#ors

[macgyvermedical]

Treating Diarrheal Illness

Someone recently sent me an ask about vomiting and diarrhea. I got almost all the way through writing it and then tumblr ate it. Didn't save it as a draft, didn't even put the ask back in my inbox, just poof'd it into oblivion.

But it was a good ask, and not one I get very often, so I still want to answer it- it essentially said the following:

How could a non-medical person in an apocalyptic setting treat someone who had severe diarrhea and vomiting, assuming the person in gastrointestinal distress was a doctor and could give them some direction? Can/should they give antidiarrheal medication and how would they go about doing that since the patient would probably throw it up?

So very glad you asked:

Diarrhea

The nice thing about most diarrheal illness is that as long as the person stays hydrated, they have a really good chance at surviving. Water is okay for hydration, but if the caregiver can get their hands on some salt, some potassium-based salt substitute, and some sugar, they can make a really easy and effective oral rehydration solution. The recipe is as follows:

Mix together:

1 liter of water

1/2 tsp salt (you want this to be slightly less salty than tears)

1/8 tsp potassium-based salt substitute (if you have this, great, if not, you can leave it out and it will still be effective)

8 tsp sugar

The goal is to get them to drink more volume of ORS than they are pooping- think at least a cup of ORS per poop.

Vomiting

The nice thing about uncontrollable vomiting is, again, that as long as the person stays hydrated, they will probably survive. Hydrating someone who can't keep anything down is a little trickier for the lay caregiver. Fortunately, there's another entrance to the GI tract.

The colon absorbs water. That's the colon's job. It takes the liquid coming from the small intestine and pulls water out of it until it becomes solid poop. A lay caregiver can take advantage of this process to hydrate someone if necessary by inserting a flexible tube (enema tip, catheter tip, NG tube, IV tubing, whatever relatively clean tube you have lying around that fits) a few inches into the rectum and SLOWLY instilling saline (1 liter water to 1/2 tsp salt). The colon can absorb between 2 and 6 liters of water this way per 24-hour period, which can absolutely keep a person hydrated even without an IV.

Diarrhea AND Vomiting

The annoying thing is that when diarrhea comes with vomiting severe enough to prevent being able to keep liquids down, neither of these really work.

So either your caregiver character needs a method that doesn't involve the GI tract at all, or they need to get creative.

IV hydration has a lot of drawbacks in the apocalypse. For one thing, it involves a lot of specialized equipment- the tiny catheters that sit in the vein, sterile tubing with a drip chamber, sterile fluids, and saline locks- all of which are nearly impossible to improvise. Plus, in the case of this ask specifically- doctors generally don't know how to start IVs. That's a nursing skill and unless a doctor is an anesthesiologist they probably haven't put an IV in since med school (where they did it exactly once).

Subcutaneous (subq) hydration is slower and requires all the same supplies. The nice thing about subq though is that unlike an IV catheter, which has to sit in the vein and takes skill/experience to place, in subq hydration the caregiver only has to place a catheter into the patient's fat (something a lot easier to talk someone through). This can instill about 60ml/hr (about 1.5 liters/24 hr). If they have the supplies and can throw more than one catheter in the person, they can probably keep them hydrated this way.

Recommendations

What I would recommend for this story, however, is to pile a bunch of anti-nausea remedies on top of each other to try to get the puking under control, then work on the diarrhea.

If this were my patient and I was in the apocalypse, I would start by putting a cool rag on the back of my patient's neck and have them smell an alcohol pad or some mint, help them wash out their mouth so it doesn't taste like puke, and try to keep them from puking for about an hour. If they make it that long, I'd start with having them drink about an ounce of clean water. If they don't throw it up over the course of the next half hour, I'd give an ounce of coca cola (I don't usually do brand names, but coca cola has a high concentration of phosphoric acid, which is a great anti-emetic plus the bubbles can help with nausea as well).

I'd then drop to an ounce every 15 mins, then an ounce every 10, alternating water and coke, or ORS and coke. The goal is very small amounts of liquid with time in between. If they become severely nauseous, back off and start again after a half hour. If they throw up, start the whole thing over again.

