Funtabulously Frivolous Friday Five 353

Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the Funtabulously Frivolous Friday Five 353

Question 1

Stethoscopes have always had a bad rap for being a harbinger of germs. What other everyday object commonly ported by healthcare workers has a 95% rate of bacterial pathogens?

Reveal the funtabulous answer

The mobile phone

It seems that the mobile is pretty disgusting as non-health care workers also have an 82% bacterial contamination on their phones. Staphylococcus Epidermidis, Bacillus spp, Staphylococcus Aureus, Pseudomonas Aeruginosa and Escherichia Coli (stop reading this while on the toilet) were the top five offenders.


Question 2

A 65 yr old male complains of hearing a sustained beep from his ICD (inserted for cardiac sarcoidosis) after smoking from his e-cigarette. No syncopal episodes or shocks occurred but he is convinced there is a noise coming from his chest. Interrogation of the device shows no shocks or arrhythmias.

What is the most likely cause?

Reveal the funtabulous answer

The magnet in his e-cigarette caused magnet reversion in the ICD.

Once he’d finished vaping, he would put the e-cigarette in his left chest pocket next to the ICD. It took the device company to integrate the device to see it was intermittently being exposed to a magnet.

EMRAP described a case of a woman face-timing family with the phone resting on her chest, and she had a syncopal episode. This is secondary to the MagSafe technology being too close to her PPM.

Other technology that can do this includes smart tablets, fitness watch wristbands and wireless headphones — basically anything with a magnet. Best not to stuff all these items in your breast pocket and keep them 15cm away from your ICD or PPM.


Question 3

Who was described as…

The bravest man in the RAF who never flew an aircraft

Reveal the funtabulous answer

Edgar Alexander Pask (1912-1966)

Edgar Pask was Professor of Anaesthesia in Newcastle upon Tyne. During the Second World War he was junior anaesthetist to Sir Robert Reynolds Macintosh (1897-1989) and volunteered for the RAF where he was involved in a number of dangerous and remarkable experiments.

He earned his nickname from his dangerous self-experiments, including discovering what height it was feasible to parachute from an aircraft without supplemental oxygen by hanging in a parachute harness and inspiring mixed oxygen mixtures. No small feat for someone who smoked 70 a day. He concluded 35,000 feet was the maximum a soldier could bail from.

The Royal Navy then tasked him with developing a safer lifejacket as 2/3rds of airmen were drowning to death.

In 1940/41, Pask was anaesthetized, intubated and lowered into the deep end of the Farnborough swimming pool, and much to everyone’s surprise – he sank

Over many weeks, Pask was anaesthetised by Macintosh and was allowed to float or sink whilst wearing a life jacket prototype, to assess flotation angle and self-righting capability. This selfless dedication to human service has seen Pask termed ‘the father of the modern life jacket’

Pask and Macintosh testing life jackets anaesthetized 1941
A. Edgar Pask being anaesthetised by Robert Macintosh (barefoot at the side of the pool). 
B. Buoyant overall, stable when prone. 
C. Buoyant overall in rough water. 
D. No life-jacket!
Pask and Macintosh 1941-1957.

Pask was tasked with finding the best method for artificial respirations in the field.

Pask concluded that Eve’s rocking method (rocking on a stretcher to 45 degrees on either side) was the method which could be most easily and safely applied. Click on the link to see for yourself.

To take things one stage further…Pask obtained some early curare from his friend Harold Griffith in 1945. He persuaded Macintosh to repeat the experiments on himself, fully paralysed for two hours, to compare results with his earlier experiment.

And for a final crazy experiment… aircrew ditching in the waters around the British Isles were likely to suffer hypothermia. Pask created an effective immersion suit to allow temperature maintenance in cold water. Once designs were complete, Pask obviously had to test them…by being parachuted into the sea in winter.

He died aged 53 from a myocardial infarction, reportedly due to his early wartime experiments but I wonder if the 70-a-day cigarette habit had something to do with it.

Question 4

Hypothetically you find yourself on a sinking ship in warm waters 5km from land. All 10 of your fellow passengers are unable to swim. On the vessel there is a medical bag packed with needles and syringes and myriad livestock including a pig, a calf and a pony.

How will you save the day?

Reveal the funtabulous answer

Hypodermic sufflation

As described by Henry Silvester in 1883, he proposed hypodermic inflation.

In 1883, Henry Robert Silvester (1828-1908) Silvester demonstrated at the International Fisheries Exhibition the possibility of inflating the subcutaneous space in animals so as to render them sufficiently buoyant to be employed either singly or yoked together to convey persons from a wreck to the coast:

Silvester showed at the Exhibition a small dog, weighing 10 lb., whose subcutaneous tissue he had inflated with air, and which was then able to sustain a weight of 18 lb. in water, in addition to its own weight. Dr. Silvester suggests that a large dog or a calf thus used might be able to bring a number of persons safely to shore

Lancet 1883

In August 1883 at King’s College Hospital, Silvester went on to demonstrate that by using a blowpipe, an elastic syringe and an incision at the wrist he was able to “inflate the subcutaneous tissue of the whole body with the result that in a few minutes, sufficient air passed under the skin to support a weight in water of between forty and fifty pounds.”

This method required some skill, practice and equipment. So Silvester set about trying to find a simple alternative method to create subcutaneous emphysema and therefore buoyancy in the imminent drowning scenario.

The intention of the proposed operation is to cause the skin of the neck and upper part of the chest to be sufficiently distended with air to support the weight of the body when immersed. The inflation being effected by the person himself by means of his lungs without the intervention of appliances. 

The operation consists in making a small puncture [for] the passage of an ordinary blowpipe in the mucous membrane of the inside of the mouth, the object being to open a communication for the passage of air from the cavity of the mouth into the subcutaneous spaces of the neck. The situation chosen for the puncture is in the angle formed between the gum of the lower jaw and the side of the under lip or cheek, about opposite the first molar tooth of the lower jaw. The point of the instrument perforating should be passed down a short distance between the skin of the side of the face and the superficial fascia of the neck, its point being guided by the finger placed on the outside of the face and neck, taking care not to puncture either the skin or the superficial fascia.

In order to inflate the skin of the neck and chest, the patient should close the mouth and nose, and make a succession of forcible expiratory efforts, when the air contained in the cavity of the mouth will pass freely into the subcutaneous tissue of the neck. These expiratory efforts, inspiration being effected through the nostrils, should be continued until the skin is fully distended with air, which will pass readily to both sides of the neck and down the chest as far as the nipples; and this is all that is required to render the body buoyant in water.

The amount of air which the skin of the average neck is capable of holding without undue distension has been measured, and found to be enough to support ten pounds, and this is amply sufficient to support the body immersed in water. The time required for inflation is found to be less than three minutes

Silvester 1885

Question 5

Grape or grain, but never the twain

In many cultures, there is folk wisdom about mixing wine and beer, and which order to do it to prevent a hangover. But is there any truth to the anti-veisalgia mantra?

Reveal the funtabulous answer


Beer before wine or wine before beer induce a similar intensity hangover.

A group of multinational authors recruited 105 adults with an online survey to conduct their study. It was unfunded but Carlsberg gave them some free beer. Presumably for the participants and not the authors.

Participants were matched into triplets and randomly assigned according to age, gender, body composition, alcohol drinking habits, and hangover frequency.

Study group 1 consumed beer up to a breath alcohol concentration (BrAC) ≥0.05% and then wine to BrAC ≥0.11% (vice versa for study group 2). Control group subjects consumed either only beer or only wine.

On a second intervention day (crossover) ≥1 wk later, study-group subjects were switched to the opposite drinking order. Control-group subjects who drank only beer on the first intervention received only wine on the second study day (and vice versa).

The primary endpoint was hangover severity assessed by Acute Hangover Scale (AHS) rating on the day following each intervention, and they found no difference in any of the groups.


… and finally, quotes:

Almost everything will work again if you unplug it for a few minutes, including you.

Anne Lamot, 2017

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Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Kelowna hospital, British Columbia. Loves the misery of alpine climbing and working in austere environments (namely tertiary trauma centres). Supporter of FOAMed, lifelong education and trying to find that elusive peak performance.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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