Shameless capitalizing on TWILIGHT

My hits are down a little, probably due to the fact that I never update. Therefore, today's entry is brought to you by pop culture vampires and a shameless ploy for search engine hits. (Hell, just to make things interesting, all the desperate ploy bits will be in blood dripping red.)

So. My first aid assignment for the day was to figure out how to treat a neck wound with "severe arterial hemorrhage." Not that wimpy, mild arterial hemorrhage. We're going all the way on this one, dudes. Clearly enough, this is not the kind of thing I could find a volunteer for too easily. Not, that is, unless I was on the set of steamy vampire romance True Blood (which, I'll have you know, I don't watch. But I see the ads on the train all the time). The first step, clearly, was to figure out what exactly arterial hemorrhage was and how it differed from regular old bleeding. The answer? Arterial hemorrhage is way grosser and more cinematic. You can tell the difference because one happens when you get a papercut and the other happens when bright red blood is spurting out at regular, pulse-like intervals.

The biggest challenge with bleeding of any kind is just to get it under control -- an adult can lose 1 pint of blood to little effect, but make that 2 pints (or a delicious snack for Twilight's Edward!), and things start to move towards shock. More than that, and we're getting into the dying part. (Or the undead? Eh, that one was kind of grasping at straws.)

The major neck artery is the carotid, which you know from being smart and I know from trashy television shows. (Like The Vampire Diaries? Or is this getting silly?) Now, while we'd usually fight arterial bleeding with direct pressure, tourniquets on the extremeties, things like that. The problem arises from the fact that we're talking about the neck here. The body part that you get all "gah!"-ish if your scarf is too tight. So pressure is not exactly the ideal situation here. Unless you're a sexy sexy vampire. Instead, we need to get a little more creative.

The first thing you want to do is to avoid touching things as much as possible -- you might dislodge some sort of beginning-of-a-clot, which would make things even worse. Well, that's really the second thing you want to do. The first is to call a hospital, because things are going to get real bad real quick -- things will get so bad that the internet seems to be pretty much telling me that the only solution is to have a really good doctor use a balloon catheter to stop the bleeding and conduct unpleasant surgeries. If your patient lives that long. (Also, tonight, I have seen more bleeding necks on the internet than I even know what to do with. There are so many reasons I am not a doctor.)

Anyway. If you've called a hospital and not mucked around inside the wound too much, you can also -- very very very carefully -- apply pressure below the wound to the carotid artery. You know where it is. Find your pulse in your neck. Yeah. Right there. Find a spot below the spurting blood and press. Don't press on both sides of the neck at the same time and try not to compress the windpipe, but give it a shot.

Hey, look at you. You saved someone's life.

And you thought you just got here to see the entire cast of Twilight naked. Psh.

Eww, I have gross legs

You may not know this. If we haven't met, you have no way of knowing this. And if we have met, you're unlikely to have noticed. But I have superdisgusting legs. Fortunately, these superdisgusting legs are also our visual aid for tonight. Yay.

Since my mid-teens, I've had icky varicose veins on my calves. They are not subtle, not by any means -- they're so pronounced that a young gentleman at the gym during my college years may in fact have once asked me if I would tell him more about the horrible accident that had so dramatically mangled me. He may specifically have inquired if it involved an animal bite. (I don't dwell on past wrongs, not me.)

Regardless, I have gross, veiny legs. I will never be Tina Turner. However, the Handbook offers tips for a modern girl on the go. Sort of. See, for the First Aid badge (that's me, always bringing it back!), I need to explain how to treat severely ruptured varicose veins.

Wait.

Ruptured? With severe hemorrhage?

(That pause was just me going to the doctor in a panic.)

(Actually, it wasn't. After my grandmother's examining my leg and asking "What is that," I did once go to the doctor. He told me to wear support hose, which I coudln't bear to purchase, and therefore I totally ignored his advice. Oops.)

Now, my icky legs just look icky -- they don't hurt. (Also, it's surprisingly hard to photograph your own leg. So you know.) But apparently, varicose veins can become a big problem when they rupture. Leading up to it, though, they tend to bulge and turn reddish or purplish, which seems like the sort of thing that would already be a problem. So, you know.

