# 231 On the road; On a rant . . .
distracted pedestrians who text or play ‘pokemon’ instead of looking where they’re
going, are provoking punitive legislation, Campaigns to decrease distracted
submit that, IMHO, considering variables, driving is the single most complex and dynamic human activity
with risk; millions participate, often with minimal training, perhaps with
impairment, and the scant controls are likely to come into play only after the
harm is done.
just survived a long journey at the wheel, I have observations that must serve
as a ‘rant’ as “I/you/we” as individuals have little direct impact, but I call
these as points of discussion.
mentality: Prevailing suburban and highway speeds ≥ 10-15 mph above posted
limits regardless of conditions; “whatever
you think you can get away with”; urban ‘racing’ traffic lights, disregard
for speed or right of way.
following distances for speed, surface condition, blind road bends and summits,
unable to see around large vehicles, tinted windows; dependent upon other fellow’s safe decisions;
extreme tailgating and weaving.
faster than one can see the roadway by the headlights’ illumination.
on shoulder/verge, where there is no lane, or crossing prohibited center line.
allowing for potential sudden events: foolish actions; objects in roadway;
shoulder activity, wind gusts, etc.
recalls the years 1966-73, each with >50,000 deaths (at one point greater
than all US deaths in Vietnam war to that date). There are fewer fatalities now
despite more cars, but this is probably due to engineered solutions, seat belts and helmets, airbags, improved
trauma care, and stricter Blood Alcohol limits.
Wikipedia reports: “Records indicate that there has been a total of 3,613,732
motor vehicle fatalities in the United States from 1899 to 2013.” This is
nearly the entire population of Los Angeles, California; a stark vision to
imagine those numbers as individual persons and the total sorrow of families.
# 232 The Glove.
Influenza season will be hitting soon. Some will be very ill, or even die. Word from Australia is that this is a hard season; as the influenza type makes its earthly progression, expect your next season to be hard.
Some patients will be restless and picky, hypothermic, or annoyed by the adhesive pulse oximetry sensor that keeps coming off. You may be struggling for good consistent signals.
Pick the best perfused digit. Carefully apply the sensor snugly. If needed, spiral a supporting piece of tape without tourniquet effect around the digit. Fit the patient's hand with a nitrile glove that has the fingerstalls cut off except the finger being sensed. This will keep the sensor snug, in place, with a warmer digit, and allow inspection for cyanosis. (IV sites in the hand can also be protected this way.) With infants, attach the sensor to the toe or foot, then replace the sock so they won't pay any attention to it. Always apply a "tug tape" for stress relief at the wrist (or ankle). We sabotage ourselves when patients move around pulling the sensor by its wire thus lifting the sensor off its site,
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