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Health Care Messaging Use Cases
Conclusion A detailed understanding of the buyer’s workflow is perhaps the most important aspect of selecting the best health care messaging solution, regardless of the use case(s) being automated. This post provides some insight into the use cases that current messaging vendors consider important enough (or popular with buyers?) to actively promote. Website descriptions and demos of use cases will always look impressive, but it is only through a detailed comparison with your own institution’s workflow that the solution that is the best fit can be discovered. Suggestions for additional use cases are most welcom...
Source: Medical Connectivity Consulting - May 26, 2017 Category: Information Technology Authors: Tim Gee Tags: Messaging Middleware care management Emergin patient engagement secure text messaging secure-messaging Source Type: blogs

You're busy at triage and another ECG is flashed before your eyes.....
4 second video EKG fromStephen Smith onVimeo.Here is the computer read: MODERATE T-WAVE ABNORMALITY, CONSIDER LATERAL ISCHEMIA ABNORMAL ECGYou are working in triage where there are 30 patients vying for your attention and more coming in every minute. The nursing assistant hands you an ECG every few minutes, wanting to know if the patient needs emergency placement. She flashes the one above before your eyes.What is your immediate impression?The triage emergency physician saw the lateral T-wave inversions and told the assistant that there was no STEMI and to have the patient wait for the next available be...
Source: Dr. Smith's ECG Blog - May 26, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

The NHS Ransomware Attack & Data Privacy in the Era of Digital Health – Part One
The data explosion in healthcare through digital health networks goes hand in hand with concerns of data privacy and security. The recent WannaCry ransomware attack impaired the smooth operation of several NHS hospitals in the UK; and led to burning questions about the state of IT security in healthcare on the individual or systemic level, and what the future of health data security should look like. Unprecedented cyberattack of scale on the NHS On 12 May 2017, the WannaCry ransomware hit 61 NHS trusts and hospitals in the UK in what is known today as one of the most serious cyberattacks on any healthcare network before. O...
Source: The Medical Futurist - May 25, 2017 Category: Information Technology Authors: nora Tags: Bioethics Future of Medicine big data cybercrime cybersecurity data privacy data security digital digital health gc4 health data healthcare data ransomware technology wannacry Source Type: blogs

Residents performing surgery: Why can ’t we reach a middle ground?
A comparison of appendectomy outcomes for senior general surgeons and general surgery residents revealed no significant differences in early and late complication rates, use of diagnostic imaging, time from emergency department to operating room, incidence of complicated appendicitis, postop length of stay, and duration of post-op antibiotic treatment. The only parameter in which a significant difference was seen was that attending surgeons completed the procedure significantly faster by 9 minutes — 39.9 vs. 48.6 minutes, but this may have been influenced by the fact that attending surgeons used laparoscopic staplers...
Source: Kevin, M.D. - Medical Weblog - May 25, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/skeptical-scalpel" rel="tag" > Skeptical Scalpel, MD < /a > Tags: Physician Surgery Source Type: blogs

Gaslighting in the Medical Literature
Have you felt that your sense of reality has been challenged lately? That the word “truth” has no meaning any more? Does the existence ofalternative facts make you question your own sanity? In modern usage, the termgaslighting refers to  “a form of psychological abuse in which false information is presented to the victim with the intent of making him/her doubt his/her own memory and perception”.Gaslighting is a form of manipulation that seeks to sow seeds of doubt in a targeted individual or members of a group, hoping to make targets question their own memory, perception, and sanity. Using pers...
Source: The Neurocritic - May 25, 2017 Category: Neuroscience Authors: The Neurocritic Source Type: blogs

Research and Reviews in the Fastlane 183
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  183rd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains  5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Jus...
Source: Life in the Fast Lane - May 24, 2017 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Emergency Medicine R&R in the FASTLANE Toxicology and Toxinology EBM Education literature recommendations research and reviews Source Type: blogs

