immediately," Owen said, turning to the nurses present. "I also want blood samples for a comprehensive analysis. Let the lab know it's urgent."

While preparations for further examinations were underway, the nurses and doctors tried to keep the unknown woman stable. An intravenous line was placed and fluids began flowing through her derm. The monitors continued to show jittery signals and the tension in the room increased.

"Call Dr. Shephard and Dr. Altmann. I want them here as quickly as possible!" He ordered as he continued to analyze the data on the screen. "And someone should inform the police. We have to find out who she is and what happened in order to prevent further damage."

The exam room was now in a coordinated state of emergency and in a room that was normally a place of rescue, the medical team battled uncertainty and a race against time to save a woman's life. He was abuzz as the neurosurgeon and cardiologist burst through the door almost simultaneously with quick steps. Their eyes were focused, the rubber of their Crocs squeaking in unison with the machines.

"Shephard, the patient is exhibiting unstable neurological signs. The CT scan and blood results are pending," she informed Hunt as he cleared the way for her to the bed.

Amelia nodded curtly and fully entered the room, closing the door behind her. A glance at the monitor and the papers on the tablet caused her eyes to flash briefly before she focused back on the patient. However, as she leaned over the lounger, she froze.

Her features slipped away, the slight smile on her lips fading as she realized who was in front of her. The woman on the lounger was none other than you. Hunt and Keppner stared at her as she noticed her reaction, not understanding why she didn't move forward with her work. "Amelia, we have a critical situation here. The patient's identity is unknown and her values are concerning. We urgently need your expertise!"

Amelia shook her head slightly, as if she could push reality away. Her heart raced as she double-checked that her eyes weren't playing tricks on her. "This is y/n. Y/n y/l/n. She's my girlfriend. Find her family, get them here!" A strangled sound escaped her throat and the world around her seemed to stand still for a moment as she processed the shock.

The emotional rollercoaster went through all the ups and downs, from worrying about you to the overwhelming need to stay in control. Her hands shook slightly as she reached for your lifeless and bloody hand.

"Y/n," Amelia whispered with a strangled sound in her voice and the two doctors and friends of the neurosurgeon were also dumbfounded, their breath catching in their throats. "What happened to you?"

Owen Hunt moved closer and tried to reassure her, while also conveying the urgency and explaining the neurological details. But Amelia only heard fragments. Her gaze was lost in your eyes, which were closed as if you were in a deep sleep.

"Amelia, I know it's hard. But we have to act immediately. The CT results are crucial and we have to find out what happened to her to prevent something worse. She could die!" April urged, concerned about her colleague's professionalism.

But Amelia couldn't let go. She ignored the two of them, her focus solely on you. The world outside the exam room seemed to fade as she held your hand tightly. "Y/n, you have to hold on. You can do this," she whispered in your ear, tears of despair welling up in her eyes. "You're strong, you know? We'll get through this together."

In her emotional despair, an internal struggle unfolded within Amelia. Her professional self fought against her personal connection to you. The shouts of other doctors and nurses became a muffled background noise as she refused to loosen her grip on your cold hand.

"Amelia," Owen Hunt spoke in a calm but firm voice. "We need you now. She needs you now. Let's find out what happened to her together.

A conflict between duty and personal pain raged within Amelia. Finally, she reluctantly gave in and removed her hand from yours. However, her gaze remained focused on you, and concern for you was reflected deep in her eyes. She struggled with fear for you as she prepared to resume her professional role as a neurosurgeon.

A deep breath flowed through her body and with a firm resolve she wiped the tears from her cheeks and turned her gaze to the surroundings. "Dr. Hunt, take her to the CT immediately. She's probably having a brain bleed." she spoke, her voice firm. The neurosurgical focus returned fully, analyzing the medical indicators.

The trauma surgeon nodded in agreement and began giving the necessary instructions, getting you up to the CT scanner. Amelia stayed at your side, letting go of your hand for a moment to oversee the diagnostic process.

The minutes that passed felt like hours. The results of the CT scan appeared on the screen, and Amelia scanned the images with a trained eye. She analyzed each region of the brain, looking for signs of bleeding, injury or other abnormalities. The intensity of her concentration was palpable, and the medical staff eagerly awaited her assessment.

"We have severe damage to the frontal lobe," Amelia explained, swallowing hard as she continued to study the images. "It looks like a severe traumatic brain injury. We need to operate immediately to relieve the pressure and prevent further damage."

The team immediately began preparing for the operation. The sterile atmosphere of the operating room seemed to embrace Amelia as her professional role took over. In her surgical uniform, surrounded by a team of experienced professionals, she struck her familiar Superman pose and focused on the procedure ahead.

During the operation, which lasted several hours, your girlfriend showed an impressive mix of calm and precision. Her hands worked in sync with the instruments as she gently treated the damaged tissue. Monitors in the operating room recorded progress, and the medical team closely followed their experienced leader's every move.

After what seemed like endless hours, but which passed like seconds, she finally closed the last stitches and the atmosphere relaxed slightly, but the uncertainty about the outcome of the operation weighed heavily on her.

Amelia let out a frustrated gasp before exiting the operating room, tearing off her gloves and hood. She immediately went to the waiting area to inform your siblings and parents. The tension in her chest eased as she saw the expectant looks of the people who were now her family and your sister immediately threw her arms around her.

"The operation is complete," Amelia began, trying to keep her voice steady as she also clung to your sister to keep her emotions at bay. "It was a complex brain injury for reasons still unknown, but I did everything I could. The next step now is to wait and hope she remains stable."

Your family breathed a sigh of relief as Amelia explained more details about the condition and cooperation with the police. Her words were reassuring to your sister, but she still felt the knot in her stomach. The outcome of the operation was uncertain, and there was no way of knowing whether you would ever wake up and be your old self again.

In the silence of the hospital hallway, as she left the waiting people behind, a moment of exhaustion overcame her. Her eyes wandered back to the exam room where she found you in. The image of you on the lounger didn't fade, but Amelia found comfort in the fact that she had saved you. Now things could only go uphill and she couldn't wait to look into your beautiful eyes again.

[shion-yu]

A Safe Place (part 3) [day 18]

A feverish Cliff is seen in the emergency room. For @monthofsick Day 18 “Unfamiliar surroundings”. 2,965 words, original work, TWs emeto, hospital content.

Part 1 | Part 2 - I swear this was supposed to be 2 parts but now it’s gonna be 4? Lol whoops.

Elliot supported Cliff into the busy ER. It was a Saturday, of course there were a lot of people there, Elliot thought regretfully. Silly to hope otherwise. Elliot eased Cliff into a seat as close to the reception desk as possible and then checked Cliff in, presenting Cliff’s ID and health insurance card. He was grateful Cliff’s wallet and phone were the two things his boyfriend had actually brought with him when he left his parents’ house, although a jacket and his inhaler would have been useful third and fourth choices.

“What’s this visit for?” The receptionist asked after scanning the cards and handing them back to Elliot.

“My boyfriend is having trouble breathing,” Elliot said, hoping this concerned her as much as it concerned him. “He has asthma, he’s wheezing, and he has a high fever. He didn’t know who I was earlier.”

The receptionist stood up a little to catch a glimpse of Cliff in his seat, who did look like he was struggling. “Okay, we’ll get him triaged as soon as possible,” the receptionist said. Elliot chose to believe her for his own sanity’s sake. “In the meantime, have him wear a mask.”

Cliff sagged against Elliot when Elliot sat next to him. He was in no shape to do paperwork, so Elliot tried to fill it out as much as he could. Fifteen minutes passed. Cliff was whimpering in pain and his wheeze had grown louder. “Just a few more minutes, Cliffy,” Elliot said, hoping it wasn’t a lie. Thirty minutes passed. Cliff was now insisting he was fine after all, and that they ought to go home. But that was when he was lucid, which would last only a minute before he’d follow up by saying something that made very little sense and reminded Elliot exactly why they couldn’t leave. Finally, about forty minutes after they’d checked in, a nurse called Cliff’s name and brought them to a small room between the waiting room and the actual ER. Elliot repeated the story he’d given the receptionist although more aggressively this time as the nurse nodded and took Cliff’s vitals.

Elliot never wanted Cliff to be so sick. However, his vitals did prompt some action and for that Elliot was grateful. Cliff’s fever was 103.5 now, his oxygen running lower than expected at 92%, and his heart rate and blood pressure were both high. The nurse led them to a stretcher in a curtained off bay and told Cliff to change into a gown. Elliot had to help Cliff climb up, his boyfriend’s coordination poor. His hands were shaking too hard to button his own gown up, so Elliot did it for him.

