ScriptMedic @scriptmedic - Tumblr Blog

I think about British Airways Flight 5390 a lot

OKAY STRAP IN because this is one of the WILDEST stories in aviation history.

In 1990, a British Airways BAC One-Eleven, captained by Tim Lancaster and co-piloted by Alastair Atchison, was cruising at 17,000 feet.

Around 15 minutes after take-off, flight attendant Nigel Ogden entered the cockpit to bring the pilots something to drink. One second everything was fine. The next second, the pilot's side window blew out from the force of the pressurized cockpit. Even though he was strapped in, the force of the explosive decompression ripped the captain out of his chair and pulled him though the window.

The flight attendant immediately leapt forward and grasped the captain's belt. The force was so strong - due to the plane's speed - the captain slipped and was pulled almost entirely out of the plane, but the flight attendant caught his leg. The captain laid on the roof, then the side of the fuselage (the above image is an inaccurate recreation - the side window was smashed) and the flight attendant's entire arm was soon outside of the plane, gripping him.

(Recreation from the show Mayday at the point of decompression)

At the same time, the event caused the autopilot to disengage, and the captain's body hitting the flight controls caused the plane to enter into a deep dive. The throttle was set to full power and could not be accessed due to debris, meaning the plane was descending rapidly. The co-pilot, experiencing hypoxia, fought to control the plane's dive while allowing it to continue descending to a level the passengers/crew could breathe at. He attempted to contact air traffic control, but the wind made communication impossible, so he broadcast a mayday signal. Finally, he was able to re-engage the autopilot and level the plane out at a breathable altitude.

Soon, the flight attendant's entire arm was burned from wind shear and frostbite, and his grip began to slip. The other attendants entered the cabin to see what was wrong and took over holding the captain's body. Seeing the blood covering the windows from the captain's severe wind sheer burns and frostbite, the attendants and co-pilot knew he was dead. However, they could not let his body go because it could smash into the wing, horz stabilizer, or engine, and bring the plane down.

For 30+ minutes the co-pilot flew a jet plane with an OPEN WINDOW and his co-worker's body hanging along the side of the plane. Finally, clearance to land from ATC came across over the sound of the wind and the flight attendants were able to dislodge the captain's ankles from the flight controls without letting him go. The co-pilot successfully landed the plane.

(tw below for blood)

(Taken same day as the incident)

BUT HERE'S THE KICKER: when they reached the ground and evacuated, they realized THE CAPTAIN WAS NOT DEAD.

He SURVIVED being outside the fuselage of a jet airplane traveling 550mph at 17,000 feet. His only injuries were extensive - but mostly superficial - frostbite and windshear burns, bruising, fractures in his hand, and shock. He has since stated that he remembers the event and was conscious for much of the time he was outside of the fuselage. The only other injury was the flight attendant's frostbitten/windshorn arm. Captain Tim Lancaster returned to flying five months later.

(Captain Tim Lancaster in bed several weeks after the incident, with flight attendant Ogden (+ Ogden's wife) above him and co-pilot Alastair Atchison to the far left, along with the two other flight attendants)

Why did this occur? Because the plane had received maintenance the day before, and the maintenance supervisor did not check he was using the correct screws in re-installing the windscreen.

(Recreation)

So yeah: you can apparently survive clinging to the side of a jet airliner traveling 500+mph at 17,000 feet.

hamletthedane

Wow! Didn't expect this many likes for an aviation post.

Just a note that I was wrong - it was the front pilot's windscreen, not the side-window! I'm used to looking at Boeing windows with different positions :)

If y'all want the full story & more analysis of what exactly went wrong, Mayday: Air Investigations did a pretty decent special on the incident. It's free on YouTube here (and here on dailymotion if you're outside the US).

desmoscatghost

Adding some stuff:

The ‘maintenance supervisor did not check the bolts’ is technically correct but ignores the amount of stuff that had to go wrong for that to happen.

1: the supervisor was the one doing the bolts (I think there was a staffing issue) and so did not have to check the work that he did

2: the window was not on the list of vital components that need to be checked by someone else even if the supervisor does it.

3: the parts store where he had to go to get the bolts was badly lit and had bolts in the wrong drawers.

4: the wrong bolts and the right bolts are almost indistinguishable by sight.

5: the correct tool to put the screws in was not available so they had to do some lite bodging to get the screws in. By this I mean it was still a torque wrench and they checked it released at the right point but the correct socket did not stay in place or something like that.