Ketamine: A Miracle Drug for Depression?
A team of researchers funded by the National Institutes of Health (NIH) recently discovered why the drug ketamine may act as a rapid antidepressant. Ketamine is best known as an illicit, psychedelic club drug. Often referred to as “Special K” or a “horse tranquilizer” by the media, it has been around since the 1960s and is a staple anesthetic in emergency rooms and burn centers. In the last 10 years, studies have shown that it can reverse — sometimes within hours or even minutes — the kind of severe, suicidal depression that traditional antidepressants can’...
Source: World of Psychology - May 24, 2017 Category: Psychiatry & Psychology Authors: Therese J. Borchard Tags: Depression Medications Research addictive Bipolar Disorder dissociative anesthetic Drug Abuse Ketamine Major Depressive Disorder Mood Disorder Mood Stabilizer Selective Serotonin Reuptake Inhibitor Substance Abuse Source Type: blogs

Managing Fatigue
Do you remember how tired you felt during chemo and at the end of radiation? That's how tired I feel every day. As a result, my new word of the year is'no'. As in:No, I am not going anywhereNo, I can't go there tomorrowNo, the only places I am going are the ones I carefully planned.Nothing else. If you want me to do something with you, we need to plan ahead. (Unless an emergency and then I am happy to help.)I cannot drop things and go to the movies or visit someone. I plan what I am going to do and then I plan how long I have to rest and recover.Yesterday I had a fairly normal day and met a friend for lunch (and gave a nei...
Source: Caroline's Breast Cancer Blog - May 24, 2017 Category: Cancer & Oncology Tags: annoyance fatigue tired Source Type: blogs

A View of How Senescent Cells Disrupt Tissue Regeneration
Normal tissue regeneration is disrupted in various ways in later life, such as the tendency for increased fibrosis, scar tissue formation rather than normal regrowth. Researchers here theorize on the role of growing numbers of lingering senescent cells in this age-related loss of function, a complex situation because the transient creation of senescent cells, soon destroyed, is an important part of the normal wound healing process. Despite their positive function in that scenario, the accumulation of long-lasting senescent cells is nonetheless one of the root causes of aging. These cells produce a harmful effect on surroun...
Source: Fight Aging! - May 24, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Surviving cardiac arrest : Pray for a competent bystander with hands of the God !
An event that happened recently  that shook my country’s  collective conscience .It was, loss of  hugely popular and beloved  President of India , Dr Abdul Kalam on 27-07-2015. He was 84.Death came in a most dramatic way when he fell down midway  during his lecture to students of Indian institute of management ,Shillong in the state of Megalaya. Indian President Kalam addressing the students snapped moments before he dropped down dead due to cardiac arrest What is the implication of this VVIP’s death for  cardiac Academic ? I believe , there is lot .The presumed cause of death was ...
Source: Dr.S.Venkatesan MD - May 24, 2017 Category: Cardiology Authors: dr s venkatesan Tags: cardio pulmonary resucitation cpr bystander vs ems Source Type: blogs

How to be EPIC
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Let it never be said that we resist change. We, the consultants in my ED, have been reinvented. Previously our title was Duty Officer, which had a pleasantly communist, scratchy grey-overalled sound to it, but now we are the EPIC. An imperious title, in my opinion. This stands for Emergency Physician In Charge. Here’s where the duplicity begins. I’m hardly in charge of my own brain, so feigning tight command of the beast of the Emergency Department is a bit of a str...
Source: Life in the Fast Lane - May 22, 2017 Category: Emergency Medicine Authors: Michelle Johnston Tags: Literary Medicine EPIC Source Type: blogs

How to be EPIC
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Let it never be said that we resist change. We, the consultants in my ED, have been reinvented. Previously our title was Duty Officer, which had a pleasantly communist, scratchy grey-overalled sound to it, but now we are the EPIC. An imperious title, in my opinion. This stands for Emergency Physician In Charge. Here’s where the duplicity begins. I’m hardly in charge of my own brain, so feigning tight command of the beast of the Emergency Department is a ...
Source: Life in the Fast Lane - May 22, 2017 Category: Emergency Medicine Authors: Michelle Johnston Tags: Literary Medicine EPIC Source Type: blogs

