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Reduce parallel play to provide decent health care for all
I have been doing health care research and advocacy for over 20 years. I’ve seen a lot of passion, anger, and rhetoric around the issues. The health care crisis is simple in that everyone needs health care. The question is what to do about it and who should pay for it. It’s not an easy answer. For starters, we have turned into a culture of entitlement. This includes health care. It might be a “right,” but someone has to pay for it. And we want to pretend that it’s someone else’s responsibility. Recently, I was reading comments following an article on an online news outlet. I was struck b...
Source: Kevin, M.D. - Medical Weblog - October 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/peggy-a-rothbaum" rel="tag" > Peggy A. Rothbaum, PhD < /a > Tags: Policy Psychiatry Public Health & Washington Watch Source Type: blogs

LITFL Review 302
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 302nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week The ALIEM AIR Series delivers another amazing collation of the best resources in FO...
Source: Life in the Fast Lane - October 15, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Emergency medicine can be exhausting. Here ’s what this doctor does to unwind.
So I’ve finished up at one job and moved on to another. I was a director for a year, and it was a learning experience. Right now I’m nearing the final approach after working a long run. Last week I had five nights, 12 hours duration each. I stayed in a hotel near the hospital. Then, after two days off at home, I started a run of five days, of 12 hours duration. I have two to go. I’m working out of town. Not locums, as I’m employed and working in the same place; it’s just a couple hours away, so I stay here. A few observations: It’s hard to turn around from nights to days in 48 hours. I f...
Source: Kevin, M.D. - Medical Weblog - October 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Medicine Hospital-Based Medicine Source Type: blogs

Trauma After a Fall Can Create a Dangerous Domino Effect for Elders
Dear Carol: Four months ago, my mother fell and broke her hip. She was admitted to the hospital for surgery and then sent to a nursing home rehab. The care seems good but Mom has completely changed. Before the fall, she was mentally sharp for someone nearly 80. Her only issue was an occasional memory gap. Then, right after the emergency surgery, she began showing signs dementia. She’s only worsened in rehab. The facility doctor says that she has Alzheimer’s, but how could that happen so fast? I thought that Alzheimer’s took time to develop. How could she go from having almost no sign of Alzheimer&rsq...
Source: Minding Our Elders - October 15, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Cardiogenic shock with wide complex tachycardia and poor LV function in a young woman
A 30-something woman presented with CP and SOB. She was hypoxic and intubated. She had very poor LV systolic function on bedside echo. There were no B-lines and the RV was normal.The following ECG was recorded:Wide complex regular tachycardia at a rate of 140, no P-wavesWhat do you think?What do you want to do?This ECG was texted to me on my iPhonewithout any clinical information, with the question: " VT or SVT with aberrancy? "Here was my response:" Tough one, as they always are. Looks like SVT with LBBB (LBBB morphology strongly supports SVT).  Lead  aVR is all negative. ...
Source: Dr. Smith's ECG Blog - October 14, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

Health Data Standardization Project Proposes “One Record Per Person” Model
When we sit around the ol’ HIT campfire and swap interoperability stories, many of us have little to do but gripe. Is FHIR going to solve all of our interoperability problems? Definitely not right away, and who knows if it ever will? Can we get the big EMR vendors to share and share alike? They’ll try, but there’s always a catch. And so on. There’s always a major catch involved. I don’t know if the following offers a better story than any of the others, but at least it’s new one, or at least new to me. Folks, I’m talking about the Standard Health Record, an approach to health data ...
Source: EMR and HIPAA - October 13, 2017 Category: Information Technology Authors: Anne Zieger Tags: Digital Health EHR Electronic Health Record Electronic Medical Record EMR Genomic Health Record Healthcare Healthcare Interoperability Personalized Medicine Precision Medicine FHIR Health Record Standards Microbiomics MITRE Corpo Source Type: blogs

Let ’s share our stories about gun violence
It’s a peculiar kind of civil war we are waging in America. 30,000 of us die each year from gun violence, exceeding the number killed annually on all sides in the Syrian civil war. On October 1, we saw more than 58 people slaughtered and hundreds injured in a carefully planned attack. At a concert. In Las Vegas. For no apparent reason. My professional interest in this problem began during my residency in Detroit 30+ years ago. I vividly remember my first day on the Emergency Surgery rotation. Six of us stood around a gurney in the ER, stocked with 2 IV poles, one for each arm, bundles of laboratory tubes with lab sli...
Source: Kevin, M.D. - Medical Weblog - October 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/barbara-meyer" rel="tag" > Barbara Meyer, MD, MPH < /a > Tags: Policy Primary Care Public Health & Source Type: blogs