6: any slight differences between the right bolts and the wrong bolts were hidden because of the tool they were using (which would have worked perfectly if they were using the right bolts).

If one of those things had not happened then the plane would have had the right bolts when it took off.

hamletthedane

^ absolutely critical edition and a great example of what’s known in risk analysis as the Swiss Cheese Model.

From Wikipedia:

“The Swiss cheese model of accident causation illustrates that, although many layers of defense lie between hazards and accidents, there are flaws in each layer that, if aligned, can allow the accident to occur. In this diagram, three hazard vectors are stopped by the defenses, but one passes through where the "holes" are lined up.”

Accidents in complex systems are very rarely one person’s fault and my original post indeed oversimplified the incident for the sake of telling a straightforward story. This was not the case of one bad maintenance worker; this was a systematic failure. The holes lined up and a tragedy nearly occurred because profit (short staffing, poor maintenance facilities, poor training and tools) was prioritized over safety at several layers. Any additional degree of safety would have prevented this from occurring.

smol-blue-bird

all STEM students should have to take humanities courses, and all humanities students should have to take STEM courses

smol-blue-bird

@caesarsaladinn I had a whole discussion with a history major who was extremely confident that smallpox is a “common childhood illness” with a very low death rate. Therefore, she believed that historical smallpox outbreaks were either massively exaggerated or used as a cover-up for something else (since “smallpox isn’t that bad.”) I eventually asked if she was possibly confusing smallpox with chickenpox, at which point she said, “aren’t they the same thing?”

the-grey-tribe

The English language really whiffed on that one. Should have called it largepox or at least regularsizepox.

myfootyrthroat

The whole "-pox" making system could use some work. Are we doing sizes? Animals? Get it together.

imjustusingthistolikeartists

One of the less deadly variants of smallpox was called cowpox, and the fact that dairy maids who contracted it tended to avoid the worst affects of smallpox is part of the development of vaccination

smol-blue-bird

Cowpox is actually a separate (but very similar!) virus!

There's a lot of confusion about different "poxes" in this post (which wasn't my intention, and now I feel bad), so here's a general overview (also, obligatory apology for messiness, this was written at like 1 AM):

Smallpox:

Smallpox, caused by variola virus, was a massive problem historically. It existed in the Western hemisphere for thousands of years (genetic evidence of smallpox has been found in Egyptian mummies from ≈1500 BCE, but it was probably around long before then), and it was introduced to the New World during the Columbian exchange, which had devastating consequences for indigenous populations (which were already suffering from colonialist violence, which made epidemics much worse than they already would've been). Historically, smallpox had a case fatality rate between 30-50%, and survivors were often left disfigured or permanently disabled (you've probably seen pictures of smallpox scars, but smallpox can also cause blindness and other complications). Importantly, smallpox only affects humans—it has no animal hosts—which is why it's one of the few infectious diseases to have been completely eradicated. As of May 8, 1980, it officially no longer exists outside of certain designated American and Russian laboratories. (There are, however, concerns that it could be used as a bioweapon, which is why the government still stockpiles smallpox vaccines and antivirals. I wrote my bioethics term paper on this exact issue, and incidentally, it's one of the major reasons why I believe that STEM majors should take ethics courses!)

There were two strains of variola virus: variola major and variola minor. Variola major was much more dangerous, with a much higher mortality rate; variola minor typically didn't cause severe disease. Fortunately, infection with one strain conferred immunity against the other. Both strains are now eradicated. (People sometimes confuse variola minor with other viruses like cowpox and horsepox, but they're different things.)

There were four clinical forms of smallpox: ordinary (classic smallpox, associated with the rash you usually see in pictures), modified (less severe, often occurred in vaccinated people who got infected anyway), malignant (caused a flat rash instead of the usual pustules, associated with immune dysfunction, almost always fatal), and hemorrhagic (caused severe bleeding, and also near-universally fatal.) All of the non-ordinary forms could be difficult to diagnose because they looked so different from typical smallpox. The less serious "modified" form was often confused with chickenpox, and the hemorrhagic form was sometimes assumed to be a completely different disease. Occasionally, historical sources will refer to hemorrhagic smallpox as "black pox," with or without an understanding that it's caused by the same virus as ordinary smallpox.

Other relevant viruses:

Cowpox, caused by cowpox virus (an orthopoxvirus similar to smallpox) causes mild disease in cows, humans, and several other animals. Infection with cowpox virus confers immunity to variola—Edward Jenner noticed this relationship and used material from cowpox lesions to inoculate people against smallpox.