“Don’t feel good,” Cliff mumbled, swaying even as he sat up on the stretcher.

“I know, just lie back,” Elliot said. “They’re gonna help you.”

Thankfully, this time they only waited about ten minutes before a new nurse came in with a small bucket full of supplies. She introduced herself as Anna and said she was going to insert an IV, take some blood, and hook Cliff up to oxygen and fluids. She was also going to swab Cliff for flu and strep, but Elliot explained the urgent care had already done that. “Well, this tests for some other stuff too, it’s a full respiratory panel. I’d recommend we just do it anyways.” Elliot agreed on Cliff’s behalf; Cliff seemed to be communicating only in nods at this point.

Nurse Anna looped some oxygen tubing over Cliff’s ears first and plugged it into the wall. She also attached a blood pressure cuff and oxygen probe that she said would stay on for now for monitoring. Elliot felt like all the devices only made Cliff look sicker. Anna swabbed Cliff’s nose, which made him cough harshly to the point of gagging, and then got ready to insert an IV.

Cliff looked to Elliot in panic, swallowing rapidly. ‘Faint,’ he mouthed to Elliot helplessly. “Um, I think he passes out when there’s needles,” Elliot spoke up for him. Cliff nodded gratefully.

“Well you’re in the right place if you do,” Nurse Anna said. She lowered the head of the stretcher and told Elliot to hold Cliff’s hand as she looked for a vein in his other arm. “I’ll go super quick,” she reassured them, and she was right. It was quick. But Cliff turned sheet white and got really sweaty and by the time she’d collected enough tubes of blood, flushed and secured the hub and hooked him up to a bag of fluids, Cliff was barely conscious. “Don’t worry, it happens,” she said. She put a pillow under Cliff’s legs and told him to breathe deeply through his nose. Elliot found her calm demeanor the only thing keeping him calm, because it seemed terrifying even if it was normal. Cliff followed her directions and eventually gained some color back. Anna said his blood pressure was coming back up and that he should just lie there with his feet up for a few more minutes, then left the room.

“I’m sorry,” Cliff apologized miserably for the tenth time since they’d come back here.

“Baby, please, stop apologizing,” Elliot told him. “You’re here because you have to be and you’re not doing anything bad or wrong. Just rest.”

Cliff’s eyes filled with tears and he covered them with his forearm. “I suck,” he whimpered, Elliot’s words clearly not having reached him as intended. Elliot sighed and put one hand on Cliff’s head to stroke his sweaty hair. It wasn’t worth fighting Cliff on this right now. Elliot just had to be there for him.

Cliff fell asleep to Elliot’s relief. Elliot texted his mom what was going on and hoped this wasn’t as bad as it felt. Cliff snored quietly until a woman came with a huge portable x-ray machine. “Sorry to wake you up,” she said, “Cliff? I’m here to get your x-ray. I’ll go fast.”

Cliff opened his eyes and stared blankly at her. Elliot wasn’t sure if Cliff knew what was going on at this point so he stroked Cliff’s arms and explained, “Cliff? She’s gonna take the pictures of your lungs now.” He helped the x-ray tech manipulate Cliff’s torso so that he was lying on a hard board. Elliot stood in the doorway while they did the films.

“Alright, take a nice deep breath for me and hold it,” the x-ray tech said. “I know, good job, got it. You can cough.” And cough Cliff did, that same desperate wet cough that had made Elliot’s mind up to bring him here. He managed to catch his breath, but it wasn’t over. “One more,” the tech said, moving the boards and machine around to point at Cliff’s side now. “Again. Deep breath. One, two, and good. Let it out.”

This time Cliff didn’t seem able to stop coughing. He coughed until each gasp sounded like a Herculean struggle and Elliot wasn’t sure that any of that air he was gulping in was actually reaching his lungs. The machine that was measuring Cliff’s oxygen levels started to beep and the tech told Elliot she was going to find the nurse. Elliot held on to Cliff and tried to soothe him, but it didn’t seem to work. Cliff just kept coughing until suddenly his eyes flew open and he spewed a sharp wave of vomit from his mouth all the way to the end of the stretcher. Elliot winced, pulling back and trying not to look at the mess. Cliff spluttered and coughed between additional harsh gags that produced little besides a stream of thick brown saliva that pooled in his lap. Elliot prayed the nurse would come in soon and hesitantly rubbed Cliff’s back. He didn’t know what to do and Cliff seemed frozen, unable to lift his head or close his mouth.

Thankfully the nurse showed up then and said, “Oh no!” Oh no was right, Elliot thought anxiously. “Did we just get coughing too hard?” She glanced at Cliff's oxygen levels and turned a small green dial on the wall, which made a quiet hissing noise for a second as the flow of oxygen increased. “Don’t worry hun, we’re going to get you cleaned up.” She found a change of sheets in one of the cupboards behind the stretcher and changed the blankets and top sheet in record time. She checked Cliff’s fluids which were nearly done and then charted standing in the room for a few minutes on her rolling computer.

Cliff was silent, hunched over holding a pink plastic basin in his lap in case of another incident, and Elliot couldn’t tell if he was just out of it or humiliated. The room still smelled of putrid stomach acid; Elliot breathed through his mouth. His phone dinged in his pocket and he saw an alarmed text from his mother. He didn’t have time to reply though, as the doctor walked in at that moment.

“Doctor Jim,” Anna greeted him politely, scooting her computer farther away from the bedside. “He just threw up coughing and I turned up his oxygen.”

“I’m not surprised,” Dr. Jim said. He looked to be in about his forties, was mostly bald and had tiny round glasses that looked too small for his face. “Cliff? I’m Jim, I’m a physician here. How are you doing today?”

Elliot thought that was a stupid question. Cliff looked at Dr. Jim with hazy eyes and mumbled, “Sick.”

“Well, that makes sense. You’ve got yourself a nasty case of double pneumonia,” Dr. Jim said. Elliot’s heart sank. “Has this ever happened to you before?”

Cliff shook his head no. He moved his hand to the edge of the bed that Elliot understood as a silent signal to hold it, which he did. “Well, I think it’s best if we admit you for observation overnight with the vitals you have. I’m going to order two IV antibiotics and some steroids, try and get that swelling down in your lungs and hopefully you’ll be feeling better in no time. How’s that sound?”

Cliff didn’t answer. “That sounds fine,” Elliot said, squeezing Cliff’s hand. “Can I stay with him?”

“Once we move him to the floor, visiting hours are eight to eight,” Dr. Jim said. “But you can stay with him for as long as he’s in the ER.” He turned to Anna and gave a few other orders for Zofran, Tylenol, albuterol and budesonide treatments. It all seemed so casual to them, but Elliot was still disturbed by how sick Cliff looked and seemed to him.

Dr. Jim physically examined Cliff next. Cliff shuddered and Dr. Jim apologized for his cold hands, but Elliot knew that the temperature hadn’t had anything to do with it. He hummed a lot, wrote down some notes, and then left with a “Hope you feel better soon.” Elliot wondered if he told all his patients that, or just the ones who could actually get better soon. Nurse Anna also excused herself to get the ordered medications, leaving Elliot alone with Cliff once again.

“So… pneumonia. That sounds pretty bad,” Elliot said. “Why didn’t you tell me you felt so sick?”

“You were at work. I didn’t want to bother you,” Cliff said in a tiny voice. “And then I tried to text you but none of the letters in my phone made sense.”

Elliot felt his chest clench painfully hearing that. “Cliff, you wouldn’t have bothered me.”

“But I’m bothering you now,” Cliff whimpered.

Elliot frowned. “I didn’t say that.” Silence from Cliff. Elliot sighed and grasped Cliff’s hand in his own. “Cliff, Cliffy, can you look at me?” It took a second, but fever-bright, hazel eyes eventually focused on Elliot. “You’re my boyfriend. I want you to be okay. Can you at least try to trust me?”

“I do trust you,” Cliff whispered, voice hurt.

“Then let me care about you.”

Cliff fell quiet again and Elliot sat back but kept Cliff’s hand in his. Cliff had his eyes closed, but it didn’t do much to hide the tears that escaped from the corners of them. Elliot didn’t say anything, just brushed them off of Cliff’s cheeks with his sleeve. Once Cliff was asleep, Elliot finally allowed his own silent tears to fall.

Eventually a CNA came to bring Cliff down to the short-stay unit. She rolled Cliff’s stretcher down the hall and into an elevator. Cliff looked nervous and kept glancing at Elliot, making sure he was still right next to him. Elliot always was. They got to a small room that had a real hospital bed in it and the CNA and Elliot both helped Cliff take two steps from the stretcher onto the bed. It was painful for Elliot to see how difficult even this brief transfer was for Cliff, and Cliff started another one of his long coughing spasms afterwards. Elliot rubbed Cliff’s arm, unsure what else he could possibly do to help. “Water,” Cliff croaked hoarsely between deep, rattling coughs.