Funtabulously Frivolous Friday Five 209
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 209. Question 1 Who wrote in their journal “I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like a hundred jackals. Still no obvious symptoms that perforation is imminent, but an o...
Source: Life in the Fast Lane - October 13, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five Anosmia Antartica appendicitis body packing Boring and Boring cocaine Edwin Boring Freesias ketones Leonid Rogozov Lucy Boring sleep temporal reference toponymous disease Source Type: blogs

Mastering Intensive Care 018 with John Marshall
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog John Marshall – Getting patients out of the ICU as soon as we can Are your ICU patients ever in a holding pattern? Do you aim to liberate your patients from ICU as soon as possible? Is your caution about moving things forward harmful to our patients? I don’t think we talk often enough about the dangers of conservatism in intensive care. About how if we are cautious in thinking the patient is not quite ready to be extubated, or have the sedation turned off...
Source: Life in the Fast Lane - October 13, 2017 Category: Emergency Medicine Authors: Andrew Davies Tags: Intensive Care Mastering Intensive Care Andrew Davies dangers of conservatism John Marshall Source Type: blogs

Taking A Long View: A Foundation ’s Rapid-Response, Data-Driven Strategy To Inform Recovery From Hurricane Harvey In Texas
When Hurricane Harvey made landfall as a Category 4 hurricane near Rockport, Texas, on August 25, 2017, we knew there would be massive winds and torrential rains. But none of us understood, and will probably not understand for some time, the full extent of the impact of this natural disaster in communities throughout the Gulf Coast region—from Texas to Louisiana. What we do know is that with a record fifty-two inches of rainfall in parts of the region, the flooding has had devastating effects. To date, 829,825 individual assistance applications have been received by the Federal Emergency Management Agency (FEMA) and ...
Source: Health Affairs Blog - October 12, 2017 Category: Health Management Authors: Shao-Chee Sim Tags: Featured GrantWatch Organization and Delivery Public Health Centers for Disease Control and Prevention disaster preparedness emergency planning Federal Emergency Management Agency (FEMA) Health Philanthropy homelessness Hurricane Harve Source Type: blogs

FDA Gives First Clearance to Siemens High-Field 7 Tesla MRI Scanner
Siemens Healthineers won FDA clearance to introduce its 7 Tesla MRI scanner, the MAGNETOM Terra. The device won European regulatory approval in August, kicking off an age of high-field MRI scanning that produces imaging details previously unavailable in a clinical setting. Previously, only scanners with a field strength of 3 Tesla were the most powerful MRIs cleared by the regulatory agencies for clinical use. Of note, 7 Tesla and more powerful scanners have been around in research institutions for years now. The MAGNETOM Terra can still be applicable in research, as it includes the ability to quickly switch it from commo...
Source: Medgadget - October 12, 2017 Category: Medical Devices Authors: Editors Tags: Critical Care Emergency Medicine ENT Neurology Neurosurgery Radiology Source Type: blogs

Digital Maps Help Fight Epidemics
Have you ever thought that it would be possible to monitor drug overdoses, Zika cases or the spread of the flu in real time? Have you ever imagined that satellites wouldbe able to tell how and where a malaria epidemic will happen months before the actual outbreak? It is mind-blowing how, in the last years, digital maps developed to a level where they serve as effective tools for evaluating, monitoring and even predicting health events. That’s why I decided to give a comprehensive overview of digital maps in healthcare. John Snow, cholera and the revolution of maps in healthcare Before Game of Thrones monopolized Joh...
Source: The Medical Futurist - October 12, 2017 Category: Information Technology Authors: nora Tags: Future of Medicine Healthcare Design Mobile Health digital health digital technology epidemics epidemiology gc4 Innovation interactive maps Source Type: blogs

