Over the last 150 years or so, the story of the advancements of drugs, treatment, and techniques in medicine has developed at a great pace. Dr Michael Mosley recently presented a trilogy of documentaries for the BBC, telling tales of the beginnings of anaesthesia and the birth of the antibiotic era. In part one of the series, he focused on man's pursuit to free pain. It begins where you may not expect - the poppy. From this rather innocent-looking plant, a resin was extracted and given the name opium. Dissolved in alcohol, the medicine was called laudanum. Morphine, the drug we are familiar today with unprecedented properties in alleviating excruciating pain, was formerly discovered by 19th century pharmacist Friedrich Sertürner. Morphine works by blocking nerve endings associated with pain at the site of pain and in the brain. The direct blockage of these signals proves morphine very effective. Eventually isolating the active ingredients in raw opium, he had managed to obtain a substance that could now be quantified and measured for ease of administration. This fact is often underestimated about drugs - simply by being able to measure out a quantity of a substance offers a huge element of control and indeed safety. It was considered back then that medicines which originated from plant sources were alkaloids, containing the suffix -ine in their name. Hence we are familiar with morphine, whose former name was morphium. According to Dr Moseley, these alkaloids were considered 'our first real medicines'. Dr Walter Sneader, Former Head of Pharmacy at the University of Strathcylde says that the discovery of morphine was 'the single most important event that has ever occurred in drug discovery - far more important than the introduction of penicillin, in terms of advancing the science'. Sertürner then went on to isolate many more alkaloid chemicals, some of which include caffeine, nicotine and quinine. Another well known alkaloid that was discovered was cocaine. Ironically enough, at the point of introduction in industry this compound dissolved in alcohol was approved by the Pope himself. The famous neurologist Sigmund Freud went on to investigate more into the properties of cocaine.
Although these alkaloids were a start, these weren't considered potent enough to be effective in the operating theatre. Sir Humphrey Davy saw nitrous oxide as a potential drug for use in surgery, however surgeons still went on to attempt operations on people who were unfortunately, fully awake. It was only until William Morton and the introduction of ether as a gaseous anaesthetic agent, that anaesthesia started to advance rapidly. To read more on the subject of William Morton's discovery, visit my post, 'The History of Anaesthesia'.
After this remarkable discovery, chemists from all around the world began to experiment with various substances, coal tar notably being one of the 'more unlikely places'. Chemist and presenter Andrea Sella, mentions that using coal tar was able to open 'a whole new library of starting materials'. Some of the most iconic drugs in today's world were a product of this seemingly unpromising raw material, aspirin and heroin just to name a couple. In the 20th century, many more drugs with anaesthetic properties were developed. However it wasn't just anaesthetics; the world's first sleeping pill was discovered, chloral hydrate which became very popular. The barbiturates were another group of drugs that had the ability to put people to sleep. Sodium thiopental was one of the more notable ones, the 'truth drug' so given the name for it's use in interrogation, is featured in the documentary.
Now in the 21st century, we have made great strides in the development of even more effective and safer drugs for use in surgery, prescription, and treatment of diseases. It has come to a point where we can, with suitable starting materials such as simple molecules, develop any molecule we want to. This means we can develop any drug we want to. A surge in technological advances in the last few decades has supplemented our understanding of anaesthesia and how pain is managed.
Credit to the BBC for their medical documentary trilogy, 'Pain, Pus and Poison', broadcasted in September 2014.
Showing posts with label iPlayer. Show all posts
Showing posts with label iPlayer. Show all posts
Thursday, 16 October 2014
Friday, 5 September 2014
Documentary on Tissue Donation
Recently I watched a documentary on the BBC about tissue and organ donation - it focuses on the various people that work in tissue transplantation and those who obtain skin and bone from the deceased. It was really fascinating to see how healthcare workers manage the deceased and what happens to tissue when it is obtained and used to treat patients who long for a donor. It has also made me appreciate that the field of medicine is more than 'dealing with the living'. The documentary was called "The Human Tissue Squad" and I encourage anyone to watch this, although those who are squeamish about blood I advise not to!
