I dont travel well any more
I used to travel at the drop of a hat. Skiing for the weekend? No problem. Run off for a weekend hiking in the mountains? Bring it on. Drop everything and head for the beach? Sure. A day in the city followed by dinner out? Let's go!!Now, can we go off for a day of fun? Only if I get enough sleep first. A weekend away? Let me count out my pills to make sure I am prepared. Is there plenty to do if I need to lie down for a bit (so my husband isn't too bored). Are there wimpy activities if I need to change plans? I am traveling, by myself, with my newest purchase, a four wheeled suitcase which is much easier on my back. I will...
Source: Caroline's Breast Cancer Blog - August 1, 2014 Category: Cancer Tags: lack of sleep pills travel Source Type: blogs
The Price of Compassion - Commercialized Hospices and the Mistreatment of Vulnerable Patients
Introduction - Commercialized Hospices We have occasionally written about the rise of the commercialized hospice industry, and concerns that commercialized hospices may not be providing the compassionate care they promise. As we have discussed before, the hospice movement began with small, non-profit, community based organizations meant to provide compassionate palliative care to the terminally ill. However, in the US, the hospice movement has been co-opted by commercial hospices, often run by large corporations, which may put profit ahead of compassion.Several long investigative articles have appeared this yea...
Source: Health Care Renewal - July 10, 2014 Category: Health Management Tags: Carlyle Group deception Fillmore Partners Gentiva Golden Living HCR ManorCare hospices marketing private equity Vitas Source Type: blogs
Gone in June
Alcohol takes a friend. What good does it do: You write about addiction, research it, think about it, formulate new ideas about it. You try to be of service.What good does it do: One of your best friends ever, a talented writer you have talked to and argued with and smoked with and paddled with for more than two decades, lies dead this morning of alcohol-related liver failure at 62.What good does it do: I couldn’t save him, couldn’t turn the head of that runaway horse, not through encouragement, shame, praise, incentive, disgust, indifference, furious anger. Not through any of that. What good does it do: His doctor, wi...
Source: Addiction Inbox - June 27, 2014 Category: Addiction Authors: Dirk Hanson Source Type: blogs
Healthcare Update Satellite — 06-23-2014
The right to carry a concealed weapon only exists if your doctor says so. Many states are requiring that physicians certify whether patients are competent to carry a concealed weapon. Some states require mandatory reporting of those deemed not competent to carry a concealed weapon. Of course, the natural extension of such laws is that if the doctors make an inappropriate determination, then the doctors can be held liable if the certifiee does something inappropriate with the weapon.
This New England Journal of Medicine article shows that many doctors aren’t comfortable making that determination.
Then again, I’v...
Source: WhiteCoat's Call Room - June 24, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Research and Reviews in the Fastlane 035
This study suggests that antiemetics are not nearly as potent as widely believed. These drugs have been shown to be effective in preventing nausea (i.e. pretreatment for chemo) but it’s appears that the mechanism for halting nausea is different than that for preventing it.
Recommended by: Anand Swaminathan
Read More: Nausea? We’ve Got Placebo for That
The Best of the Rest
Emergency Medicine, Pulmonary
1. Kew KM, Kirtchuk L, Michell C. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev. 2014 May 28;5 PubMed ID: 24865...
Source: Life in the Fast Lane - June 18, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Evidence Based Medicine Featured General Surgery Intensive Care Palliative care Pediatrics Respiratory Resuscitation Trauma critical care literature R&R in the FASTLANE recommendatio Source Type: blogs
Research and Reviews in the Fastlane 035
This study suggests that antiemetics are not nearly as potent as widely believed. These drugs have been shown to be effective in preventing nausea (i.e. pretreatment for chemo) but it’s appears that the mechanism for halting nausea is different than that for preventing it.
Recommended by: Anand Swaminathan
Read More: Nausea? We’ve Got Placebo for That
The Best of the Rest
Emergency Medicine, Pulmonary
1. Kew KM, Kirtchuk L, Michell C. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev. 2014 May 28;5 PubMed ID: 24865567
This Cochr...
Source: Life in the Fast Lane - June 18, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Evidence Based Medicine General Surgery Intensive Care Palliative care Pediatrics Respiratory Resuscitation Trauma critical care literature R&R in the FASTLANE recommendations resear Source Type: blogs
The LITFL Review 140
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
Welcome to the 140th edition, brought to you by:
Kane Guthrie [KG] from LITFL
Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles
Brent Thoma [BT] from BoringEM, and ALiEM
Chris Ni...
Source: Life in the Fast Lane - June 16, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
Is it Ok to Shrink your Sister in an Emergency?