Vaccinia virus, another orthopoxvirus, is the source of the modern smallpox vaccine. It's closely related to both cowpox and horsepox (weirdly, it's actually closer to horsepox), but it's distinct enough to be its own species. Infection usually causes mild symptoms, and, of course, confers immunity to smallpox.

Chickenpox is an entirely different thing. It's caused by the varicella-zoster virus, which is a herpesvirus, not a poxvirus at all! Infection with varicella-zoster does not confer immunity to smallpox or any other poxvirus—chickenpox is from a totally different family.

So why are the names so weird and confusing? Why is everything about all of this so weird and confusing?

There are multiple reasons for this, so bear with me.

Historically, a "pox" was any disease that caused a bumpy rash of pustles/blisters. Chickenpox, smallpox, and the other "poxes" all cause superficially similar rashes—thus the similar names. (Even though we know now that chickenpox comes from a completely different family, this wouldn't have been apparent before the dawn of modern medicine.)

Smallpox was given that name to differentiate it from syphilis, which was known as the "great pox" when it first appeared in Europe. (Fun[?] microbiology fact: There are debates about the origins of syphilis, but the most common theory holds that it originated in the New World, and Christopher Columbus brought it back to Spain. In that way, it's kind of the inverse of smallpox.) Historically, smallpox was also known by a variety of other names in different European, Asian, and African cultures. Again, this gets murky, because historical physicians sometimes struggled to distinguish between similar-looking-but-different diseases.

Other poxviruses are often named after the animals in which they were first identified. This is not a hard-and-fast rule, though, and it can sometimes be misleading (for example, monkeypox virus was first discovered in laboratory monkeys, but it more often affects rodents and other small mammals. The disease formerly known as "monkeypox" was recently renamed "mpox" because the name wasn't accurate.) Also, some poxviruses aren't named after animals at all! It's a weird and inconsistent system (but a lot of virus names are kinda weird and inconsistent).

Related to the above: We don't even know where the name "chickenpox" comes from. I mean, we know it was called a "pox" because it causes a pox-y rash, but we don't know where the "chicken" part originated. There are multiple theories about this, none of which are definitive. The disease itself has nothing to do with chickens.

Basically, a lot of the weirdness is a result of historical naming practices—people identified and named these diseases before modern virology existed, and those names stuck, so now we have similar names for superficially-similar-but-ultimately-different viruses, and names whose origins have been completely lost to time. Later, virologists muddied the waters further by naming newly-discovered poxviruses after the animals in which they were first seen, even when these animals aren't natural hosts or reservoirs of those viruses. It's a mess! And, again, all of this is complicated by the fact that some of these diseases were very hard to diagnose (or distinguish from one another) before modern medicine existed. Now, we can sequence viral DNA and figure out what's actually going on—which viruses caused which symptoms, whether those viruses were closely related, and whether being infected with one disease conferred immunity to another—but historical doctors and scientists didn't have those tools, so they were doing they best they could with very limited information, and that led to a lot of weirdness in terms of how these viruses were named and classified. Our current system inherited some of that weirdness, so here we are.

TL;DR: Poxvirus names are messy. Smallpox is caused by variola virus, which has two strains: variola major (the more severe one) and variola minor (less severe). Cowpox and vaccinia are different viruses in the same family, and being infected with one of them confers immunity to smallpox. Chickenpox isn't a poxvirus at all, but a herpesvirus—it just happens to cause a pockmark-y rash that looks superficially similar to smallpox pustules (and mild forms of smallpox were historically confused with chickenpox).

(P.S. none of this is super relevant to the average person, so don't feel bad if you didn't know any of it. Unless you are a history major inventing new conspiracies about smallpox, in which case you definitely should feel bad.)

Sources & further reading under the cut!

revangerang

Unrelated but there should be more “art appreciation” and “film appreciation” type courses for non majors.

I would love to take a “sports appreciation” class. Tell me what all the straights find so entertaining lol

professorwetware

We will all die someday. But not from smallpox. Think about it.

constance-mcentee-deactivated20

Without naming your job, tell me something you say over and over again at work.

"I can note your interest in that feature for future development."

calling-the-angels

"Fuck this shit." 😆 repeated over and over cause I don't really talk to people or customers.

sweaterkittensahoy

"Okay, so we do have a procedure, but no one wrote it down."

spyderqueen

"No, this function doesn't have an audit trail. Only like 3 things total have an audit trail."

vaspider

"Unfortunately we don't have any more information than you do on your package tracking. Here's the number to your local post office, start there."

memories-of-ancients

"Albuterol doesn't do that."

scriptmedic

"The bad news is that I have to stop your heart for about ten seconds. The good news is, that should fix it."