If at any point during this they had a prescription medication available like ondansetron, compazine, or promethazine, they could crush it and have the patient put it under their tongue- that way they wouldn't have to swallow it and risk throwing it back up. Some of it would absorb, and if they happened to swallow some, that would also be great.

Once the vomiting is moderately under control, they could give bismouth subsalicylate (pepto-bismol) and loperamide. Both work against diarrhea. For loperamide, the dosing is two tablets after the first loose stool, then one after each subsequent loose stool. Bismouth subsalicylate and loperamide can be taken together.

Stopping Things Up

A question a lot of people ask is whether you should take anything to stop diarrhea. This usually comes with the idea that the person with diarrhea must be pooping for a reason, and stopping it up is trapping an infection in there and making it worse.

If the diarrhea is being caused by a bacteria or virus, that infection is in the walls of the digestive tract, and it spreads to other people via infectious poop. Pooping does not get rid of the infection. It just makes it more likely that someone else will catch it, and that the patient will become dehydrated. So taking medication to slow down the poopcano is generally a good idea here, since the goal is basically just to wait until the immune system kicks the infection or antibiotics wipe it out, and pooping doesn't help with that.

Now. If the diarrhea is being caused by a toxin, including a toxin from, say, c-diff (an infection from a bacteria that takes over the gut after some antibiotics and causes life-threatening diarrhea/colitis), taking a medication to stop the poop is a bad idea- since the toxin will get trapped and continue to cause problems. Same if it's something like a food allergy or intolerance- it's going to keep messing you up until it's out, so better to let it get out.

How can you tell? Well, here's where I refer you to a doctor. In this situation, the doctor might be able to make an informed choice on whether they wanted to take an anti-diarrheal medication based on what they thought was causing the vomiting and diarrhea.

#vomiting #diarrhea #whump reference #writing reference #emeto #dehydration #oral rehydration solution #ORS

[beespackingheat]

old school runescape drawings related to vampires and other fun things, 2021

#clip studio #clip studio paint #ors #old school runescape #runescape #doodles #shitposts

[proudfreakmetarusonniku]

I think there’s a very fine line between just sharing experiences and actively talking over ppl and that’s where all the discourse comes from tbh. Like, there are dickheads talking over people with other disabilities and there’s also people who have different disabilities but want to share and relate in a way that’s supportive and kind, but a lot of people lump them in together and either get mad at people for talking about any disability that isn’t theirs or vice versa and they end up saying the wildest ableist shit. and like. neither of those are healthy nor good. lashing out at other disabled people who are genuinely trying to relate isn’t helpful, even if their disabilities are less severe or very different is just cruel and unhelpful and often crosses the line into lateral ableism. defending people who place their needs first and talk over everyone and treat their own disabilities like the only ones that exist is very cruel and crosses the line into lateral ableism too.

#can y’all jsut stop talking over each other basically. it’s disability pride month dumbass infighting literally helps no one but our oppress #ors

[kai-andrew-art]

Very interested in your Hels Ex. I want to know what is going on with that man

Xy is a physically powerful being, with the only mindset of “must destroy everything!” He’s being reigned in by Ors (Hels!Xisuma), he uses Xy to threaten other Helsmits and keeps him as a body guard.

Xy has a walnut brain, and is easily exploitable (so long as he gets beat someone up or break shit lol)

#anon #ask #helsmits lore #helsmits #Xy #Ors #my art #sketch #hermitcraft #hermitblr #hels!ex #hels!xisuma #Cw gag

[alicantodrugsinfo]

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#pcdpharmafranchisecompanyinindia #pharma #pcdpharmafranchise #health #medicine #ors #energydrink #orspowder

[maisha-online]

#diarrhea #Health #Howdoyouknowifyouhavenorovirus? #Howlongisnoroviruscontagious? #Norovirus #Norovirusinfection #ORS #StomachBug #stomachflu #StomachVirus #Symptomsofnorovirus #viralgastroenteritis #vomitingbug #Whatisthetreatmentfornorovirus?