Giving Urban Health Care Access Issues The Attention They Deserve In Telemedicine Reimbursement Policies
A May 2017 Wall Street Journal analysis highlights the plight of rural America: People there who are sick are getting sicker because health systems are struggling to deliver care in rural areas. The challenges are multifactorial, but a key driver is the availability of providers. Only 10 percent of physicians serve rural populations, and the number of specialists per capita is a third of the number that practice in urban areas. The Centers for Medicare and Medicaid Services (CMS) considers the per capita physician shortage to be an important health care access problem. In an effort to improve access to care, CMS has create...
Source: Health Affairs Blog - October 12, 2017 Category: Health Management Authors: Yash S. Huilgol, Aditi U. Joshi, Brendan G. Carr and Judd E. Hollander Tags: Featured Health Equity appointment timeliness health care access Medicare reimbursement Telemedicine Source Type: blogs

The Insufficiency Of Medicaid Block Grants: The Example Of Puerto Rico
Medicaid block grants have been a centerpiece of Republican health proposals for more than a decade. Proponents, including House Speaker Paul Ryan (R-WI), argue that giving states a fixed amount of money through a block grant or per-person limit with few strings attached gets Washington out of the way and allows for state innovation. Although the most recent block grant legislation did not reach the Senate floor, proponents have promised to continue to push for it. But one need look no further than the growing health crisis in Puerto Rico to understand why capped federal money and state flexibility will not solve serious h...
Source: Health Affairs Blog - October 12, 2017 Category: Health Management Authors: Vikki Wachino and Tim Gronniger Tags: Medicaid and CHIP block grants disaster relief Puerto Rico Source Type: blogs

Please make primary care as sexy as Grey ’s Anatomy
Dear Shonda Rhimes, the brilliant mind behind my favorite television show, We need to talk about “Grey’s Anatomy.” I’m a fan. A really, really big fan. The kind of fan who — in the last 48 hours — rewatched all of last season’s episodes to prepare for the season premiere, and who has blocked off every Thursday night this fall to get lost in the drama at Grey Sloan Memorial. We all have our vices, and “Grey’s” is mine. But something occurred to me as I was bingeing on last season. From the lifesaving surgeries to the metastasized cancers, half of the plot lines and...
Source: Kevin, M.D. - Medical Weblog - October 11, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/elizabeth-metraux" rel="tag" > Elizabeth M étraux < /a > Tags: Policy Mainstream media Primary Care Public Health & Source Type: blogs

Diffusing Innovation: A Case Study Of Care Management In Louisiana
Conclusion The diffusion of innovation in health care doesn’t happen on its own. As we learned in Louisiana, it takes strong support for early adopters and gleaning from their experiences to tailor workflows as implementation efforts are spread to other practices. It also takes a collaborative learning environment, inclusive of both online and in-person forums, and standardized training content that can be tailored to the unique needs of each practice. With local leaders, a dedicated team in the field, support from a growing national value-based care network, and comprehensive population health technology that helps ...
Source: Health Affairs Blog - October 11, 2017 Category: Health Management Authors: Charisse Hunter, Nadine Robin and Erin Flowers Tags: Diffusion of Innovation Accountable Care Organization chronic care management Louisiana value based care Source Type: blogs

No female physician should have to feel that her gender is a factor limiting her success
A father and a son are in a car accident.  The father dies instantly, and the son is taken to the nearest hospital.  The doctor comes in and exclaims, “I can’t operate on this boy!” “Why not?” the nurse asks. “Because he is my son,” the doctor responds. How is this possible? *** I first saw this riddle in a Washington Post article in October 2016. I was four years out of residency, and for the first time in my career, had started to feel like I wasn’t treated quite the same as the male physicians that made up the majority of my group.  I read the riddle ov...
Source: Kevin, M.D. - Medical Weblog - October 11, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Emergency Medicine Practice Management Source Type: blogs

We Simply Won ’ t Go To Mars Without Digital Health
“It’s 2017, we should have a lunar base by now,” noted Elon Musk when he revealed his grandiose plans about going to Mars in at least five years. “What the hell is going on?”, he asked clearly not being satisfied with the current state of astronautics. However, I say, we should not only concentrate on the development of space technologies but devote more focus to advancing technologies to keep people well and alive on the Red Planet. Digital health opens amazing horizons there. That’s what I detailed in my paper in New Space. We’ll colonize Mars There are plans for h...
Source: The Medical Futurist - October 11, 2017 Category: Information Technology Authors: nora Tags: Future of Medicine Telemedicine astronautics digital health elon musk gc3 Healthcare Innovation mars NASA Personalized medicine space space travel SpaceX technology wearables Source Type: blogs

