Medicine isn ’t a competition. It’s a team sport.

I love sports analogies. There is so much in competition and team play that mirrors the way departments work in many sectors of medicine. “There is no ‘I’ in ‘team,'” as the adage says. Michael Jordan, for example, did not win his championships in the NBA until he had fairly decent and dependable team of support around him. The stars in many sports cannot achieve the greatest height of success without the team dynamic. Medicine is no different. Physicians in the hierarchy of medicine are often considered the clinical “team leaders.” Yes, there has been an onslaught on physician autonomy. Yes, there is a lot more administrative bureaucracy that many physicians answer to which is infringing on the autonomy and leadership of doctors. However, in the big scheme of our clinical work we are still at the helm — but precarious our positioning is. The clinical decision making and fall out from clinical concerns still largely rests on our shoulders. Some time ago, I found myself working closely with my team on a lumbar puncture. As we prepped our patient and secured the position, successfully extracting CSF our team comprised of nursing staff, residents, and myself as the attending celebrated our first attempt success. A champagne tap never gets old. There is a saying in this situation: “If the LP is a success, the physician doing the LP was good. If the LP fails, the support staff or holder failed”. That saying has been circu...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Hospital-Based Medicine Source Type: blogs

Related Links:

CONCLUSION: Because 25-40% of cases of facial nerve palsy are not idiopathic, differential diagnosis is very important; key diagnostic methods include a clinical neurological examin- ation, otoscopy, and a lumbar puncture for cerebrospinal fluid examination. High-level evidence supports corticosteroid treatment for the idiopathic form of the disorder. PMID: 31709978 [PubMed - in process]
Source: Deutsches Arzteblatt International - Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
ConclusionsCrowned dens syndrome should be considered, and craniocervical junction imaged in the context of acute cervical or occipital pain with stiffness and elevated inflammation markers not only in patients previously diagnosed with calcium pyrophosphate dehydrate arthropathy but also in diverse clinical settings.Key Points•This report highlights that crowned dens syndrome should be considered in various clinical setting besides calcium pyrophosphate dehydrate (CPPD) arthropathy.• Vigilance to this syndrome allows rapid treatment and may spare the patient unnecessary invasive procedures (i.e., temporal artery...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
ConclusionsGiven the expanding applications of immunotherapy in cancer management, clinicians should stay vigilant against the potential development of unusual but life-threatening immune-mediated toxicities.
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Conclusion: Our data suggest that a regular examination of routine CSF parameters in patients in which intrathecal ASOs are administered is important to obtain information on possible side effects and to gain further insights into intrathecal processes.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Automated assessment of WM ‐hypo volume is closely associated with WM‐hyper and both provide equivalent measures of leukoaraiosis progression with aging and prediction of abnormal CSF β‐amyloid. WM‐hypo volumes generated by FreeSurfer, which are currently rarely employed, can serve as a meaningful measure of white ma tter insult. This may facilitate retrospective analysis of older imaging data sets or serve as a standardized technique for comparison of WM lesion severity in existing studies using a widely available automated technique with a corresponding FDA‐approved version available for clinical use. Abst...
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Conclusions: In SMA type 2 and 3 patients undergoing radiological imaging-assisted injections, the effective dose and DAP decreased during therapy with nusinersen. The mean effective dose in patients with spondylodesis was higher than that in patients without spondylodesis. Dosimetry should be monitored carefully in order to detect and prevent unnecessary radiation exposure.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
This study was conducted to assess the diagnostic value of CSF-CRP levels for differentiating between septic (bacterial) and aseptic infantile meningitis.Methods: 49 hospitalized infants aged less than two months with suspected meningitis were enrolled in a cross-sectional analytic study. All of patients underwent lumbar puncture to obtain CSF. smears, cultures, cytological and biochemical analysis and latex agglutination testing were carried out on all CSF samples. Latex agglutination test was carried out on all CSF samples using a commercially available kit. CSF-CRP level of all infants was measured using the immunoturbi...
Source: African Health Sciences - Category: African Health Source Type: research
A 17-year-old boy developed postdural puncture headache after several lumbar punctures (LPs) for intrathecal chemotherapy. The pediatric anesthesiology service was consulted for an epidural blood patch (EBP). Sedation was required for the LPs, which made performing an EBP problematic because of the need for the patient to be conscious and able to report symptoms during injection of blood. An epidural catheter was placed after the next LP while the patient was sedated. After he woke up, blood was injected through the catheter and the headache resolved. This technique can be used in pediatric patients requiring deep sedation for an EBP.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
We describe a previously healthy 11-month-old female infant with nondepressed skull fracture who developed increased ICP in the absence of intracranial changes on imaging. Funduscopic examination revealed unilateral papilledema, and opening pressure on lumbar puncture was elevated at 35 cm of H2O. Computed tomography scan demonstrated a nondepressed occipital bone fracture. However, further imaging, including magnetic resonance imaging with angiogram/venogram, did not reveal any intracranial abnormalities. In particular, there was no evidence of sinus venous thrombosis. Given her presentation and signs of increased ICP, sh...
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Abstract Nitrous oxide (N2 O) is frequently used for short anaesthesia/analgesia in children undergoing painful or repetitive procedures1 . Children with acute lymphoblastic leukaemia (ALL) require repeated lumbar punctures with direct instillation of intrathecal chemotherapy, usually the anti-folate agent Methotrexate, during their treatment. These procedures are frequently performed under anaesthesia. Concerns have been intermittently raised about a drug-interaction between methotrexate and N2 O that may potentiate the undesirable side effects of methotrexate, including neurotoxicity. However, the clinical evide...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
More News: Blogging | General Medicine | Hospitals | Jordan Health | Lumbar Puncture | Middle East Health | Nurses | Nursing | Sports Medicine