“Sure. Um…” Elliot looked around him but this room was barely more than an ER bay. It didn’t even have windows. “Let me go check,” he said, and went to go look for the nurse’s station. There were two tired and rather bored looking, middle aged women sitting at computers at the end of the hall. “Excuse me? My boyfriend just got here and he could use some water…”

“I’m almost there,” one of the nurses said, which Elliot thought was a weird thing to say when she very much wasn’t almost there. Regardless, they didn’t seem to like him hovering very much so Elliot went back to Cliff’s room. There was nowhere for him to sit, so he stood at the bedside. Cliff had managed to stop coughing at least.

The nurse, despite her indifferent demeanor, did show up with a little bin that contained hospital socks, meds and a large plastic jug of water. “Clifford Barrows, hmm? I’m Carey. And you are…?” She raised an eyebrow at Elliot.

Suddenly feeling extra protective, Elliot quickly said, “His boyfriend.”

“Alright. Mr. Barrows, are you okay to have Elliot in here?”

Cliff nodded a yes. Elliot thought it was so weird to hear Cliff called by his last name. They seemed too young for that.

“Well, your boyfriend will have to leave after I finish this admission paperwork as visiting hours are over soon, but remind me to get you a chair for tomorrow,” Carey said. She started a myriad of questions, which included Cliff’s emergency contact.

“Make it Elliot,” Cliff said quickly, looking at him. “Um, will my dad know I’m here?”

“You’re eighteen, right? Not unless you tell him,” Carey said. “But I see your dad is the primary insurance holder so he may see the invoice after you’re discharged. It shouldn’t show any details though.”

Cliff grimaced but nodded. At least there would be no confrontation in the actual hospital, Elliot thought to himself. Carey kept asking questions, which ranged from did Cliff smoke to could he walk up a flight of stairs to did he have any plans to hurt himself right now. They seemed a little ridiculous to Elliot, but Cliff was able to answer all of them with simple yes’s and no’s pretty quickly since he was for the most part entirely healthy.

“You’re easy,” Carey said, winking at Cliff. “Boyfriend? Visiting hours are over now honey, so you say your goodbyes and you can come back at 8am tomorrow morning.” Elliot thought she was kind of like those old ladies at diners who yelled at you for your order but called you honey so you couldn’t feel totally attacked.

He nodded and gave Cliff a quick hug. He thought about kissing him, but Cliff didn’t like to be kissed in front of other people so he just squeezed Cliff’s hand instead. “I’ll be back in the morning,” he promised. “Get some rest and tell them if you don’t feel good, okay?”

“Okay,” Cliff said. He looked scared, so Elliot hugged him again and kissed the top of his head this time.

“I love you,” Elliot said. “I know you can be strong for me. You’ve got your phone right here.”

Elliot didn’t look back as he left, because he could feel Cliff’s kicked puppy expression trailing him and knew if he did, it would be ten times harder to leave. He walked to the parking lot without thinking, got in his car, and drove home without Cliff beside him. He made it to the park a block away from his parents’ house before he pulled over and cried for a solid ten minutes.

Cliff was going to be okay, Elliot told himself. Cliff was stronger than he seemed, and realistically Elliot couldn’t be there for him every second of the way. But he’d promised Cliff they weren’t going to the hospital, and then he promised Cliff that he’d be right there next to him the whole time. He’d broken both of these promises and now Cliff was sleeping in a hospital bed, in a tiny room with no windows and only a crotchety old lady to keep an eye on him. Elliot felt just terrible and wondered if he’d made the wrong choice dragging Cliff to the ER. All he wanted was for Cliff to be okay, though, and he really hadn’t seemed okay today.

Elliot wiped his tears away and told himself he had to be strong. This seemed so intense and adult, but Elliot couldn’t let it overwhelm him. He tried to remember the coping mechanisms his therapist had taught him back in high school. Deep breaths. One second at a time. He could do it, and so could Cliff. Elliot turned on the car and returned home by himself.

[Part 4]

[science-lover33]

Exploring the Intricacies of the Respiratory System 🫁💨

Welcome to my Tumblr blog, where we embark on an exciting journey through the intricate world of human anatomy and physiology. Today, we're focusing our lens on the respiratory system – a wondrous network of organs and tissues that orchestrates the exchange of gases essential for our survival. So, fasten your seatbelts as we venture into the fascinating realm of respiration!

Anatomy of the Respiratory System: A Symphony of Structures

At its core, the respiratory system consists of a highly organized ensemble of organs and structures working together seamlessly. This symphony of components includes the nose, pharynx, larynx, trachea, bronchi, and, of course, the lungs. Each of these elements has a crucial role to play in the intricate process of breathing, ensuring our bodies receive a constant supply of life-sustaining oxygen while effectively eliminating carbon dioxide.

The Alveoli: Tiny Powerhouses of Gas Exchange

Now, let's zoom in on the alveoli, the star players in the respiratory system's performance. These microscopic air sacs, nestled deep within the lungs, are where the real magic happens. Through the process of diffusion, oxygen from inhaled air enters the bloodstream, while carbon dioxide, a waste product of metabolism, is expelled from the blood into the alveoli to be exhaled. It's here, at this cellular level, that the respiratory system's vital exchange takes place.

Breathing Mechanics: The Art of Inhalation and Exhalation

But how does it all come together? Breathing, a seemingly simple act, is a complex process guided by the contraction and relaxation of specialized muscles, primarily the diaphragm and intercostal muscles. These muscular movements manipulate the volume of the thoracic cavity, creating changes in pressure that facilitate the flow of air in and out of the lungs. Understanding the mechanics of breathing is fundamental to comprehending various respiratory disorders and their potential treatments.

Regulation of Respiration: A Symphony Conducted by the Brain

The respiratory system doesn't operate in isolation; it's under the watchful eye of our central nervous system. The medulla and pons, two regions of the brainstem, serve as the conductors in this symphony of breath. They continuously monitor factors like blood pH, carbon dioxide levels, and oxygen levels, adjusting our breathing rate and depth to maintain the delicate balance required for optimal body function.

Recommended Resources to Dive Deeper:

Book: "Principles of Anatomy and Physiology" by Gerard J. Tortora and Bryan H. Derrickson - This comprehensive textbook provides an in-depth exploration of the respiratory system, complete with detailed illustrations and accessible explanations for all levels of learners.

Article: "The Physiology of Respiration" by Stephen A. Ernst and John R. Helliwell - Published in the New England Journal of Medicine, this scholarly article offers an authoritative look into the physiological mechanisms of respiration, making it a valuable reference for those seeking in-depth knowledge.

Book: "Respiratory Physiology: The Essentials" by John B. West - For a concise yet informative journey through the key concepts of respiratory physiology, this book is an excellent resource, perfect for those looking to grasp the essentials of the subject quickly.

I hope this extended entry has sparked your curiosity about the intricate workings of the respiratory system. Feel free to reach out if you have any questions or if you'd like to explore another captivating topic in the realm of medicine and biology! 🌬📚

Here is my YouTube channel where you will find interesting videos, here is the anatomy and physiology of the respiratory system

Don’t forget to like, share and subscribe

[medstudentblues]

it's the first day of my new rotation -- community of family medicine! i just accomplished my outside rotation. the last two weeks have been lighter compared to our 1 week in a public hospital somewhere in pasig, but the hospital i just rotated in came with its own challenges.

i was decked in ward 4 (onco/hema) ward where there are lots of leukemia patients (as mentioned in this post). then ward 8 where i stayed longer. ward 8 is the surgery ward where i was decked with a notorious resident who was rumored to throw a test tube at a junior intern but we were good when we worked together. we became close she bought ice cream for us and even asked for perfume recommendations. it wasn't so bad!

ward 8 was also full of interesting cases. i was able to handle neonates with omphalocele, gastroschisis, hirschsprung disease etc. it wasn't as depressing as the oncology ward, but it was humid (as the doctor's quarters weren't airconditioned). there is more room compared to the oncology ward so the relatives either sleep on the floor or beside the patient. i heard that some patients code (meaning, we have to resuscitate/revive them), especially neonates with multiple congenital anomalies, but there weren't any during my shift. some children came in just for the surgery (inguinal hernia, ruptured appendicitis) then was discharged after. some didn't stay long compared to the onco ward children who spends their life in hospitals.

