Is it even healthy to consume charcoal?

No, it is not healthy to consume charcoal.

I know that there's all kinds of fad cleanses and this and that.

I would not recommend any of them.

You don't need that toothpaste.

Trust me, I'm Annie Onishi and I'm a trauma surgeon.

And this is surgery support.

Our first tweet comes from wes mull bash.

Wes asks, I'm a novice camper and I'm putting together my first aid kit.

What do I need for a makeshift tourniquet?

Well, wes why get a makeshift one when you can have a real one.

This is a combat application tourniquet.

It is readily available on the internet.

It runs about 30 bucks and it is much better than anything.

You could fashion from a rope or a belt or a shirt.

So basically what you would do is say you had a wound here on the arm that was bleeding uncontrollably and you couldn't control that bleeding by simple pressure.

You would pull out your trusty tourniquet, slide it on above the arm, tighten it just above where the injury is, tighten the belt and velcro it just in place like so next you're gonna turn this windless.

This really hurts in real life so I'm not gonna do it.

But this windless basically titans this tourniquet to a pressure that is above arterial pressure.

Once you tighten it, it locks into place underneath this little clip, you have this velcro strap to keep your windows in place and you would leave that on until you could seek definitive care.

Why use a fake one when you can use the real thing at Liz gillies writes, wow, how long does it take to feel normal slash not like a corpse after an appendectomy.

I'm really over it.

Really over it.

Well, Liz in cases like this, what I usually recommend is a little can of suck it up, appendectomy is really a minor, you should really be feeling pretty much good as new within 24 48 hours.

Take some Tylenol and call me in the morning.

Here's a question from red fulfill at creeps.

Creation asks how come at the er they cut off your clothes instead of just taking them off.

Like what is that?

That was my favorite shirt.

First of all, you're welcome for saving your life.

Second of all, we use these little kitty safety scissors.

These are called trauma shears.

They have a nice flat little lip here so we won't cut you in general.

If somebody's not super sick or dying right away, we try to make an effort to not cut stuff like jeans, nice pants belts, but t shirts are fair game.

Underpants are fair game, especially if they look old and dirty.

Sometimes we just have to get your clothes off in a great big hurry so we can see what's hurt and get you fixed.

Next question comes from at t burn.

Don't eat or drink before eight hours before surgery.

Oh and also take these four pills now before you get here.

How?

Alright.

Patrick, just chill out.

We just don't want you have a big cheeseburger on board when you're going to sleep and getting that breathing tube put in.

If you barf that cheeseburger up while we're putting the breathing tube it and you get cheeseburger in your lungs, you're in for a long stay in the ICU with an aspiration pneumonia.

That's why you can't eat a couple of sips of water with your pills.

Not a big deal.

Next question comes from at sex Warlocks.

Any doctors on here that know why my pissed stink like beef.

No, no, there are no doctors on here.

Who know why you're piss stink like beef.

Why are you smelling your piss?

Next question is from at Harris twist.

Okay, but in Grey's Anatomy, why do all the surgeons in the hospital go and wait outside when an ambulance is coming?

Like does the hospital only hire eight surgeons and they do everything.

There's a lot more than eight surgeons in any given hospital for trauma and emergency, There's usually only one on call.

No, we do not go outside and wait for the ambulance.

We got better stuff to be doing than that.

But every now and then if the chopper's coming in.

I love watching that thing land we get patients via chopper with some degree of frequency.

Probably once a day.

So I'll run out and see that once in a blue.

Next question comes from Jimmy Gems.

22 Ouch Ouch just cut my finger.

How do I know if I need a stitch or not?

Sounds like if you're tweeting you're probably fine or maybe the cuts just not on your thumbs.

My friends from all walks of life call me all the time with all sorts of horrific photos of injuries on themselves, their pets, their kids, essentially.

You need a stitch if you can see subcutaneous fat.

So if you can see little globules of yellow things that's fat, that probably could use a stitch or two.

If you're in the neighborhood, knock on my door, I got all this stuff.

Come on by.

We'll get you fixed up.

Here's a question from brian at B.

A.

Underscore 27 asks, can someone educate me on why is it that when I get a little cut on my finger, I bleed like crazy.

But when doctors do surgery, it seems like people don't bleed as much.

Well brian, I'm a professional.

I know where your arteries and veins live, therefore I avoid them.

When I cut you don't.

Next up from at heath underscore McGregor can an electric eel shock a person's heart back into rhythm?

Like a defibrillator.

A defibrillator is a machine that delivers a targeted measured amount of electricity to a heart that is either in something called ventricular fibrillation or v ventricular tachycardia.

This is a heart rhythm where the heart is just shaking and not pumping blood.

The shock is meant to surprise the heart cells back into a normal pumping rhythm.

An electric eel would not be able to cardioverter patient back into a normal rhythm because it's not timed along with the patient's own heart rhythm.

Next up is a question from at naps and mugs.

Sometimes I think about the fact that I had a surgery a while ago and they took a whole ass organ out of me.

Like how do you show that ship back?

Where is my gallbladder?

I have so many questions.

Well the gallbladder is a tiny little bag that lives underneath the right lobe of the liver.

As you can see here it's attached via the cystic duct to the common bile duct.

That is sort of the plumbing of your liver.