After Las Vegas: What is the change that needs to occur?
Las Vegas: 59 dead, 500+ injured. I worry about our medical colleagues who will suffer tremendously while treating the injured; they will be wracked with guilt for the patients they could not help and false back to the horror of that night and the ensuing days and weeks caring for the living. We must find ways to support each other help them cope as well as looking for sensible solutions. My son was 18 months old when the Columbine shootings took place. The school and nearby park were where we spent many hours playing. I was shocked, and grief-stricken. I had friends whose children were trapped at the school, and others wh...
Source: Kevin, M.D. - Medical Weblog - October 10, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/rita-agarwal" rel="tag" > Rita Agarwal, MD < /a > Tags: Physician Emergency Medicine Public Health & Policy Source Type: blogs

The adverse consequences of premature diagnosis
I have spent 3 days at the Society to Improve Diagnosis in Medicine.  Whenever I come to this meeting, I have insights from listening to talks and many conversations with leaders in the field. When one considers diagnostic errors, one must consider two important factors – physician factors and system factors.  We have a major system factor that can cause problems.  Most hospitals in the US require a diagnosis for admission.  I believe this rule increases diagnostic errors. Currently I am developing a talk based on the lessons we can learn from fictional detectives.  One example that I will li...
Source: DB's Medical Rants - October 10, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Mass Shootings and Trauma -- the New Normal
Mass shootings and similar tragic events are so frequent here in the United States that they appear to be the new normal. There were apparently more than 250 mass shootings in the U.S. in the first 9 months of 2017. As nurses and healthcare professionals, how do we cope, respond, and prepare for such seemingly commonplace yet traumatic events?Mass shootings are generally defined as events wherein a minimum of four people are injured or killed, and by this definition, an event with three people shot is not considered a mass casualty. So if we changed the definition, these situations would be even more statistically frequent...
Source: Digital Doorway - October 10, 2017 Category: Nursing Tags: crisis debriefing healthcare nurse nurses nursing Source Type: blogs

Jellybean 79 with SurferKist – Kirsten Kingma of BadEM
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog The Africans are coming. BadEM are surfing a #FOAMed wave at the moment and they are doing it with style, which isn’t that surprising when Kirsten Kingma is on board. The Jellybean Podcast is a big fan of the www.BadEM.co.za bunch. Of course we are. Why wouldn’t we be? They are a great cohesive team of fabulously varied individuals. We like that sort of team. If you were at #dasSMACC you won’t have forgotten the BadEM team standing up with their ...
Source: Life in the Fast Lane - October 10, 2017 Category: Emergency Medicine Authors: Mike Cadogan Tags: JellyBean #badEMfest18 Kirsten Kingma SurferKist Source Type: blogs

Jellybean 79 with Kirsten Kingma of BadEM @SurferKirst
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog The Africans are coming. BadEM are surfing a #FOAMed wave at the moment and they are doing it with style, which isn’t that surprising when Kirsten Kingma is on board. The Jellybean Podcast is a big fan of the BadEM.co.za bunch. Of course we are. Why wouldn’t we be? They are a great cohesive team of fabulously varied individuals. We like that sort of team. If you were at #dasSMACC you won’t have forgotten the BadEM team standing up with their frie...
Source: Life in the Fast Lane - October 10, 2017 Category: Emergency Medicine Authors: Mike Cadogan Tags: JellyBean #badEMfest18 Kirsten Kingma SurferKist Source Type: blogs

How the pain scale and patient satisfaction leads to death
Unless you’ve been living under a rock, you’re well aware that the United States is in the grip of a really big epidemic of opioid abuse.  The epicenter of much of this has been my beloved Appalachia.  My home-town, Huntington, WV, might as well be re-named “Oxycontin,” or maybe “Heroinville.”  It’s ugly. Enormous amounts of ink have been spilled on this topic, and I don’t intend to explain the genesis of it in detail.  In short, however, about 20 years ago some doctors thought we weren’t being kind enough in our treatment of pain.  Some article...
Source: Kevin, M.D. - Medical Weblog - October 9, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Medicine Hospital-Based Medicine Primary Care Source Type: blogs

LITFL Review 301
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 301st LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week How can we individualize learning for our learners and for ourselves? The Curbsider...
Source: Life in the Fast Lane - October 8, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