Warren Buffett Compares Cost of Healthcare in the U.S. to a Corporate Tax
Warren Buffett was quoted in a recent article as comparing the cost of healthcare in the U.S. to a corporate tax (see:Forget Taxes, Warren Buffett Says. The Real Problem Is Health Care). This line of reasoning is important because many executives are lobbying the administration for a lower corporate tax rate. Buffett thinks that they should more appropriately be seeking a lower cost of healthcare in order to be able to operate more competitive globally. I think that he's right and we need a broader discussion of this topic. Below is an excerpt from the article...
Source: Lab Soft News - May 22, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Direct Access Testing (DAT) Healthcare Delivery Healthcare Insurance Lab Industry Trends Lab Regulation Medical Consumerism Medical Research Source Type: blogs

LITFL Review 283
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 283rd 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 An incredible and eye opening review of his visit to meet the team at Mitchell’s Plains ...
Source: Life in the Fast Lane - May 21, 2017 Category: Emergency Medicine Authors: Anand Swaminathan Tags: LITFL review Source Type: blogs

LITFL Review 283
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 283rd 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 An incredible and eye opening review of his visit to meet the team at Mitchell&rsq...
Source: Life in the Fast Lane - May 21, 2017 Category: Emergency Medicine Authors: Anand Swaminathan Tags: LITFL review LITFL R/V Source Type: blogs

Configuring an iPhone for special needs users - the summary table
I've been using Facebook to share my book work (still ongoing!). It has limitations though so sharing today's update here. Apologies for the formatting ...SettingRecommendedWiFiOff to reduce noisy prompts. I dislike the way Apple does WiFi connections, but if you turn WiFi off completely location finding becomes less accurate. So leave it on.BluetoothOff to simplify use until neededCellularSee “Controlling data use”, aboveNotificationsAMBER alerts may be upsetting and are certainly disruptive. Turn them off. Emergency Alerts are much less frequent and may be valuable in tornado country. Application Notification...
Source: Be the Best You can Be - May 21, 2017 Category: Disability Tags: smartphone4all Source Type: blogs

Mandate
A few weeks ago I was awakened by a 2 a.m. call from the ED regarding a case of pneumoperitoneum. I barely recall the specifics of the conversation, but I vaguely remember snippets of phrases, words that light the fires and compel immediate action: "free air, tender all over, hypotension". I donned some old scrubs and quickly drove in to the hospital.The patient wasn't much older than me. He looked healthy, had a robust build. No other medical problems. But his vitals were perilously unstable. Heart rate 120's. Blood pressure 70 systolic despite several liters of fluid. The...
Source: Buckeye Surgeon - May 21, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs

Even short-term opioid use can set people up for addiction risks | Science News
Even though a sprained ankle rarely needs an opioid, a new study of emergency room patients found that about 7 percent of patients got sent home with a prescription for the potentially addictive painkiller anyway. And the more pills prescribed, the greater the chance the prescription would be refilled, raising concerns about continued use.The research adds to evidence that it's hard for some people to stop taking the pills even after a brief use. State officials in New Jersey recently enacted a law limiting first-time prescriptions to a five-day supply, and other states should consider similar restrictions, says Kit De...
Source: Psychology of Pain - May 20, 2017 Category: Anesthesiology Source Type: blogs

Is Suicide Contagion Real?
With the popularity of the Netflix hit teenage high school show, “13 Reasons Why,” there’s been some debate among mental health care professionals and researchers as to whether an actual “suicide contagion” exists. Would such a contagion effect apply to something like a fictional TV series? Is suicide contagion a real thing? And if so, is it really something we need to be concerned about as much in this day and age of instant entertainment and information available on the Internet, where people’s graphic depictions of self harm and suicide stories are always just a single click away for ...
Source: World of Psychology - May 19, 2017 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: Celebrities Children and Teens General Minding the Media Research Suicide Technology 13 Reasons Why depiction of suicide is suicide contagious suicidal contagion Suicide contagion suicide in movies suicide on tv Source Type: blogs

