Ebola And EHRs: An Unfortunate And Critical Reminder
The Dallas hospital communication lapse that led to the discharge of a Liberian man with Ebola symptoms is an example of the failure of the American health care system to effectively share health information, even within single institutions. It is not possible to know whether a faster response would have saved Thomas Eric Duncan’s life or reduced risk to the community and health workers.
What is clear is that rapid sharing of information is one of the elements critical to halting the spread of Ebola. Had all members of the initial care team known of the patient’s recent arrival from an Ebola-stricken country and acted ...
Source: Health Affairs Blog - October 28, 2014 Category: Health Management Authors: Lara Cartwright-Smith, Jane Hyatt Thorpe, and Sara Rosenbaum Tags: All Categories Emergency Medicine Global Health Health IT Hospitals Policy Public Health Technology Source Type: blogs
Research and Reviews in the Fastlane 052
This study looked at compliance with discharge instructions. Surprisingly (or maybe not so), 39% of pediatric patients returned to play (RTP) on the day of the injury. RTP is widely recognized as a risk for recurrent and more severe concussions as well as significant morbidity. It is the duty of the Emergency Physician to stress the importance of discharge instructions as well as the importance of appropriate follow up.
Recommended by: Anand Swaminathan
PediatricsSingleton T et al. Emergency department care for patients with hemophilia and von Willebrand disease. J Emerg Med. 2010; 39(2): 158-65. PMID: 18757163
Bleeding...
Source: Life in the Fast Lane - October 9, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Administration Anaesthetics Cardiology Clinical Research Education Emergency Medicine Haematology Infectious Disease Intensive Care International Emergency Medicine Microbiology Neurosurgery Obstetrics / Gynecology Ophthalmology Source Type: blogs
WHO on Ebola virus transmission
The World Health Organization has issued a situation assessment entitled ‘What we know about transmission of the Ebola virus among humans‘. WHO is rather later entering the transmission discussion which began on 12 September 2014 with the suggestion that Ebola virus transmission could go airborne. But WHO is a big organization and moves slowly; nevertheless their voice may reassure those who are not convinced by what virologists have to say. Here are the salient points (voiced here and by many others in the past few weeks).
The Ebola virus is transmitted among humans through close and direct physical contact ...
Source: virology blog - October 7, 2014 Category: Virology Authors: Vincent Racaniello Tags: Uncategorized aerosol airborne droplet ebola virus ebolavirus transmission viral virology Source Type: blogs
Howzzat again?
A couple of days ago I heard Neko Case on National Pubic Radio recalling that as a child, she heard the Rascals Hit "Groovin'" as "That would be ecstasy, You and me and Leslie, Groovin .. . " She thought that was great that they could hang out with Leslie. Actually I heard it the same way, but I thought, "Who the f. is Leslie?" Is it a menage a trois? Do they have a kid? A dog? Actually it's not "and Leslie," it's "endlessly," but the singer (that would be Eddie Brigati) for some reason put the accent on the wrong sillobble. It's weird because endlessly scans just fine with ecstasy. If you look for the song lyrics using yo...
Source: Stayin' Alive - September 26, 2014 Category: American Health Source Type: blogs
Reflections on Rapid Response to Unjustified Climate Alarm
Richard Lindzen
The Cato Institute’s Center for the Study of Science today kicks off its rapid response center that will identify and correct inappropriate and generally bizarre claims on behalf of climate alarm. I wish them luck in this worthy enterprise, but more will surely be needed to deal with this issue.
To be sure, there is an important role for such a center. It is not to convince the ‘believers.’ Nor do I think that there is any longer a significant body of sincere and intelligent individuals who are simply trying to assess the evidence. As far as I can tell, the issue has largely polar...
Source: Cato-at-liberty - September 18, 2014 Category: American Health Authors: Richard Lindzen Source Type: blogs
Chikungunya – Coming to America ?
Chikunguna is hardly a “household” word in the United States; but we may all be talking about the disease very soon! This viral infection, transmitted by mosquitoes, is associated with high fever, rash and severe joint pains. Even after recovery, the pains may persist for many months. Originally described in Africa, the disease spread to Asia, causing an epidemic of over 1.5 million cases in India during 2006 to 2007. At one point, an Indian traveler carried the infection to Italy, resulting in hundreds of cases in the region of Ravenna.
During the first half of 2014, new outbreaks were reported in the South Pa...
Source: GIDEON blog - September 17, 2014 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Ebooks Epidemiology Outbreaks Source Type: blogs
Funtabulously Frivolous Friday Five 102
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.
Question 1
What obstetric condition/procedure may have this baby christ gone through?
+ Image of Madonna and Child 1496 - Albrecht Durer
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Reveal Answer
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Erb’s palsy
Albrecht Durer painted Madonna and Child depicting an infant with an Erb’s palsy
Other differen...
Source: Life in the Fast Lane - August 8, 2014 Category: Emergency Medicine Authors: Neil Long Tags: Arcanum Veritas Frivolous Friday Five Albrecht Durer Auenbrugger Disco Felon FFFF osteopoikilosis Source Type: blogs
The Export-Import Bank and Its Victims: Which Industries Bear the Brunt
Daniel J. Ikenson
The Export-Import Bank of the United States is a government-run export credit agency, which provides access to favorable financing for the foreign customers of some U.S. companies. For several months, Washington has been embroiled in a debate over whether to reauthorize the Bank’s charter, which will otherwise expire on September 30. While Republican House leadership remains publicly committed to shutting down the Bank, a bipartisan group of eight senators introduced reauthorization legislation last night, setting the stage for a post-August recess showdown.