(Okay not THAT often, but it is a perk.)

twocubes

what if you combined a pressure cooker and a deep fryer and made a pressure fryer, the most dangerous kitchen implement in history

baedlyweathered

does this imply you want to heat cooking oil to past its boiling point at one atmosphere

iatrophilosophos

Its real and its called a broaster.

garaged0g

*grabs america by the shoulders* we have got to lock the fuck in. south asia and the middle east are running goddamn circles around us. we have got to come up with a more dangerous way of cooking food now or we can kiss these quarter finals goodbye

mcdevinpants

@scriptmedic you thought the idea was bad!

scriptmedic

Man. And I thought the time I saw a street vendor cart explode because of the rain was bad...

*cries in paramedic*

modern-politics111

scotty-wolf-lover1968

important and encouraging

pcamtschatica

Found a great (free) documentary on the Freedom House Ambulance Service here- https://www.wqed.org/freedomhouse/ (has captions too)!

hoodiedeer

I can’t believe this is the first time I’ve heard about this. like for years I’ve been thinking “imagine if the police were in charge of ambulances and firefighting, all the horrible problems that would cause, wouldn’t it be better if they were a separate thing, etc” as a way to better understand/explain the fundamental problems with the existence of police. that framing was part of what made me start to understand why my friends were saying “ACAB” and “abolish the police”. I had no idea it was literally once historically like that and not just a hypothetical tbh

ardentdelirium

Interview with one of the original members of Freedom House Ambulance

scriptmedic

This is cool as shit, and a part of my own career's history that I didn't even know about.

#ems #ambulance #ecnalubma

I was thinking about how my position on medical realism in storytelling has changed.

When I started this blog, all the common mistakes/tropes/myths really got inder my skin, because life/medicine/the human body usually doesn't work the way it does in movies or TV.

Or rather, movies and TV like to ignore how things really work in service of telling a better story.

And when people think life works like the movies, it adds real difficulties by way of unrealistic expectations. It makes the real world harder.

Then my pendulum swung toward, "tell a good story with enough detail that it feels real enough for the world you're building." Basically, I loosened up a bit, and recognized that stories are meant to be fantasies.

Then I watched the first few episodes of E.R. for the first time the other day courtesy of Mrs. Scripty, and realized that when a good writer gets the medicine right, you can have both incredible storytelling and pinpoint accuracy. (I spotted one tiny error in the first 4 episodes of ER, which, all else being equal, is an incredible accuracy rate. Even the characters' mistakes are completely appropriate based on specialty and experience).

I think you're still better off deciding how real you want your story to be, and what you want the impact of a given injury/illness to have on your character, and what you want it to reveal about them, and back-building from there.

But damn is it good to watch a show really fucking nail it.

#scripty gotta script #er (tv show)#this post is not medical advice

I know this is a super duper longshot. But. Do any of my GIFmaster friends have either of the following?

• The line "Tricky fish! Tricky fish!" from Lilo & Stitch

• The moment from the Invader Zim Christmas special where Santa ignores a question and just.... shoves a little girl under the bed

• The line "Naaaaah... eh-eh" from the Muppets Christmas Carol

I would be eternally grateful if any of these things existed, but my GIF-fu is weaksauce.

PS, love you all ❤️

xoxo, Aunt Scripty

#gif request #halp plz plz halp

Hi I’m new here idk know the ‘about books only’ part of asks works, but does it count if I ask for book recommendations? Because I was wondering if you knew (or had written) any books about eating disorders and how to write and/or support someone with one.

Hey! Sorry, I don't know any books on the topic, but for the overlap of mental health and storytelling, try @scriptshrink !

bump-of-whump

Ref Recs for Whump Writers

Violence: A Writer’s Guide: This is not about writing technique. It is an introduction to the world of violence. To the parts that people don’t understand. The parts that books and movies get wrong. Not just the mechanics, but how people who live in a violent world think and feel about what they do and what they see done.

Hurting Your Characters: HURTING YOUR CHARACTERS discusses the immediate effect of trauma on the body, its physiologic response, including the types of nerve fibers and the sensations they convey, and how injuries feel to the character. This book also presents a simplified overview of the expected recovery times for the injuries discussed in young, otherwise healthy individuals.