Here is the video embedded below:
What is especially striking is that this whole sector of healthcare is solely dependant on people opting for their loved ones' tissues to be donated, and people themselves registering onto the organ donation register. The documentary follows staff at the National Tissue Bank in Liverpool during a time of struggle to obtain tissue surgery on patients who have very particular conditions. One member of staff in the film stressed that "it's younger donors that [they] really need". In the last year this documentary was filmed, only 51 donors were under 35.
The National Tissue Bank stores an incomprehensibly diverse range of tissues, from eyes, to femoral arteries, to Achilles tendons. Tissues generally need to be collected as early as 24 hours after death. However sometimes there is a rising pressure from the bank to supply tissues needed by surgeons in many different hospitals around the country. I was also amazed at the work the nurses do at the bank to support the loved ones of those that have very recently passed away. They talk with families over the phone to decide whether tissues will be donated from the deceased. I can empathise that this could be a distressing task, one nurse mentions she takes up to 24 calls a day. Despite recognises these sad losses, it is of importance that they have enough tissues in stock in supply to the many nationwide hospitals. In one week, the bank may go without one single donation, the next, it may be a 'mad rush' to distribute the tissues with as many as four teams a day on the shift.
One outstanding factor that renders the National Tissue Bank being effective is the teamwork between colleagues within small groups. Also, there is a defining commitment to the job as one pair have to venture out for dissection as early as 5:00AM.
The importance of tissue donation means lives can be saved, however there is always a need for tissue supplies. This relies on the difficult decisions of thousands of families all over the country. An interesting question to consider is whether by law, everyone should be enrolled onto the organ doner register - then it is up to the individual to un-enroll.
Credit to the BBC for their televised documentary "The Human Tissue Squad" (available on iPlayer until 15th September 2014)
Here is the video embedded below:
What is especially striking is that this whole sector of healthcare is solely dependant on people opting for their loved ones' tissues to be donated, and people themselves registering onto the organ donation register. The documentary follows staff at the National Tissue Bank in Liverpool during a time of struggle to obtain tissue surgery on patients who have very particular conditions. One member of staff in the film stressed that "it's younger donors that [they] really need". In the last year this documentary was filmed, only 51 donors were under 35.
The National Tissue Bank stores an incomprehensibly diverse range of tissues, from eyes, to femoral arteries, to Achilles tendons. Tissues generally need to be collected as early as 24 hours after death. However sometimes there is a rising pressure from the bank to supply tissues needed by surgeons in many different hospitals around the country. I was also amazed at the work the nurses do at the bank to support the loved ones of those that have very recently passed away. They talk with families over the phone to decide whether tissues will be donated from the deceased. I can empathise that this could be a distressing task, one nurse mentions she takes up to 24 calls a day. Despite recognises these sad losses, it is of importance that they have enough tissues in stock in supply to the many nationwide hospitals. In one week, the bank may go without one single donation, the next, it may be a 'mad rush' to distribute the tissues with as many as four teams a day on the shift.
One outstanding factor that renders the National Tissue Bank being effective is the teamwork between colleagues within small groups. Also, there is a defining commitment to the job as one pair have to venture out for dissection as early as 5:00AM.
The importance of tissue donation means lives can be saved, however there is always a need for tissue supplies. This relies on the difficult decisions of thousands of families all over the country. An interesting question to consider is whether by law, everyone should be enrolled onto the organ doner register - then it is up to the individual to un-enroll.
Credit to the BBC for their televised documentary "The Human Tissue Squad" (available on iPlayer until 15th September 2014)
Wednesday, 16 July 2014
Meeting the Target - The NHS and A&E
With the population as large as ever in the UK, subsequently in the last few years there has been a noticeable and increasing strain on NHS services across the board. However I believe, along with many others, that the Accident and Emergency Department can be considered to be under the biggest of pressures today. A programme on the BBC I watched recently showed exactly the effects of this population pressure on staff and patients alike. The Panorama documentary was a rather short 30 minutes, nevertheless a real eye-opener to the general public to appreciate the scale of the problem.
