The Quigley Maneuver for Ankle Fractures
Certain emergency department procedures bring us a sense of accomplishment. We cheer after a shoulder returns to its correct position from our relocation technique and smile when a laceration closes just right. Emergency department procedures can be very rewarding for providers and patients, especially during times of stress in the workplace. Sometimes, just stapling a scalp or molding the perfect splint may seem cathartic. There are days where we can only see so much abdominal and chest pain—and COVID-19.The double-person Quigley maneuver technique for an ankle fracture. Photo by Martha Roberts.This month we want to ...
Source: The Procedural Pause - August 3, 2020 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The DEA ’s Opioid Production Quotas Threaten Hospitalized Patients, Yet Supply of Street Fentanyl is Plentiful
Jeffrey A. SingerThe COVID-19 pandemic has placed another stumbling block in the way of the Drug Enforcement Administration ’sfutile effort to reduce the country ’s drug overdose rate through quotas on the manufacture of all forms of prescription opioids.The DEA ’s annual quotas have brought production levels more than 50 percent below 2016 levels. But, in response to the COVID-19 pandemic, the agency increased this year’s quota by 15 percent, to allow drug makers to respond to pandemic‐induced shortages. Intravenous opioids such as fentanyl are va luable tools used to manage patients on ventilators—as well ...
Source: Cato-at-liberty - July 24, 2020 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
The Medical Exception to the Prohibition of Killing: A Matter of the Right Intention?
Govert den Hartogh (University of Amsterdam), The Medical Exception to the Prohibition of Killing: A Matter of the Right Intention?, 32 Ratio Juris. 157 (2019): It has long been thought that by using morphine to alleviate the pain of a... (Source: HealthLawProf Blog)
Source: HealthLawProf Blog - July 13, 2020 Category: Medical Law Authors: Katharine Van Tassel Source Type: blogs
32 yo with right sided chest pain. Zero ST Elevation, but that does not matter.
DiscussionIn hindsight I feel there are very few alternative causes for an ECG like this other than an acute LAD occlusion. I believe this is one of those ' subtle STEMI ' cases where neither the ECG nor the symptoms are very obvious or severe and the usual evolution is not seen.I think of these cases as ' insidious infarcts ' and I have seen this in all infarct territories and I do not think they are particularly rare. Essentially the patient is fairly comfortable and the ECG is not obvious but the patient ended up with Q waves, huge troponins and we missed the opportunity to reperfuse the artery when it counts. These pat...
Source: Dr. Smith's ECG Blog - February 17, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
That There Are Errors In Care Related To EHR Use Is Not A Surprise. There Are Also Errors When They Are Not Used!
This appeared last week:Health documents reveal patient harm linked to Queensland's new medical record systemExclusive by state political reporter Josh Bavas24 December, 2019Almost 100 cases of patient harm have been linked to Queensland's new electronic medical record system in just over a year, including instances of patients being administered incorrect doses of drugs.Key points:Documented cases include child given 10 times the amount of insulin they were prescribed and a patient administered morphine in milligrams, not microgramsOne patient in severe pain was unable to be given pain relief because of a 'compute...
Source: Australian Health Information Technology - January 2, 2020 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
What is an Opioid?
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others. All individuals who take opioids run the risk of addiction. As such, when asking “what is an opioid?” it is important to know the different types, the signs of addiction, and the signs of an overdose.
Prescription Opioids
Opioids interact with the opioid receptors on nerve cells in the body and brain. This interaction interferes with communication between the body’s nerves and the brain. For ind...
Source: Cliffside Malibu - December 27, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Detox Resources for Alcohol and Drugs/Opiates Heroin Painkiller fentanyl opioid opioid crisis opioids prescription drug addiction Source Type: blogs
Signs of Opioid Use
What are the Signs of Opioid Use?
Opioids are a group of drugs derived naturally from the poppy plant, or are man-made in a laboratory, also known as synthetic opioids. Opioids are generally prescribed to individuals suffering from chronic pain, whether from surgery, a major injury or other health issues. Legally prescribed opioids include morphine, codeine, and oxycodone, while illegal opioids include heroin. It is easy to know if an individual is using opioids if they’ve been prescribed, but it is also important to know the signs of opioid use if it has crossed the line into an addiction.
Signs and Symptoms
There are m...
Source: Cliffside Malibu - December 11, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction to Pharmaceuticals Painkiller opioid opioids prescription drug abuse prescription drug addiction prescription drug detox prescription drugs prescription medication signs of addiction Source Type: blogs
Signs of Opioid Withdrawal
Opioid withdrawal is one of the more uncomfortable parts of treatment, but it is one of the most important. There are many signs of opioid withdrawal, the length and severity of which can vary from person to person. However, each detox experience almost always includes strong cravings. Symptoms can be mild, such as sweating and yawning, while others can become more serious, like severe anxiety and depression.
Opioid withdrawal can look like a scary experience; one that could deter people from getting the help they need. The good news is that it doesn’t need to be fought alone, and there are resources available to make i...
Source: Cliffside Malibu - December 6, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Recovery Detox Resources for Alcohol and Drugs/Opiates drug detox medical detox medicated-assisted detox opioid opioids prescription drug detox withdrawal withdrawal symptoms Source Type: blogs
What Are Opioid Overdose Signs?
On average, 130 Americans die from an opioid overdose every day. The Centers for Disease Control and Prevention (CDC) considers opioid overdose an epidemic in the United States, estimating it responsible for nearly 68 percent of 70,000 drug-related deaths in 2017. Understanding the effects of opioids can prevent opioid overdose, and knowing the opioid overdose signs can save lives.
What Are Opioids?
Opioids are a class of drugs naturally found in the opium poppy plant. Opioid drugs reduce pain by binding to opioid receptors in your brain, spinal cord and other areas of the body, creating morphine-like effects.
The CDC ide...
Source: Cliffside Malibu - November 21, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Heroin Painkiller Substance Abuse drug overdose opiate opiate abuse opiate addiction opiates opioid opioids Source Type: blogs
Mandated Queries of the Florida Prescription Drug Monitoring Program: A Three-Month Experience from a Cancer Center-Based Outpatient Palliative Medicine Clinic
This article represents the findings from the queries over the first three months ’ queries and brings further clarity to our initial findings.Methods This quality improvement (QI) project was reviewed and approved by the Orlando Health/UFHealth Cancer Center Joint Oncology Committee for 2018-19. We began recording results of all E-FORSCE queries occurring after the law ’s implementation of July 1, 2018 through September 30, 2018. We informed each patient that the PDMP query had become mandatory in Florida, and we discussed the results of each query with each patient. Each query examined the last 12 months of the patie...
Source: Pallimed: A Hospice and Palliative Medicine Blog - November 18, 2019 Category: Palliative Care Tags: kollas opioid pain quality improvement statte Source Type: blogs
What is the Definition of “Opioid”?
What is the Definition of “Opioid”?
The definition of opioid is as follows: Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others.
Opioids work by interacting with the opioid receptors on nerve cells in the body and brain. By interacting with these receptors, opioids medications are able to cut off communication between the pain point on the body to the brain. This chemical interaction gives it’s users pain relief that is too great for over-t...
Source: Cliffside Malibu - November 15, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction to Pharmaceuticals fentanyl heroin heroin addiction opiate opiate abuse opiate addiction opiates opioid opioids Source Type: blogs
End-Of-Life Comfort Drugs Can Be Confusing
Photo credit Brandon Wong
Dear Carol: My mother, who has advanced dementia, went into a nursing home six months ago. She’s received excellent care but is now declining quickly so that she no longer swallows any type of food. Her doctor has determined that she is ready for hospice and I'm glad for their help. Hospice took her off medications that didn’t seem to be helping and then prescribed some occasional Ativan for agitation and low-dose morphine for pain. Her response has been satisfying to watch since she’s more alert and far more peaceful than she has been...
Read the full column to learn more about drugs ...
Source: Minding Our Elders - November 8, 2019 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs
Withdrawal from Vicodin
Your Guide to Vicodin Addiction and Vicodin Withdrawal
Hydrocodone (also known by the brand name Vicodin®) has been the second-most commonly encountered opioid pharmaceutical in drug evidence since 2009, as reported by the Drug Enforcement Administration (DEA). Withdrawal from Vicodin can vary in length and symptoms depending on the length and severity of the addiction.
Vicodin is relatively easy to obtain and is perceived as safe when prescribed by a medical professional. If the drug is taken as prescribed for a limited time, Vicodin withdrawal symptoms will be either minimal or nonexistent. However, Vicodin is considere...
Source: Cliffside Malibu - October 28, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Recovery Drug Treatment Painkiller Substance Abuse painkillers prescription drug abuse prescription drug addiction prescription drug detox prescription drug use prescription drugs prescription medication prescription pills Source Type: blogs
Part 4 - Everything We Were Taught About High Doses Was Wrong, and the Same Hand-Crafted Graph
by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 4th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Another Hand-Cr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - October 5, 2019 Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
