Today started out rather embarrassingly. I decided to attend the weekly neurosurgery conference up at the hospital. I had never been before, so I figured I'd play it safe and wear a shirt with a collar. I had to go to class right after, so I opted for my nicest pair of jeans. Turns out that dress shirts and ties are the norm. Oops! It didn't help that today was also apparently an interview day for prospective residents, meaning that half the room was wearing suits. Joy.
Anyways, after biting the bullet and finding a hiding spot in the corner, the presentation started. The five neurosurgical residents sat in the front row and alternately led the discussion of current interesting cases and were grilled by the attendings asking what they would have done in each case (and telling them why they were wrong). Both the cases and the gauntlet were terrifying and fascinating at the same time.
I think the most disconcerting part was watching the insensitive reactions of the residents to the grim prognoses of the patients. They've seen crazy cases like this every day for years and the only way to cope is apparently to laugh. I'll definitely be going back next week (with more appropriate attire), but I'll endeavor not to be desensitized too quickly.
TIL: Dead space volume (VD) is the volume of air involved in respiration that is stuck in the trachea, bronchi and other rigid non-respiratory spaces. When you inhale, the fresh air in this space never makes it to the lungs; similarly, during exhalation some used air never makes it out of the body and gets sucked back in during the next inhalation. This is normally not an issue because the total volume inhaled is far more than the VD.
However, if you hyperventilate, taking lots of super-shallow breaths, you start increasing the proportion of each breath taken up by that used air, which eventually can lead to hypoxia and unconsciousness. Snorkels, when used improperly, can result in a similar effect. The tube of the snorkel effectively doubles your VD, meaning more stale air re-enters the lungs.
Obstructive sleep apnea is a condition that is caused by the collapse of the airway due to weak muscles that can't resist the negative pressure of inspiration during sleep. Essentially, instead of sucking in air, the lungs suck the walls of the pharynx closed, causing the patient to choke. This is treated by the administration of CPAP (or BiPAP) which involves the wearing of a mask while sleeping that helps push air into the lungs, preventing the collapse of the airway.
Anyways, after biting the bullet and finding a hiding spot in the corner, the presentation started. The five neurosurgical residents sat in the front row and alternately led the discussion of current interesting cases and were grilled by the attendings asking what they would have done in each case (and telling them why they were wrong). Both the cases and the gauntlet were terrifying and fascinating at the same time.
I think the most disconcerting part was watching the insensitive reactions of the residents to the grim prognoses of the patients. They've seen crazy cases like this every day for years and the only way to cope is apparently to laugh. I'll definitely be going back next week (with more appropriate attire), but I'll endeavor not to be desensitized too quickly.
TIL: Dead space volume (VD) is the volume of air involved in respiration that is stuck in the trachea, bronchi and other rigid non-respiratory spaces. When you inhale, the fresh air in this space never makes it to the lungs; similarly, during exhalation some used air never makes it out of the body and gets sucked back in during the next inhalation. This is normally not an issue because the total volume inhaled is far more than the VD.
However, if you hyperventilate, taking lots of super-shallow breaths, you start increasing the proportion of each breath taken up by that used air, which eventually can lead to hypoxia and unconsciousness. Snorkels, when used improperly, can result in a similar effect. The tube of the snorkel effectively doubles your VD, meaning more stale air re-enters the lungs.
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| Diagram showing the various lung volumes - VD is not shown because that volume never reaches the lungs. |
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