Summary #1

Shock is challenging to diagnose in children even though it is one of the easiest things to treat. Children have different symptoms of shock than an adult would have and they pose much harder investigational challenges. It is harder to tell in a child what’s wrong with them when they are brought in to the emergency room. You need to know whether they are crying because they are severely injured, in pain, or are suffering from anxiety. In order to expedite treating them you will need to learn how to differentiate between them quickly.

                A symptom of shock in children and infants is tachycardia, but it is not a good general assumption that tachycardia equals shock. Tachycardia can also occur because the child cannot breathe, a lack of circulation somewhere, or because the child is experiencing anxiety from being around so many strange people. To find out what is wrong, the ABC’s (airway, breathing, circulation) should be addressed first. Look for signs the cardiovascular system isn’t working properly. Sometimes this can be difficult since children have very strong cardiovascular systems. This can cause problems since a child can have normal blood pressure, but still be going into shock. Sometimes shock won’t be diagnosed until a child is hypotensive and in need of resuscitation. Luckily children can survive this and recover fully.

                A good recommendation for children in shock is to start administering oxygen immediately regardless of what their oximeter reading is. If a child has a Glasgow coma scale of that is less than 8, is hypoxic, or cannot maintain patency then you should first secure the airway. Intubating in a child has much different difficulties than if it were an adult. A child is anatomically different from an adult and they have much smaller mouths with leads to much less space for the equipment. Infants are inclined towards becoming bradycardic during intubation. There are other options for those who are comfortable intubating an infant. You can hand ventilate until a pediatric specialist can come intubate them. An LMA which is an artificial airway can be used or an anesthiologist can be called in.

                The rapid restoration of blood is also crucially important. Unfortunately IV access in children is exceedingly hard due to subcutaneous fat and small veins. Luckily there are other options such as intraosseous infusion which is a temporary measure when IV access is impossible. IV access should be obtained quickly. If you are struggling than should insert an intraosseous needle into a long bone like the tibia or the femur. Instead of focusing on putting in an IV, it is more important to get vascular access quickly. Intraosseous infusion has experienced a resurgence since it was first used in the 1930s, especially in pediatric resuscitation. The marrow within the bone is effective in the rapid infusion of drugs and fluids due to the venous circulation in and around it. Intraosseous access can be established in a minute or less when completed by experienced hands.

                Most important is constant reassessment of the patient. Hemodynamics will tell you quickly what is going on. In most tachycardic pediatric patients, the heart rate will come down with good fluid resuscitation. Continued blood loss could be a problem if the heart rate does not come down. Luckily no matter how difficult they are to treat, pediatric patients recover much more quickly. If you can keep control of the injuries and bleeding, you can usually return the patients back to their former health.

 

 

“Helping Severely Injured Children Make A Full Recovery.” Mayo Clinic. Mayo Foundation, n.d. Web. 22 January 2014.

How Would You Find Out How Writing Works In Your Field?

                I think that I would probably start by finding articles within my field of study. I would probably read through them and see if I can put labels to different parts of the article. After I have done that I would probably go to someone I know in that field who would be able to explain it to me. I would have them help me label the different parts of the article and then compare it to what I already labeled to see how close I was to understanding it. I would also compare it to how a normal English article would be written to see how they differed from each other. I think combining all these things together helps me to better understand the difference between the articles in my field and other articles on different subjects.

Thought Piece-Rosenberg

                I really felt like I could connect with this writer. I faced a lot of these problems whenever I read something that I don’t like and it has been a problem for a while. I never really could find a way to solve this problem either. In high school we were always getting all these different strategies on how to read and none of them ever really helped me. The strategies she talked about in her reading made so much more sense. It was more about finding the right information in your reading and not just doing the reading. I thought the advice on how to find the main argument in a reading was especially helpful, because I never really knew how to do that. Most of the time I would guess and just hope that I was right. I think that this article definitely came at a good time for me. I am taking a lot of class this semester that require a lot of reading so I am going to give these strategies a try. Hopefully my reading comprehension will improve.