Body Trauma: A writer’s guide to wounds and injuries. Body Trauma explains what happens to body organs and bones maimed by accident or intent and the small window of opportunity for emergency treatment. Research what happens in a hospital operating room and the personnel who initiate treatment. Use these facts to bring added realism to your stories and novels.

10 B.S. Medical Tropes that Need to Die TODAY…and What to Do Instead: Written by a paramedic and writer with a decade of experience, 10 BS Medical Tropes covers exactly that: clichéd and inaccurate tropes that not only ruin books, they have the potential to hurt real people in the real world.

Maim Your Characters: How Injuries Work in Fiction: Increase Realism. Raise the Stakes. Tell Better Stories. Maim Your Characters is the definitive guide to using wounds and injuries to their greatest effect in your story. Learn not only the six critical parts of an injury plot, but more importantly, how to make sure that the injury you’re inflicting matters.

Blood on the Page: This handy resource is a must-have guide for writers whose characters live on the edge of danger. If you like easy-to-follow tools, expert opinions from someone with firsthand knowledge, and you don’t mind a bit of fictional bodily harm, then you’ll love Samantha Keel’s invaluable handbook

scriptmedic

So so honored to get THREE separate mentions in this list! (I haven't read the first few, but the first one sounds fascinating!)

To differentiate the last 3, which are mine:

10 BS Tropes: this is how not to piss off medical folks in storytelling. It is short, and it was free the last I checked.

Maim Your Characters: this is a guide to injury as a plot structure tool. As in, how and when do you make the most out of a good character thrashing, from a plot perspective?

Blood on the Page is the book that tells you how long a specific injury might take to heal, what the character would go through, and details about their treatment.

Also, if cash is an issue, most of Blood on the Page and Maim Your Characters is available in my blog archives if you can navigate the hellsite. (The #masterposts tag is your best bet). And 10 BS Tropes was free the last I checked!

(Since I've had people ask: I priced the books so that, last I checked, I earn equivalent royalties whether you buy paperbacks or digital.)

xoxo, Aunt Scripty

P.S.: While I no longer answer asks about specific scenarios or injuries, I'm happy to answer questions about the books themselves via DM or ask box. Including the "hey I want this but REALLY can't afford it could you PDF me?" ones.

0dde11eth

when giving a witcher CPR do you do chest compressions:

same speed as for a human

1/4 the speed to match their regular heartbeat

Voting ended onOct 26, 2023

coffee-mage-sans-caffeine

Okay, as a nurse with an advanced cardiac life support certification for adults and a neonatal resuscitation certification, I feel like this is a question I can answer.

First, understand that the blood moved by cpr is much less than that moved by a normal heartbeat. Our goal with cpr is to maintain brain and critical organ perfusion until ROSC (return of spontaneous circulation) is achieved. The number of beats per minute recommended is based on what we know about about basically the maximum speed of cpr that can a) be achieved by an average person, b) be sustained by an average person, and c) (this is the most important) allow full chest recoil. Chest recoil is the chest getting back to full thickness after you release pressure on it. This is extremely important because that allows the heart to fill back up with blood so you can push it out with your next compression. Faster cpr doesn't move blood efficiently because there's not enough blood returning into the heart to push back out. We also compress in adults to a depth of 2-2.4 inches (5-6 cm) in an adult to ensure that we're emptying the heart sufficiently. This depth is smaller in children because they have a proportionately smaller chest cavity. The key is we want to compress to a depth around 1/3 the total depth of the chest.

Second thing to understand is that the movement of oxygen is via a gas gradient. Oxygen wants to move from where there's the most oxygen to the last oxygen until all fluids present have the exact same amount of oxygen. So we need to get oxygen into the blood. In one rescuer cpr this is achieved via compressions only because when you compress the chest you compress the lungs as well, which means that chest recoil also moves air into the lungs and this air allows for gas exchange which removes some CO2 and adds some oxygen. Chest recoil isn't as good at this as ventilation, which is why if there are two rescuers we prefer to have one ventilate and one compress (ideally you'll have more than 2 rescuers because best practice is to change compressors every 2 minutes). This will move more oxygen into the lungs.

Thirdly, we're trying to maintain a minimum blood pressure (we probably won't measure this during cpr until ROSC is achieved). In order to maintain brain, heart tissue, and kidney perfusion, we need enough blood pressure to move oxygenated red blood cells into the tissues and remove spent ones. Because we don't measure this, I can't remember the exact values, but I think in nursing school they said we needed a minimum of 80/40 to prevent kidney failure in sepsis, so I assume it's somewhere around there.