The Humanity In End-Of-Life Care
Health care is personal, especially when it comes to caring for someone as they approach death. However, half of Americans feel they have too little control over end-of-life medical decisions. As the industry moves toward a more holistic approach to care delivery, health care organizations are beginning to rethink how they treat patients and starting to embed end-of-life care plans into the overall approach earlier on, sometimes before people even become ill. In a recent report on end-of-life care by the Aspen Health Strategy Group, several principles are discussed that take a broader view around caring for seriously ill p...
Source: Health Affairs Blog - May 19, 2017 Category: Health Management Authors: Susan DeVore Tags: Costs and Spending End of Life & Serious Illness Long-term Services and Supports Payment Policy Quality advance care planning Palliative Care Source Type: blogs

Hours out of the OR for valve replacement surgery: patient with paced rhythm becomes hemodynamically unstable
Conclusions: ACO in VPR is an uncommon condition. The MSC showed good Sens for diagnosis of ACO in the presence of VPR, especially among patients with high peak cTn, and Spec was excellent. These methods and results are consistent with studies that have used the MSC to diagnose ACO in LBBB. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - May 19, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

Funtabulously Frivolous Friday Five 190
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 190. This week we focus on #middleclassinjuries. Question 1 Finally you get the weekend off you’ve been waiting for, ready to dive into your brunch with the standard artisan bread. What sourdough injury should you be wary of? + Reveal the Funtabulous Answer expand(doc...
Source: Life in the Fast Lane - May 18, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five avocado hand kilner sprain Meryl Streep middle class injuries middle class injury middleclassinjuries necrotising fasciitis oyster shuck pestle and mortar Sourdough gum vibrio vulnificus Source Type: blogs

Funtabulously Frivolous Friday Five 190
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 190. This week we focus on #middleclassinjuries. Question 1 Finally you get the weekend off you’ve been waiting for, ready to dive into your brunch with the standard artisan bread. What sourdough injury should you be wary of? + Reveal the Funtabulous Answe...
Source: Life in the Fast Lane - May 18, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five avocado hand kilner sprain Meryl Streep middle class injuries middle class injury middleclassinjuries necrotising fasciitis oyster shuck pestle and mortar Sourdough gum vibrio vulnificus Source Type: blogs

Loss of Maternity Care and Mental Health Coverage Would Burden Those in Greatest Need
The Affordable Care Act (ACA) required most individual and small-group health insurers to cover 10 “essential health benefits,” including outpatient services such as office visits, hospitalization, emergency department visits, prescription drugs, and other specific types of care. By requiring insurance coverage for these services, the ACA ensures that everyone who enrolls in insurance receives a standard benefit package that covers, at a minimum, commonly used services. However, the requirement may raise insurance premiums relative to what would be expected if coverage of these services were not required. The A...
Source: The Commonwealth Fund: Blog - May 18, 2017 Category: International Medicine & Public Health Source Type: blogs

Research and Reviews in the Fastlane 182
This study was called LOV-ED. Initiation of a mechanical ventilation protocol in the ED using a low tidal volume strategy, PEEP protocols, rapid FiO2 weaning, and head-of-bed elevation resulted in dramatic clinical improvement in the composite primary outcome: ARDS or ventilator-associated conditions; NNT = 14. And a secondary outcome, mortality, was also improved, NNT = 7. There is no way to account for all the confounders or other process improvements that may have also led to better outcomes, but the use of propensity analysis makes this association very believable. REBEL EM has a great deep-dive on this article. Starti...
Source: Life in the Fast Lane - May 18, 2017 Category: Emergency Medicine Authors: Jeremy Fried Tags: Education Emergency Medicine Intensive Care Pediatrics R&R in the FASTLANE EBM literature recommendations research and reviews Source Type: blogs

Research and Reviews in the Fastlane 182
This study was called LOV-ED. Initiation of a mechanical ventilation protocol in the ED using a low tidal volume strategy, PEEP protocols, rapid FiO2 weaning, and head-of-bed elevation resulted in dramatic clinical improvement in the composite primary outcome: ARDS or ventilator-associated conditions; NNT = 14. And a secondary outcome, mortality, was also improved, NNT = 7. There is no way to account for all the confounders or other process improvements that may have also led to better outcomes, but the use of propensity analysis makes this association very believable. REBEL EM has a great deep-dive on this article. Starti...
Source: Life in the Fast Lane - May 18, 2017 Category: Emergency Medicine Authors: Jeremy Fried Tags: Emergency Medicine Intensive Care Pediatrics R&R in the FASTLANE EBM Education literature recommendations research and reviews Source Type: blogs