i was excited during my pedia surgery ward rotation because i love surgery, i love scrubbing in surgical cases. i was waiting for an open heart surgery but i was on night duty when they had an operation scheduled :-( i was able to scrub in, however, in a bag insertion in a patient with gastroschisis. it was interesting.

my rotation ended with me being pulled from neonatal ICU to the hema/onco ward again. i was pulled out because a kid with myelodysplastic syndrome need to be monitored. she was on DNR (do not resuscitate). she was grunting, had high fever (Tmax 41C), and was seizing every now and then. when i got there at 8pm, everything was up (her temperature, heart rate, and respiratory rate). we advised tepid sponge bath to the mother after ordering an antipyretic, to which she complied, and had units of platelet concentrate standby. in the past few days, this kid was receiving platelet concentrates because her platelets were consistently, extremely low, to the point that she already had intracranial hemorrhage. this kid has polydactyly (with extra fingers) and trisomy 8. her mouth was red from the mucosal bleeding.

at 2 in the morning, she expired. the mother called me because her breathing seemed slow so i ran to the patient and immediately checked her heartbeat. my adrenaline was up, thinking of all the possibilities that could come after (basic life support sequence), but then i remembered that kid was on DNR, and that made me melancholic. i listened to the heartbeat and from 164 just an hour ago, it was 64. i checked the radial pulse and it was really thready, almost next to nothing. after a few more seconds, i listened to the heartbeat again and there was nothing i could hear. i informed the parents that their kid just expired and informed the hospitalist (junior consultant) on duty that the kid just died.

this time, i wasn't on the verge of tears like the last time a kid died on my shift. this time i was rational, i was thinking of what came after -- the papers that had to be prepared and submitted and the doctors i had to inform. i offered my condolences to the parents and left them to grieve. there is only so much i could do.

the hospitalist told me, "you don't have to monitor a kid hourly now," and i did not say anything. for me that kid was not an hourly monitoring hurdle for me. that kid's initials was A,D. that kid liked soup and stew. she was born with trisomy 8, myelodysplastic syndrome, and had polydactyly. her mother told me she was a good kid. and she just left this world, and a hole in her parents' heart.

[olowan-waphiya]

https://www.yesmagazine.org/environment/2022/07/15/navajo-nation-citizen-science-pollution

Methane pollution is poorly tracked, so Diné activists are monitoring it themselves.

—

From behind her FLIR GF320 infrared camera, Kendra Pinto sees plumes of purple smoke otherwise invisible to the naked eye. They’re full of methane and volatile organic compounds, and they’re wafting out of an oil tank in New Mexico’s San Juan Basin.

Pinto, a member of the Diné (Navajo) community and field advocate with environmental group Earthworks, relies on this device in her fight to keep her community’s air clean. She lives in the Eastern Agency of the Navajo Nation, home to booming oil and gas production.

“When I walk outside, I can’t just think about fresh air. I’m thinking about the VOCs. I’m thinking about the methane that I’m breathing in, because I know what’s out there,” Pinto said. “I see it all the time.”

She’s one of countless citizen scientists across the country who are tracking and reporting environmental harms committed by the oil and gas industry to regulators. And here, there are many: The Environmental Defense Fund estimates that each year, New Mexico’s oil and gas companies emit more than 1.1 million metric tons of methane, a greenhouse gas around 86 times more potent in its warming potential than carbon dioxide over a 20-year period. Much of this comes from wasted natural gas—$271 million of it in this state alone, according to the EDF. It leaks out of faulty equipment and is intentionally expelled through the processes of venting and flaring, in which excess, unrefined natural gas is released or burned from oil wells and refineries to eliminate waste or reduce pressure buildups.

This is bad for the planet—high volumes of methane released into the atmosphere accelerate the pace of the climate crisis. It’s also bad for the people who live around it who are exposed to the pollutants that typically come along with methane emissions, like benzene, a carcinogen, and PM2.5 and PM10—particulate matter small enough to get lodged deep in the lungs. Pinto said her neighbors experience disproportionately high rates of headaches, nosebleeds, allergies, and respiratory issues, like sinus and throat discomfort.

“I think the scariest thing about methane is it’s odorless,” Pinto said. “It’s a silent killer. And if my neighbors are breathing it in, that’s worrisome.”

These emissions and the fossil fuel development that causes them have long been “insufficiently regulated,” said Jon Goldstein, senior director of regulatory and legislative affairs at EDF. In 2020, then-president Donald Trump rolled back Obama-era regulations on methane that effectively eliminated the requirement that oil and gas companies monitor and repair methane leaks in their infrastructure.

The Senate voted to reinstate them in April 2021, and last November, the Biden administration announced it would introduce even more comprehensive regulations in an interagency effort to crack down on emissions from the oil and gas sector. As part of the plan, the Environmental Protection Agency proposed its own rules, which include a requirement that states reduce methane emissions from thousands of sources nationwide, and a provision that encourages the use of new technology designed to find major leaks. A final methane rule is expected to be implemented later this year.

The Navajo Nation, too, is taking things into its own hands: The Navajo Nation Environmental Protection Agency is currently considering adopting a permitting program to regulate methane from oil and gas development on its land.

Here, methane emissions from oil and gas companies are 65% higher than the national average, seeping out of pipelines, oil rigs, and the like. The San Juan Basin, some 150 miles northwest of Santa Fe, has received a failing grade from the American Lung Association for ozone pollution, or smog, the result of the combination between VOCs and radiation from sunlight.

Exposure to ozone has been tied to degraded respiratory health and asthma attacks, and it’s typically seen in cities, Goldstein said.

“The San Juan Basin isn’t home to large cities,” he said. In San Juan County, ozone is the result of the widespread build-out of oil and gas wells; approximately half of the county’s 50,000 residents who identify as Indigenous live within half a mile of those wells, according to EDF.

Catching emissions at the source will be crucial to changing this legacy. And where regulators can’t (or won’t) step in, residents like Pinto are. The federal government is now relying upon community monitoring, or work that citizens do to contribute to public understanding of the scope of air pollution near fossil fuel sites, a development that Eric Kills A Hundred, tribal energy program manager at EDF, believes will be “huge.”

The EPA’s methane proposal includes a plan to implement a program to “empower the public to detect and report large emission events for appropriate follow-up by owners and operators,” according to an agency news release.

During the comment period for the EPA’s proposed community monitoring program, members of the petroleum industry questioned whether the agency has the authority to establish it at all, primarily objecting to the idea that air quality monitoring be conducted by entities other than agencies and producers themselves, E&E News reported​​ in May.

But Pinto said groups like Earthworks have a track record of doing this work long before federal regulators began tapping them for their data collection.

“Documenting these types of emissions is important because no one else is really doing it,” she said. “Even the agencies that are regulating this type of thing. Because we’re in a rural area, what can they actually capture when they come out here? Are they going to more than 100 sites?”

Kills A Hundred said these efforts are not only about what the Navajo Nation can contribute to government data on methane pollution, they’re also about empowering the community to play a role in stopping it.

“Having been the stewards of the land for so long,” he said, “it’s just so important for these communities to be active and raise their voice.”

[theunholyrogue]

if time could stop (REWRITTEN!)(bay!raph ending)

tw: angst, cursing

intro.itcs

“Let's do this.”

Raphael gazed up at the machine, his brow bone contorted into a frown as he listened to Donatello explain the controls of the teleportation device. If only it were on already, he would hop through with no hesitation– but of course his brother was smart enough to know that.

He couldn’t stop himself from thinking of what was to come, but no plague of doubt consumed him over this. The Shredder would be defeated, they would take him down before he had a chance to take over their beautiful home of New York, and he wouldn’t drive his blades through your body another time.

Everytime he had went back to thinking about that night, everytime he turned his body around to look over his shoulder, he saw you pushing April out of the way and taking the fall for her, your blood oozing down over the blades and dripping to the concrete road below, your body falling to the ground with April catching you in her arms, the screaming, crying, and begging that you would make it. It made him sick to think about, and the turtle had blamed himself and April for your death. He blamed himself for not being able to block the Shredder attack, to stop him, or for even assuming he knew the enemy’s next move. He blamed April for being there, in the way, for not realizing what was going on. Hell, he even blamed you for being so compassionate towards your friend that you would put your own life on the line for them.

But, Raphael knew that it wasn’t your fault, or April’s fault, and at moments of clarity– he knew that you wouldn’t blame him for your death, that it wasn’t his fault either, but that was harder to accept. Because why else would you not be here, with him, alive and healthy if he had ran forward instead of moving backwards with his brothers? Why would he had given the Shredder a moment to change his trajectory and go for April instead of staying in the way and blocking him? It was his fault, surely.

