Zombie warning

Got this on a listserv and I don't see a copyright mark

Bullet shortage

Do you realize that this is affecting law enforcement agencies?

Shooting ranges, gun dealers and bullet manufacturers say they have never seen such shortages. Bullets, especially for handguns, have been scarce for months because gun enthusiasts are stocking up on ammo…

We have seen it, too.

My deputies do carry handguns (Coroner’s deputies in this county have carried at least since 1991). We do respond to somewhat risky neighborhoods at risky times in the immediate aftermath of violence or when violence may erupt for other reasons. (Deputies also wear ballistic vests) This shortage results in increases in the cost of ammunition and makes finding available sources more difficult.

Just a note about something else folks may not think about when they are pondering what the Coroner’s Office does.

I agree with the author that this trend is scary and a sad commentary on our society, as well.

Interesting Week for Coroner, Never Routine

It was an interesting week of meetings.

Tuesday I presented my 2010 budget to the County Board committees that need to approve it before it goes to the full Board. To meet county targets set because of projected county income short-falls, I had to make some cuts. It was tough to do because we have been running a pretty lean budget since I set my first one after taking office. I am pretty sure we will accomplish this expense reduction without forcing my deputies to use only one glove per case. Actually, despite already submitting my budget I have some other cost saving ideas that I have mentioned to the county Finance folks. We will see how they pan out. Then there is also my reserve plan to sell Coroner Office T-shirts, etc as a revenue enhancement.

Yesterday I went to a meeting to discuss a way to expand access to healthcare for uninsured folks here in Lake County. It was an interesting discussion on trying to port/modify a system in DuPage County to ours (the discussion continues). This is important because, as I have mentioned before, folks are dying from lack of insurance. This is a project I helped explore a few years ago, I am glad it has come up again. Not that I don’t trust changes occurring on a national level, but I don’t trust changes occurring on a national level.

Today I spoke to a group of 80 senior men (one guy was celebrating his 91st birthday). Who would have guessed that they would love the story about a case we investigated complete with the discussion of decomp odor, skeletalization, maggots on crack, and a blender rendering of those maggots for toxicology testing. I know the teens I talk to enjoy it, so I thought I’d try it on this audience. It was fun for me and I hope informative for them.

Oh sure there were death investigations, discussions of death investigations, media calls, and other routine things happening as well, but it is always the other stuff that moves the week along.

Level I Challenge for Coroner’s Office

We were already on track for a significant increase in the number of deaths in Lake County that involve Coroner office investigation (approximately 15%) this year. Most deaths (about 80%) require little or no investigation, e.g. hospice deaths, natural deaths from normal disease processes.

Then came the news that a local hospital will begin operating as a Level I Trauma Center October 1st. We knew it was coming, but couldn’t get concrete numbers on how many individuals (victims of trauma) that are currently flown out of our county would now be staying for treatment and potentially dying in county. The folks that are flown out are the most severely injured and unfortunately many succumb to their injuries despite the best care possible.

Now we know that the hospital projects that about 300 folks currently flown out will be going to their hospital for care. It must be an incredible undertaking on their part to prepare for that caring and that rather precipitous jump in treatment volume. But no one consulted us on how that will impact our functioning; apparently they felt we would just take up the potential jump in case volume. I’ve already submitted my budget for 2010 and it includes cuts because of concern for Lake County’s limited resources projected by County administration, not service expansion possibly mandated by this change in the county milieu.

I don’t mean to sound cold about these individuals dying, but the reality is that these things must be thought about as well. These deaths will challenge our resources, staffing, autopsy services, and toxicology testing. Planning is difficult because we don’t know how many more deaths will need investigation or what will be necessary in our death investigations for these individuals. For example, will they have had enough testing (x-ray, CT, MRI, toxicology) during their in-hospital care to preclude the need for autopsy?

These are interesting times and our personnel will rise to the challenge, but a bit of number projection and information about possible cases would have been nice.

Food for Misdirection of Thought

(Note: I had thought of this post before I ran across the article that prompted the above post. It became an interesting juxtaposition.)

I often get asked what we in the Coroner’s office do to decompress, to get our minds off the death we deal with all the time.

