Executions, Doctors, The U.S. Supreme Court, And The Breath Of Kings
This report concluded that even though prison officials decided to inject the drugs into Lockett’s femoral vein (which is a more difficult and risky procedure), Lockett’s surface and deep veins had “excellent integrity.” Another execution that was scheduled to occur that same night has now been stayed for six months, pending an investigation into Mr. Lockett’s execution.
On July 23, 2014, Arizona encountered a problem with the same drug in the execution of Joseph Wood, wherein the condemned inmate allegedly gasped for almost two hours before dying.
The executions have prompted two important but different kinds of...
Source: Health Affairs Blog - March 26, 2015 Category: Health Management Authors: I. Glenn Cohen Tags: All Categories Health Law Policy Politics Public Opinion States Source Type: blogs
Ask for Dilaudid, get Dilaudid. No questions asked.
A local hospital is trying a new, controversial but more efficient approach to medical care. “We have changed our guidelines, if you want Dilaudid you get Dilaudid, if you want Valium, you get Valium. No questions asked,” CEO Michael Shoemaker told reporters Wednesday.
In what experts are calling pure genius, emergency department utilization has never been better, costs have been severely cut down, and patient satisfaction scores are through the roof: a national high.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Ke...
Source: Kevin, M.D. - Medical Weblog - February 28, 2015 Category: Journals (General) Authors: GomerBlog Tags: Meds Emergency Pain management Source Type: blogs
MKSAP: 72-year-old man with dyspnea at rest
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. He is uncomfortable, with chronic air hunger that has gradually increased over the past 2 weeks. Otherwise, his symptoms have been stable without change in cough, sputum production, or fever. Following a physical exam, what is the most appropria...
Source: Kevin, M.D. - Medical Weblog - February 7, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Pulmonology Source Type: blogs
Once More, the Hospital CEO as Scrooge - Cape Cod Healthcare CEO Collected Millions in Severance After Laying Off Hundreds of Health Professionals, and Being Sanctioned by the State Medical Board
The theme of non-profit hospital CEO as Scrooge seems to be persisting in the media even beyond the holiday season. (Our last post on this theme was in December, 2014). The previous cases we discussed (also here) involved marked contrasts between how well top hired managers of non-profit hospitals were doing, and how their institutions were doing.Turning Around the Hospital, but Turning Away Employees The background to this story comes from an article in the Cape Cod (MA) Times from January, 2014. Cape Cod Healthcare, a regional non-profit hospital system, hired Dr Richard Saluzzo as CEO to turn aro...
Source: Health Care Renewal - January 8, 2015 Category: Health Management Tags: boards of trustees Cape Cod Healthcare executive compensation perverse incentives Source Type: blogs
The Shadow Boxer
Conclusion
The patient was admitted to a monitored setting with a diagnosis of GHB withdrawal. He had multiple episodes of agitation and combativeness during his admission. He was administered escalating doses of diazepam, a total of 480 mg of diazepam IV during his eight-day hospital stay. The patient recovered in eight days, and was referred to drug rehabilitation.
References
1. Dyer JE, Roth B, Hyma BA. Gamma-hydroxybutyrate withdrawal syndrome. Ann Emerg Med 2001;37(2):147.
2. Tarabar AF, Nelson LS. The gamma-hydroxybutyrate withdrawal syndrome. Toxicol Rev 2004;23(1):45.
3. Craig K, Gomez HF, et al. Severe gamma-h...
Source: The Tox Cave - October 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Shadow Boxer
Conclusion
The patient was admitted to a monitored setting with a diagnosis of GHB withdrawal. He had multiple episodes of agitation and combativeness during his admission. He was administered escalating doses of diazepam, a total of 480 mg of diazepam IV during his eight-day hospital stay. The patient recovered in eight days, and was referred to drug rehabilitation.
References
1. Dyer JE, Roth B, Hyma BA. Gamma-hydroxybutyrate withdrawal syndrome. Ann Emerg Med 2001;37(2):147.
2. Tarabar AF, Nelson LS. The gamma-hydroxybutyrate withdrawal syndrome. Toxicol Rev 2004;23(1):45.
3. Craig K, Gomez HF, et al. Severe g...
Source: The Tox Cave - October 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Medical lessons from Robin Williams
This article originally appeared in the Jewish Journal.
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 12, 2014 Category: Journals (General) Authors: Afshine Ash Emrani, MD Tags: Physician Mainstream media Source Type: blogs
Research and Reviews in the Fastlane 042
This article challenges the notion that lacerations need to be closed within a specific “golden period” lest they become infected. The authors find that diabetes, wound contamination, length greater than 5 cm and location on the lower extremity are important risk factors for wound infection. Time from injury to wound closure is not as important as previously thought.