“Two turtles at a time to keep the portal from going crazy and changing us getting stuck in the past,” Donatello stated before typing in on a digital keyboard and cutting the machine on. Suddenly, in the middle of the round frame, a purple, swirling mass engulfed the inside of the device, waiting patiently for the turtles to walk through.

“Casey, you’ll be keeping track of our vitals while we’re on the other side, or the past– I mean. These suits has built in monitors to keep track of our oxygen and respiratory rate, blood pressure and heart rate, and temperature,” the tech genius spoke as he handed his brothers a black suit that fit to their bodies. “April, you’ll be keeping track of the portals soundwaves and making sure that it doesn’t want to shut down and trap us in the past. It has an auto-correcting system but for precautions, if the waves don’t die down or a message alert comes up, just yell out. We have a communication system built into these suits as well so that we can you and Casey talking on this side while we’re on the other side.”

“Gotcha,” April and Casey both nodded, understanding their roles in this situation.

“The portal will act haywire at first whenever we go through, but it should calm down after a few minutes. Wait a bit and then send the next two over. If it doesn’t calm down, you know the drill.”

“Understood, Donnie. Good luck.” April responded with a confident smile.

“Raphael and I will go through first, so that Donatello can make sure the portal is doing what it is supposed to. Once it’s clear, he and Michelangelo will come through. We’ll wait for you on the other side and from there, we’ll defeat the Shredder once and for all,” Leonardo stated.

“Sounds good,” Raphael remarked before pushing his eldest brother through, “Let’s stop yapping and get to beating.”

Raphael didn’t hesitate to jump through the swirling mist, falling out through the other side– though once he looked around, nobody was in sight. Mikey, Donnie, Leo… nobody was in the empty lab.

“Leo! Where are you?” He called out, though he received no response in person– though his brother’s voice came through his suit. “In in the lab– where are you?”

Raphael’s brow bone contorted into irritation. “I am too. I don’t see you.”

“Guys…” Donatello’s voice echoed through the suit with a worried tone. “You two aren’t on the same plane anymore.”

“What the hell does that mean?”

“Raph?”

Raphael’s heart dropped as the familiar voice called out from behind him, his gaze slowly trailing the room as he turned his body around to face the direction of the voice.

“I thought you were…” You murmured, watching as the turtle turned around.

There, you were standing with a half-ripped bloody shirt, along with bandages wrapped around the upper half of your torso. You held your hand against your side, evident that you were sore from the attack. But… you were alive.

Raphael uttered your name in a whisper, the first time he had said it in five years.

“You’re… alive,” he murmured, causing you to tilt your head.

“Yeah, I’m alive?” You asked, a breathy laugh escaping your throat then quickly whimpering.

Raphael walked up to you and wrapped his arms around your body. He slowly inhaled, taking in your scent and allowing his tense posture to relax since your death.

“Raph, are you good?” You asked, reaching up and wrapping your arms around his shell, dragging your digits up and down slowly.

“Raph, you have to come back. The portal is going crazy on our end. Leo’s already—,” April was speaking over the comms system, but Raphael pulled away and spoke.

“No.”

“No?”

“No, I’m not coming back,” Raphael firmly started, his hands sliding down to meet your hands. Tightening his grip around your digits, Raphael continued. “I’ve been fucking miserable for five years. Five whole years. I’m finally feeling okay again. Goodbye.”

“Wait, Raph!” April called out as Raphael moved away and took a sai from his side, jamming into his portal and causing the mist to disappear.

He took a deep breath, before looking back at you.

“Yeah. I’m okay.”

[lovedrunkheadcanons]

Chapter Contents

(Arranged Marriage Fic) Read on AO3

RATED M

The clock struck five in the morning. Contaminated test tubes and beakers were wet in the sink. A bright green bar nearing 65% completion was loading on a large computer screen surrounded by monitors. Shoko was busy in her lab, observing a single drop of blood, splotched between two thin slides under a beaming microscope. She hadn't left work since yesterday. You’d think after all these years hunkered down in the school’s basement like an obsessive recluse, she’d be used to the loneliness. She could already hear poor Ghost yowling for his breakfast, but there was no room for pause. The blood sample results from the New National Theater had finally come back, but Shoko was only interested in one.

The jujutsu doctor’s lips drew together in concentration, suspending the tail end of a depleted cigarette. Screw resolutions. This was far more important than her respiratory health. Her findings so far were not as she’d hoped. The red blood cell count was starkly lesser than last week. She reckoned about a third of them had vitiated in that timeframe, even with the aid of reverse curse technique, but how? How? The discovery troubled her. She would start from scratch again if need be. After all, there was still more testing to be done.

Exhausted, Shoko wiped the beads of sweat off her brow and smothered her depleted cigarette in the ashtray. The computer monitors increased to 66%. She just prayed her hypothesis did not hold the truth.

Nanami Kento removed the strainer of brewed oolong leaves from the Royal Copenhagen he had sitting on a tray; a teapot and two cups with matching saucers, Blue Fluted Full Lace. They were heirlooms once owned by his late great uncle, who subsequently died of a stroke three years ago; another Henriksen lost. He had no wife or children and his mother didn’t want them, despite their value, so she bequeathed the china over to him. Not that he ever had a reason to use it. The full set of plates and fine tableware cost more than his apartment lease. He mostly kept the novelties for decoration. And perhaps nostalgia.

But not today.

Today he had a guest.

Nanami closed the lid on his uncle’s Copenhagen teapot and lifted the tray to walk back inside the living room of his small, one-bedroom sized apartment. It wasn’t the grandest place in the world, nor the cheapest. He could afford a much bigger unit if he wished, yet the space was well accommodated. It was furnished with all the essentials befitting of a bachelor; functional kitchen appliances, a washing machine and dryer, a brand new air conditioning system, and modern furniture. He had picked the farthest unit down the hall, so he wouldn’t be subjected to the loud elevator cranking up and down the many floors. It allowed him some peace and quiet in this bustling, wayward city known as Tokyo, granted, if you ignored the endless stream of ambulance sirens, blaring jumbotrons, and cries for help.

The part-time Jujutsu sorcerer entered his living room and acknowledged his guest sitting on the sofa.

“I apologize for bringing you out here like I did. I’m usually not this spontaneous.”

Nanami set the tray down along the coffee table and handed his guest a teacup. Hannah smiled at her host warmly and took the blue and white china from his hand. The porcelain clashed with the pink roses on her dress.

“Not at all, it’s perfectly alright,” she assured him. “I hear you’ve been busy with work, so this is me intruding on your time.” She looked down at the coffee table. “Anyway, I hope you like the rødgrød. Satoru mentioned you were Danish, so...”

Nanami sat down on the leather armchair, opposite her, and glanced at the small portable crockpot she had brought atop the table. Rødgrød med fløde was as much part of the Danish diet as cheeseburgers and fries were to the American. People preferred eating the berry porridge with custard or poured over freshly baked bread. Everyone loved it. Nanami hadn’t tasted the dessert since he was a young boy visiting his grandparents on holiday. Hannah had used raspberries and cherries for hers; exactly how his mormor used to make it. The tarter, the better.

Well, there were those waves of nostalgia hitting him again. He’d sample a bite later.

Satoru had dropped his wife off at his place that afternoon and hurried to go “run some errands.” Whatever that meant. Nanami had no choice but to leave the office. As ever, the Six Eyed moron liked to make things difficult and keep his whereabouts elusive, in addition to getting his lineage wrong.

“A quarter Danish,” Nanami clarified, loosening the lavender silk tie around his neck. He hadn’t been allotted time to change out of his business attire. “My grandfather was born and raised in Denmark, however my grandmother is Swedish.”

Hannah looked positively delighted.

“Ah, a Swede and a Dane,” she exclaimed. It would explain his blond hair. “That’s quite a match. The closest I got to living in Denmark was Germany. Did your grandparents ever alternate between countries?”

“For a time,” the quarter Dane replied. “But my grandmother has lived alone in Aarhus since my grandfather’s passing. I still get Christmas cards from her every year. She’ll be ninety-one this October.”

Unable to stop herself, Hannah heard the word “Christmas” and blurted the next question out loud without thinking.

“Oh. So you’re Christian?”

She could see the tug pull on the corner of his lips, barely noticeable to the untrained eye, and instantly regretted it. He was so cool, you’d think he hadn’t reacted at all. The quarter Dane shook his head. “Mom had me baptized in the Lutheran church as a baby to appease my grandfather, but the buck stopped there. She wasn’t very religious and I myself hold no beliefs.”

Hannah felt her cheeks burn hotter than the tea she was sipping, flushed with embarrassment. Her shoulders sagged. Of course he wasn’t Christian. What a foolish thing to expect? She felt awkward.

