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Saturday, October 18, 2014

I'm a Hazmat-Trained Hospital Worker: Here's What No One Is Telling You About Ebola | Abby Norman



Ebola is brilliant.
It is a superior virus that has evolved and fine-tuned its mechanism of transmission to be near-perfect. That's why we're all so terrified. We know we can't destroy it. All we can do is try to divert it, outrun it.
I've worked in health care for a few years now. One of the first things I took advantage of was training to become FEMA-certified for hazmat ops in a hospital setting. My rationale for this was that, in my home state of Maine, natural disasters are almost a given. We're also, though you may not know it, a state that has many major ports that receive hazardous liquids from ships and transport them inland. In the back of my mind, of course, I was aware that any hospital in the world could potentially find itself at the epicenter of a scene from The Hot Zone. That was several years ago. Today I'm thinking, by God, I might actually have to use this training. Mostly, though, I'm aware of just that -- that I did receive training. Lots of it. Because you can't just expect any nurse or any doctor or any health care worker or layperson to understand the deconning procedures by way of some kind of pamphlet or 10-minute training video. Not only is it mentally rigorous, but it's physically exhausting.
PPE, or, personal protective equipment, is sort of a catch-all phrase for the suits, booties, gloves, hoods and in many cases respirators worn by individuals who are entering a hot zone. These suits are incredibly difficult to move in. You are wearing several layers of gloves, which limits your dexterity to basically nil, the hoods limit the scope of your vision -- especially your peripheral vision, which all but disappears. The suits are hot -- almost unbearably so. The respirator gives you clean air, but not cool air. These suits are for protection, not comfort. Before you even suit up, your vitals need to be taken. You can't perform in the suit for more than about a half hour at a time -- if you make it that long. Heat stroke is almost a given at that point. You have to be fully hydrated and calm before you even step into the suit. By the time you come out of it, and your vitals are taken again, you're likely to be feeling the impact -- you may not have taken more than a few steps in the suit, but you'll feel like you've run a marathon on a 90-degree day.
Getting the suit on is easy enough, but it requires team work. Your gloves, all layers of them, are taped to your suit. This provides an extra layer of protection and also limits your movement. There is a very specific way to tape all the way around so that there are no gaps or "tenting" of the tape. If you don't do this properly, there ends up being more than enough open pockets for contamination to seep in.
If you're wearing a respirator, it needs to be tested prior to donning to make sure it is in good condition and that the filter has been changed recently, so that it will do its job. Ebola is not airborne. It is not like influenza, which spreads on particles that you sneeze or cough. However, Ebola lives in vomit, diarrhea and saliva  -- and these avenues for infection can travel. Projectile vomiting is called so for a reason. Particles that are in vomit may aerosolize at the moment the patient vomits. This is why if the nurses in Dallas were in the room when the first patient, Thomas Duncan, was actively vomiting, it would be fairly easy for them to become infected. Especially if they were not utilizing their PPE correctly.
The other consideration is this: The "doffing" procedure, that is, the removal of PPE, is the most crucial part. It is also the point at which the majority of mistakes are made, and my guess is that this is what happened in Dallas.
The PPE, if worn correctly, does an excellent job of protecting you while you are wearing it. But eventually you'll need to take it off. Before you begin, you need to decon the outside of the PPE. That's the first thing. This is often done in the field with hoses or mobile showers/tents. Once this crucial step has occurred, the removal of PPE needs to be done in pairs. You cannot safely remove it by yourself. One reason you are wearing several sets of gloves is so that you have sterile gloves beneath your exterior gloves that will help you to get out of your suit. The procedure for this is taught in FEMA courses, and you run drills with a buddy over and over again until you get it right. You remove the tape and discard it. You throw it away from you. You step out of your boots  --  careful not to let your body touch the sides. Your partner helps you to slither out of the suit, again, not touching the outside of it. This is difficult, and it cannot be rushed. The respirators need to be deconned, batteries changed, filters changed. The hoods, once deconnned, need to be stored properly. If the suits are disposable, they need to be disposed of properly. If not, they need to be thoroughly deconned and stored safely. And they always need to be checked for rips, tears, holes, punctures or any other even tiny, practically invisible openings that could make the suit vulnerable.
Can anyone tell me if this happened in Dallas?
We run at least an annual drill at my hospital each year. We are a small hospital and thus are a small emergency response team. But because we make a point to review our protocols, train our staff (actually practice donning/doffing gear), I realized this week that this puts us ahead at some much larger and more notable hospitals in the United States. Every hospital should be running these types of emergency response drills yearly, at least. To hear that the nurses in Dallas reported that there were no protocols at their hospital broke my heart. Their health care system failed them. In the United States we always talk about how the health care system is failing patients, but the truth is, it has failed its employees too. Not just doctors and nurses, but allied health professionals as well. The presence of Ebola on American soil has drawn out the true vulnerabilities in the health care system, and they are not fiscally based. We spend trillions of dollars on health care in this country -- yet the allocation of those funds are grossly disproportionate to how other countries spend their health care expenditures. We aren't focused on population health. Now, with Ebola threatening our population, the truth is out.
The truth is, in terms of virology, Ebola should not be a threat to American citizens. We have clean water. We have information. We have the means to educate ourselves, practice proper hand-washing procedures, protect ourselves with hazmat suits. The CDC Disease Detectives were dispatched to Dallas almost immediately to work on the front lines to identify those who might be at risk, who could have been exposed. We have the technology, and we certainly have the money to keep Ebola at bay. What we don't have is communication. What we don't have is a health care system that values preventative care. What we don't have is an equal playing field between nurses and physicians and allied health professionals and patients. What we don't have is a culture of health where we work symbiotically with one another and with the technology that was created specifically to bridge communication gaps, but has in so many ways failed. What we don't have is the social culture of transparency, what we don't have is a stopgap against mounting hysteria and hypochondria, what we don't have is nation of health literate individuals. We don't even have health-literate professionals. Most doctors are specialists and are well versed only in their field. Ask your orthopedist a general question about your health -- see if they can comfortably answer it.
Health care operates in silos -- we can't properly isolate our patients, but we sure as hell can isolate ourselves as health care workers.
As we slide now into flu season, into a time of year when we are normally braced for winter diseases, colds, flus, sick days and cancelled plans, the American people has also now been truly exposed to another disease entirely: the excruciating truth about our health care system's dysfunction -- and the prognosis doesn't look good.
Note: In response to some comments, I would like to clarify that I am FEMA-trained in level 3 hazmat in a hospital setting. I am a student, health guide and writer, but I am not a nurse.
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WILLIAM S. BURROUGHS-NARRATED ‘HÄXAN: WITCHCRAFT THROUGH THE AGES’