One of the things we do is participate in what I jokingly refer to as “food porn”. Not “porn” in the usually thought-of context, but reveling in the earthly delight of food. If you have ever watched some of the photography of food shows (and even food ads), you can see the visual quality they often strive for. Actually some of that photography comes pretty close to a porn presentation. I am also not referring to gluttony either. I think of that more in the sense of mass quantity consumption with “vomitoriae” (or is it vomitorii?). Again, some of the shows on TV do seem to cross that line, but we prefer a less gross presentation (although we sometimes catch a bit of Andrew Zimmern for grossness). Also our tastes do not run toward haute cuisine, but more the burgers, BBQ, and bacon sort of food selections.

We enjoy watching Anthony Bourdain during lunch while making multiple comments about his food exploits and the attractiveness, to us, of the food he is sampling. We also trade stories and recommendations about local, and not so local, eateries and food options. We trade web-based food information, like the recently circulated “squeezable bacon” ad and a recent article about potentially deadly fast food.

It’s fun, it’s something else to think about and sometimes it’s a tip that leads to a nice night out with the family.

16 year-old's death with hot dog

Now this is a pretty unusual occurrence, but I thought it might be worth a caution. Kids do choke on food, as do folks on the other end of the age spectrum, with hot dogs being high on the list (I remember during my ER days, pulling a gumball out of a young child’s larynx just in time). But it is pretty unusual to see this in a healthy teen.

An autopsy report on a 16-year-old Spartanburg boy came with a warning from the Cherokee County coroner. "Hot dogs are a choking hazard and should be consumed carefully,” he said
… died as a result of a hot dog lodging in his throat.
Friends at a youth group pool party tried the Heimlich maneuver but it failed.

With all the foody shows on TV showing folks wolfing their food, it behooves us to remind young people that it is important, and potentially life saving, to chew well when eating.

Suicide Prevention Week

Next week is “National Suicide Prevention Week” so I thought I’d post the “Suicide Warning Signs” from SAMHSA.

Last year Lake County had 67 individuals die by suicide (up 46% from the year before) and this year looks to be in the same range as 2008.

For folks that you think might be at risk of taking their own life, talk to them, suggest help, push them to get help. That will not push them toward suicide, but may help them to see that there are other options. Empathy expressed can be a useful tool to prevent suicide.

Seek help as soon as possible by contacting a mental health professional or by calling the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) if you or someone you know exhibits any of the following signs:

Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself

Looking for ways to kill oneself by seeking access to firearms, available pills, or other means

Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person

Feeling hopeless

Feeling rage or uncontrolled anger or seeking revenge

Acting reckless or engaging in risky activities—seemingly without thinking

Feeling trapped—like there’s no way out

Increasing alcohol or drug use

Withdrawing from friends, family, and society

Feeling anxious, agitated, or unable to sleep or sleeping all the time

Experiencing dramatic mood changes

Seeing no reason for living or having no sense of purpose in life

Nitrous Oxide Abuse

It is easy to lose sight of the real dangers of inhalant abuse with all our focus on the growing problems of illicit and licit drug abuse so obviously going on around us. Abuse of inhalants can be a cause of death in young people. We need to keep that in mind and make certain that it gets mentioned in our efforts to keep young people drug-free, alive and well.

“A study by the Partnership for a Drug-Free America indicated that nearly 4 of every 10 parents are not aware of the risks of inhalant abuse. Information on this important topic needs to be distributed both via the media and during parent programs in the schools.”

I mention this because we were recently reminded of the abuse potential and the potential for harm with nitrous oxide abuse.

“…abuse of nitrous oxide is no laughing matter.”

“[However] few students (in this study) were aware of the potential acute or chronic ill effects from the use of nitrous oxide”

Talk about your “fun” intoxicant: “Inhaling nitrous oxide produces a brief euphoric "high" caused by oxygen deprivation.”

“Asphyxiation takes place when nitrous oxide depletes the oxygen supply to the body because too much of the inhalant is in the lungs. If inhalation continues, a person will die…”

As the article ends:

“While there is no easy solution to the problem of drug experimentation among youth, encouraging and assisting parents to become informed participants in raising drug-free children is an excellent beginning.

Let's make sure our community and schools continue to allocate sufficient resources -- financial, personnel and curricular -- to achieving this goal.”

"Informed participants" is a very important aspect, as is ensuring broad prevention programming. Substance abuse is not a focused problem and programming to prevent it must be broad-based.