Improvised Medicine with Kenneth Iserson
In this episode Dr Will Duffin takes a deep dive into Dr Iserson's book: 'Improvised Medicine'. Dr Iserson is Professor Emeritus of Emergency medicine at The University of Arizona and former Medical Director of the Southern Arizona Rescue Association. He has published hundreds of scientific articles on emergency medicine and biomedical ethics and authored numerous books. Dr Iserson describes Improvised medicine as 'a spectrum of ad hoc equipment and special methods and knowledge for advanced health care practitioners' with an emphasis on 'opening your mind to ways of solving problems in a crisis and providing options for you (and your patients) when alternatives seem limited or nonexistent.' 'The difficult we do immediately. The impossible takes a little longer' -US Air Force. In this episode the pair discuss: The origins of improvised medicine and how it draws on the history of medical practice through the ages. Some techniques are surprisingly effective even today. Hypnosis as effective analgesia Diagnostics - including direct auscultation, stethoscopes as hearing aids and making 3D X Rays using the power of your eyes. Digital intubation techniques How Dr Iserson sited three endotracheal tubes as chest tubes in a major trauma scenario. Intraosseous infusions using regular needles Safe patient evacuation of a vertical hospital Substitute medications Medicine expiration dates - do they matter? Techniques that definitely don't work including the mythological emergency front of neck access using a biro. The ethics and medicolegal implications of using improvised techniques - how this tallies in with the doctrine of 'first do no harm' and when it is appropriate to deviate from established protocols, techniques and guidelines.