That's how the bile gets out of your liver and into your intestines.

Once it's out it goes into a little jar about that big, sometimes it goes into a big bucket.

If it's a big gallbladder we send it off to the pathology lab, they look at it under the microscope and then they discard it.

I think it actually gets incinerated.

So your gallbladder has probably been long incinerated and is just a memory at this point.

Our next question comes from at don't mess with puppy when given anesthesia before surgery.

Why does the doctor have their patient count backwards from 10 rather than just counting 123.

Hate to break it to you papi but we don't actually do that.

There's no counting involved.

You just kind of drift off to sleep.

I usually try to make a little small talk as the patient's going off to sleep.

Little kids.

I try to tell them to have a nice dream and have a good rest and everything's gonna be fine.

Adults, I like to say, well what are you gonna eat after surgery?

Because that's usually what most people are focused on next at Banzai soy.

Do surgeons really wear diapers through long surgeries?

No, our next question is from at Umeda M.

Doctor.

This has been cited as a major difference which is pneumonia and which is a covid X ray.

This is a really tricky question briefly.

Just looking at these two X rays.

If I had to guess, I think I would guess the X ray on the right, the one on the left looks more like a consolidated bacterial pneumonia.

On the left again, all the inflammation is located to what I know to be the location of the right upper lobe.

Covid is not ever localized just one lobe, it's more diffuse meaning throughout all the lobes of both lungs.

Our next question comes from at cara underscore Marie 12 to 0.

So if you have one of the dissolvable sutures from a surgery you had three weeks ago.

It doesn't dissolve.

What the hell do you do asking for myself?

Because I have both ends of suture sticking out of my abdomen upside down?

Smiley face.

Dissolvable sutures.

They are supposed to supposed to take about 7 to 10 days to dissolve, depending on the material.

Here's an example of an absorbable suture.

This is called P.

D.

S.

This is a mono filament types future meaning it's one long filament.

Something like a fishing line is also a mono filament.

This is a type of future that I personally have a strong preference for when I sew on bow.

So this is absorbable in about a week's time.

If you have some sticking out of your skin, it's not that big of a deal.

I would just take a pair of tweezers, yank it and cut it right at the skin to just remove those annoying little loose ends and then the not beneath is probably already dissolved or just leave it alone.

It will eventually deal with itself.

Here's a question from at Megan Megan.

How the hell does a surgeon leave an instrument inside their patient.

Unfortunately, this is something that has happened before.

You would be very surprised how big and deep and abdominal or chest cavity is.

I mean, in a tall guy, I can get my whole arm inside somebody's belly.

So yes, there is room for instruments.

Here's a question from at Beasley carry.

Why did I schedule surgery when I can't drink alcohol for 24 hours afterwards.

On National Beer Day.

What the heck is wrong with me?

Hashtag National Beer Day.

Can't is a strong word sort of depends what operation you had, whether you're taking heavy duty pain medication.

I don't see why one little beer is going to hurt anything.

Just don't tell your doctor.

I said that next at brady to full 08 is over applying peroxide to a cut.

Bad.

I don't think you can over apply peroxide.

The bottles only that big it's just it's dissolving into water and air.

So I really I wouldn't worry about it too much if you have a big open surface like road rash, peroxide can be good because the bubbles can sort of rinse the little dust bits away.

But over a cut I don't think it's really that helpful just running it under some water in the sink with some soap is usually enough to keep it clean.

I don't really use peroxide that much.

Except in that case.

Like I mentioned of road rash.

Here's one from at S.

Jones 565.

How long does it take a wounded distance to close asking for a friend?

A wounded his since for those of you who may not be familiar is when a surgical wound falls apart usually from an underlying infection.

The D.

Hisense will then after the infection has been adequately treated and dealt with the wound will then sort of closed by what we call secondary intention.

So it will basically fill in from the bottom up the length of time that takes will depend on a number of factors.

Number one is the infection underneath the D.

Hisense adequately treated and controlled.

Number two.

How big is the wound?

Number three, what is your nutrition like?

So nutrition is probably the most important predictor of wound healing.

I think under the best circumstances in my experience with patients with big open surgical wounds.

Once the infection is controlled and once the nutrition is optimized, big distance takes about 4 to 6 weeks to close up next from ap finegar.

When the scrub machine gives you scrubs with holes, you would exchange them for better scrubs or be suture them with a Cron.

Hashtag ep fellowship hashtag life skills.

I mean I use at home to fix stuff little tears and T shirts and things that I'm not ready to throw out.

My dog's toys will sometimes get some surgery to get them to last a little bit longer.

But scrubs, I mean, come on.

Those are essentially disposable.

Next at kondo XX II.

Is it even healthy to consume charcoal?

No, it is not health to consume charcoal.

I know that there's all kinds of fad cleanses and this and that.

I would not recommend any of them.

We will occasionally, occasionally occasionally use activated charcoal down a tube into a patient's stomach.

If we know that they have ingested certain medications, but this doesn't work for all poisons activated charcoal as a health trend is one of the stupidest things I've ever heard.

Activated charcoal is used for medical poisoning emergencies only You don't need that toothpaste.

Trust me, thank you for your questions.

This has been surgery support.

I gotta say.

I'm kind of worried about some of you out there.