Rose

We have managed to potentially determine Sara is Finnish and maybe Josh is Australian and there's been a trip to Whitchurch but that's it!

I bought a second hand copy of @scandikitchen.bsky.social's Scandikitchen and found a load of photos and letters from a Josh and Sara inside. Not sure if we can find them incase they want them back?

- Haemorrage is rare but these digestive juices can dissolve the external layers of blood vessels around the pancreas resulting in haemorrage. This would potentiallly show as bruising and signs of shock. 10/10

This is why clinicians will look for amylase in blood tests for pancreatitis - amylase may have been released from the aciner cells and ended up in the blood stream in higher volumes than we'd expect. It is also why people who have chronic pancreatitis might be on enzyme supplements. 9/10

- Exocrine dysfunction. The pancreas has aciner cells for digestive enzymes which when damaged two things happen: autodigestion of the pancreas resulting in further damage and exocrine insufficiency. The enzymes can cause further damage to the pancreas as they can corrode the tissue. 8/10

- Endocrine dysfunction - When the pancreas isdamaged it develops scar tissue which doesn't have endocrine functions. Therefore someone can develop diabetes or we might see large changes to blood sugars without a formal diagnosis. 7/10

- SIRS: Damage to the pancreas results in an exceptional release of inflammatory mediators which results in a systemic inflammatory response. This produces a similar pattern of signs to a septic response but without the pathogen. Therefore may have a ⬇ BP, ⬆HR, ⬆ RR and ⬆ Temp. 6/10

Pancreatitis can result in quite severe complications. Many of these will only be detected in hospital however there are some that we might see in the pre-hospital setting:
5/10

Symptoms include:
💥 central abdominal pain (that can radiate to the back or the left side).
🤮Nausea and quite persistent vomiting
🌡A fever may be present
🍷Symptoms may be associated with eating or drinking alcohol.
4/10

The most common causes of pancreatitis are due to alcohol or gall stones blocking the pancreatic duct. This can be acute or chronic. As paramedics we are most likely going to deal with acute pancreatitis. 3/10

The pancreas is an endocrine (releases hormones into the blood stream: notably insulin and glucagon) and exocrine organ (releases digestive enzymes and NaHCO3 into the duodenum to aid digestion). 2/10

Highlighting an unsung villian that often get's overlooked in paramedic practice: pancreatitis and it's complications. 1/10
#paramedic #prehospital #emergencycare #pathophysiology

I just feel there is some element of compassion missing. Both in the expectations of his recovery but also in the expectations of the public. Is this really what's best? But hey who am I to talk, I'm not one of the staff treating him but I'd be intrigued to know how they feel about it.

I wonder what the expectations are that are being given to the public. I'm unsure if the general public are aware of the realities of recovering from this level of medical intervention. Even following recovery, is the expectation that he returns to work?

I have to question what the expected quality of life for him is right now and the quality of life should he recover. Pneumonia is HARD on the body let alone a) bilateral b) polymicrobial c) as we get older and d) with part of our lung missing.

Pope Francis 'alert' after respiratory failure, Vatican says The Pope resumes mechanical ventilation after suffering two "acute respiratory failures" on Monday.

As someone interested in PEoLC and a paramedic who has dealt with my fair share of elderly people with pneumonia I have found the Pope's situation intriguing and concerning but for a different reason.
www.bbc.com/news/article...

When considering lung cancers, it is worth considering chest wall tumours and lymphoma as they can press on the lungs and affect breathing. It is also worth considering complications such as superior vena cava syndrome which are more common in chest wall and lung cancers. 9/9

😷Mesothelioma is a very slow growing cancer primarily caused by asbestos exposure. It can happen in the pleura of the lungs but also can occur in the peritoneum and even the pericardium. The fibres from asbestos are thought to lodge in the body and cause mutations that prevent tumour supression. 8/9

⏱Small Cell Cancers can be isolated or combined. They tend to spread rapidly once they develop. A subgroup of these are neuroendocrine tumours. 7/9

Large Cell Carcinoma - These are other lung cancer cells that don't fit into the other categories. This used to be the most common type of non-small cell cancer but this was before adenocarcinoma and squamous cell carcinomas were recoginised.🔬 6/9

- Squamous cell carcinomas - This is often associated with skin cancer but it can occur on the flat superficial cells in the airways. They tend to occur in the bronchi or just at the centre of the lung as the bronchi branch into bronchioles. Smoking is a major risk factor🚬5/9

Non-small cell cancers (80-85%) are more common & include: Adenocardinoma - The most common NSC-C and often occur in the alveoli. Although smoking can cause adenocarcinoma it is the most common lung cancer found in non-smokers; my guess is this is what Walter White was diagnosed with🧪4/9

Initially there are 'small cell cancers' (sometimes these are also known small cell carcinomas) and 'non-small cell carcinomas. This is based on how they appear under microscopic examination. 3/9

Firstly, there can be primary cancers and secondary cancers. A primary cancer is the organ of origin for the cancer. For example, primary lung cancer originated in the lung. Secondary lung cancer will have originated elsewere but metastisised to the lung. 2/9

In general, us paramedics are pretty bad at understanding different cancers and what they mean.
Here I have tried to cover some of the basic terms surrounding different lung cancers that can occur. 1/9

Got my royalties from my book. Spent most of it at the garage. 🥲 #adulting

Unlike my email and the app that cannot be named, I've spelt my name right here :P

She's here!

www.amazon.co.uk/Paramedic-Po...