Psychology Around the Net: October 7, 2017
Can a “psychological autopsy” help us determine violent and criminal motives? Why do power outages affect a person’s mental health? Do you know the right way to approach a service dog? Find out in today’s Psychology Around the Net! Las Vegas Shooting: Police Conducting ‘Psychological Autopsy’ of Gunman Stephen Paddock in Search for Motive: Retired FBI profiler Jim Clemente says a “psychological autopsy” might establish a motive for Stephen Paddock’s shooting spree, and that if suicide didn’t destroy Paddock’s brain, experts might be able to find a neurolog...
Source: World of Psychology - October 7, 2017 Category: Psychiatry & Psychology Authors: Alicia Sparks Tags: Brain and Behavior Disorders Men's Issues Psychology Around the Net Research Schizophrenia Sexuality Women's Issues Genetics Mood Disorders psychological autopsy Psychosis Puerto Rico Service Dogs Stephen Paddock study Subs Source Type: blogs

Anti-immigrant policies put people at risk during Harvey. And that ’s just the beginning.
As Harvey’s devastation raged through Houston recently, the city’s mayor was compelled to address rumors that those seeking aid could be deported. In the wake of a statewide ban on “sanctuary cities,” the mayor sought to reassure the Houston area’s more than 500,000 undocumented immigrants that they would not be targeted for deportation at emergency shelters. Nevertheless, out of the disaster have come stories of immigrants afraid to seek shelter, and of undocumented mothers sitting at home with their American-born children, weighing the threat...
Source: Kevin, M.D. - Medical Weblog - October 6, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/elisabeth-poorman" rel="tag" > Elisabeth Poorman, MD < /a > Tags: Policy Critical Care Emergency Medicine Hospital-Based Medicine Public Health & Source Type: blogs

Funtabulously Frivolous Friday Five 208
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 208. Guest post by Dr Mark Corden – paediatric fellow in Melbourne Question 1 A 5 year old presents to you after being picked up from a day at Grandma’s house, she has a pruritic, red, blanching, papular rash to both hands.  After so...
Source: Life in the Fast Lane - October 5, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five aspirin contact dermatitis diet pills digoxin grevillea oleander phentermine reyes syndrome Source Type: blogs

5 ways doctors can cope when natural disaster strikes
The ice storm of 2013 in Atlanta, Georgia made headlines for weeks described as “snowpocalypse” and “snowmageddon.” It looked like something from a sci-fi movie — the end of the world, an alien invasion. It was the subject of social media memes and discourse for quite some time. In the midst of all that human frustration, there were ice-trapped cars, parents who struggled to reach children trapped at elementary schools. Physicians, nurses and hospital staff remained steadfast in their commitment to patient care. They were bound to duty and remained in hospital critical areas, intensive care un...
Source: Kevin, M.D. - Medical Weblog - October 5, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/n-bande-virgil" rel="tag" > N. Bande Virgil, MD < /a > Tags: Physician Emergency Medicine Hospital-Based Medicine Source Type: blogs

Though Much Maligned, BVM is a Good Tool
​I’ve heard for years in emergency medicine circles that it was impossible to preoxygenate with a bag-valve mask (BVM) unless one is actually compressing the bag and forcing oxygen flow to the patient. I recently did an informal survey of my colleagues at work, and the responses varied from confident affirmation that the BVM was an inadequate tool for preoxygenation to quasi-warnings not to tread on this dogma without first consulting anesthesia or respiratory therapy. What started as a simple quest to clarify whether the dogma about BVMs and preoxygenation was true turned into a fascinating review and new personal...
Source: M2E Too! Mellick's Multimedia EduBlog - October 5, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A strategy for working in the ER: Serenity now, insanity later
When I meet a new person, and they find out I am a pediatric ER doctor, the most common response is a variation of: “Oh, that must be hard,” accompanied by a sympathetic frown. The statement is well-intentioned, but I wonder — is their view of medicine closer to “Grey’s Anatomy” or “Scrubs?” (Hint: “Scrubs” is a better show and a more accurately reflects life in medicine.) I imagine they think my days/nights are filled with miserable, screaming children trying to get away from me. Sure, that’s my home life in a nutshell, but in the ER I can give the kids a s...
Source: Kevin, M.D. - Medical Weblog - October 5, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/rogue-dad" rel="tag" > Rogue Dad, MD < /a > Tags: Physician Emergency Medicine Pediatrics Source Type: blogs

