8 ms·
Years ago, a friend of mine was in med school, and headed off for a semester in the rainforest of Ecuador, performing basic medicine and stuff for people who ra
by myself248 8y ago
Years ago, a friend of mine was in med school, and headed off for a semester in the rainforest of Ecuador, performing basic medicine and stuff for people who rarely got to the city to see a doctor. He called me up, on a Sunday afternoon, with this question:
"Our dentist in the group just realized she doesn't have a source of suction, you know, like the vacuum that slurps saliva out of the way during a procedure. We're in Houston and our flight leaves in 6 hours. Any solution needs to work off-grid for a month. Got any ideas?"
I thought for a moment, and said "Hit an auto parts store. Get a brake-bleeder kit. This has a hand-pump vacuum with a clear collection jar. Aim for one with a glass jar if possible, since it'll be easier to clean. Should set you back about thirty bucks."
And we didn't speak again for a few months. When he was stateside again, he said the brake bleeder kit had worked so well and was so simple to operate, they'd often just hand it to the patient. Not only did this free up a physician, it also gave the patient something to do during what's often a nervous and fidgety time, and may have thus decreased the need for sedation in some procedures.
Sometimes it really is that simple. He had numerous stories of doctors in hospitals picking the brains of janitors -- they called it a "facilities consult" -- to see if they could MacGuyver a solution to a problem that the medical industry hadn't packaged yet. PTFE plumber's tape apparently comes in a medical grade too, but sometimes you need to toss around ideas with some other hands-on maker-fixer sort of people before you figure out how to apply it.
- asdf9ij 8y agoYou really are a genius aren't you?
- WrtCdEvrydy 8y agoIn a pinch, I've seen third world doctors use super glue to seal cuts. American culture doesn't allow for anything better than the best outcome in medicine.
- dotancohen 8y agoAmerican culture allows for exactly two possible types of medical care: 1. The best 2. None at all Often the choice between the two is financial.
- jessaustin 8y agoJust as true of housing, transportation, education, etc.
- WilliamEdward 8y agoThis sounds really good to the ear, but it's just not true is it? Americans have a lot of choice when it comes to these things, at least compared to healthcare.
- jessaustin 8y agoWe have some level of choice with respect to healthcare as well. I'm just thinking of other nations I've traveled, in which lots of people chose to live in housing that wouldn't be allowed here, and drove vehicles that wouldn't be legal to sell here. You might argue with the idea that they "chose" those things. That argument would apply just as much to health care. Yes, if someone had the choice between vast wealth and penury, one would choose vast wealth. Given the condition of penury, however, what's wrong with e.g. a tuk-tuk or a corrugated tin shack? Are those not better than living on the street in a cardboard box and walking everywhere you go?
- rconti 8y agoIt's a byproduct of regulation. When you start telling people they can't consume this substance, or buy a car with fewer than this number of airbags, or without traction control, or you can't sell an apartment with a size smaller than this, you create consequences. Maybe people buy used cars instead of new cars. Maybe they live in illegal units that skirt the regulations not just on sizing, but on fire safety. And so on. You create black markets. This is absolutely not to say that regulation is bad! It is just to point out that it creates unintended consequences you have to be aware of, and place the slider of regulation in the appropriate place. After all, we all intuitively know that a minimum wage of $500/hr and a minimum allowable housing size of 7000sqft won't work! But we also know that telling a surgeon "just use whatever you find lying around" may not be the best approach either.
- throwaway5752 8y ago
- mhb 8y agoSuper glue for cuts has been a thing in the first world for a few decades too.
- grzm 8y ago> "I've seen third world doctors use super glue to seal cuts." Expanding on this a bit, commercial cyanoacrylate (such as Super Glue or Krazy Glue) was used during the Vietnam War by US personnel for wound closures, but was not approved by the FDA for medical purposes because its side affects hadn't been explored. Dermabond and other medical grade cyanocrylates have since been approved. https://en.wikipedia.org/wiki/Cyanoacrylate#Medical_and_veterinary https://en.wikipedia.org/wiki/Cyanoacrylate#Medical_and_vete...
- ryanmcbride 8y agoWhen I worked in food service we had a brown medical looking bottle of "liquid bandage" that was basically just weak crazy glue. We had to use that if we cut ourselves to make sure not to contaminate the food. Once I found out what it was I started using normal crazy glue gel instead. Closed up the cut, kept it clean, totally waterproof. I keep a bottle of it in my medicine cabinet to this day.
- Stratoscope 8y agoLiquid bandage is not weak "crazy glue" (cyanoacrylate). It is a completely different formulation. https://en.wikipedia.org/wiki/Liquid_bandage https://en.wikipedia.org/wiki/Liquid_bandage For example, the popular brand New Skin consists of: Active ingredient: Benzethonium Chloride 0.2% (antiseptic) Inactive Ingredients: Amyl acetate, camphor, ethyl acetate, ethyl alcohol, n-butyl acetate, nitrocellulose.
- darkpuma 8y agoThat's not completely true. For instance the "LiquiBand" brand includes some products that are CA. http://www.liquiband.com/region/uk/liquiband-product-range-wound-closure/liquiband-octyl-0-4/ http://www.liquiband.com/region/uk/liquiband-product-range-w...
- Stratoscope 8y agoInteresting, thanks for the correction. I noticed that the product you linked is intended for medical professionals. I wonder if there is a CA-based liquid bandage sold over the counter?
