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See, that’s what the app is perfect for.

Sounds perfect Wahhhh, I don’t wanna
adventuresandshopping
vintagerpg

The first book released for Advanced Dungeons & Dragons was the Monster Manual (I’d have published the Player’s Handbook, first, but what do I know). Written entirely by Gary Gygax, the book is a compendium of, as the back cover says, over 350 monsters, compiling statistics, detailed descriptions and, in most cases, a now-iconic illustrations.

It wasn’t the first RPG bestiary – Chaosium released two volumes of its primitive All the World’s Monsters earlier in 1977, but those books don’t have the polish or detail of the Monster Manual. It was the first hard cover RPG supplement, but what makes the Monster Manual special is, as is so often the case with early TSR publication, that it set the mold for others to follow. Even now, decades later. I have piles of books dedicated to RPG monsters. Out of the Pit, Malleus Monstrorum, Creatures of Barsaive, The Gloranthan Bestiary, Galaxy Guide 4: Alien Races – all following in the standard created by Gygax. Monsters got me into the hobby and they’ve remained a strong interest. I mean, who doesn’t love monsters? I’ve gotten rid of most of my Third and Fourth Edition books, but I kept all the Monster Manuals.

There are a lot of great artists in the first Monster Manual, but David C. Sutherland III steals the show with his cover and his two full-page illustrations. DCS isn’t my favorite early TSR artist, but the amateurishness of the cover is endearing (Except the manticore. Manticore’s don’t have wings). His interiors tend to be sketchy and stiff for my taste, but the battle against the kobolds is kind of magical (A web spell! That roman-looking dude! Why is there an ant on his shield? That is awesome!). The fighter advancing on the mob is maybe my favorite illustration by DCS – detailed, well-drafted, entirely surreal.

One last thing worth noting: the Monster Manual, with its devils, demons and exposed breasts, is one of the key books that would eventually get TSR in trouble with conservative Christians, so I guess it was trendsetting in that regard, too.

regionstraumapro

The “Double-Barrel” IO: Can It Work?

regionstraumapro

Intraosseous lines (IO) make life easy. They are quicker to insert, have a higher success rate, and require less experience than a standard IV. And they can be used for pretty much any solution or drug that can be given through an IV.

But there are some limitations. They can’t be inserted into a fractured bone. The manufacturer cautions against multiple insertions into the same bone. A second insertion should not be performed in the same bone within 48 hours.

But, as with so many things in medicine, there is little in the way of proof for these assertions. They seem like good ideas for precautions, but that does not mean they are correct. No real research has been done in this area. Until now.

The concept of using two IO needles in one bone was explored in an animal model by researchers in Canada. They used a swine model (using the foreleg/humerus, to be exact), and tested several infusion setups.

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Here are the factoids:

  • Infusing crystalloid using an infusion pump set to 999ml/hr took 30 minutes with a single IO, and 15 minutes with a “double-barrel” setup
  • Giving crystalloid using a pressure bag set at 300 mm/Hg took 24 minutes with a single IO, and 23 minutes with double the fun
  • The double-barrel setup also worked for a blood/drug combo. 250cc of blood and 1 gm of TXA in 100ml of saline infused via pump in 13 minutes.
  • Simultaneous anesthesia drugs (ketamine infusion in IO #1, fentanyl and rocuronium bolus in IO #2) without problems
  • Multiple fluid + drug infusion combinations were tested without incident
  • There were no needle dislodgements, soft tissue injuries, fractures, or macrohistologic damage to the bone or periosteum

Bottom line: Remember, these are pigs. Don’t do this in humans yet. However, this is pretty compelling evidence that the double-barrel IO concept will work in people. And it appears that infusion pumps must be used for effective, fast infusions. I recommend that prehospital agencies with inquiring minds set up a study in people to prove that this works in us, too.

Related posts:

Reference: Double-barrelled resuscitation: A feasibility and simulation study of dual-intraosseous needles into a single humerus. Injury 46(11):2239-42, 2015.

Source: http://thetraumapro.com/2017/05/26/the-double-barrel-io-can-it-work-2/
Source: thetraumapro.com
blood gore needles cool!
gplusbfics

DS9 Podficcing

gplusbfics

Brief update to say I’m currently recording a podfic of @tinsnip amazing long-form Deep Dish Nine fic “Disconnnect” and will soon be doing one of “Complementing Baggage” by kittyknowsthings, which follows off of that storyline. And I ultimately have plans to do a podfic of my novella “Outside Chance,” which will take me a while since it’s 50,000 words and 14 chapters. But I love doing podfics, including doing them for other people. (FYI, on the two I’m doing now/soon and the one I did already, I offered, they didn’t ask.)

DS9 podfics I’ve done so far, BTW:

On a related note, I’ll be doing a post this weekend with an index of a SLEW of podfics that’ve been posted to AO3 in the past week plus other podfics I’ve enjoyed and have bookmarked.

Wendy

cosmictuesdays
thoodleoo

no punctuation we read like romans

caecilius-est-pater

NOPUNCTUATIONORLOWERCASEORSPACESWEREADLIKEROMANS

terpsikeraunos

INTER·PVNCTVATION·WE·INSCRIBE·LIKE·ROMANS

imaginarycircus

words doesn’t classical matter order in greek;

tanoraqui

we, in a manner akin to that of a man who once was, in Rome, an orator of significant skill, who was then for his elegance of speech renowned and now for his elaborate structure of sentences cursed by generations of scholars of Latin, the language which he spoke and we now study, Cicero, write, rather than by any efficiency, functionality, or ease of legibility have our words, our honors, the breaths of our hearts, be besmirched.

ceuulusuoluptatemcapit

The fact that this has yet to devolve into boustrophedon is a miracle… or a challenge. I’m looking at you @terpsikeraunos @macdicilla @labellamordens

macdicilla

image

I’m up to it