Nightingales and Norco

Nightingale I'm almost a nurse with basic knowledge and a lot of textbooks. Send me your whump questions and I'll do my best to answer. If I can't find an answer, I'll try to send you to someone who can. Also read the notes! People smarter than me sometimes chime in and correct wrong information. PLEASE NO REQUESTS FOR GENUINE MEDICAL ADVICE. I am NOT qualified for that.

[nightingalesandnorco]

New Whumper on the Block!

Hi! I'm Nightingale, and I'm almost a nurse. What's the best part about being almost a nurse? Being able to write medically accurate whump of course!

I may not be a full nurse yet, but I have basic knowledge and a lot of textbooks. Ask me your whump questions and I'll do my best to answer them. If I can't, I'll try to send you to someone who can. And don't forget to read the notes on my posts! People smarter than me might have chimed in to give additional information or correct wrong information.

Please no requests for genuine medical advice. I am not qualified to answer them.

The nurse will see you now!

[nightingalesandnorco]

I’m making an overdose prompt whump fic that involves cpr, i have question about how exactly narcan or any drug-reverse medication works exactly in cardiac arrest scenario, would the patient slowly regain their pulse after administering narcan because I saw some first aid video where the dispatcher kinda stopped doing CPR after administering narcan, and would the patient still able to be revived without narcan?

I’ve been taking a break from answering asks for school, but I felt that I needed to answer this one now because opioid overdoses are a very real and common thing and I want to clear up this misconception for anyone who might find themselves in the position of administering Narcan in real life.

Narcan, or naloxone, is an opioid antagonist. That means it specifically, temporarily reverses the effects of opioids like morphine, hydromorphone, hydrocodone, fentanyl, heroin, etc. The reason opioid overdoses are so serious is that opioids depress the respiratory system, meaning that patients hypoventilate and don’t get enough oxygen. If overdoses are severe enough, patients can suffocate and die. Narcan reverses the effects of opioids, raising the respiratory rate and allowing the patient to breath effectively.

It must be noted that Narcan is not a cure-all for opioid overdoses. Narcan only works for about 3-5 minutes, so it must be readministered every 3-5 minutes until the opioid has left the patient's system. Narcan can be administered by injection or nasal spray, the latter being the most common because it can be done fast and works fast. Narcan is available over the counter in most pharmacies and is not a bad thing to have with you. Always call emergency services after administering Narcan. The video below explains how to administer Narcan.

Please note, if the overdose is not caused by opioids, Narcan will not work and the best course of action is to call emergency services immediately.

If a patient experiencing an opioid overdose goes into cardiac arrest, forget Narcan, call emergency services, and begin chest compressions. The patient already has no respiratory drive because they’re dead, Narcan will not change anything. If an overdose patient is found with a pulse but no respirations, administer Narcan and call emergency services. If return of spontaneous circulation is achieved, Narcan can be administered.

[nightingalesandnorco]

Is it possible to like, having a seziure then foaming at mouth without consuming any drugs prior?

Tonic-clonic (grand mal) seizure can sometimes cause people to foam at the mouth.

Happy whumping!

[nightingalesandnorco]

What would be the general "oh i think theyre starting waking up" from coma stuff? Becoz i heard that the usual hand/eyes twitching can also happen when the person is still in deep coma so it cannot be used as measurement?

Because everyone is different, comas can present differently, but eye opening or muscle twitching that is new onset or increasing in frequency may indicate an increasing level of consciousness.

Happy whumping!

[nightingalesandnorco]

Would person who suffer long cardiac arrest (at least 10 min) have longer recovery time comparing to brief cardiac arrest (1-2 min)?

With the assumption that both are healthy male with exact same reason on why they suffer cardiac arrest, and immediate medical treatment.

CPR is essentially chest and abdominal trauma, and thus, prolonged CPR would be more likely to result in complications like broken ribs, broken sternum, punctured lung, and bruised organs than brief CPR. However, nothing is absolute, so anyone can conceivably develop any of these complications after any length of CPR.

Happy whumping!

[nightingalesandnorco]

What considered as "Stable but critical" actually?? Since both stable and critical kinda contradic eo no??

Stable and critical are opposites. Did I say "stable but critical" in an earlier post? If so, it must have been a typo. Could you point me to it so I can correct this error?

[nightingalesandnorco]

Say someone was put into induced coma for 48 hours, in the 48th hours the doctor turn down the sedation, would the patient wake up right after the sedation is out of their body or its still unpredictable?

Everyone responds differently to sedation, so this is by no means an exact science. My best answer for this is "maybe, maybe not."

Happy whumping!

[nightingalesandnorco]

When someone stopped breathing after drowning but still have their pulse, is it possible to bring them back by only mouth to mouth or basically anything without medical intervention?

Rescue breathing is the preferred treatment for patients who experienced a near-drowning but still have a pulse. As always, ensure that the person's airway is open using the head-tilt or jaw thrust technique before delivering rescue breaths.