By all reports (and I'm not willing to crack open my own legs to test it), the main strategy for a bleeding varicose vein is the standard elevation-and-pressure -- keeping the bleeding extremity above the heart and applying firm pressure above the wound (hence, I suppose, my deeply-refused compression hose).

Mission? Accomplished!

Got an idea?

Any thoughts on how one might demonstrate ladder-based rescue techniques in an apartment that is tiny by US standards, moderate by NYC standards, and quite reasonable by most-of-the-world standards? (I'm in a 4-room, 4th floor walk-up, and no, I am not going to carry anyone or anything up and down the fire escape. That's just insane, dudes.)

Things that make me mad

When I lost on Jeopardy, I was angry, but I wasn't mad. (Okay, fine. I wasn't angry, either. But I'm trying to make a charming connection to my return to the First Aid badge, so bear with me here.)

Anyway. I wasn't mad because I have never been bitten by a mad dog. Out of concern for the safety of one and all, though, the Handbook's First Aid badge requires understanding how to treat for just such a thing. And so, off we go!

Now, this component of the badge comes as something of a surprise to me. See, I knew that Louis Pasteur had developed a rabies vaccine in the 1880s, and so I saw treating a mad dog bite as kind of an irrelevant thing. Then again, I just wasn't thinking hard enough -- as anyone who's ever read To Kill a Mockingbird knows, rabid dogs were plenty scary in the 1930s.

The Handbook deals with mad dogs in one way and one way only: killing them. This makes any actual mad dog-related demonstration difficult, since I am not a horrible human being, and since most US rabies cases nowadays are found in wild animals. I considered, briefly, hoping Charlie the cat would bite at me (look at those choppers! ps, he posed for this while purring, because I was also holding him up to gaze at pigeons outside the window), but even that seemed ineffective. But alas, he wasn't feeling too bitey. So instead, I was unable to engage in the Handbook's primary anti-rabid-dog methods, which consist of waggling a handkerchief at a charging dog, matador-style, in order to distract him, then kicking him in the chin. (Alternate methods include wrapping a coat around your arm, presenting that arm to be bit, then either choking the dog with your remaining arm or clubbing him over the head. Please don't be angry with me for this. I am not urging you to do this to your pet, or to your neighbor's pet, or to any actual dogs. Ever. Really.)

Once you've subdued the mad dog, of course, there's still the first aid component: holy crap, you've been bitten by a mad dog! You have rabies! YOU ARE GOING TO DIE!

Never fear. Well, fear in 1911. But don't fear now. In the pre-rabies treatment days, you had a few options. Some included the 18th-century method of swigging a drink of liverwort, pepper, and cold milk followed by an icy bath, or the even older method of drying the dog's heart and eating it. Don't do this. Please don't. It will be a terrible idea.

(If you have gotten here via things like "eat a dog's heart," leave, you sick, sick individual.)

In real life, if you get bitten, all you really need to do is get to some soap and water, then get yourself to the doctor immmmmmmmediately. (If you can, by the way, let animal control know who bit you so they can quarantine the critter for a couple weeks.) Thorough washing will minimize viral transmission, so give yourself a solid 5 minutes with plenty of soap. (Since rabies is viral rather than bacterial, antibacterial soap will do nothing for you -- this is a huge pet peeve of mine.) Regardless, rush to the doctor for some post-exposure prophylaxis, a series of shots over the course of 6 weeks or so. It's supereffective, and since its introduction rabies deaths in the US have dropped to only a couple per year. Go team!

Zoo zoo zoo

Yesterday, I visited the zoo. See, I've been reading "The Lost City of Z" (like I mentioned a couple days ago), and all the talk about snakebite convinced me that now is the best possible time to pursue the, well, snakebite treatment portion of the First Aid badge. And where better to learn about snakes than at the zoo?

Despite last summer's exploration of Prospect Park, I'd never visited the Prospect Park Zoo, which was very much intentional -- I'm a big wuss, and I reliably find myself getting depressed at the zoo. It's the same reason I can't have pets who need to stay in cages or tanks, or that the NY ASPCA's subway ads bum me out for the day. While I understand intellectually that zoos have a lot of merits -- public awareness, preservation/breeding programs, things like that -- I find it uncomfortable in the moment. The thing the PPZ had going for it, oddly, was its smallness -- they didn't have big, big animals with ranges of hundreds of miles. Most of the critters were pretty small, and that helps at least a little. (I have mixed feelings about the two forlorn sea lions there, but we'll take a pass on that for the time being.) Also, they have what may well be my new favorite animal, the Pallas's Cat.