- ryanmcbride 8y agoMy mistake
- amluto 8y agoSure, American medicine does, for non-human animals. I suspect that at least part of the difference is that veterinary medicine is mostly uncorrupted by insurance. And there is little reason to use hardware store cyanoacrylate glue on skin — you don’t know what’s in it, and there is evidence that hardware store formulations may cause issues on skin. Animals get to use a product such as Vetbond, which is designed for the purpose and is not much more expensive. (A whole bottle of Vetbond, which is reusable, seems to cost a little less than a single Dermabond applicator.)
- briandear 8y ago> I suspect that at least part of the difference is that veterinary medicine is mostly uncorrupted by insurance. It’s mostly uncorrupted by million+ dollar malpractice suits.
- lenticular 8y agoSuperglue is standard operating procedure for sealing small wounds in Antarctica, since they like to crack open more.
- rtkwe 8y agoIt's in use in America too. A couple years ago I dropped a knife and like an idiot tried to catch it, of course I didn't succeed it wound up stuck in the palm of my hand making a cut about .5" to .75" long and .25" to .5" deep (didn't measure quite how deep it was at the time you know other priorities) and the hospital cleaned, irrigated, disinfected and then glued it shut. Worked pretty well.
- simongr3dal 8y agoIt's also simpler because you don't need to have the stitches taken out.
- marvin 8y agoA relative of mine is a veterinarian, and does this whenever one of her kids gets a cut. First-world country.
- thwarted 8y agoUsing superglue to keep paper cuts closed is a household remedy, at least in American midwest. But most paper cuts are hardly considered to require medical attention. I assume you're talking about surgical cuts that would otherwise require small sutures?
- Pete_D 8y agoAnecdote: I had a surgical incision around six inches long glued shut after an operation in the UK. No stitches. I was surprised, but from talking to the nurses it sounded like that was standard procedure. Judging from other comments, the stuff they used (DermaBond) is a variant of superglue.
- rurp 8y agoAfter a major knee surgery my incision was closed up with staples that looked suspiciously similar to ones I've seen in an office supply store. Well, except the price; I think the surgical ones cost several orders of magnitude more.
- toomanybeersies 8y agoSurgical staples will be stainless steel, which office staples aren't.
- toomanybeersies 8y agoI think you'll find it's done in America too. For cuts that aren't clean and straight, it's often more practical to just glue it together.
- mikeash 8y agoOne prominent example is superglue, which started being used by medics in the Vietnam War to control bleeding until a soldier could get to a hospital. Now you can buy special medical versions of the stuff at any drug store.
- maxerickson 8y agoI recently looked at a couple places and couldn't find it.
- aaaaaaaaaaab 8y agoRegular cyanoacrylate aka “superglue” is perfectly safe for wound closure (after cleaning and disinfecting of course).
- vonmoltke 8y agoThe issue is not the compound itself, it's the impurities in the packaged substance. You don't know what possibly-toxic impurities or allergens might be present in a tube of hardware store adhesive, since they probably don't affect the glue's ability to do its intended job.
- jschwartzi 8y agoAlso cyanoacrylate glue has a tendancy to react exothermically with cotton, which is a common bandage material. For the layman this means that it can get burning hot if you get some on a cotton bandage. The medical-grade superglue does not have this problem.
- darkpuma 8y agoIf you have the opportunity to use something better, then obviously use something better. But in practice these objections are not a huge deal for the vast majority of people closing their wounds with CA glue. Pro-tip: you don't need to put the CA glue inside your wound. Squeeze your wound together, put the CA glue on either side of it on your intact skin, then place a piece of thread across the wound, fasted to the skin on both sides with the CA glue. The effect is a do-it-yourself suture without needing a needle. And YES, it's exothermic with the thread. So obviously don't use a lot of it. Use the absolute bare minimum and don't attempt it with wounds severe enough that a lot would be required. If you slather on the glue than slap a patch of denim over the wound, you're going to get burned badly. Don't do that.
- sl1ck731 8y agoBeing able to apply suction on my command seems like an added benefit. Sometimes I think I'm going to choke at the dentist waiting for him to start vacuuming. Could be comforting for people who aren't typically in the sort of situation and feel out of control of themselves.
- jimmy1 8y agoJust set up a signal with your dentist before hand. "Hey doc, just to let you know I am sensitive to my own saliva, when I point to my mouth can you do the straw thingy?" Works like a charm
- myself248 8y agoYup, or even ask if you can work the suction yourself. I've done this lots of times with my current dentist. I hold the handpiece out of the way, and if I feel like I'm drowning, I kinda wiggle it in the direction of my mouth, they make room, and I go in and vacuum things up. If they see the need before I do, they just say "suction", just like they'd say it to any other assistant. It's no different than holding my own jaw open. If the patient is awake, they're part of the procedure. Might as well make the most of that. And if it means less anxiety and discomfort, which means you're happier and more likely to return, that's a win for everyone. During one visit, I noticed that the swing-arm lamp had a flat plastic cover on it that acted as a mediocre mirror, and I could see what they were doing in my mouth. As soon as I noticed that, the random shoving and scraping (which always made me nervous as hell) gained context of the work they were doing, and I calmed way down. I ask for the lamp every time now.
- trhway 8y agoThe first dialysis machine was made of auto parts.
- agumonkey 8y agoI strongly believe that we should all be taught ~primitive engineering like this.