Day of the Dead Salad Plate, Set of 4 | Pottery Barn

Day of the Dead Salad Plate, Set of 4 | Pottery Barn

That’s me in the picture: Kevin Berthia on the Golden Gate bridge | Art and design | The Guardian

'I was convinced I was going to hurl myself off but his voice made me stop and grab the railings. That's what you see'

The Guardian, Friday 17 October 2014 11.00 EDT

Kevin Berthia says he had never spoken to anybody about how he felt or accepted he had depression. Photograph: John Storey/SFC
I had never been to the Golden Gate bridge before that day. I didn't even know how to get there – I had to ask for directions.
I had never dealt with any of the problems in my life, and that morning I was overwhelmed by it all. I was adopted at six months and my adoptive parents divorced when I was 12. I had just become a father; my daughter was born prematurely and was in an incubator for eight weeks. I blamed myself.
I had never spoken to anybody about how I felt and I never accepted I had depression. Where I come from – Oakland, California – reputation is everything, so I convinced everyone I was OK. But I was tired and I couldn't do it any more.
I parked and walked towards the bridge. As I jumped over the railings I heard someone say: "Hey, wait a minute." I was convinced I was going to end my life , but at the last moment his voice made me stop and grab the railings. That's what you see in the picture – me standing on the ledge. I now know that was Officer Briggs (centre, leaning on the railings). He snapped me back to reality. I was on that ledge for 92 minutes, and for 89 of those I just talked. I got everything out and he listened without judging.
He tried to show me the important things in my life, focusing on my daughter. Hope came back. I put my arms up, and he and another officer helped me up and back over the railings.
There were reporters everywhere, so they covered my face and took me to San Francisco general hospital. I was exhausted. The next thing, I was at Fremont Medical Centre, where I stayed for a week.
Afterwards I went back to my old habit of burying things, and never talked about the bridge. When I discovered that the photograph was on the front page of the San Francisco Chronicle, that shut me down. It just so happened that they were voting on whether to install a suicide prevention barrier the same day, so the photograph became iconic; but I wasn't ready to deal with it.
The first time I faced the picture was eight years later, in May 2013, when I was asked to present an award to Officer Briggs at the American Foundation for Suicide Prevention's lifesavers dinner in New York. That was the first time I had looked him in the eye – on the bridge I had my head down. At that dinner I saw the impact of the photograph on everyone in the room and realised my story could help people.
News reports from that event got it wrong. They said I was happy and married with two children. Reporters are always after the happily-ever-after ending. I had two children, yes, but I wasn't married, nor was I happy. I had had a lot of highs and lows in those intervening eight years. But that night was the first time I actually started to feel OK. So, really, Officer Briggs saved my life twice.
I have since become a suicide prevention advocate, encouraging people to talk through their problems rather than think about ending their lives. I now know that depression is a part of me but not who I am. I have three children and a new partner with whom I will spend the rest of my life. Now is the happily ever after.

In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In the UK, the Samaritans can be contacted on 08457 90 90 9008457 90 90 90. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

Interview by Abigail Radnor


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American Schools Are Training Kids for a World That Doesn't Exist | WIRED


Architect and designer Neri Oxman sits in her "Gemini" chaise, which was 3D-printed by Stratasys using a Connex Multi-Material printer, CNC milled by SITU Fabrication and designed in collaboration Prof. W. Craig Carter (Dept. of Materials Science, MIT). The chaise is part of the interactive creative learning environment at the author's Le Laboratoire in Cambridge, Mass. It uses cutting-edge materials and technologies to provide an unexpected insight into the experience of being in the womb.

Are Americans getting dumber?
Our math skills are falling. Our reading skills are weakening. Our children have become less literate than children in many developed countries. But the crisis in American education may be more than a matter of sliding rankings on world educational performance scales.
Our kids learn within a system of education devised for a world that increasingly does not exist.
To become a chef, a lawyer, a philosopher or an engineer, has always been a matter of learning what these professionals do, how and why they do it, and some set of general facts that more or less describe our societies and our selves. We pass from kindergarten through twelfth grade, from high school to college, from college to graduate and professional schools, ending our education at some predetermined stage to become the chef, or the engineer, equipped with a fair understanding of what being a chef, or an engineer, actually is and will be for a long time.
We "learn," and after this we "do." We go to school and then we go to work.
This approach does not map very well to personal and professional success in America today. Learning and doing have become inseparable in the face of conditions that invite us to discover.
Against this arresting background, an exciting new kind of learning is taking place in America.
Over the next twenty years the earth is predicted to add another two billion people. Having nearly exhausted nature's ability to feed the planet, we now need to discover a new food system. The global climate will continue to change. To save our coastlines, and maintain acceptable living conditions for more than a billion people, we need to discover new science, engineering, design, and architectural methods, and pioneer economic models that sustain their implementation and maintenance. Microbiological threats will increase as our traditional techniques of anti-microbial defense lead to greater and greater resistances, and to thwart these we must discover new approaches to medical treatment, which we can afford, and implement in ways that incite compliance and good health. The many rich and varied human cultures of the earth will continue to mix, more rapidly than they ever have, through mass population movements and unprecedented information exchange, and to preserve social harmony we need to discover new cultural referents, practices, and environments of cultural exchange. In such conditions the futures of law, medicine, philosophy, engineering, and agriculture – with just about every other field – are to be rediscovered.
Americans need to learn how to discover.
Being dumb in the existing educational system is bad enough. Failing to create a new way of learning adapted to contemporary circumstances might be a national disaster. The good news is, some people are working on it.
Against this arresting background, an exciting new kind of learning is taking place in America. Alternatively framed as maker classes, after-school innovation programs, and innovation prizes, these programs are frequently not framed as learning at all. Discovery environments are showing up as culture and entertainment, from online experiences to contemporary art installations and new kinds of culture labs. Perhaps inevitably, the process of discovery — from our confrontation with challenging ambiguous data, through our imaginative responses, to our iterative and error-prone paths of data synthesis and resolution — has turned into a focus of public fascination.
Discovery has always provoked interest, but how one discovers may today interest us even more. Educators, artists, designers, museum curators, scientists, engineers, entertainment designers and others are creatively responding to this new reality, and, together, they are redefining what it means to learn in America.