“I see,” she said rather sheepishly. “Please, forgive me. I shouldn’t have assumed.”

Nanami nodded understandingly. He thought it wasn’t dumb of her to ask, but with introductions out of the way, they had official matters to attend to.

“Satoru said you had some information about a possible Sukuna finger.”

Hannah nervously tucked a strand of long auburn hair behind her ear, lowering the expensive Copenhagen in her lap.

“Yes,” she said, swallowing her tea and straightening her bad posture. “I think I know where one is.”

Nanami leaned back against the armchair and crossed his legs, hands folded patiently in his lap. His eyes never wavered.

“I’m listening.”

Hannah coughed. “Well, you see,” she began, trying to decide where to start. “I think nothing of them at first. My dreams - er visions - are often quite,” she searched for the adjective, “sporadic, if you know what I mean. But lately I’ve been having a recurring dream.”

“A recurring dream.” Nanami quirked a pencil thin, blond eyebrow. “I’m guessing that’s a dead giveaway?”

Hannah let slip a dry laugh. “You’d be correct. In my experience, whenever a dream is recurring, it’s usually indicative of a vision.”

“What has the vision shown you?”

“It’s hard to describe,” she continued, squinting her eyes as though aiming for a moving target that refused to stay still. “I don’t know why, but it always begins with me…drowning. I’m ever so slowly sinking towards the bottom.” She closed her eyes for a second, trying to imagine the nightmare in her mind. “It’s very dark and murky, so I can’t see anything. I’m terrified out of my wits. I try to kick and swim my way back up to the surface, except someone, or rather something, has me by the ankles and won’t let go. I fight and struggle to free myself, but I can’t. It isn’t until my lungs give out that I finally look down and…” she stopped for a second.

“Go on,” Nanami coaxed gently, waiting in silence. He wasn’t going to force her to talk, if she didn’t want to.

“Eyes,” the seer said, own eyes flitting open. She took a much needed breath from the horrid memory. “Four glowing, scarlet eyes staring at me from the black. That’s it. That’s all I see. Then the vision pivots.”

“Pivots?”

Hannah took a sip of oolong before humming in agreement. “I’m shown a film reel of things. Places, I think. I can’t remember what they are, but there is one feature that stands out from all the rest.”

Nanami also took a sip of tea. “Like what?”

Hannah placed her teacup on the coffee table and used her fingers to “draw” an invisible picture for him. “A massive red o-torii, floating above a large body of water.”

The quarter Dane’s brow narrowed ever so slightly. He knew what place she was referring to.

“Itsukushima Shrine,” he said. It wasn’t a question.

“Yes,” Hannah sighed. “Satoru showed me a picture of it when I told him. It’s the exact same gate. He then mentioned you were working on a secret case and that I should speak to you immediately.”

Well, it’s not so secret anymore, Nanami thought, holding his tongue. Now he understood why Satoru had been so adamant the two of them talk, but hell, what a pain in the ass. The white haired dolt could’ve explained all this on the phone, or typed a quick text, instead of wasting he and his wife’s time. Even though she was a lovely person, both inside and out. Reminded him a bit like Haibara; her kindness and selflessness towards others.

But a tad miffed by this new flux of information, Nanami rose from his leather chair, teacup in hand, and walked over to the large window overlooking Shibuya Crossing, the thousands of city nerdowells commuting below, crammed like sardines.

“In the last four weeks, a total of eighteen people have been reported missing from the shrine,” he said, staring monotonously out the apartment window. “Evidence suggests it’s curse related. I and a few other sorcerers have been called in to investigate the disturbance.”

“Then perhaps this is your lucky break,” Hannah added, hoping to shed some light on the subject.

The quasi-business man continued looking out the apartment, almost like he wasn’t listening (but of course he was). “Itsukushima Shrine is a popular tourist destination in Miyajima. We’ll be fighting heavy crowds if we search during the day. Curse activity tends to worsen at night, but then there’s high and low tide to contest with. Your presence might also be needed. Could get dangerous.” He was listing all the potential roadblocks ahead.

“Can’t we disperse the crowds at least?” was Hannah’s suggestion. “Close the shrine off to tourists?”

Nanami hummed deeply in thought. Things were never that simple. He at last turned away from the window. “You’re sure this is a vision?”

Hannah shrugged. “More sure than not.”

“And you think a Sukuna finger is hiding somewhere at the bottom of Hiroshima Bay?”

The seer frowned. She felt her confidence wane at his scrutiny. “It’s the only lead I have.”

Confined to his thoughts, Nanami walked back towards the coffee table, relinquishing his empty teacup and saucer, and plopped back down in the leather chair, hand in his chin. A disconcerted expression became him, though his eyes were fixed on the Royal Copenhagen. Hannah thought he looked far older than his real age said on paper. He was handsome, she decided, with golden blonde hair and mixed Scandinavian features, but in a battle-hardened, wise kind of way. Forever pensive and stoic, like he had crossed the river Styx and managed to survive the harrowing ordeal, but only just so. Even without the bloody cleaver knife in his hand from that night at the opera, she could tell he wasn’t much for taking days and nights off. Kento Nanami was certainly a man operating under a lot of stress.

“I can’t name anyone on the top of my head with a water curse technique,” he vexed tiredly, observing the porcelain tea set. “A diving team will have to be dispatched. Damn. It’s always a risk when we get non-sorcerers involved.”

“But maybe we won’t have to,” Hannah said, complexion brightening. “Because as it were, I know someone who might be able to help us. That is, if we can persuade her.”

Nanami’s hand fell to his lap, eyes raised. “Her?”

Hannah rested her teacup on the coffee table and hurriedly rummaged through her dress pocket for a folded piece of paper. She offered it to him.

“Her.”

Feeling pessimistic, Nanami took the paper and slowly opened it. His eyes landed on the contact’s name above, and thus the part-time jujutsu sorcerer’s face tensed into a shrewd scowl. He exhaled loudly through his nose.

A bowl of that rødgrød didn’t seem like such a bad fix all of a sudden.

Neither did some brandy.

Chapter Contents

[brainanalyse]

Function of Brain Stem

Introduction 

The brain stem, often referred to as the “gateway to the brain,” is a vital component of the central nervous system responsible for regulating essential bodily functions and facilitating communication between the brain and the rest of the body. Comprising the midbrain, pons, and medulla oblongata, this intricate structure plays a crucial role in sustaining life and maintaining homeostasis.

1. Regulation of Basic Life Functions

At the core of its function, the brain stem governs fundamental physiological processes necessary for survival, including heartbeat, respiration, and blood pressure regulation. The medulla oblongata, situated at the base of the brain stem, serves as a control center for autonomic functions, such as breathing rate and heart rhythm, by monitoring sensory input and orchestrating appropriate responses.

2. Conduction Pathway for Sensory and Motor Signals

As a conduit between the brain and the spinal cord, the brain stem serves as a relay station for sensory information from the body to the brain and motor commands from the brain to the body. Nerve fibers ascend through the brain stem carrying sensory impulses towards the brain for processing, while descending fibers convey motor signals from the brain to the spinal cord, coordinating voluntary movements and reflex actions.

3. Integration of Reflexes

The brain stem plays a pivotal role in mediating reflex actions, automatic responses that occur in response to specific stimuli without conscious effort. Reflex arcs involving sensory receptors, afferent nerves, interneurons within the brain stem, and efferent nerves facilitate rapid, involuntary reactions to stimuli, such as withdrawing from pain or adjusting posture to maintain balance, ensuring swift and adaptive responses to environmental changes.

4. Control of Arousal and Consciousness

Crucially, the brain stem regulates levels of consciousness and arousal, exerting influence over wakefulness, alertness, and sleep-wake cycles. The reticular formation, a network of nuclei spanning the brain stem, modulates neural activity to promote wakefulness during periods of stimulation and facilitate transitions into sleep or altered states of consciousness, underscoring its pivotal role in regulating the overall level of cognitive awareness.

5. Coordination of Cranial Nerve Functions

Integral to its function, the brain stem houses nuclei responsible for controlling several cranial nerves involved in sensory perception, motor control, and autonomic regulation of organs in the head and neck region. By coordinating the activities of these cranial nerves, the brain stem facilitates crucial functions such as vision, hearing, facial expressions, swallowing, and maintaining cardiovascular and respiratory homeostasis.

6. Facilitation of Postural Control and Balance

Moreover, the brain stem contributes to postural control and balance through its connections with the cerebellum, a structure located at the base of the brain. By integrating sensory feedback from the body and coordinating motor commands, the brain stem helps maintain stability and equilibrium, enabling smooth and coordinated movements essential for navigating the environment safely.