Fourth, every time you pause compressions to change compressors, a gap in compressions of more than roughly one second plummets that blood pressure we're trying to maintain down to zero. Your next 3 or so compressions won't move oxygen. They'll just be working to 'pump up' blood pressure to where we're properly moving oxygen again.

So now that we know what cpr does, let's talk Witcher physiology versus human physiology a little bit.

Now, in the shows, fan films, and games, witchers have roughly the same chest circumference as a human. This implies that the organs in the chest are roughly the same size as those of a human. So that means we should be keeping that compression depth of 2-2.4 inches or 1/3 the total chest depth to move blood.

We should also compare human pulse rate to Witcher, right? Well, a normal pulse rate for a human is 60-100 bpm. 1/4 that is 15-25. CPR is done at an ideal rate of around 120 bpm, meaning it's clinically tachycardic for a normal human. We also need to know that normal pulse range doesn't mean every human's resting pulse lays in that range. For very fit people, like say marathon runners and cross country skiers with excellent cardiovascular health, they often have a much lower resting pulse. I once looked after a marathon runner whose resting pulse rate was 30. What's the resting rate for a Witcher again? Up to 25? Pretty close, right?

We do not taper the rate of our cpr for marathon runners. A couch surfer like me with a resting pulse of 80 gets the same 120 bpm cpr as a marathon runner who is well oxygenated at 30 bpm.

Given this, I believe that the Witcher should receive standard human cpr.

But here's where it gets weird. Marathon runners and witchers live at a lower heartrate and (probably got witchers, definitely for marathon runners) blood pressure than your average human. Their body uses perfusion or efficiently. Which means that with good quality cpr, in marathon runners we sometimes achieve consciousness before ROSC. Which is great because it tells us we're achieving perfusion of the brain. We do not want to slow down just because they became conscious. We want that perfusion.

But most people who wake up disoriented with someone bouncing on their chest and cracking their ribs become combative. So fun fact, you're going to do cpr on your Witcher at normal human speed and then convince him to fucking stop fighting you until ROSC.

Now, we also use drugs and electricity to help restart the heart in ACLS and achieve ROSC. We probably don't have electricity, so let's consider drugs and run a 'chemical code'. Two big ones are atropine and adrenaline. If we want to be really nerdy, based on the ingredients and effects in the Witcher video games, Cat should have a decent amount of atropine. Maribor forest and Blizzard both generate adrenaline points so let's assume those are artificial adrenaline at least in part.

So depending on what you think caused your Witcher to go down, when he wakes up from your excellent human speed cpr, have him drink Blizzard, Maribor forest, or Cat and hopefully you'll achieve ROSC!

Tldr: it should be human speed.

xoxoauntscripty

From a former critical care paramedic with 15 years experience: absolutely flawless.

I would add one bit of nuance about chest compression rates, because the recommended rate has changed over time.

It was 100bpm for a long time (to the beat of "Staying Alive" or, if you're a twisty little cruller like me, "Another One Bites the Dust"). It's faster than resting human heartbeat, but on the low end of human heart rates during critical illness (can go up to 200bpm depending on age).

When the standards were raised to 100-120bpm, I remember the logical justification being that it was raised for 2+ rescuer CPR, because if you're going 100 beats per minute solo you're good, but if you stop to add breaths you actually decrease the heart rate waiting for 2 breaths every 30 compressions. So 120/min, minus breaths, = 100.

But once you intubated the patient, you didn't have to increase heart rate to accommodate breaths, because those breaths were given asynchronously, i.e. the breaths go in without stopping compressions.

So the new guideline was originally sold as -

1 rescuer = 100bpm = Another One Bites the Dust

2 rescuer = 120 bpm = boring, no song, boo

2 rescuer intubated = 100bpm, Another One Bites the Dust but with more tubes

I honestly haven't renewed my CPR since leaving health care, but I believe the 2020 AHA guidelines were still like this, but they framed it as "100-120 bpm" to not confuse people?

Anyway yeah, solid agree, hump the corpse to the beat of Another One Bites the Dust and all will be well.

soy-sauce-and-mothra-deactivate

Hey! Are there blacksmiths in your story? I'm a hobbyist blacksmith and I'm here to help!

Blacksmithing is one of those things that a lot of people get wrong because they don't realize it stuck around past the advent of the assembly line. Here's a list of some common misconceptions I see and what to do instead!

