Myth

Pneumatic Syringes: Fact or Science Fiction?

/ Jordyn Redwood / Leave a comment

I had an interesting question from fellow author Eric J. Gates about what medications could be given via pneumatic syringe.

Now, my suspense author mind went to exactly where he was thinking (what kind of toxic medication can I give on the fly without having to actually inject someone with a needle.) Sadly, with current medical technology, the scenario doesn’t translate into real life.

First, you have to consider the way medications are given route wise because this is how they will end up working. They are as follows.

IN: Intranasal (up the nose.)
IM: Intramuscularly (into the muscle.)
IV: Intravenously (into the vein– blood.)
Oral
SL: Sublingual (under the tongue.)
SQ: Subcutaneous (into the fat tissue just under the skin.)

And then we can talk other orifices but they really don’t apply here.

When you give something via pneumatic syringe you’re pushing the medication under pressure into the tissue underneath which is fat tissue. Few medications work well when given into fat. One of the medications given consistently this route is insulin.

That’s author problem #1– the route in which a pneumatic syringe would work doesn’t work with a lot of devious medications.

Author problem #2– pneumatic syringes aren’t really used in human populations for anything at this moment. The closest possibility I could come up with is what we call a J-tip. This is a device that will force medication under the skin using high pressure caused by a chemical reaction. When the medication is delivered, it sounds like three pop cans opening simultaneously. The only use for it now is to inject Lidocaine (which is a numbing agent) painlessly under the skin to numb the site for IV starts.

Even though it may be a great thing in the future as a delivery method for medications and could be used at some point to kill off a fictional character– right now I would consider it outside the realm of possibilities and more in the realm of science fiction.

Ten Myths of Drug Addiction 2/2

/ Jordyn Redwood / Leave a comment

Today, we’re concluding Dr. Rita Hancock’s guest post on the ten myths of drug addiction. Today, we’re finishing the last five. These posts have been a wealth of information. Thanks, Rita.

Myth #6:
Most addicts have a “favorite” class of drugs to abuse. Crank addicts don’t necessarily like barbiturates b/c crank addicts like uppers. They might like cocaine, though, b/c that’s also an upper.

Myth #7:

If you’re going to use the term “narcotics,” make sure you know what the term means. Not all habit-forming drugs are “narcotics.” Narcotics are only one specific type of drugs, even though the term “narcotics” is mistakenly used to describe all varieties of illicit drugs. E.g. a “narcotics” police officer actually investigates abuse of non-narcotic drugs, as well. Drugs that are potentially addictive but are non-narcotic include, amphetamines, cocaine, marijuana, hallucinogens, barbiturates, benzodiazepines, etc.

Myth #8:

Naloxone is a medicine used as a antidote for narcotic overdoses. But it does NOT treat overdoses of ALL (e.g. NON-narcotic) controlled substances. On TV shows, I’ve seen it given for barbiturate overdoses, and that’s utterly wrong. It’s used ONLY to reverse narcotic overdoses (with examples of narcotics being morphine, codeine, hydrocodone, oxycodone, methadone, etc.). Moreover, the effects of naloxone don’t last very long. If the overdose is on a long-acting narcotic like methadone, you’re going to have to repeat the naloxone dose after only a short time (like minutes). You might have to give the patient many doses of the naloxone before they’re “safe.”

Myth #9:

Flumazenil is a medicine used as an antidote for benzodiazepine withdrawals (e.g. Valium, Librium, Xanax, etc). In the same way that naloxone is specific for narcotic OD’s, flumazenil is specific for benzodiazepine withdrawals. Again, some benzo’s are longer-acting than others. If your character overdoses on a long-acting benzo, like Librium, he or she may need several doses of Flumazenil in the E.R. 

Myth #10:

There’s a drug called buprenorphine (an orally absorbable narcotic) that’s mixed with naloxone (a narcotic antidote) to form a new type of drug called Subutex (aka Suboxone). It’s novel and interesting b/c it can’t be abused easily and it’s often used to help addicts come off the drugs more safely. It gives the desired therapeutic effect only when you let it dissolve on the tongue. In contrast, if you try to abuse it by swallowing it or by altering it (by crushing, dissolving, etc.), the naloxone takes effect, overriding the narcotic portion, and causes you to go into withdrawals. Doctors have to apply for special licenses to administer Subutex, and they’re limited to having only a small number of patients on it at any given time for the purposes of detox.
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Dr. Rita Hancock, a full-time physician and author of Christian health books, writes about how emotional and spiritual factors contribute to physical disease through the mind-body-Spirit connection. According to Dr. Rita, “Once these underlying barriers fall away in the healing light of God’s truth, patients automatically feel less physical pain, experience fewer stress-induced symptoms, lose weight, and shed addictive behaviors more easily.” Dr. Rita is the author of The Eden Diet (Zondervan, 2008) and an as-yet untitled release with Charisma House, pending January 2013. She resides in Oklahoma City with husband Ed, and two wonderful children, Lindsey and Cory.

Top Three Most Popular Posts: #1

/ Jordyn Redwood / Leave a comment

I’m so blessed that it’s been such a great first year for this blog. I owe it to all of you and your interest in how to appropriately injure, main and kill your fictional characters. Thanks to everyone who follows and subscribes and even the lurkers who peruse by….

It isn’t surprising to me that this remains the most popular post of all time here at Redwood’s Medical Edge with nearly 1000 page views. This myth continues to be perpetuated in books and TV.

I love the series Dexter. If you’re unfamiliar with it and you’re a writer, I think it’s a great exercise in intricate plotting techniques. However, it is violent, so proceed with caution. The general premise is that Dexter works for Miami Police as a blood splatter specialist. In his free time, he’s a serial killer, but only kills those that the justice system doesn’t put away. This show is also good study for the sympathetic villain.

In one episode, poor Dexter has been in a motor vehicle collision. He is dazed and is taken to the ER. The doctor says something to the effect of, “You have a head injury. You’ll need to stay awake for the next several hours.” Great.

Sleepiness post head injury is a classic set-up for pediatrics. Every day in the ER is a story like this. It’s close to bed time. The children are running amok. Some child falls down, falls into, or falls off of something and hits their head. They cry their little heart out. After all, hitting your head hurts, a lot. After a good crying bout, they’re sleepy. Parents first thought is, he must have a terrible head injury. Off to the ER.

Now, one, I want to make it clear. Getting your child checked in the ER for head injury is good and reasonable. However, we aren’t all that concerned with sleepiness. What we are concerned with is how arousable they are from sleep. This is what we’ll be monitoring every fifteen minutes to an hour if the child sleeps during his ED visit.

Level of consciousness is assessed as an indicator of an injury going on inside of the head. How arousable you are is the most sensitive indicator of level of consciousness. If the child falls asleep, and we are concerned about head injury, we’ll try to wake them up every so often to assess their level of arousability. If we cannot wake them up, then we are concerned. It has to be more than a gentle nudge. You are really working to wake the patient and they won’t respond. This is concerning.

Remember, things that are injured need rest. This is why we put you on crutches if you break an ankle. The brain rests by sleeping. It helps it to heal. If you’re a subscriber to this myth, how long should we keep the patient awake? An hour? Two hours? A day? If you want a skewed neuro exam, try doing one on a sleep deprived patient.

For additional resources regarding this myth, check out the following:

1. http://firstaid.about.com/od/headneckinjuries/f/09_Waking_Heads.htm

2. http://familydoctor.org/online/famdocen/home/common/brain/head/084.html