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Calling all medics


Shamrock
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I am looking for some help with two medical situations I have in a book.

 

The first is fairly simple. I have a guy who has been in a fight and he has got a busted knee. He is on the floor trying to get up when friends arrive. What 1st aid would they administer to him. Would they splint it? 

 

Second is a bit more complication. One character has Acute Myeloid Leukemia.  According to my research, it is possible to seek a bone marrow transplant from a donor who matches them. They have a a lumber puncture where fluid is taken from the spinal bone?  

 

The site I looked at stated that relatives could be tested via giving blood and that someone could ask for their blood to be stored for such use when they died (it can last 2/3 years apparently). SO the match in the book is the person dead sister. 

 

What I am not sure is whether the patient is given a bone marrow transplant extracted from the donor's blood or they are simply given a blood transfusion. 

 

I have looked on medical sites but it is quite confusing. Any help with clarifying would help.

Thanks

 

Edited by Shamrock
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Hope this helps. Here are some thoughts I found...

 

The most common type of transplant for AML is an allogeneic transplant. This type of transplant uses healthy blood-forming cells donated by someone else to replace the unhealthy ones. These healthy cells can come from a family member, unrelated donor or umbilical cord blood. First, you get chemotherapy (chemo), with or without radiation, to kill the unhealthy cells. Then, the healthy cells are given to you through an intravenous (IV) catheter. The new cells travel to the inside of your bones and begin to make healthy blood cells.

The entire process, from when you start chemo or radiation, until hospital discharge, can last weeks to months. This is followed by many months of recovery near the transplant center and at home. Your transplant team will watch you closely to prevent and treat any side effects or complications.

 

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The efficacy is widely assumed to be related to the high doses of drugs and radiation administered before transplantation.

 

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The largest concentration of blood stem cells is in your bone marrow. However, the blood stem cells can be moved or "mobilized" out of the bone marrow into the bloodstream (peripheral blood) where they can be easily collected. Most transplants these days use stem cells collected from the bloodstream.

 

When blood stem cells are collected from the bloodstream, the procedure is called a peripheral blood stem cell collection or harvest.

 

Prior to the harvest, you will receive injections of a drug such as filgrastim (Neupogen®) or plerixifor (Mozobil®) over a four to five day period. These drugs move stem cells out of the bone marrow into the bloodstream.

 

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Peripheral blood stem cell collections are done in an outpatient clinic.

You will sit in a comfortable chair or bed.

 

A needle connected to thin, flexible tubing will be inserted into a vein in each of your arms.

 

Blood will be withdrawn from one arm and passed through a machine that separates out the stem cells.

 

The rest of the blood product will be returned to you through the tubing connected to the needle in your other arm.

 

Each collection takes three to four hours.

 

It can take one to three days to collect enough stem cells for transplant.

 

If the collection takes more than a day, you can return home each night after the collection.

 

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The procedure used to collect bone marrow for transplant is called a bone marrow harvest. It is a surgical procedure that takes place in a hospital operating room. Typically it is done as an outpatient procedure.

 

While you are under anesthesia, a needle will be inserted into your rear pelvic bone where a large quantity of bone marrow is located. 

 

The bone marrow will be extracted with a syringe.

 

Several skin and bone punctures are required to extract sufficient bone marrow for transplant.

 

There are no surgical incisions involved, only skin punctures where the needle was inserted.

 

A sterile bandage will be applied to the site when the collection ends.

 

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Maybe a bit more detail on what exactly you mean by “busted knee?” Is it a torn or badly strained ACL? Is the kneecap itself shattered?

 

Also, the real question probably is...how well versed are his friends in emergency first aid procedures? Unless they have training, they’ll probably just do whatever seems helpful or comes naturally...which probably would be to stabilize the leg. Not to say that’s a bad idea, just that you don’t have to make them know lots about it, unless for some story reason they’re supposed to.

 

From personal observation, I would say that a person with this kind of injury would be in extreme pain, and probably wouldn’t be terribly interested in trying to get up/walk unless they’re somehow in danger where they are...

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Thanks Zee.

 

I am thinking that perhaps they have had a significant blow to the knee to disabled them. Say the butt of a gun or baseball bat.  

One of the two friends would know 1st aid but be more concerned about checking out the house to ensure it is secured and empty of any intruders. YEs, the person is going to be in a lot of pain and not mobile as a BR pointed out. 

I think I have enough to go on now for both situations.

Thank you everyone.

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