Social norms are not the norm in the ER
. Things that are regarded as gross in the real world are an everyday occurrence. Our ER especially lived in a special universe where all social graces were stripped away, and the rawness of humanity is what remained. I begin my night shift. I hadn’t taken a solid nap before my shift, and I am now headed into round 3 of 4. Nights like this always start in a haze before the caffeine has a chance to kick in. I drop my stuff off at the doc box and see that there are a couple of patients that need to be picked up. My first patient is in the middle of the big room bed 7. It’s a woman with a chief complaint of vagina...
Source: Kevin, M.D. - Medical Weblog - October 4, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/zahir-basrai" rel="tag" > Zahir Basrai, MD < /a > Tags: Physician Emergency Medicine Source Type: blogs

An episode of racism in medical school. Did it affect her care years later?
The young woman was curled up in a ball. She was sweating and shivering from pain. As she answered my questions — all my many, many questions — tears fell silently from her eyes. I was a third-year medical student, and the resident I was working with had asked me to evaluate this woman. She had been here several times before. She was in the middle of a sickle cell crisis. I remembered this young woman while reading STAT’s recent story about how too many patients with sickle cell face exhausting, infuriating — and life-threatening — delays in getting care when they arrive in emergency...
Source: Kevin, M.D. - Medical Weblog - October 4, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jennifer-adaeze-okwerekwu" rel="tag" > Jennifer Adaeze Okwerekwu, MD < /a > Tags: Physician Emergency Medicine Oncology/Hematology Source Type: blogs

The 2017 ACO Survey: What Do Current Trends Tell Us About The Future Of Accountable Care?
This article presents an overview of the results from the inaugural 2017 Annual ACO Survey and provides important insights into the current and future state of the ACO industry. Overall, we found that a large number of ACOs are currently considering or have firm plans to participate in future risk-based contracts (47 percent planning for shared savings/shared risk and 38 percent planning for capitation), although care management strategies are largely unchanged. This and the data below suggest that ACOs are slowly becoming willing to accept increased financial risk, but they are largely still learning how to actually manag...
Source: Health Affairs Blog - October 4, 2017 Category: Health Management Authors: Kate de Lisle, Teresa Litton, Allison Brennan and David Muhlestein Tags: Medicare Payment Policy Quality Accountable Care Organizations delivery reform NAACOS Payment Reform Source Type: blogs

How can we solve the rural clinician shortage?
I was recently at a meeting where some very influential physicians were discussing a question that I’ve been thinking about for a while: how do we find medical staff for rural emergency rooms and hospitals? It’s a tough question, because, increasingly, it seems that young physicians are trained to work in urban hospitals. Those are also the places these young doctors prefer to practice. Big hospitals and teaching centers in the city. Modern medicine is highly technical and remarkable specialized, so many young docs are very uncomfortable when they have to practice far from “the mother ship” (the ter...
Source: Kevin, M.D. - Medical Weblog - October 4, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Medicine Hospital-Based Medicine Source Type: blogs

Health 2.0 Fall Conference Startup Pitch Competition: Meet the Companies
This week, healthcare technology innovators, thought leaders, and business owners convene in Santa Clara, California for Health 2.0’s 11th Annual Fall Conference. While this year’s event runs from October 2-4, Medgadget was able to participate in the Sunday pre-conference and the annual Startup Pitch Competition. Evaluating eight “Series A ready” companies, organized into professional solution (B2B) and consumer solution (B2C) tracks, were six judges. The diverse panel of judges included: Anya Schiess from Healthy Ventures Caroline Arenz from Healthbox Alexander Hoffman from Merck Ve...
Source: Medgadget - October 3, 2017 Category: Medical Devices Authors: Michael Batista Tags: Exclusive Source Type: blogs

Ways Of Securing Unsecured Loans For Poor Credit
You're reading Ways Of Securing Unsecured Loans For Poor Credit, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles. When you need loan while you are the owner of the property, things will not be difficult. Among the various kinds of loans, fetching secured homeowner loans are the easiest to get. Homeowners who can present collateral, things are very easy for them. As the home is used as security, the lender and even the financial institution will not have a problem in forwarding a loan. A secured loan is the matter of protec...
Source: PickTheBrain | Motivation and Self Improvement - October 3, 2017 Category: Consumer Health News Authors: kellysuttle Tags: money and finance Homeowner loans uk London Oyster Loan Secured Homeowner Loans Source Type: blogs