7. Modulation of Autonomic Functions

Additionally, the brain stem modulates autonomic functions, regulating visceral activities such as digestion, urination, and sexual arousal through its influence on the autonomic nervous system. Sympathetic and parasympathetic pathways originating in the brain stem orchestrate physiological responses to stress, rest, and various internal and external stimuli, ensuring adaptive adjustments to maintain internal balance and respond to changing environmental demands.

8. Regulation of Cardiovascular and Respiratory Functions

Furthermore, the brain stem plays a central role in regulating cardiovascular and respiratory functions, ensuring the delivery of oxygen-rich blood to tissues and organs and maintaining optimal gas exchange in the lungs. Through specialized nuclei and reflex pathways, the brain stem modulates heart rate, blood pressure, and breathing patterns in response to physiological needs and environmental cues, safeguarding vital organ perfusion and metabolic balance.

9. Contribution to Neuroendocrine Control

Lastly, the brain stem contributes to neuroendocrine control by serving as a bridge between the nervous system and the endocrine system. Hypothalamic nuclei within the brain stem integrate neural and hormonal signals, regulating the release of pituitary hormones that govern various physiological processes, including growth, metabolism, reproduction, and stress responses, thereby exerting profound influence over systemic homeostasis and adaptation.

Conclusion

In summary, the brain stem embodies the intricate interplay between neural structures and physiological functions, serving as a linchpin of the central nervous system’s regulatory machinery. Its diverse roles encompass vital autonomic, sensory, motor, and integrative functions essential for maintaining life, consciousness, and adaptive responses to internal and external stimuli. Through its complex networks and dynamic interactions, the brain stem exemplifies the remarkable complexity and resilience of the human brain, underscoring its paramount importance in sustaining health, vitality, and cognitive function.

FAQs

1. What is the primary function of the brain stem? The brain stem is responsible for regulating essential physiological functions, including breathing, heart rate, and blood pressure, as well as controlling basic involuntary movements like swallowing and vomiting.

2. How does the brain stem connect the brain to the rest of the body? The brain stem serves as a conduit between the brain and the spinal cord, facilitating the transmission of sensory and motor signals to and from the body’s peripheral nervous system.

3. What are the major anatomical divisions of the brain stem? The brain stem comprises three main regions: the medulla oblongata, the pons, and the midbrain, each with distinct structures and functions contributing to overall neural regulation and coordination.

4. How does the brain stem contribute to consciousness and arousal? The reticular formation, a network of nuclei located throughout the brain stem, plays a critical role in regulating wakefulness, attention, and arousal levels by modulating the activity of cortical and subcortical brain regions.

5. What happens when the brain stem is damaged? Damage to the brain stem can result in profound neurological deficits, including loss of consciousness, impaired vital functions such as breathing and heart rate, and disturbances in sensory and motor control, depending on the extent and location of the injury.

[skyloftian-nutcase]

Rough Days (LU in Healthcare AU)

Hyrule grabbed the stickers to take the EKG as his partner placed their patient on oxygen. A firefighter/paramedic worked on getting IV access. The patient looked terrible as soon as Hyrule had laid eyes on her, pale and gasping for air and initially refusing any kind of treatment. Her grandson hovered outside the ambulance door, trembling from head to toe. Hyrule handed off the wires to his partner, who started to place them on the patient so they could assess her further. He stood and walked to the doorway, hearing the grandson fretting and wringing his hands. Hyrule stood in the stairway leading up into the back of the truck and put a hand on the young man's shoulder.

"Hey," he said, getting the grandson's attention. "We're going to do everything we can for her, okay?"

Giving his shoulder a squeeze, Hyrule looked him in the eye. "You're going to be okay."

The grandson nodded, taking a step from the ambulance and trying to calm down. Hyrule climbed back into the truck just as the apnea alarm went off. Hyrule at first dismissed it since she was desperately gasping for air - clearly she was breathing - and then, just as the EKG wires got put on the patient's chest, one of the paramedics asked, "Is that v-fib?"

Hyrule whipped his head to the monitor and saw the scrambled heart rhythm, one of the few rhythms that a patient absolutely could not survive with, and immediately felt for a pulse. The patient had gone unresponsive, staring off in the distance with half lidded eyes.

"She doesn't have a pulse," Hyrule said, and he shoved the stretcher flat and started compressions as his partner grabbed defibrillator pads.

Forty-five minutes later, drenched in sweat and exhausted, having expended every possible resource, Hyrule watched as a fellow paramedic went outside to tell the grandson and was thankful he had a partner who could do that for him, because he couldn't bear to look the grandson in the eye.

XXX

Four bit back a moan as alarms went off once more the instant his backside hit the seat. Rising, he stepped quickly back into his patient's room and went straight for the IV pumps as his patient's blood pressure dropped below safe levels. He adjusted a few medication drips and waited, hating the thirty seconds it would take for the medication to kick and see if he needed to adjust his dosage.

The patient's mean arterial pressure, lingering in the 50s, started to slowly rise above the life sustaining level of 60 and the normal level of 65.

Then the ventilator alarmed. The patient jerked, coughing on the endotracheal tube currently lodged in his throat. Four automatically went to the patient's side and started speaking reassuringly to him, trying to calm him down.

"It's okay," he said gently. "You're in the ICU. You have a breathing tube in your throat right now. I know it isn't comfortable, but I need you to take nice, slow breaths, okay? The vent is helping you breathe right now. You're okay. You're safe."

He continued to repeat the mantra over and over, and though the patient would settle, something would set him off and make him start coughing and fighting again. He reached up, trying to pull the tube out altogether, and Four hastily snatched his hands away, essentially leaving him unable to handle the screaming ventilator and the patient's steadily rising blood pressure and heart rate.

After what felt like an eternity, the patient stopped clawing for different tubes and Four hastily lowered the pressor medication dosage since the patient's agitation had caused his blood pressure to skyrocket. The respiratory therapist was nowhere in sight to handle the ventilator, so Four looked it over, registered the "high pressure alarm" and recognized that it was because the patient was fighting the ventilator due to agitation and reasonable fear, and silenced the alarm. Calming the patient and keeping their blood pressure regulated was his priority.

The patient started to settle, and his blood pressure tanked. Swearing under his breath, Four changed the dosage of the pressors once more. Then had to wait again to see if the adjustment worked. Then watched as something else made the patient awaken and the whole routine started all over again. Four wanted so desperately to increase the patient's pain medication and sedation regimen, but the instant he did, the patient's blood pressure would fall so low that he'd max out on pressors, which led to its own host of issues.

Two hours later, Four finally exited the room, collapsing at the nurse's station. Wild, who was bringing a bedside commode to the unit, paused upon seeing him.

"Hey, you okay?" he asked softly.

Four buried his face in his hands. "My patient is terrified and in pain and there isn't a damn thing I can do about it."

Before Wild could even try to reassure him, the alarms were going off again, and Four was back in the room.

XXX

Wind gritted his teeth as he tried to view the patient's vocal chords. He couldn't pass the breathing tube into their airway unless he could visualize their airway, but there was so much blood.

His preceptor looked over his shoulder in an attempt to help him, but he struggled just as much. Exhaling sharply in frustration, he put a suction catheter in the patient's mouth to try and clear the blood, but no matter how much he sucked out there was always more.

Time stood in the corner, unable to do anything, watching with his hands tucked under his armpits to maintain sterility in his surgical gown and gloves. He wanted desperately to step in, but intubation was not in his practice; he hadn't done one since residency many years ago. Wind and his preceptor were far more skilled at the maneuver than him, but it still drove him insane watching them struggle and not being able to help.

They knew the patient was going to be a mess when they'd heard the report. The patient was already barely stable, but her airway had been the one thing in her favor, the one thing that had been intact and well, the one thing that had not been as much of a priority. Until they'd gotten to the OR, and then she'd started crashing.

Wind yelped as blood spurted out of the patient's mouth like a volcano, and suddenly it was all hands on deck. His preceptor immediately snatched the tube out of his hands, the OR team was hovering around him with extra suction but not really able to do anything about it. Every single person in that room was itching to fix this.

When they finally saw the patient's throat enough to recognize there were no more landmarks due to sheer amount of swelling, they cut into the trachea instead to establish an airway.

Wind scrubbed the blood off his arms after the procedure was over, his head hanging. Time went over to him and put a hand on his shoulder.

"That was one of the worst airways I've seen," Time said sincerely. "Don't beat yourself up about it."

"We had to trach him," Wind snapped, pulling away. "That isn't a victory. I should've noticed the swelling sooner if it was going to be an issue. What if I caused the irritation? And how long was that patient hypoxic before we got an airway? How much damage did her brain just take from lack of oxygen?"