Mental health and new models of care: lessons from the vanguards
This report draws on recent research with vanguard sites in England, conducted in partnership with the Royal College of Psychiatrists. It finds that where new models of care have been used to remove the barriers between mental health and other parts of the health system, local professionals saw this as being highly valuable in improving care for patients and service users. It concludes that there remains much to be done to fully embed mental health into integrated care teams, primary care, urgent and emergency care pathways, and in work on population health.ReportBlog Nine principles for success: integrating mental health ...
Source: Health Management Specialist Library - May 18, 2017 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Mental Health Source Type: blogs

Physicians have to stay in their lanes
I drive a fast car. Which if you know me, is quite uncharacteristic. I would say that it is one the few possessions that generally doesn’t reflect upon who I am. How I chose this car, the make, and model, are a long story not to be discussed here. But let’s just say that it has quite a kick. These thoughts jostled through my mind this morning as I pulled into the hospital parking lot. A recent momentous decision, I surrendered my privileges at this hospital and started using the hospitalists. It had all become too hard. The inane compliance issues with the new EMR. The ER attendings admitting my patients withou...
Source: Kevin, M.D. - Medical Weblog - May 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jordan-grumet" rel="tag" > Jordan Grumet, MD < /a > Tags: Physician Primary care Source Type: blogs

How to Keep Your Children Safe From Prescription Drugs
Recently in the news are reports of children overdosing on their parents or caregivers medications. According to the Centers for Disease Control and Prevention, every year emergency rooms get about 60,000 cases of kids who get into over-the-counter medicines or prescription drugs. So how can you keep your children safe? Follow the link to detailed guidelines and tips, from the American Academy of Family Physicians, on how to safely store your medications to keep your children safe.  https://news.nnlm.gov/bhic/sldt   (Source: BHIC)
Source: BHIC - May 17, 2017 Category: Databases & Libraries Authors: Michelle Burda Tags: Children and Teens General Source Type: blogs

Interview: Momentum Software Links Trained Responders with Nearby Medical Emergencies
The progress of emergency medicine and the technology that’s inside of modern ambulances helped to save millions of people around the world. Yet, in many cases the response time to acute life threatening situations is still too long, with too many people dying that could have been rescued. Modern technologies, such as automatic stoplight signaling, are helping to cut that time, but ambulances can’t be everywhere while traffic and distance play a big role. Momentum is a software product developed by DOS Group, a Swiss firm, that allows emergency response centers to rapidly identify, notify, and direct train...
Source: Medgadget - May 17, 2017 Category: Medical Devices Authors: Editors Tags: Emergency Medicine Exclusive Informatics Public Health Source Type: blogs

Medicaid: What Happens Now?
With public attention completely focused on the wild effort to reach closure on the private health insurance provisions of the American Health Care Act (AHCA) (H.R. 1628), it was easy to overlook (at least for a moment) the extraordinary nature of its Medicaid changes. Were these provisions to become law, the AHCA would represent the most sweeping federal policy shift since the program’s 1965 enactment. How The AHCA Would Affect Medicaid The AHCA would end the Affordable Care Act’s enhanced funding for the adult expansion population. More profoundly, however—and completely disconnected from the AHCA&rsquo...
Source: Health Affairs Blog - May 17, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Medicaid and CHIP Quality ACA repeal and replace AHCA EPSDT Medicaid block grants Medicaid expansion Medicaid per capita cap medicaid work requirement Source Type: blogs