I encourage you to see it and I have embedded the video below:
What I found quite shocking is that many of the staff are under constant pressure from the many patients who arrive to the hospital every hour. However it isn't just the local pressure - government-set deadlines and targets ensure the conveyer belts of NHS services are rolling quickly. One doctor in the film says "it's a more stressful place to work than it once was"when referring to the A&E Department of today.
Judging from the documentary, the staff seem stressed, however I deeply respect their professionalism as when dealing with the wide variety of patients, they control their emotions. This is vital when dealing with the public and representing an organisation as important as the NHS. One example from the clip I especially remember is when a heavy alcoholic was admitted to A&E. His rowdy, agitated and rather unpredictable manner meant the nurses in particular were dealing with a tough patient. Refraining from raising their voice too much, they managed to control the patient. In fact if he had turned very aggressive, the staff may have been at risk from harm. The number of alcoholics and drug abusers admitted to A&E is alarming, and they are transported to hospital 'around the clock'. For this hospital alone there are '3 to 4 overdoses a day'.
The pace at which staff need to work is tremendously quickly, whilst being efficient. It shows how training is vitally important to sustain such roles in the health service.
In the video, I was rather interested to see that one GP said that she once wanted to work for the A&E department of the NHS as it suited here own interests. However she ended up settling for a job less manic as a GP, as she no longer wanted to be part of a "sinking ship". She is clearly an experienced health professional, and I respect here view which is why I appreciate the scale of the problem we face in A&E.
One of the major problems in fact is the limited number of hospital ward beds available to patients after they leave the A&E department. Some patients are left to wait hours. The large number of patients poses a dilemma. The NHS need to strike a balance between treating as many people as possible and giving each patient the thorough and correct care they need to make a good recovery.
Solutions to the problem are already being implemented. However many people simply aren't aware of alternative healthcare services that have been made available by the NHS. Walk-in centres and dialling 111 are just a named couple that one could use in out-of-hours for GP's instead of visiting A&E. More awareness is needed to inform the public that personal health advice is available very readily on a local level and is easily accessible.
I encourage you to see it and I have embedded the video below:
What I found quite shocking is that many of the staff are under constant pressure from the many patients who arrive to the hospital every hour. However it isn't just the local pressure - government-set deadlines and targets ensure the conveyer belts of NHS services are rolling quickly. One doctor in the film says "it's a more stressful place to work than it once was"when referring to the A&E Department of today.
Judging from the documentary, the staff seem stressed, however I deeply respect their professionalism as when dealing with the wide variety of patients, they control their emotions. This is vital when dealing with the public and representing an organisation as important as the NHS. One example from the clip I especially remember is when a heavy alcoholic was admitted to A&E. His rowdy, agitated and rather unpredictable manner meant the nurses in particular were dealing with a tough patient. Refraining from raising their voice too much, they managed to control the patient. In fact if he had turned very aggressive, the staff may have been at risk from harm. The number of alcoholics and drug abusers admitted to A&E is alarming, and they are transported to hospital 'around the clock'. For this hospital alone there are '3 to 4 overdoses a day'.
The pace at which staff need to work is tremendously quickly, whilst being efficient. It shows how training is vitally important to sustain such roles in the health service.
In the video, I was rather interested to see that one GP said that she once wanted to work for the A&E department of the NHS as it suited here own interests. However she ended up settling for a job less manic as a GP, as she no longer wanted to be part of a "sinking ship". She is clearly an experienced health professional, and I respect here view which is why I appreciate the scale of the problem we face in A&E.
One of the major problems in fact is the limited number of hospital ward beds available to patients after they leave the A&E department. Some patients are left to wait hours. The large number of patients poses a dilemma. The NHS need to strike a balance between treating as many people as possible and giving each patient the thorough and correct care they need to make a good recovery.
Solutions to the problem are already being implemented. However many people simply aren't aware of alternative healthcare services that have been made available by the NHS. Walk-in centres and dialling 111 are just a named couple that one could use in out-of-hours for GP's instead of visiting A&E. More awareness is needed to inform the public that personal health advice is available very readily on a local level and is easily accessible.
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