Rapid Diagnosis: Pinpoint Pupils
Abnormally constricted or “pinpoint” pupils are a great finding for our rapid diagnosis series. There are many things that can cause the pupil to abnormally dilate. Very few things will make the pupil abnormally constrict. Constricted pupils are a doorway to a very short list of ailments and with a bit of background you should be able to hang your hat on one fairly quick.
How So We Assess For “Pinpoint” Pupils?
Recall that the pupil should be mid-range and reactive under normal lighting conditions. When subjected to bright light, the pupil will constricted to reduce the volume of light entering the iris. In d...
Source: The EMT Spot - November 1, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Nitazene Overdose Deaths on the Rise —The Iron Law of Prohibition Cannot Been Repealed
Jeffrey A. SingerLast week the Tennessee Department of Healthreported that overdose deaths from synthetic opioids classified asnitazenes have increased four ‐fold between 2019 and 2021. Nitazenes, like fentanyl and its analogs, aresynthetic opioids that were originally developed to treat pain. They are anywhere from 10 to 20 times more potent than fentanyl. As with overdoses from fentanyl and other opioids, overdoses from nitazenes can be reversed by administering naloxone, although the antidote might need to be given repeatedly to the victims.The first nitazenes were developed in the late 1950s by the Swiss drug make...
Source: Cato-at-liberty - September 23, 2022 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Fentanyl Is Smuggled for U.S. Citizens By U.S. Citizens, Not Asylum Seekers
ConclusionBorder enforcement will not stop fentanyl smuggling. Border Patrol ' s experience with marijuana smuggling may provide even clearer evidence for this fact. Marijuana is the bulkiest and easiest-to-detect drug, which is why it was largely trafficked between ports of entry. Despite doubling the Border Patrol and building a border fence in the 2000s in part to combat the trade, the only thing that actually reduced marijuana smugglingwas U.S. states legalizing marijuana. It is absurd to believe that interdiction will be more effective against a drug that is orders of magnitude more difficult to detect.The DEA plainly...
Source: Cato-at-liberty - September 14, 2022 Category: American Health Authors: David J. Bier Source Type: blogs
Undisclosed Conflicts of Interest by Physicians Creating the CDC Opioid Prescribing Guidelines: Bad Faith or Incompetence?
We described above how changes in opioid policy aimed at reducing Washington State’s Medicaid and Workers Compensation costs contributed to an increase in methadone deaths between 2003 and late 2014 (23-25). Focusing on similar cost reductions, the Centers for Medicar e and Medicaid Services (CMS) proposed rules for 2019 including several directives intended to reduce " Opioid Overutilization, ” including adoption of the “90 morphine milligram equivalent (MME) threshold cited by the 2016 CDC Opioid Guideline (147, 148). Simply put, reduced prescribing reduces costs for prescribed medications.Chou received research fu...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 12, 2022 Category: Palliative Care Tags: health policy judy kollas opioids research schechtman Source Type: blogs
Understanding the Fentanyl Overdose Epidemic
Content reviewed by Karen Rubenstein, LMFT, Chief Clinical Officer at Cliffside Malibu Recent data from the...
The post Understanding the Fentanyl Overdose Epidemic appeared first on Cliffside Malibu. (Source: Cliffside Malibu)
Source: Cliffside Malibu - September 5, 2022 Category: Addiction Authors: ebarbour Tags: Substance Abuse fentanyl opioid overdose Substance Use treatment Source Type: blogs
September 2022: The Torsed Testicle Traction Technique
I asked in my May blog whether immediate attempts at manual reduction of a testicular torsion should be the standard of care. Without a doubt, timely manual detorsion of a torsed testicle saves the organ from death. (Pediatr Emerg Care. 2019;35[12]:821; Pediatr Emerg Care. 2012;28[1]:80; https://bit.ly/3T9W0N0.)The detorsion procedure is sometimes quick and easy, but other times it is technically difficult and even unsuccessful. Unfortunately, many physicians are hesitant to attempt manual detorsion because they lack procedural confidence or have anxiety about worsening the torsion.Testicles torsed for a prolon...
Source: M2E Too! Mellick's Multimedia EduBlog - August 31, 2022 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Bonus Features – August 28, 2022 – Epic data shows only 5% of OD patients get tested for fentanyl, 40% of clinicians plan to add AI to their day-to-day work, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.
News and Studies
A report from Epic Research and the University of Maryland’s Center for Substance Abuse Research (CESAR) found that just 5% of overdose patients are tested for fentanyl in the ED, compared to an opiate t...
Source: EMR and HIPAA - August 28, 2022 Category: Information Technology Authors: Brian Eastwood Tags: AI/Machine Learning Analytics/Big Data C-Suite Leadership EMR-EHR Health IT Company Healthcare IT Hospital - Health System Bamboo Health BronxCare Health System Cadence CalOptima Health CESAR Clarify Health CloudDx Conduit Heal Source Type: blogs
Arizona Becomes the 19th State to Ban Warrantless Searches of Prescription Drug Database
Jeffrey A. SingerOn June 8, Arizona Governor Doug Ducey (R) signedSB 1469 into law. Introduced by Senator Nancy Barto (R ‑Phoenix), the bill requires law enforcement toobtain a search warrant before perusing the state’s prescription drug monitoring program (PDMP) database, administered by the Arizona Board of Pharmacy. The bill passed unanimously through both houses of the state legislature. Until now, law enforcement could inspect the PDMP database without a warrant by simply stati ng in writing that the information is necessary for an open investigation or complaint. The new law further states that if, upon perus...
Source: Cato-at-liberty - June 16, 2022 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Allow patients to continue their opioid of choice while starting microdoses of buprenorphine
Twenty-six hours into the shakes, sweats, crawling anxiety, and gripping nausea of opioid withdrawal, Faye caves in and takes a couple of fentanyl tabs. She knows that she must tough out a couple of days without fentanyl to start Suboxone (buprenorphine/naloxone) through a medication-assisted treatment program, but the sickness gets the better of her. ThoseRead more …Allow patients to continue their opioid of choice while starting microdoses of buprenorphine originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 16, 2022 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/post-author/julie-craig" rel="tag" data-wpel-link="internal" > Julie Craig, MD < /a > < /span > Tags: Meds Pain Management Source Type: blogs
Living in Christ: A Teaching Story
IntroductionWhen thinking about moral and ethical values, objective and subjective claims, and the meaning, and understanding of difficult ideas, philosophers have traditionally used teaching stories. More impactful and often more challenging than non-fiction essays, these stories encourage their disciples to analyze and learn the condensed wisdom presented, to make connectioins, see relationships, trace out causes and effects, and go deeper into the implications of what is said and done. Even relatively simple tales about seemingly ordinary events can shed light on the human condition more clearly, immediately, and powerf...
Source: The Virtual Salt - June 9, 2022 Category: Neurology Authors: Robert Harris Source Type: blogs
Drug Paraphernalia Laws Undermine Harm Reduction
Jeffrey A. SingerWith overdose deaths from non ‐medical drug use skyrocketing to a horrifying108,000 in 2021,state andfederal policymakers are finally beginning to appreciateharm reduction strategies that can reduce the risk death and disease from using drugs obtained in the black market fueled by drug prohibition. These strategies include syringe services programs (also called SSPs or “needle‐exchange programs”), distributing drug testing devices such as fentanyl test strips, and distributing the overdose antidote naloxone (which is inexplicably still classified asprescription ‐only by the Foo...
Source: Cato-at-liberty - June 7, 2022 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
“Prohibition Theater” and “The Iron Law of Prohibition”
Jeffrey A. SingerA May 18 opinion column in theWall Street Journal by Joseph Grogan and Casey B. Mulligan titled “Fentanyl Overdose Rates Are Rising Fast” argued that to better address the overdose crisis, the Biden administration should tighten border security, give law enforcement better tools to combat the drug trade, toughen sentencing, and add illicit fentanyl and its analogs (easily created in clandestine labs) to the Drug Enforcement Admini stration’s Schedule 1 (“no currently accepted medical use and a high potential for abuse ”), joining cannabis, LSD, heroin, MDMA (“ecstasy”) and other drugs wi...
Source: Cato-at-liberty - May 31, 2022 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Retail Pharmacy Paranoia is Understandable –But Patients Are The Real Victims
Jeffrey A. SingerThere is already ample evidence that the war on opioid prescribing has intimidated many pharmacies and pharmacists intorefusing to dispense legally ‐prescribed opioids. This is tragic for patients, but an understandable result of incredulouslawsuits brought by state attorneys general against pharmacy retailers CVS, Walgreens, and others for allegedly contributing to the opioid overdose crisis by filling opioid prescriptions —even as overdose deaths continue to mount while opioid prescribing continues to drop precipitously. (87 percent of those overdose deaths involve illicit fentanyl, more than a&nb...
Source: Cato-at-liberty - May 25, 2022 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
3 solutions to combat rising drug overdoses during COVID-19
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD. Recent data from the Drug Enforcement Administration (DEA) has shown a sharp increase in drug-related overdoses attributed to fentanyl and other synthetic opioids, deepening the tragedies of the already challenged opioid epidemic and COV ID-19 pandemic. Unraveling the snowball effect of these public health challengesRead more …3 solutions to combat rising drug overdoses during COVID-19 originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 16, 2022 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/post-author/anita-gupta" rel="tag" data-wpel-link="internal" > Anita Gupta, DO, PharmD < /a > < /span > Tags: Physician Psychiatry Source Type: blogs