Health Datapalooza 2017 Day 2: Consumer Tech Ecosystems, Healthcare Policy and Two Big RWJF Announcements
Ensuring that a conference discussing health did indeed practice what it preached, day two of this year’s Health Datapalooza got off to an early start with a Stride Health-sponsored 3 and 5 mile fun run. Back at the conference venue, the day’s content began on the main stage with Dr. Mark McClellan, Director of the Duke Margolis Center for Health Policy and Former Administrator at the Centers for Medicare and Medicaid Services (CMS). Mark’s opening comments characterized the politics of healthcare as one of consistent bipartisan stories, since healthcare spending has historically been prior...
Source: Medgadget - May 16, 2017 Category: Medical Devices Authors: Michael Batista Tags: Exclusive Informatics Source Type: blogs

8 things to watch for when your child has a headache
Headaches are common in childhood. Most of the time, they are nothing to worry about and are caused by common minor illnesses, a mild bump to the head, lack of sleep, not getting enough food or drink, or stress. Migraines can also be seen in childhood, but with awareness and avoidance of triggers, they don’t usually cause problems. Sometimes, though, headaches are a problem — and something to worry about. Here is when you should worry: 1. When a headache is accompanied by a fever and a stiff neck. Your child should be able to look up at the ceiling, touch his chin to his chest and shake his head back and forth....
Source: Harvard Health Blog - May 16, 2017 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Children's Health Headache Parenting Source Type: blogs

Antimicrobial Resistance: Where to from Here?
Conclusion Newer tools capable of informing these early decisions are under development, but integrating an awareness of AMR into both hospital and GP practice is a key component of winning the fight against superbugs. Throughout the development process, discussion between clinicians and researchers will ensure that diagnostic tools are effective, and also meet the needs of frontline staff. In the mean-time, cultivating an AMR aware mind-set is the best defence against over-prescription. Understanding and accepting the systematic, ubiquitous biases which affect our judgement of risk is particularly helpful. For example, do...
Source: Life in the Fast Lane - May 16, 2017 Category: Emergency Medicine Authors: Jarrad Hall Tags: Clinical Research Microbiology AMR Antimicrobial resistance ESBL MROs multi-resistant organisms multidrug resistant organisms (MROs) Source Type: blogs

Antimicrobial Resistance: Where to from Here?
Conclusion Newer tools capable of informing these early decisions are under development, but integrating an awareness of AMR into both hospital and GP practice is a key component of winning the fight against superbugs. Throughout the development process, discussion between clinicians and researchers will ensure that diagnostic tools are effective, and also meet the needs of frontline staff. In the mean-time, cultivating an AMR aware mind-set is the best defence against over-prescription. Understanding and accepting the systematic, ubiquitous biases which affect our judgement of risk is particularly helpful. For example, do...
Source: Life in the Fast Lane - May 16, 2017 Category: Emergency Medicine Authors: Jarrad Hall Tags: Clinical Research Microbiology AMR Antimicrobial resistance ESBL Joanna Tedeschi MROs multi-resistant organisms multidrug resistant organisms (MROs) Source Type: blogs

Why medical professionals have potty mouths
While Muzak plays (think Kenny G covering John Mayer) and courteous expressions like “excuse me” and “thank you” are exchanged in hospital waiting rooms, behind the front desk, angry patients are firing curse words into the hallway like their mouths are assault rifles with an endless supply of ammunition. Nurses are being cussed out by patients who sound like characters in “Platoon.” And medical professionals are dropping f-bombs. All of this would give the pearl-clutching crowd palpitations (and I know because I used to belong to the pearl-clutching crowd). I had a sheltered childhood, ...
Source: Kevin, M.D. - Medical Weblog - May 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/kristin-prentiss-ott" rel="tag" > Kristin Prentiss Ott, MD < /a > Tags: Physician Emergency Source Type: blogs

Amid ACA Uncertainty, Covered California ’s Risk Profile Remains Stable
One of the constant concerns about the Affordable Care Act (ACA) and the status of the exchanges involves the average health status of enrollees in these state Marketplaces. While the ACA has helped reduce the uninsured rate to record lows and increased access to needed care, the law, the Obama administration, and the US Supreme Court granted states flexibility in implementation. States could choose whether to operate a state-based exchange, whether to expand Medicaid eligibility, and whether to immediately transition to ACA-compliant products. The amount of autonomy has allowed some state exchanges to thrive, while other ...
Source: Health Affairs Blog - May 15, 2017 Category: Health Management Authors: John Bertko, Andrew Feher and Jim Watkins Tags: Following the ACA Insurance and Coverage Population Health ACA Marketplaces California Chronic Illness and Disability Payment System Covered California risk adjustment Source Type: blogs