Now, I went to the zoo largely to investigate what types of snakes they might have, but the answer was, sadly, very few. I only saw a corn snake (no photography in the reptile house!), and everything I learned about it is totally irrelevant to the First Aid badge -- the corn snake is a constrictor which, while terrifying, means it's not so likely to be a biter. Zoo trip? Fun but irrelevant. Phooey.

Now, it's time to return to my total not-research in "The Lost City," which has mostly featured the 1920s explorer Percy Fawcett loading up his boats and packs with dozens of different antivenom serums and informing aspiring explorers that a snakebite is dangerous only if it turns blue and doesn't bleed. Sadly, this isn't actually true -- some bites (from coral snakes, for example) don't lead to major symptoms for hours and hours. I would bet money, also, that the Fawcett expedition -- and any expeditions launched using the 1911 Handbook -- might suggest sucking venom from a wound. Not so, says my Red Cross instructor! First, ew. Second, you won't necessarily get out most of the venom anyway.

So what do you do for snakebite? Nothing too surprising, it turns out. Splint the bitten limb (but not too tightly), wash the area well, and keep it below the heart (which makes sense, after all). Some folks might steer you towards use of a Sawyer Extractor (which looks kind of like the lease useful syringe ever), but that appears to be optional. Really, this is pretty much it, and everyone -- everyone! -- I've spoken to or dealt with says one thing and one thing only: call for help. Really. Call right away.

I finished all this, though, and I wasn't really feeling satisfied. Whether calling for help is the thing to do or not, seems to run counter to everything the Handbook cares about -- being competent in the woods, away from home. Fortunately, the internet is an excellent and reliable source for information about how to ignore medical advice. So I leave you with something you probably should not actually do if you're bitten by a snake: pressure immobilization. This sounds fancy, but it's really just wrapping the bitten limb snugly (but not so snugly as to restrict bloodflow) with a series of bandages before splinting it. This restricts the movement of the venom through the bloodstream, which has the side effect of loading up the near-bite area chock full of venom and maximizing damage there, but this is (often) a worst case scenario kind of treatment. So let's not do it unless we have to, okay?

There is no better day for this post

Before I begin, I have to say that the House's health care vote could hardly have made me happier. Having spent a large portion of childhood and adolescence on the wrong side of hard-to-insure, and having parents who've been self-employed in some capacity for the majority of their working lives, I've taken great umbrage throughout the debate at the idea that lack of health care is only an issue for the lazy and for mythical welfare queens (haven't we been done with that stereotype since like 1994?). Finally. While I know the new plan isn't perfect (what is?), the acknowledgment that 1) the protection of the people should be a primary role of government and 2) hardworking people can still be screwed over by the insurance system gives me the happiest grin this side of a icanhascheezburger. And believe me, I love a lolcat.

Now. I spent yesterday completing a major badge requirement for first aid. See? See? The promise of cheaper, more accessible health care is not making me abandon my commitment to being able to actually respond to a medical emergency. So there. (Sorry. I shouldn't check in with comments at the NY Times website while writing this.) Anyhow. As I was saying. I spent yesterday obtaining my Red Cross first aid certification.

In general, I was surprised with the brevity of the training program, though of course something is better than nothing. The real problem for me, at the training, is that I'm a wimp. I had a hard time looking at the images of amputations, objects embedded in eyeballs, that kind of thing, in the training manuals. For me, all this is straight-up nightmare fuel, though of course there's the (valid) argument that it's better to experience seeing pictures of it before I find myself walking down the street and coming upon someone whose internal organs have become external. (Despite Good Samaritan laws, I'm still not sure if I'd be able to handle that. Honestly, though, could you?) I know that this isn't a big deal for a lot of people -- at least, popular movies (of the sort I don't watch) would suggest it isn't. But still, I had a real problem with it.