Not all blacksmiths are gigantic terrifying muscly guys with beards and deep voices. I am 5'8, skinny as a twig, have the muscle mass of wet bread, and exist on Tumblr. Anybody who is strong enough to pick up a hammer and understands fire safety can be a blacksmith.

You can make more than just swords with blacksmithing. Though swords are undeniably practical, they're not the only things that can be made. I've made candle holders, wall hooks, kebab skewers, fire pokers, and more. Look up things other people have made, it's really amazing what can be done.

"Red-hot" is actually not that hot by blacksmith terms. when heated up, the metal goes from black, to red, to orange, to yellow, to white. (for temperature reference, I got a second degree burn from picking up a piece of metal on black heat) The ideal color to work with the metal is yellow. White is not ideal at all, because the metal starts sparking and gets all weird and lumpy when it cools. (At no point in this process does the metal get even close to melting. It gets soft enough to work with, but I have never once seen metal become a liquid.)

Blacksmithing takes fucking forever. Not even taking into account starting the forge, selecting and preparing metal, etc. etc. it takes me around an hour to make one (1) fancy skewer. The metals blacksmiths work with heat up and cool down incredibly fast. When the forge is going good, it only takes like 20 seconds to get your metal hot enough to work with, but it takes about the same time for it to cool down, sometimes even less.

As long as you are careful, it is actually stupidly easy to not get hurt while blacksmithing. When I picked up this hobby I was like "okay, cool! I'm gonna make stuff, and I'm gonna end up in the hospital at some point!" Thus far, the latter has yet to occur. I've been doing this for nearly a year. I have earned myself a new scar from the aforementioned second degree burn, and one singe mark on my jeans. I don't even wear gloves half the time. Literally just eye protection, common sense, and fast reflexes and you'll probably be fine. (Accidents still happen of course, but I have found adequate safety weirdly easy to achieve with this hobby)

A forge is not a fire. The forge is the thing blacksmiths put their metal in to heat it up. It starts as a small fire, usually with newspaper or something else that's relatively small and burns easily, which we then put in the forge itself, which is sort of a fireplace-esque thing (there's a lot of different types of forge, look into it and try to figure out what sort of forge would make the most sense for the context you're writing about) and we cover it with coal, which then catches fire and heats up. The forge gets really hot, and sometimes really bright. Sometimes when I stare at the forge for too long it's like staring into the sun. The forge is also not a waterfall of lava, Steven Universe. It doesn't work like that, Steven Universe.

Welding and blacksmithing are not the same thing. They often go hand-in-hand, but you cannot connected two pieces of metal with traditional blacksmithing alone. There is something called forge welding, where you heat your metal, sprinkle borax (or the in-universe equivalent) on it to prevent the metal from oxidizing/being non-weldable, and hammer the pieces together very quickly. Forge welding also sends sparks flying everywhere, and if you're working in a small space with other blacksmiths, you usually want to announce that you're welding before you do, so that everyone in a five-foot radius can get out of that five-foot radius. You also cannot just stuck some random pebbles into the forge and get a decent piece of metal that you can actually make something with, Steven Universe. It doesn't work like that, Steven Universe.

Anvils are really fucking heavy. Nothing else to add here.

Making jewelry is not a blacksmithing thing unless you want jewelry made of steel. And it will be very ugly if you try. Blacksmithing wasn't invented to make small things.

If there's anything here I didn't mention, just ask and I'll do my best to answer.

scriptmedic

If anyone has some fiction questions for a blacksmith, perhaps this kindly Tumblr could help?

#unvetted #but seems nice

porcellune

TO THOSE MAKING NATIVE OCS

I see this a lot, no one has actual names, or any reference for names, that are legit Native American, varying among the tribes, for their characters.

Babynames.com and shit like that will give you names made up by white people.

However, I’ve got your solution.

Native-Languages is a good website to turn to for knowledge on a lot of native things, including native names. If you’re unsure about the names you’ve picked, they even have a list of made up names here!