Solving Homelessness: The Need For Innovative Solutions And The Role Of Health Care
Homelessness affects people from many walks of life. A recent study found that one out of 25 Americans have been homeless sometime in their lives. Tales of how people became homeless and what their lives have been like since they have become homeless are often disheartening and complex. As illustrated in Tammy Kling’s Narrative Matters essay in the May issue of Health Affairs, “Dave Didn’t Have To Die: On Health Care For Homeless Patients,” many people who are homeless have major medical, mental health, and social needs. Dave is not an anomaly: People who are homeless die sooner than their housed co...
Source: Health Affairs Blog - May 15, 2017 Category: Health Management Authors: Jack Tsai and Kelly M. Doran Tags: Health Equity Insurance and Coverage Medicaid and CHIP Narrative Matters Population Health Public Health homelessness Medicaid expansion mobile health care Tammy Kling Veterans Health Administration Source Type: blogs

Trial By Error, Continued: The CMRC Affirms Full Support for Libelous Esther
By David Tuller, DrPH For the last couple of weeks, I have been hammering the CFS/ME Research Collaborative to take a position on the actions of its deputy chair, Libelous Esther—better known as Dr. Esther Crawley. As I reported in several previous posts, Dr. Crawley falsely accused me of writing “libelous blogs” and Dr. Racaniello of posting them. To keep members of the CMRC board in the loop, I have sent them e-mails with links to these posts. In these e-mails, I have tried to be direct and pointed, but reasonably polite. I have mostly succeeded, although the recipients might have their own perspective....
Source: virology blog - May 15, 2017 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information CFS/ME Research Collaborative chronic fatigue syndrome CMRC libel libelous mecfs myalgic encephalomyelitis PACE Source Type: blogs

Lessons From the 100 Nation Ransomware Attack
By ROSS KOPPEL and HAROLD THIMBLEBY The world is reeling from the massive ransomware attack on at least a hundred nations’ computer systems. The unprecedented malware spasm infected hundreds of thousands of computers, and would have infected millions more but for a 22-year old computer science student who found a vulnerability in the malware that he used to curtail the infection. He found it looked for a non-existent URL, so he a set up that URL and found he could stop it spreading. Of course, now the hackers know that, it is an easy matter to update the malware to use other URLs and other techniques. Clearly, this i...
Source: The Health Care Blog - May 14, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

LITFL Review 282
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 282nd 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 A LITFL guest post by Peter Hutchinson discusses the challenges of discussing decompressive craniec...
Source: Life in the Fast Lane - May 14, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

LITFL Review 282
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 282nd 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 A LITFL guest post by Peter Hutchinson discusses the challenges of discussing decompres...
Source: Life in the Fast Lane - May 14, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

Being superhuman in the most human circumstance
As we enter into the hospital each day, our goal is giving patients the best care we can provide. We get a list of patients that we will take care of each day, and as we get that list, we start thinking about what we should monitor in terms of their physical exam, lab results, and vital signs to ensure that their hospital course runs smoothly for the day. However, at a moment’s notice, a patient’s course can become critical, and our training comes into play as we try to save our patients’ lives. Most of the time, this happens with patients that we are worried about coming into the day, those who have had ...
Source: Kevin, M.D. - Medical Weblog - May 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/chiduzie-madubata" rel="tag" > Chiduzie Madubata, MD < /a > Tags: Physician Heart Hospital Source Type: blogs

Becoming a millennial mother: 3 tips for labor and delivery
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Expecting a baby? Congratulations! Giving birth today is not the same as when your mother gave birth. You have new options and different choices to make. You will recover faster than even before, and your participation will be requested. Ready? Let’s talk about three tips that will help you to power through the labor and delivery process. 1. Help me help you. You may not know it, but I’m your guardian angel during your labor and post-delivery experience.  As a physician anesthesiologist specializing in obs...
Source: Kevin, M.D. - Medical Weblog - May 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mark-zakowski" rel="tag" > Mark Zakowski, MD < /a > Tags: Conditions OB/GYN Source Type: blogs