[el-ladron]

Sydney Sweeney

#sydney sweeney #ana de armas #emily ratajkowski #lindsay lohan #olivia wilde #celebrity bikini #celebrity crush #lick my ass #sexy tiddies #sexy titts #anne hathaway #youtube #juno temple #millie bobby brown #ore dake level up na ken #isabela merced #melanie griffith #nathalie emmanuel

[oracle-fae]

x

#flower #flowers #flower ore #flower aesthetic #interiors #cottage #cottagecore

[drpedi07]

Diarrhea

Diarrhea is the passage of watery stools. Diarrhea often occurs with fever, nausea, vomiting, cramps, and dehydration.

#Diarrhea #Hepatology #stools #illness #ORS

[thepriceofsurvival]

This is very unfinished but I needed everyone to see the vision I had

#I’m going on hiatus because I need to focus if imma keep my job #so no. ore drawing traumatized gay boys for a while #I have no idea what direction I want to take this in and I really need to learn lighting and shading #but I needed everyone to see my vision before I disappear #all for the game #jean moreau #aftg #the sunshine court #the foxhole court #fanart #my art #also I’m totally gonna make a Kevin one #wip

[waitongutbildning]

Jag ska till Västerås på SFLK:s lösningsfokuserade konferens 2-3/6 - Jag har dessutom fått förmånen att prata om min favoritkombo FIT & LF! Ses vi? Många vänner och bekanta som jag ser fram emot att lyssna på inte minst då Scott Miller. Anmälan https://simplesignup.se/event/193861-fraagans-kraft Läs mer om de hittills presenterade föreläsarna https://www.facebook.com/events/1143409833223609 #fråganskraft #WaitongUtbildning #WU #Waitong #handledning #utbildning #FIT #DP #ICCE #ORS #SRS #OQ #InternationalCenterforClinicalExcellence #ScottMiller #FeedbackInformedTreatement #DeliberatePractise #socialtarbete #terapi #Socialstyrelsen #metodguiden #SFLK #EBTA #SFBT #LiP #LF #SF #Lösningsfokus #LösningsinriktadPedagogik #Solutionfocused https://www.instagram.com/p/Crnnx4PseNX/?igshid=NGJjMDIxMWI=

#fråganskraft #waitongutbildning #wu #waitong #handledning #utbildning #fit #dp #icce #ors #srs #oq #internationalcenterforclinicalexcellence #scottmiller #feedbackinformedtreatement #deliberatepractise #socialtarbete #terapi #socialstyrelsen #metodguiden #sflk #ebta #sfbt #lip #lf #sf #lösningsfokus #lösningsinriktadpedagogik #solutionfocused

[yuricides]

#Ore Janee to Damena Kuse ni ~ Kono Otoko Aishikata mo Chou Ichiryuu

[tofixtheshadows]

The fact that this is canon non-genderbend long haired Kabru ... Madame Kui please, I'm about to start chewing glass.

#Kabru #Dungeon Meshi #Dungeon Meshi spoilers #sorry for locking spoiler conscious anime onlys out of this post for the sake of a stupid meme but it was crucial to my process #also I can imagine Kabru growing out his hair post canon. as a treat. #I posted this pic in one of my group chats with “guy who uses 'ore wa'” #also shout out to buzzcut Kabru looking like the butchest woman twitter can handle before they get scared

[el-ladron]

Fake

Billie Eilish

#billie eilish #ore dake level up na ken #fake #ana de armas #emily ratajkowski #lindsay lohan #sexy titts #sexy tiddies #lick my ass #celebrity bikini #olivia wilde #sydney sweeney #celebrity crush

[chronic-monachopsis]

fellas is it gay to run away to cuba with ur enemy/lover just to dance around ur kitchen ://

#post fall delusional posting #hannibal fanart #hannibal #will graham #HEY IF THIS LOOKS KINDA WEIRD. IG N ORE I T OK #murder husbands #:3

[waifubuki]

#maou no ore ga dorei elf wo yome ni shitanda ga dou medereba ii? gif #maou no ore ga dorei elf wo yome ni shitanda ga dou medereba ii?