Please don’t trust names like babynames.com for native names, they’re made up and often quite offensive to the cultures themselves.

ileniagennari

Thank you!

atthelamppost

Native Languages is a great website. I use it for my fact-checking since it always has reliable links to tribal sites.

maccreadysbaby

things people do after having a nightmare that isn’t crying

struggle to catch their breath

grab onto whatever’s close enough to ground themselves in reality

become nauseous / vomit

shake uncontrollably

sweat buckets

get a headache

things people do to combat having nightmares if they occur commonly

sleep near other people so they can hear the idle sounds of them completing tasks

move to a different sleeping spot than where they had the nightmare

leave tvs / radios / phones on with noise

just not sleep (if you want to go the insomnia route)

sleep during the day in bright rooms

things people with insomnia do

first, obviously, their ability to remember things and their coordination will go out the window

its likely they’ll become irritable or overly emotional

their body will start to ache, shake, and weaken

hallucinate if it’s been long enough

it becomes incredibly easy for them to get sick (and they probably will)

add your own in reblogs/comments!

catchymemes

scriptmedic

What makes you think we haven't???

(Once. Just once. But it was glorious.)

keplercryptids

common myths about migraines (AKA if you get headaches regularly, please seek treatment for migraines)

"i don't have migraines because while i get them several times a week, it's only when i am hungry or dehydrated."

those are probably migraines. thirst, hunger, sleep disturbances, or any disruption to routine are common migraine triggers.

"my headaches are specifically barometric related, i get them when the weather/altitude changes."

those are probably migraines. barometric pressure is a common migraine trigger.

"i get headaches all the time but ibuprofen gets rid of them so they can't be migraines."

that's not true. ibuprofen works great at relieving migraine pain for many people.

"my consistent headaches are tension headaches. i feel them originate in my neck/shoulders."

those are probably migraines. muscle tension is a common migraine trigger.

if you are regularly getting headaches (once a week or more), you are likely getting migraines. in fact, a good rule of thumb if you're consistently getting headaches is to treat them as migraines until you can rule out migraines. that's how common "chronic headache = migraine" actually is.

migraines are a neurological disorder wherein pain is one symptom. pain is often the MAIN symptom, and the most noticeable symptom, which can make diagnosis tricky. other symptoms of migraine include:

fatigue

nausea/vomiting

digestive issues

visual disturbances (auras)

sensitivity to light and/or sound

mood changes

brain fog/cognitive changes

ringing in the ears

dizziness/vertigo

numbness/weakness on one side of the body

this list is NOT complete, but is a starting point. i really like the comparison to a hangover. if you generally feel hungover when you get a headache (without having consumed alcohol), that's a classic migraine presentation.

so many people suffer from migraine and don't even know it, so they aren't able to advocate for themselves to get treatment. there are great new migraine treatments on the market! if you're able, please seek treatment for your migraines. a better quality of life is possible.

keplercryptids

here's some more myths! brought to you by the most frequent comments i get on my migraine posts.

"but migraines are extremely painful/debilitating and i can push through my pain."

migraines certainly can be debilitatingly painful. the pain can also be mild/easily treatable. it depends on the person and it depends on the day. regardless, your ability to live with chronic pain does not mean your pain isn't a problem!

"my headaches always have a direct cause/trigger so they can't be treated/they're my fault."

wrong! migraine is a sensory disorder in many respects. most/all migraines are triggered by something. avoiding triggers is good but isn't the whole story, and migraines with triggers can be treated effectively!

"i feel pain in (x) area of my head so it's not a migraine."

migraines can hurt in a specific area of the head/one half of a person's head. but this is not universally true for every person. please forget every silly infographic you've ever seen about areas of the head equaling different kinds of headaches. that's just literally false.

scriptmedic

Seems like this could be useful to some of y'all

20th-centuryghost

HEY ARTISTS!

Do you design a lot of characters living in not-modern eras and you’re tired of combing through google for the perfect outfit references? Well I got good news for you kiddo, this website has you covered! Originally @modmad made a post about it, but her link stopped working and I managed to fix it, so here’s a new post. Basically, this is a costume rental website for plays and stage shows and what not, they have outfits for several different decades from medieval to the 1980s. LOOK AT THIS SELECTION:

OPEN ANY CATEGORY AND OH LORDY–

There’s a lot of really specific stuff in here, I design a lot of 1930s characters for my ask blog and with more chapters on the way for the game it belongs to I’m gonna be designing more, and this website is going to be an invaluable reference. I hope this can be useful to my other fellow artists as well! :)

Did you find this helpful? If you’re able, maybe buy me a coffee please? :D

scriptmedic

Aaaaand could maybe be helpful for writers too!

If I were to do something Very Stupid and mildly unretire to write ONE (1) post about storytelling + health/injuries/trauma/diseases/...

....What would you want it to be about?

(NOT a promise)

#blog business #this is a mistake

Trending Blogs

Recently Viewed Blogs

ScriptMedic