“ Beholders ” or patients and families?
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog This is a guest post by Dr Peter Hutchinson, Professor of Neurosurgery; Dr Angelos Kolias, Clinical Lecturer in Neurosurgery; and Dr David Menon, Professor of Anaesthesia – all at the University of Cambridge and Addenbrooke’s Hospital, Cambridge, UK. It is a response to the recent LITFL post by Dr Alistair Nichol titled RESCUEicp and the Eye of the Beholder. * beholder NOUN literary, archaic  A person who sees or observes someone or something. We...
Source: Life in the Fast Lane - May 14, 2017 Category: Emergency Medicine Authors: Chris Nickson Tags: Intensive Care Neurosurgery angelos kolias david menon Decompressive craniectomy peter hutchinson RESCUEicp TBI traumatic brain injury Source Type: blogs

“ Beholders ” or patients and families?
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog This is a guest post by Dr Peter Hutchinson, Professor of Neurosurgery; Dr Angelos Kolias, Clinical Lecturer in Neurosurgery; and Dr David Menon, Professor of Anaesthesia – all at the University of Cambridge and Addenbrooke’s Hospital, Cambridge, UK. It is a response to the recent LITFL post by Dr Alistair Nichol titled RESCUEicp and the Eye of the Beholder. * beholder NOUN literary, archaic  A person who sees or observes someone or so...
Source: Life in the Fast Lane - May 14, 2017 Category: Emergency Medicine Authors: Chris Nickson Tags: Intensive Care Neurosurgery angelos kolias david menon Decompressive craniectomy peter hutchinson RESCUEicp TBI traumatic brain injury Source Type: blogs

Tomorrow, we may fail you: Vignettes of pre-existing conditions
Today, I cleaned the laceration above your eye from where he punched you with a closed fist. As I was stitching up the gaping wound with two layers of sutures, I told you that the scar would fade into the line of your eyebrow. I helped you apply your foundation on your neck to cover the bruising from where he strangled you. I monitored you for any swelling of your airway. I wrote down the names of the local battered women’s shelters and hotlines and slipped the paper in your shoe. I offered to call the police for you no fewer than ten times. I told you how I feared the next time you would not be discharged home. Toda...
Source: Kevin, M.D. - Medical Weblog - May 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/amanda-guarniere" rel="tag" > Amanda Guarniere, CRNP < /a > Tags: Conditions Emergency Source Type: blogs

A physician ’s response to Jimmy Kimmel’s monologue
Jimmy Kimmel recently delivered a 13-minute monologue that transfixed the nation.  He told the story of how his newborn son, Billy, was diagnosed with a potentially fatal cardiac anomaly, tetralogy of Fallot, and had undergone emergency surgery. He painted the picture of a sick child and a terrified family, who have the benefit of excellent care that ends well. He complimented the nurses and physicians who had cared for Billy, and encouraged donations to the hospital. Most importantly, Mr. Kimmel put a face on the importance of health insurance and the inhumanity of not providing it to those who need it most: tho...
Source: Kevin, M.D. - Medical Weblog - May 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jonathan-kohler" rel="tag" > Jonathan Kohler, MD < /a > Tags: Policy Health reform Source Type: blogs

An intoxicated, agitated, 20-something with chest pain
Here is a one hour lecture on the topic of subtle coronary occlusion, especially on the left anterior descending coronary artery. Case 1:The outcome of this case is at the far bottom.A thin, athletic young African American male presented by private transportation to the ED after use of " ecstasy " and alcohol and other drugs. He complained of severe chest pain and was extremely agitated, so much so that he was throwing chairs in triage. He had an ECG recorded and was brought to a room. Here is the ECG:Figure 1:Sinus rhythm.What do you think?Figure 1 shows marked ST Elevation (STE) at the J-poi...
Source: Dr. Smith's ECG Blog - May 13, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs