bookofjoe

BehindTheMedspeak: Diprivan (Propofol) and Michael Jackson

Reader Nikolas R. Schiller last evening sent me a link to a July 1, 2009 TMZ story reporting that propofol (Diprivan) was found at Michael Jackson's house after he died.

TMZ did a very nice reporting job about the drug, accurate in every respect about its indicated use, side effects and risks.

Wrote TMZ, "We're told the drug propofol was discovered at the residence. The drug is used to put people under anesthesia before surgery. It is an extremely powerful drug that is only available to medical personnel. As one source said, 'There is no conceivable way this drug can be properly prescribed for home use.'"

"The drug can only be administered with an IV. Interestingly, propofol burns [on injection] and the drug lidocaine is used to reduce the pain associated with the propofol injection. As we first reported, lidocaine was found near Jackson's body."

"One of the major side effects of propofol is cardiac arrest if it's taken in combination with narcotic painkillers, however, propofol is so powerful it can stop someone's heart on its own."

"Sources say the drug is so inappropriate and reckless for home use, if a doctor facilitated it for Jackson and it caused his death, he or she could be prosecuted for manslaughter."

Precisely.

Propofol can also cause respiratory arrest if given in a large enough dose.

Which — in my experience of having used it for for over 20 years in thousands of patients — can be a relatively small dose in terms of milligrams which turns out, for a particularly sensitive patient, to be plenty big.

Only people capable of  expertly maintaining an airway — up to and including emergency endotracheal  intubation — can safely use this drug.

Emergency resuscitation equipment including a source of oxygen and a breathing bag and mask must always be present for backup use.

That propofol is routinely employed in settings and by practitioners — doctors, dentists and nurses — who have no business using it does not mean it's safe.

It only means those foolhardy people (and their unwitting patients) have — so far — been very lucky.

Walls Notebook — getting in touch with your inner Banksy

"A notebook filled with pictures of walls. Empty New York walls that is, just waiting for you to add some art. A sketch, a doodle, a note; or really work it and let your inner Banksy emerge and show off your artistic capabilities."

"Or maybe you are more into graffiti? That's fine too; there are clean subway cars, delivery trucks and post boxes, just waiting to be tagged."

160 pages; 8.5" x 6.6" (21.5cm x 17cm).

$17.

What's Hot Weekly — 'Find the most popular items on eBay'

Created by Randy Yates, who writes, "This is great for sellers and marketers looking for niches."

PeaceKeeper Handbag

Designed by James Piatt.

Nice mashup.

$85.

[via LikeCOOL]

Fancy Fast Food

"These photographs show extreme makeovers

of actual fast food items

purchased at popular

fast food restaurants."

You could look it up.

[via Anjan Gewali]

Skeleton Mirror

Measuring 67"H x 25.5"W, it's self-adhesive and goes on (or in) your closet.

Configure to suit your mood and/or needs.

Laser-cut Perspex (Lucite to you, gringo).

$192.

[via Street Anatomy]

HYDESim: High-Yield Detonation Effect [Atom Bomb] Simulator

"The data used in HYDESim are based on information found in "The Effects of Nuclear Weapons," 3rd Edition by Samuel Glasstone and Philip J. Dolan.

[via Milena]

Seatback Organizer

From the website:

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Seatback Organizer

This ingenious organizer case hangs from your tray table lock, keeping in-flight essentials at your fingertips.

It has a magazine-size pocket, large mesh pocket for headphones, books or DVD player, padded pockets for iPod, cell phone and eyeglasses, mesh pocket for your 3-1-1 toiletry bag, snacks or water, plus two pen loops.

Tuck the bottom portion into the seat pocket for clear aisle access.

Zips closed to pack in your carry-on bag and has two carry handles and a detachable shoulder strap.

Made of black ripstop nylon.

14" x 23" open; 14" x 10½" closed.

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$29.85 (please note that you will not be receiving the items shown in the organizer in the photos above. As if.).