Recommended by: Anand Swaminathan
Read More: Goldfinger (More Dogma of Wound Care) (SGEM)
Emergency Medicine, Procedural Sedation
Green SM, Andolfatto G. Managing Propofol-Induced Hypoventilation. Ann Emerg Med. 2014 Jul 11. pii: S0196-0644...
Source: Life in the Fast Lane - August 4, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: R&R in the FASTLANE critical care Emergency Medicine Intensive Care literature recommendations research and reviews Source Type: blogs
Research and Reviews in the Fastlane 035
This study suggests that antiemetics are not nearly as potent as widely believed. These drugs have been shown to be effective in preventing nausea (i.e. pretreatment for chemo) but it’s appears that the mechanism for halting nausea is different than that for preventing it.
Recommended by: Anand Swaminathan
Read More: Nausea? We’ve Got Placebo for That
The Best of the Rest
Emergency Medicine, Pulmonary
1. Kew KM, Kirtchuk L, Michell C. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev. 2014 May 28;5 PubMed ID: 24865567
This Cochr...
Source: Life in the Fast Lane - June 18, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Evidence Based Medicine General Surgery Intensive Care Palliative care Pediatrics Respiratory Resuscitation Trauma critical care literature R&R in the FASTLANE recommendations resear Source Type: blogs
Research and Reviews in the Fastlane 035
This study suggests that antiemetics are not nearly as potent as widely believed. These drugs have been shown to be effective in preventing nausea (i.e. pretreatment for chemo) but it’s appears that the mechanism for halting nausea is different than that for preventing it.
Recommended by: Anand Swaminathan
Read More: Nausea? We’ve Got Placebo for That
The Best of the Rest
Emergency Medicine, Pulmonary
1. Kew KM, Kirtchuk L, Michell C. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev. 2014 May 28;5 PubMed ID: 24865...
Source: Life in the Fast Lane - June 18, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Evidence Based Medicine Featured General Surgery Intensive Care Palliative care Pediatrics Respiratory Resuscitation Trauma critical care literature R&R in the FASTLANE recommendatio Source Type: blogs
The LITFL Review 140
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
Welcome to the 140th edition, brought to you by:
Kane Guthrie [KG] from LITFL
Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles
Brent Thoma [BT] from BoringEM, and ALiEM
Chris Ni...
Source: Life in the Fast Lane - June 16, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
Is it Ok to Shrink your Sister in an Emergency?
I'd like to bend your ear with a hypothetical situation and see what you think. This one is for the docs, and I'm going to start and end it with a simple question: is it okay to prescribe for a family member? Is it okay to prescribe a psychotropic medication for oneself or a family member? Before you jump on me, let me tell you that to the best that I am aware, docs have always written prescriptions for themselves and for their family members. An antibiotic, an allergy medication, I think this has been par for the course for straightforward things. When I was an intern, one of the nurses ...
Source: Shrink Rap - June 9, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Destiny
It was a sunny spring day as the bus turned the corner. It was a yellow school bus filled with young children jumping up and down in their seats. It was an average day in an average school year. Nothing about it stood out. Let’s take a closer look.The boy sitting in the front of the bus holding tightly to his lunch box is named William. His clothes are tattered and his jeans have patches. The lunch box is empty, but no one around him knows that. His is quiet and withdrawn. He doesn’t play with the other children. He is much too thin. He will grow up to be a su...
Source: In My Humble Opinion - June 7, 2014 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
The “Olden Days” and the (o)esophagus
aka American ER Doc Gone Walkabout… 027
I got another “Pathway” to be used in our ED today – for the management of esophageal obstruction. It ought to be pretty useful, as it defines what the various departmental roles and responsibilities are if medical management fails – i.e. who manages sedation while GI disimpacts via endoscope and what happens next if endoscopy under procedural sedation only fails.
But, I was surprised that the only recommended medical management was IV glucagon. I gave up on that decades ago – it’s never worked for me (except when the patient vomits from the glucagon, and b...
Source: Life in the Fast Lane - March 6, 2014 Category: Emergency Medicine Doctors Authors: Rick Abbott Tags: American ER Doc Gone Walkabout Emergency Medicine ENT and Maxillofacial Featured Gastroenterology esophageal obstruction flood bolus oesophagus rick abbott Source Type: blogs
A Quick Lesson on Medical Terminology with 1980’s Batman
Today, I’m digging back in the archive to 1994 to the Knightquest storyline in order to present a brief lesson about medical terminology.
With it’s quasi-Latin and quasi-Greek, medical terms can be confusing and don’t always mean what you expect. Case in point, Batman: Legends of the Dark Knight #59. In this comic, physician Shondra Kinsolving has been kidnapped by her evil step-brother so he can use her telepathic powers to kill from a great distance. Understandably, Shondra doesn’t want to be a part of this, so he brother injects her with a drug of his own invention:
For those of you who may...
Source: Polite Dissent - February 9, 2014 Category: Family Physicians Authors: Scott Source Type: blogs