At Harvard University, where I teach, Peter Galison, in History of Science, asks his students make films, to understand science; Michael Chu, in business, brings students to low income regions to learn about social entrepreneurship; Michael Brenner, in Engineering and Applied Science, invites master chefs to help students discover the science of cooking; and Doris Sommer, in Romance Languages, teaches aesthetics by inviting students to effect social and political change through cultural agency. Similarly, in the course I teach, How to Create Things and Have Them Matter, students are asked to look, listen, and discover, using their own creative genius, while observing contemporary phenomena that matter today.
Because that's what discoverers do.
Learning by an original and personal process of discovery is a trend on many US university campuses, like Stanford University, MIT, and Arizona State University. It also shows up in middle school, high school and after school programs, as in the programs supported by the ArtScience Prize, a more curricular intensive version of the plethora of innovation prizes that have sprung up in the last years around the world. Students and participants in these kinds of programs learn something even more valuable than discovering a fact for themselves, a common goal of "learning discovery" programs; they learn the thrill of discovering the undiscovered. Success brings not just a good grade, or the financial reward of a prize. It brings the satisfaction that one can realize dreams, and thrive, in a world framed by major dramatic questions. And this fans the kind of passion that propels an innovator along a long creative career.
Discovery, as intriguing process, has become a powerful theme in contemporary culture and entertainment. In art and design galleries, and many museums, artists and designers, like Olafur Eliasson, Mark Dion, Martin Wattenberg, Neri Oxman and Mathieu Lehanneur, invite the public to explore contemporary complexities, as in artist Mark Dion's recent collaborative work with the Alaskan SeaLife Center and Anchorage Museum on plastic fragments in the Pacific Ocean. Often they make visitors discovery participants, as in Martin Wattenberg'sApartment, where people enter words that turn into architectural forms, or sorts of memory palaces. In a more popular way, television discovery and reality programs, from Yukon Men to America's Got Talent, present protagonists who face challenges, encounter failure, and succeed, iteratively and often partially, while online the offer is even more pervasive, with games of discovery and adventure immersing young people in the process of competing against natural and internal constraints.
All this has led to the rise of the culture lab.
Culture labs conduct or invite experiments in art and design to explore contemporary questions that seem hard or even impossible to address in more conventional science and engineering labs. Their history, as public learning forum, dates from the summer of 2007, when the Wellcome Collection opened in King's Cross London, to invite the incurably curious to probe contemporary questions of body and mind through contemporary art and collected object installations. A few months later, in the fall 2007, Le Laboratoire opened in Paris, France, to explore frontiers of science through experimental projects in contemporary art and design, and translate experimental ideas from educational, through cultural, to social practice. And in the winter 2008 Science Gallery opened in downtown Dublin to bring contemporary science experimentation to the general public (and students of Imperial College) with installations in contemporary art and design. Other culture labs have opened since then, in Amsterdam, Kosovo, Madrid and other European, American, Asian, African and Latin American cities. In the USA, culture labs especially thrive on campuses, like MIT's famous Media Lab, Harvard's iLab, and the unique metaLAB, run by Jeffrey Schnapp within Harvard's Berkman Center. These will now be joined by a public culture lab, Le Laboratoire Cambridge, which opens later this month near MIT and Harvard, bringing to America the European model with a program of public art and design exhibitions, innovation seminars, and future-of-food sensorial experiences.
The culture lab is the latest indication that learning is changing in America. It cannot happen too fast.
We may not be getting dumber in America. But we need to get smarter in ways that match the challenges we now face. The time is now to support the role of learning in the pursuit of discovery and to embrace the powerful agency of culture.

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Earth Chakras And Vortices - The Earth Energy Grid | The Mind Unleashed

Earth Chakras And Vortices - The Earth Energy Grid | The Mind Unleashed




Fall Foliage Map & Peak Leaf Forecast

Fall Foliage Map & Peak Leaf Forecast

I can still get my Northeast Fall Foliage fix by driving up into Wine Country...