Health Affairs October Issue: Emergency Departments, Behavioral Health & More
The October issue of Health Affairs includes several studies relating to the ultimate health care safety net: the emergency department (ED). Additional content in this variety issue focuses on behavioral health, spending, clinician satisfaction, and more. A DataGraphic spotlights aging and health. US emergency department visits for firearm-related injuries, 2006–14 According to the Centers for Disease Control and Prevention (CDC), firearm-related deaths accounted for more than 36,000 deaths in the United States in 2015. However, due to the politicized environment surrounding gun violence, Congress has yet to app...
Source: Health Affairs Blog - October 2, 2017 Category: Health Management Authors: Health Affairs Tags: Elsewhere@ Health Affairs journal Source Type: blogs

Wine Glass in the Foot: A Case Study
​Emergency department providers welcome the weird, the wild, the wonderful, and the unexpected. Routine chest pain workups and negative abdominal CTs occasionally bore us. Last summer we had the pleasure of meeting a man who was a line cook at a local restaurant. He came via ambulance for a foreign body in his foot. What we saw was unanticipated—he arrived with half a wine glass lodged in the sole of his foot.​ The stemware was lodged in the patient's foot, going through his shoe and sock. Photos by Martha Roberts.The patient was laughing and not in much pain. He said he had a high pain tolerance and could b...
Source: The Procedural Pause - October 2, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The Proof is the Bottle
​An 18-year-old woman presented for altered mental status. EMS reported that she was at a beach party when she became unresponsive. Friends said she may have been drinking alcohol, but denied other illicit drug use. Initial vital signs included a blood pressure of 117/69 mm Hg, heart rate of 110 bpm, respiratory rate of 11 bpm, SPO2 99% on room air, and a temperature of 98.9°F. ​The patient was somnolent and reacted intermittently to physical stimuli on exam. She intermittently moved all four extremities. Her gag reflex was intact. Pupils were 4 mm bilaterally reactive without nystagmus. She had tachycardia, her lu...
Source: The Tox Cave - October 2, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Case of Missing Teeth
​An older man presented to the emergency department for respiratory complaints, and a routine series of studies—blood work, ECG, and a chest x-ray—almost automatically appeared in the orders.​Haziness on the left side—left hilar fullness probably isn't good. A CT scan would likely confirm the fears of cancer.​The large mass wasn't unexpected, but did you see the metallic foreign body in the stomach? There was something on the left side under the diaphragm on the upright chest radiograph. The same thing appeared on the coronal CT image. Did he swallow something?Upon detailed questioning, the patient ...
Source: Lions and Tigers and Bears - October 2, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Making a Choice: Staying Home vs. Going Back to Work
Did you just have a baby? Are you wondering whether or not you should stay home with your child or if you should go back to work? Can you stay home even if you wanted to? This can be a tough decision for many families and many factors must be considered before making it. Some things to think about are: Is there flexibility at your current job? Things happen. There may be days where you need to come in late or need to leave work early. Does your employer understand this and can you change your hours to better fit your new schedule? If necessary, is there the possibility of working part time? Can you afford not to work? Look...
Source: Cord Blood News - October 2, 2017 Category: Perinatology & Neonatology Authors: Maze Cord Blood Tags: pregnancy Source Type: blogs

Poor leadership and disastrous decision-making are to blame for Florida ’s nursing home deaths
An eleventh nursing home resident has died after an air conditioning failure following last week’s Hurricane Irma. The Rehabilitation Center at Hollywood Hills, located outside of Fort Lauderdale, was one of 160 nursing homes that had no electricity and no air conditioning, as power lines across the state were decimated by the storm. Yet, it was the only nursing home facility in the state of Florida where multiple deaths occurred as a result of power loss. Overcome by heat as temperatures swelled, residents were forced to remain inside the facility for three days, despite being located directly across the street from...
Source: Kevin, M.D. - Medical Weblog - October 2, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/krysten-clark-wilkes" rel="tag" > Krysten Clark Wilkes < /a > Tags: Physician Geriatrics Public Health & Policy Source Type: blogs

How the nurse makes it possible
The day drags on; you hang in there until the job is finally complete. You are exhausted, tired, and sure something is clearly wrong. Arriving in the emergency department is never one of those moments you expect. Staff greetings are quickly followed by people taking your vital signs, pressure on various parts of your body, and placing you under X-ray machines. Symptoms come and go, and verdicts are read. Good news or bad, you have just been put thru a million-dollar work up all made possible by the dedicated healthcare workers of America. Chances are one of the first faces greeting you was that of a nurse. From arrival to ...
Source: Kevin, M.D. - Medical Weblog - October 2, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/john-green" rel="tag" > John Green, RN < /a > Tags: Conditions Hospital-Based Medicine Infectious Disease Nursing Source Type: blogs