Reauthorization buffs conten...
Source: Cato-at-liberty - July 31, 2014 Category: American Health Authors: Daniel J. Ikenson Source Type: blogs
The Double-Faced Pain Problem: Reflections On July’s Narrative Matters Essay
Reading Janice Lynch Schuster’s tormented account of her persistent pain and her journey through the medical maze of care in the July issue of Health Affairs, I’m reminded of how millions of Americans are living with not one, but two, pain challenges. The first is the epidemic of over-prescription; the second is the condition of endemic under-medication.
In her essay “Down The Rabbit Hole: A Chronic Pain Sufferer Navigates The Maze Of Opioid Use,” Schuster herself hints at the dual issues when she writes: “pain patients like me often feel trapped between the clinical need to treat and manage pain and the social ...
Source: Health Affairs Blog - July 28, 2014 Category: Health Management Authors: Keith Wailoo Tags: Access All Categories Chronic Care Narrative Matters Personal Experience Pharma Policy Source Type: blogs
Answer to Case 311
Answer: Ascaris lumbricoides and Trichuris trichiura eggs.As noted by a few of the readers, both fertilized and unfertilized Ascaris ova are present. It is common to see co-infections with geohelminths in patients from endemic settings. Therefore, a good take home point is: if you see one parasite, keep looking! (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 13, 2014 Category: Pathologists Source Type: blogs
Implications of finding poliovirus in sewers of Brazil and Israel
Wild poliovirus has been detected in the sewers of Brazil and Israel. Fortunately, no cases of poliomyelitis have been reported in either country. Why is poliovirus present in these countries and what are the implications for the eradication effort?
Wild type poliovirus (e.g. not vaccine-derived virus) was detected in sewage samples that had been collected in March 2014 at Viracopos International Airport in the State of Sao Paulo. Wild type poliovirus had not been detected in Brazil since 1989 when the last case of poliomyelitis was reported in that country, and has not been found since March 2014.
Sequence analysis of the...
Source: virology blog - June 28, 2014 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information Source Type: blogs
Disease eradication
World Malaria Day was a couple of weeks go, and I missed posting on it due to my recent indisposition. Yeah, yeah, I don't usually pay much attention to these artificial occasions --- National Pickle Week, Administrative Assistant's Day, yadda yadda -- but the WHO and the Global Fund used the day to push hard to get attention and maybe raise some dough. Here's the UN Special Envoy's statement on the day, which was April 25. Malaria matters because it is a leading killer of children and because endemic malaria is a major factor that holds down poor regions of the world. With lots of people debilitated, economic welfare suff...
Source: Stayin' Alive - May 8, 2014 Category: American Health Source Type: blogs
How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work
It’s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction, “burn out” and even suicide. In fact, some believe that up to a third of the US physician work force is planning to leave the profession in the next 3 years – an alarming statistic.
Direct primary care practices are touted as the best way to restore patient and provider satisfaction. Those brave enough to cut out the “middle man” (i.e. health insurers, both public and private) find a remarkable reduction in billing paperwork, unrecovered fees, an...
Source: Better Health - May 5, 2014 Category: American Health Authors: Dr. Val Jones Tags: Expert Interviews Health Policy Opinion Anesthesiologists Freedom Hospitalists ICU Intensivists Job satisfaction Locum Tenens Physicians Temp Work Source Type: blogs
The Medical Chart: Ground Zero For The Deterioration Of Patient Care
For the past couple of years I’ve been working as a traveling physician in 13 states across the U.S. I chose to adopt the “locum tenens lifestyle” because I enjoy the challenge of working with diverse teams of peers and patient populations. I believe that this kind of work makes me a better doctor, as I am exposed to the widest possible array of technology, specialist experience, and diagnostic (and logistical) conundrums. During my down times I like to think about what I’ve learned so that I can try to make things better for my next group of patients.
This week I’ve been considering how in-pa...
Source: Better Health - April 21, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Communication Data EHR Electronic Hospital Records Electronic Medical Records EMR Errors Medical Errors Near Misses Patient Care Source Type: blogs
What Ails Mt. Sinai Hospital Ails The Entire US Healthcare System
A Bloomberg News article raises extremely troubling questions about policies and procedures that have made the Mt. Sinai hospital catheterization laboratory the busiest and most lucrative in New York City. It is unclear whether the specific allegations in the article will stand up to rigorous scrutiny but, say some experts, the ills identified in the article go far beyond Mt. Sinai and New York City and are actually endemic throughout the entire US healthcare system. The most explosive charge in the story by David Armstrong, Peter Waldman and Gary Putka is that hospital physicians scheduled emergency room appointments ...
Source: CardioBrief - March 7, 2014 Category: Cardiology Authors: Larry Husten Tags: Interventional Cardiology & Surgery People, Places & Events Policy & Ethics Bloomberg News Mt. Sinai Samin Sharma Source Type: blogs