Portrait of a Writer

            I think that I am best at creative writing. I am good at creating a story in my head and putting it down in writing. I am not very good at summarizing things or analyzing them. I like to write things that I would want to read. I love reading nonfiction, but anything on a serious topic that I am not interested in isn’t going to happen. It is the same thing with my writing. If I am not interested in the type of writing we are doing or the topic it is over, than I will have a very hard time writing it. A good example of this was one day in physics class our teacher made us summarize a science article. Most of the articles were really boring and hard to read let along summarize. I struggled with trying to finish this assignment. This can lead to several other problems. I either don’t make sense, I ramble through several different topics, or I repeat things frequently. I am also good at writing speeches and summarizing articles for speech. It helped that most of the articles were over things that were at least sort of interesting since we didn’t want a boring news/radio show. Usually these were on topics that I enjoyed, but not all of them were enjoyable. They took longer than my creative writing though because I wanted to get everything just right and I wanted them to be really good. I also have this problem that if we are supposed to analyze something and I don’t understand the reading or the assignment, I make things up. I started this in high school because I decided that I would rather turn in something horrible than have it be late. I also hate going back over things that I write. I have three problems with this. First if I do it too early than I get caught up in fixing things and I don’t finish what I am trying to write. I also get distracted when I am typing if those lines appear under words that says they are wrong which leads me back to my first problem. I big example of this happening was when I was in Creative Writing class and was working on this semester long story. I never managed to finish it because I kept going back to make sure it sounded write and I was punctuating correctly. My last problem is that I am horrible at figuring out what is wrong with my writing or anyone else’s. I have hard time remembering where commas and things go and don’t go.

            I frequently suffer from being distracted while writing. A lot of the time it is grammar and making sure that my sentences sound alright. I also spend time trying to figure the difference between certain words like effect & affect and then & than. I am better at this than I used to be, but it still can be hard for me since I still am not always sure what context certain words are used. I also am horrible at limiting my sentence length and my paragraph length. I am not always where I should turn one sentence into two. I also am not always good at judging where I change topic and create a new paragraph. For the longest time my stories were just one long paragraph. I don’t have that problem anymore unless it is like a paper or something where there isn’t any people talking. I know when I am writing a story that I should start a new paragraph when someone new talks which makes it much easier than say a research paper.

            I am horrible at preparing to write a paper. I am the worst at preparing research papers because I haven’t had that much practice. I think I did one or two research papers in high school. It was pretty easy then because we always had a long time to do them and there was due dates for each section. We would turn in our research at certain time, our rough draft at a certain time, and our final draft at the end of the semester. I also had a hard time getting the appropriate number of pages for the research paper. I had a big problem with this my senior year when I wrote a research paper on genetically modified organisms. I had to do a lot of extra research just so I could get a seven page paper. I also sometimes have the opposite problem. If I am really passionate about something I can go on forever. I have done this twice when I was giving speeches. I had a speech for speech class on a TV show I like that was supposed to be about seven minutes long and it ended up being about twelve minutes long. The other speech I did for leadership class and it was supposed to be between ten and fifteen minutes long. It turned into a twenty minute speech. If I am really into a topic than I feel like everything I find is important and it HAS to be in the speech. So it’s a good thing that a get passionate I just need to work on toning it down so I can edit it better. Overall I think my writing could just use a lot of work and I actually think that this paper just helps prove that fact.

Thought Piece-Goodwin

I think that sometimes turning off or ignoring your inner critic can be really hard. It can also be really annoying to be stuck in the middle of writing something because your inner critic is sitting on your shoulder ripping it apart. If you do manage to get your inner critic to shut up then I think you can write much better. I think that all the famous writer that Goodwin mentioned probably also suffered from having an inner critic. If any of them had given up because they listened to their inner critic then we wouldn't have any of the plays and stories that we read today. Who knows what will happen if you ignore your inner critic. You might write the worst book ever or you could end up being the next Shakespeare or Mark Twain. All it takes is ignoring your inner critic and writing that first sentence.