"Wind--"

"No!" Wind shook his head, making his way to the door. "No. That was horrible."

Time watched the door slam shut behind him and took a deep breath, steeling himself for the conversation with the patient's family.

XXX

Legend watched with dread as yet another person approached the triage desk, frustration and anger evident on their face.

"I have been waiting here for six hours," the man said as he got within hearing distance. "That person you just let in got here after me! I am sick and I need to be treated!"

Legend looked him over to see if his condition had worsened since the last two times he'd come up to ask how much longer he had to wait, and since the last time he'd assessed his vital signs thirty minutes ago. He looked exactly as he had before, nauseous and unwell but stable. "Sir, we go by acuity here; the ER isn't first come, first serve."

"What the hell is that supposed to mean?!"

It means you get back faster if you're dying, dipshit, Legend thought irritably. This wasn't the first time he'd had this discussion, especially with this particular patient, in the past four hours of his shift and it wouldn't be the last. They'd been told at huddle at the start of shift that there were over a hundred patients in the department, forty of whom were in the waiting room and had been for hours. Paperwork was behind, lab results and assessments were behind, the entire department was behind, and it was up to Legend's shift to pick up the pieces.

Which included getting yelled at over something he couldn't control.

"It means your condition is more stable than those who went back before you did," Legend finally explained.

"I feel like I'm going to throw up! My stomach hurts, aren't you going to do something about that?! This is ridiculous!"

Legend bit back another remark and waited patiently as the tirade turned far more spiteful and vulgar.

Eight more hours to go.

[killed-by-choice]

Kelly Morse, 32 (USA 1996)

Kelly Morse was 32 years old when she found out she was 8 weeks pregnant. At 8 weeks and 5 days pregnant, she went with her husband Scott to Hillcrest Women’s Medical Center in Harrisburg, Pennsylvania. Despite the name, Hillcrest was just an abortion facility and would provide no medical care to her.

Kelly had allergies and asthma. She made sure to notify the staff at the abortion facility that she was severely allergic to Lidocaine and other medications ending in “caine”. Her allergies were highly dangerous, but easily avoided by simply not using the medicine she was allergic to.

Despite Kelly’s warning, Delhi Elmore Thweatt, Jr. administered 12 cc’s of 1 percent Lidocaine to Kelly. The effect was immediate.

Kelly couldn’t breathe and started turning blue. A licensed practical nurse got Kelly’s inhaler out of her purse and helped her use it, but Kelly told her that it was not helping. She was very agitated and struggling to breathe.

Instead of immediately calling, the abortionist proceeded with the abortion, rushing through it in about four minutes. Then he spent some time trying to administer incorrect measures to a dying Kelly before finally bothering to call an ambulance. Kelly needed medical treatment, but the abortionist killed her baby and watched her turn blue instead of helping her.

While all this was happening, Scott was waiting outside for his beloved wife, wondering what was taking so long. Before anyone at Hillcrest even told him about Kelly’s condition, paramedics arrived. He went inside with the ambulance crew to see what was happening. To his horror, Kelly was naked and blue-black from lack of oxygen, lying on a table that was halfway out of the examination room into the hallway.

The paramedics intubated Kelly, properly administered medicine, and performed CPR as they brought her to the Polyclinic Medical Center, where she was admitted to the Intensive Care Unit. The abortion was done on June 19, 1996. Kelly died on June 22 after a few days of barely clinging to life in the ICU.

Scott sued Hillcrest for killing Kelly. Here are some quotes from the lawsuit:

“As Mrs. Morse’s dyspnea and cyanosis continued to worsen, Defendant Thweatt improperly administered Epinephrine subcutaneously instead of intravenously….” (This measure would do nothing to assist a patient in Kelly’s extremely severe condition.)

“No one started an IV. No respiration rate was recorded, no pulse was checked and no blood pressure was measured. No EKG was applied. No cardiac monitoring was conducted. No pulse oximeter was applied. No intubation or emergency tracheotomy was performed. No oxygen was administered. Kelly continued to agitate in fear, desperately gasping for air, and remained blue in color. Defendant Thweatt just stood there with a stethoscope in hand and listened to Kelly’s breathing and wheezing progressively worsen.”

“As Plaintiff choked and gasped for air, none of the Defendants, took steps to immediately dispatch an ambulance. In fact, the ambulance was not summoned until 11:24 a.m., or 10 minutes after Plaintiff violently choked, gasped, wheezed, and discolored to a blue-black appearance from respiratory arrest and hypoxia.”

It was also discovered that even though Hillcrest advertised Thweatt as being a Board-certified OB/GYN, “Defendant Thweatt failed the OB/GYN Board certification examination not once, not twice, but on three consecutive attempts…Defendant Thweatt failed his Board certification exam even after a fourth attempt, following his deposition of July 27, 1997.”

On April 20, 1999, Thweatt and Hillcrest settled out of court with Scott. No amount of money could give his surviving son and daughter their mother and sibling back.

Even while Kelly was scared and dying because of the abortion facility’s lethal malpractice, the abortionist killed her baby instead of immediately calling for help. Kelly’s health and safety was clearly not important to Hillcrest.

Dauphin County (PA) Court of Common Pleas, Civil Action # 6070 S96 SCOTT B. MORSE v. DELHI THWEATT, MD.

[dokidokienjoyer]

Cardiophile with a Heart Rate Sensor

I bought a new toy the other day.

The POLAR H10 is a heart rate sensor that tracks your heartbeat with built in electrodes in the included chest-strap.

I bought it because it don’t have EKG or a watch the has EKG functionality. But i always wanted one.

The H10 can be used to record a simple EKG with an app. After the recording is done it shows you stats about the recording.

The H10 also has a built-in accelerometer that can be used to track your sleep and wake you up if you are not in deep sleep. It also tracks your heartrate, heart rate variability and respiratory rate during sleep.

I really enjoy when my heart is being monitored and recorded. The H10 is perfect for that. You can wear it under a shirt, and no one knows that you are wearing it.

Overall I would recommend the H10 to every cardiophile that likes being monitored :)

[whatevergreen]

"Days after a catastrophic train derailment prompted officials to conduct a "controlled release" of the toxic chemicals onboard, animals are dying at alarming rates in East Palestine, Ohio.

A woman in North Lima, roughly 11 miles away from the village of East Palestine, where the crash occurred, checked on her chicken coop on February 7 only to find her five hens and rooster laying lifeless, with no sign of a predator entering their enclosure.

"I'm beyond upset and quite panicked, 'cause this, they may be just chickens, but they're family," Amanda Breshears told local news outlet ABC27 WHTM.

Though local officials have indicated drinking water in the region is safe to drink, CBS News reported, and the Environmental Protection Agency is monitoring air quality and has indicated there is no reason for concern, Breshears and other Ohio residents aren't convinced.

"My video camera footage shows my chickens were perfectly fine before they started this burn, and as soon as they started the burn, my chickens slowed down and they died," Breshears said. "If it can do this to chickens in one night, imagine what it's going to do to us in 20 years."

Onboard the train — which derailed in a fiery crash on February 3 — were highly flammable hazardous materials, including vinyl chloride, used to create a polymer that forms a popular plastic. Worried that the materials could explode, sending deadly shrapnel flying up to a mile through the air, officials conducted a "controlled release" of the chemicals and burnt them, sending a toxic cloud of black smoke into the air."

..."Breshears' chickens weren't the only fatalities locals are attributing to the burn. Taylor Holzer, an East Palestine resident who rescues foxes, told Newsweek all four of his animals are experiencing signs of chemical exposure. One rescue fox had such severe symptoms it died before it could receive treatment.

"He went downhill very fast," Holzer said, adding that the fox had symptoms including diarrhea and breathing issues. "He crashed so fast and unexpectedly. He wasn't able to blink or function properly as he died in my arms."

In addition to the domesticated animals suffering from the toxin exposure, locals have reported seeing streams full of dead fish in recent days. An official with the Ohio EPA confirmed toxic material had entered the waterways after the burn and killed fish but reiterated that drinking water is safe and air contaminant levels are not currently cause for concern, CBS News reported."

"The water is 'safe to drink' but everything in it is suddenly dead"

..."While the animal deaths initially alarmed residents, human health problems are also beginning to appear, even among residents who initially evacuated the area.

Chelsea Simpson, who lives near the site of the derailment, told The New Republic she has had a sore throat since the burn, and her 8-month-old baby has suffered respiratory issues that are being treated with a steroid. Simpson said her eyes were bloodshot and burning after visiting her home for just 10 minutes a few days ago, and she has yet to return."