Happy whumping!

[nightingalesandnorco]

In what scenarios rubbing knuckle to someone’s chest helpful since it seems to be painful instead of comforting?

A sternal rub in used to rouse a person who is seemingly unresponsive but has vital signs. Their reaction to the rub can help determine their level of consciousness. You often see this done to people who are suspected of having a drug overdose, but it isn't always done.

Happy whumping!

[nightingalesandnorco]

Re : the drowning and broken ribs recovery ask

Since it took at least a month would the victim stays in hospital for that time being or would they be allowed to leave even before the ribs is fully recovered?

The patient can go home that day as long as nothing in their condition indicates a need for further observation like a brain injury or an inability to maintain an adequate oxygen saturation.

Happy whumping!

[nightingalesandnorco]

In movie or series after someone suffer traumatic injuries, sometimes there are scene of their friend or family watching them getting treated for a while behind glass or door before the doctor cover the view usually with curtain, but like, realistically, what is the furthest patient's friend or family can watch them before the doctors cover the view?

As long as their presence does not impede the medical team's ability to care for the patient, the patient's family and friends can stay with them unless they go to dangerous or sterile areas like the operating room or radiology suite (for x-ray, fluoroscopy, CT, MRI, etc.).

Happy whumping!

[nightingalesandnorco]

Aside from broken nose, is there any facial injuries that can cause nosebleed?

Any nasal trauma can cause a nosebleed, regardless of whether the trauma results in a fracture.

Happy whumping!

[nightingalesandnorco]

I read your answer that heart monitor on patient's room usually doesn't have sound, but does this apply too on portable heart monitor (whatver the name is) that medic bring to resus scenario outside hospital?

I'm not a paramedic or an EMT but according to my research, the portable vital sign monitors used by EMS and paramedics function in the same way as vital sign monitors used in the hospital.

Happy whumping!

[nightingalesandnorco]

Imagine a person getting impaled through the body by at thick spear or anything that could leave gapping hole on the body, asumming they survive, would the gap in their body heal and close on its own or would it need medical intervention?

The person would need medical intervention regardless because they sustained a penetrating injury, but I suppose whether or not the wound closes could depend on how wide the spear was. A spear with a circumference of about 1 inch (which I think is standard but I'm no spear expert) would probably be okay, though. The body is under a lot more pressure that you might think and it has a very vested interest in keeping itself together. Assuming the person didn't die from a lack of medical intervention, the wound would eventually close itself over with scar tissue.

Happy whumping!

[nightingalesandnorco]

In movie or series cardiac arrest scene they ocasionallsy shock the victim twice in a row or so but if I see documentary about similar stuff they need to wait for around a min before doing it again, obviously the docu is more realistic but is there any reason why they delay the second shock for a min or so?

The purpose of defibrillation is to momentarily stop the heart from beating when it is beat ineffectively (ventricular tachycardia or ventricular fibrillation). This allows the heart's natural electrical activity to regain control and start a healthy rhythm. For this reason, defibrillators are not used for cardiac arrest because there is no ineffective rhythm to eliminate.

In a situation in which defibrillation is required, the heart needs time to restart itself after the shock, so multiple consecutive shocks would be counterintuitive. If the rhythm continues to be ineffective after defibrillation, a second shock is delivered after a few rounds of CPR (the defibrillator determines the frequency).

Happy whumping!

[nightingalesandnorco]

So if someone almost drowns, and ends up with brain damage as a consequence, what different symptoms could that cause? I'd be curious to hear both about the milder (relatively speaking) and more severe possibilities

(sorry if this is phrased badly, it's 2am and english is not my first language...)

The type of brain damage caused by drowning, or any type of asphyxiation, is known as anoxic brain injury. The manifestations of anoxic brain injury can include behavioral or personality changes, difficulty with tasks that used to be easy, concentration and memory problems (long-term and short-term), difficulty with reason and logical thinking, problems with balance, sensory changes, difficulty speaking and swallowing, difficulty recognizing familiar people, new-onset phobias, unexplained anxiety or depression, mood swings, sleep disturbances, headaches and unexplained aches and pains, bowel and bladder dysfunction, and changes in sexual function.

Happy whumping!

[nightingalesandnorco]

How long would the average recovery time for a drowning victim until they got discharged and deemed fully or mostly recovered if they got their ribs broken during the cpr and they was basically dead for like 5-8 minutes?

(For context, my character is an athlete that are going to start new sport event, but they have a lot of haters and around 1.5 months before said event, they were attacked, incapacitated then thrown to body of water and left to drown, but ofc they were found, resuscicated, and still going to said event and like "LMFAAOO you cant kill me!!")

Broken ribs can take at least a month and up to three to fully heal, which would be the longest recovery time assuming the near-drowning event did not cause brain damage. Other injuries like pulmonary contusions and lung/airway irritation from inhaling water would also heal during that time.

Happy whumping!