Jellybean 78 Toby Fogg – ipsa scientia potestas est
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog “ipsa scientia potestas est” Toby Fogg talks to Matt McPartlin about the ever growing Airway Registry ANZEDAR This is FOAMed. Thus there are a lot of people that are nothing short of obsessed with airways. It’s as if humans were primarily a giant “Pass the Parcel” game with a super difficult intubation inside. This will allow us individually to be the airway super-hero that we know we are. Or do we really know? We don’t have sup...
Source: Life in the Fast Lane - October 2, 2017 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean ANZEDAR Matt McPartlin toby fogg Source Type: blogs

LITFL Review 300
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 300th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Flavia Machado is this week’s Master of Intensive care, discussing how she ma...
Source: Life in the Fast Lane - October 1, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Philando Castile, Charleena Lyles, and PTSD: The consequences of fatal police encounters
Fatal police encounters can engender PTSD in non-white communities and forever impact interactions with police. In​ ​the​ ​last​ ​few​ ​years,​ ​we​ ​have​ ​witnessed​ ​in​ ​horror​ ​the​ ​erosion​ ​of​ ​trust​ ​between​ ​public​ ​servants charged​ ​to​ ​protect​ ​the​ ​community​ ​and​ the non-white ​communities​ they serve.​ ​The​ ​killing​ ​of​ ​Philando​ ​Castile​ ​and​ ​Charleena​ ​Lyles​ ​compounded the​ ​horror,​ ​as​ ​their​ ​violent​ ​deaths​ ​were​ ​witnessed​...
Source: Kevin, M.D. - Medical Weblog - October 1, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/marshall%e2%80%8b-%e2%80%8bfleurant-and-elizabeth%e2%80%8b-%e2%80%8bparris" rel="tag" > Marshall ​ ​Fleurant, MD, MPH and Elizabeth​ ​Parris, MS < /a > Tags: Physician Emergency Medicine Public Health & Policy Source Type: blogs

Hemodynamics of sudden “ Toilet deaths ” following STEMI !
The age old  statistics , 30 % of deaths following STEMI happen even before patients reach the hospital may still be true. But ,there is an untold story that happen regularly in the rehabilitation phase .Its ironical many  apparently stabilised STEMI patients still lose their life just before they get discharged or within 30 days .More often than not this happens in the toilet when they strain for defecation. At least a dozen deaths I have witnessed in the last few years. Of course we have resuscitated many near deaths as well. What exactly happens to these ill-fated patients inside the toilet  ? Strain...
Source: Dr.S.Venkatesan MD - October 1, 2017 Category: Cardiology Authors: dr s venkatesan Tags: acute coroanry syndrome Cardiology -Interventional -PCI cardiology -Preventive Cardiology -unresolved questions acs hemodynamics in LAD following valsalva predischarge stress test primary pci stemi Sudden cardaic deaths in bath room toil Source Type: blogs

Inside EMS Podcast: The Human Side of Addiction
In this week’s episode of Inside EMS, co-host Chris Cebollero and I invite video producer Ray Kemp to the Guest Table, to talk about his latest EMS video project, a mini-documentary humanizing the face of addiction. Check it out here. (Source: A Day In the Life of An Ambulance Driver)
Source: A Day In the Life of An Ambulance Driver - September 30, 2017 Category: Emergency Medicine Authors: ambulancedriverfiles Tags: Inside EMS Podcasting Source Type: blogs

Large Hospital Chains Developing More Specialized Standalone Centers
We are moving toward a future where inpatient admissions are becoming less common with more specialized, remote centers becoming more numerous. More hospitals are also being designed as"bedless" facilities (see:The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology;The Future of Healthcare: Virtual Physician Visits& Bedless Hospitals;Some Additional Ideas About the Bedless Hospitals of the Future). A recent article discussed how large hospital chains seems to be moving in this direction (see:Warding Off Decline, Hospitals Invest in Outpatient Clinics). Below is an excerpt from it...
Source: Lab Soft News - September 30, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Hospital Executive Management Hospital Financial Radiology Source Type: blogs