I'd like to bend your ear with a hypothetical situation and see what you think. This one is for the docs, and I'm going to start and end it with a simple question: is it okay to prescribe for a family member? Is it okay to prescribe a psychotropic medication for oneself or a family member? Before you jump on me, let me tell you that to the best that I am aware, docs have always written prescriptions for themselves and for their family members. An antibiotic, an allergy medication, I think this has been par for the course for straightforward things. When I was an intern, one of the nurses ...
Source: Shrink Rap - June 9, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Fat people and feeding tubes.
This isn’t a post I like to write. The idea to write it always comes after someone, who is not communicating with me in good faith, approaches me and makes snide remarks about how I can possibly need a feeding tube if I’m fat. Except they usually go beyond calling me fat. They usually make some reference to my weight that makes it sound like I’m unusually fat, just to make things worse. In one case, a known repeat cyber-bully (he has made threatening phone calls to a friend of mine — if I’d recognized him on sight I’d have deleted his comment unread) even told me he’d lost...
Source: Ballastexistenz - May 15, 2014 Category: Autism Authors: Mel Baggs Tags: Abuse Bullying Death Ethics Ethics, justice, etc. Food Medical Medical stuff Prejudice Rumors Stereotypes Treatment Trolls Discrimination fat fat and health fat health fatphobia feeding tube feeding tubes gastropare Source Type: blogs
Agitation and Tachycardia
A young male with unknown past medical history presents with AMS and tachycardia. EMS was called by a roommate after the patient was noticed to be nonverbal and lethargic. He reportedly took meth and had a recent drinking binge, but has not had alcohol for the last 2 days. His HR was 160 on arrival of EMS, and they gave him adenosine 6 mg and 12 mg and 500 cc NS, but with no response. The preshospital ECG and strips are not available. The patient was restless, agitated, and nonverbal on arrival to ED, with elevated HR at 150. Here is the first ED ECG:What is the likely diagnosis?There is sinus tachycardia...
Source: Dr. Smith's ECG Blog - May 8, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs
What does it mean for a patient to be undermedicated?
A patient I see for psychotherapy, without medications except for an occasional lorazepam (tranquilizer of the benzodiazepine class), told me his prior psychiatrist declared him grossly undermedicated in one of their early sessions, and had quickly prescribed two or three daily drugs for depression and anxiety. He shared this story with a smile, as we’ve never discussed adding medication to his productive weekly sessions that focus on anxiety and interpersonal conflicts. Indeed, the lorazepam is left over from his prior doctor. I doubt I would have ordered it myself, although I don’t particularly object that he...
Source: Kevin, M.D. - Medical Weblog - March 22, 2014 Category: Family Physicians Tags: Conditions Psychiatry Source Type: blogs
Hospital Quality Measures: Value Based Purchasing 2.0 (The Funny Version).
For years, hospital quality measures have been tracked by private and government insurance programs to try and improve the healthcare services received by their beneficiaries. The most recent example is the Value-Based Purchasing Program (VBP) initiative by The Centers For Medicare & Medicaid Services (CMS). How does CMS describe VBP?"Under the Program, CMS will make value-based incentive payments to acute care hospitals, based either on how well the hospitals perform on certain quality measures or how much the hospitals' performance improves on certain quality measures from their performance during a basel...
Source: The Happy Hospitalist - March 14, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Foreign Body to the Face and Facial Laceration Repair
Part 1 in a Series
Wound care and suture repair are two of the most frequently encountered issues in the emergency department. It is the midlevel provider’s job to be familiar with proper wound care and suturing techniques as well as quick and safe treatment of soft tissue skin injuries. You can use various suturing techniques and styles, but it is important to find a few that really work for you, often tailored to the area of injury.
This month, we are focusing on lacerations and puncture wounds to the soft tissue of the face. Future posts will touch on other suturing skills, with some great tips from our plastic surge...
Source: The Procedural Pause - January 31, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Give and Take Medicine (Good Doctor and Nurse Humor).
Being a great doctor or nurse means learning how to give and take. Healthcare professionals are not dictators and patients are not entitled to whatever they read on the internet. Nursing and doctoring are an art of skillful negotiation with patients and their families. As professionals, doctors and nurses have an obligation to seek out the care plan that is in the best interests of their patients. The Happy Hospitalists wants all patients to know that your doctor and nurse are there for you. They are ALWAYS thinking about how to make you the most satisfied patient. They have to because ...
Source: The Happy Hospitalist - January 26, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Popular Quotes By Famous People (Had They Been a Doctor or a Nurse).
Ever wonder what Bill Clinton or Martin Luther King or Jesus would have said if they were a doctor or a nurse? Ever wonder what their famous quotes would have sounded like had they been in the medical field? The Happy Hospitalist has. Doctors and nurses are different. Their training changes them. In some ways for the good and and some ways for the bad. For many , they develop a different sense of humor. That's good for you because that's how we found out what Bill Clinton actually would have said if he tried albuterol instead of marijuana. We discover what Martin Luther Kin...
Source: The Happy Hospitalist - January 4, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