There were thirteen of us in the class, and Antoine, our chipper instructor, walked us through bandaging each others' arms and legs with the least possible thought of actual gore. We spent a large portion of the morning improvising splints and making slings out of strips of gauze which, despite the certain Civil War field hospital air to it, I really enjoyed and was actually quite good at. (Witness John's bandaged arm for the show-and-tell portion of our program. They -- justifiably -- wouldn't let me take pictures at the actual training. Please note, I did not actually injure John's arm in order to wrap this bandage. I'm willing to sacrifice a certain amount of verisimilitude.)

My partner, an older gentleman taking the class in order to become a Red Cross instructor, supplied a counterpoint to Antoine's good nature. He'd done all the classes before, but he had no interest in any amount of sugar-coating. When the first-aid handbook suggested calling for EMT services, each time he'd lean over and ask me "what if we have a 9-11 situation and the infrastructure collapses?" I didn't have an answer. For a minute, I thought he was just paranoid. On the way home on the train, though, a tourist couple asked for directions to the World Trade Center site. Maybe he had a point.

One final thought, and this has more to do with my adjustment to New York than with anything actually first aid based. I'm interested, more and more, with the notion of "the country" here. I still get confused when I hear "the country" applied to places like Long Island, northern New Jersey, and all of Westchester, and a woman in my class made me think about this time and again. She explained that she was taking the class because she has a country house and, when she's there, she's scared to be so far from the hospital. How far, someone asked? Fifteen minutes by car.

I'll leave you with that one.

Sylvester

I did nothing this weekend. So, so much nothing. It's in preparation for spring break, see. I need to relax in order to be able to actually, thoroughly relax. My doing nothing consisted of making two more batches of hummus, which means I am, at this point, made of nearly 75% chick pea, and of reading a whole hell of a lot of books I don't like much, then posting vitriolic reviews of them over at goodreads. Everyone needs a hobby.

Actually, I did one thing: practiced a new lifesaving technique. For the First aid badge, I need to know not only the Schaefer method of resuscitation (with which, if you'll remember, I nearly killed John in October), but also the Sylvester method. Which does not involve being an animated cat, so you know.

Sylvester's method, it seems, has a lot in common with the version you see a lot in cartoons -- setting up the victim, then working his arms like a pump while he spits out water. In this case, of course, the patient needs to be flat on his back, and some materials instruct you to bind his tongue with elastic to keep him from swallowing it. (I tried this. It hurt more than I expected and got me all spitty, plus looked creepy. Based on all three of these criteria, I would advise you not to bother with the tongue-binding portion.)

Anyway. Once your victim (well, the victim. Presumably, you are not the one who got him there) is sprawled flat-out, there's a certain amount of flipping his arms above his head to make him inhale, followed by flopping them back down for an exhalation. It sort of works, though John (who is, once again, an extraordinarily good sport) found it vastly inferior to the flat-out chest-thumping of Schaefer. It appears that Sylvester (sometimes spelled Silvester, in case you wondered) is a less-vigorous (well, yes) lifesaving method, for when you need less total resuscitation power. Maybe your victim is less-dead, or maybe he's more fragile, I'm not sure.

One week to my first aid class!

Danger!

As you guys know (I think), I'm a teacher. And while I'm justifiably coy about the name and location of my school, I take it enormously seriously. Not humorlessly. Just seriously.

This is what's pushed me towards my next badge: first aid. Once again, I'll be coy, but the subject I teach occasionally requires using sharp or hot tools and there's the potential for injury, no matter how careful I am (or how careful my students are). This isn't an issue of negligence, or of lack of safety precautions, anything like that. We wear gloves, goggles, masks, whatever's necessary. I've never had a serious injury in my classes, though at some of the schools I've taught in, I've broken up some fights. But you never know what's going to happen, and that's why I think it's time for me to, um, be prepared.

The more I've thought about it, the more convinced I've become that my next project ought to be the first aid badge. I just signed up for a Red Cross course, and in 2 weeks I will be first aid trained. Who thought the Handbook project would make me better at my job?

(Incidentally. Are other people as troubled as I am by the arrival of a movie starring the guy from Twilight that uses Sept. 11 as a twist ending? It probably says more about the age of the movie's likely audience -- for them, the WTC hardly existed except as something fated to fall -- but still.)