Posted by Jason on June 12th, 2008 — in Check this out dude
Here’s an insane long shot - did any of you read the Trouble Club books when you were a kid? I just found all four (I think there were only four) on eBay and of course I grabbed them. The Trouble Club are these four kids (and two dogs) that get into all sorts of 1950’s science predicaments, like stealing a rocket and accidentally running out of air, and catching some dude who is blackmailing the government with his cloud-bouncing heat ray (!). They stole a page from Rocketship Galileo (or vice-versa) and fight Nazis on the moon. The books are stuffed with that Heinlein juvenile style of breezy optimism and scientific gung-ho spirit, and they could be surprisingly dark - people die, for example, and not artfully. I think I read my dad’s dog-eared copies one hundred times each. They are very weird and wonderful books - I remember the terrible art and flimsy paper, like they had been printed in Latvia or something. I can’t wait to read them again!
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Posted by Jason on June 9th, 2008 — in Design, Medical Hospital
I wanted a way to simulate cardiac emergencies that are a staple of medical dramas, and reading through The Scut Monkey’s Handbook (Clinician’s Pocket Reference, 7th Edition), I found my answer in the rigid steps of the ACLS protocol. So:
MEDICAL HOSPITAL: CARDIAC ARREST
At each step in the protocol, the doctor announces the procedure and an assistant randomizes. A zero digit (or ten on a ten-sided die) indicates a successful return to a normal heart rhythm. The doctor can increase the odds of success by taking stress – one point of stress may be accrued per step, and increases the odds of success by 10%. Thus, if a doctor adds a point of stress, all further attempts will succeed on a nine or ten. If a doctor steadily adds stress, the chances of success increase accordingly. Only one point of stress may be added per step. After randomizing, the assistant reports the patient’s status to the doctor.
1. Check for pulse. If absent, initiate basic CPR. Check rhythm. If ventricular fibrillation or tachycardia is occurring, continue to perform basic CPR until a defibrillator is available. When available, apply paste and place paddles as directed on handles. Defibrillate at 200 joules. Clear!
If no conversion, continue.
2. Defibrillate at 300 joules. Clear!
If no conversion, continue.
3. Defibrillate at 360 joules, maximum output. Clear!
If no conversion, resume CPR and continue.
4. Establish an IV line and give epinephrine 1:10,000 solution 0.5-1.0 mg IV push. Intubate if possible. Defibrillate at 360 joules. Clear!
If no conversion, continue.
5. Give lidocaine 1 mg per kg of patient weight, IV push. Defibrillate at 360 joules. Clear!
If no conversion, continue.
6. Repeat lidocaine at 0.5 mg per kg of patient weight IV push. Defibrillate at 360 joules. Clear!
If no conversion, continue.
7. Give bretylium 5 mg per kg of patient weight, IV push. Consider bicarbonate or additional lidocaine bolus. Defibrillate at 360 joules. Clear!
If no conversion, patient dies.
So it’s a dumb little mini-game where the doctor must accrue stress to succeed, and the question is how much, and when. Meanwhile, you’ve got the defibrillator going, some drama at the table, I think it’ll be fun. Don’t use the above protocol to try and convert somebody for real, please.
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