Ebola: Local hospitals cannot be prepared
Recently at our community hospital, after we concluded a nearly two-hour standing room only Ebola preparedness meeting, I practiced donning and doffing the personal protective equipment (PPE) for Ebola cases.
PPE is the protective wardrobe health workers wear when examining a patient with a contagious infectious disease. Each disease has a different level of transmission and requires an appropriate level of protection. I wear gloves 25 times a day to examine each patient I see. (Not all doctors do this; in my specialty of infectious diseases, though, it is prudent.) I dress in a gown a dozen times when entering a room of a...
Source: Kevin, M.D. - Medical Weblog - October 25, 2014 Category: Journals (General) Authors: Manoj Jain, MD, MPH Tags: Physician Hospital Infectious disease Source Type: blogs
Healthcare Update Satellite — 09-15-2014
This study should be required reading in every emergency medicine residency in this country. In fact, the concepts in the studies should be tested on the emergency medicine board exams.
Now if the study only compared the type of a patient’s insurance with the likelihood of emergency department recidivism.
How else can the media try to tarnish this guy’s reputation? The doctor who oversaw Joan Rivers’ fatal endoscopy was once *sued* 10 years ago. Gasp.
The former patient’s attorneys are really trying to create their 15 minutes of fame. They alleged that 10 years ago the patient received no informed ...
Source: WhiteCoat's Call Room - September 15, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Obama’s Foreign Policy Is Linked to a Healthy, Restrained Immune System
With 58% of Americans disapproving of Obama’s foreign policy, mounting Ebola virus deaths, and flu season around the corner, I think it is important to synthesize an overlapping theme between how our country fights perceived threats, and how our bodies successfully or unsuccessfully fight disease. In short, I think Obama’s continued restraint and use of soft power is evidence of a good prognosis for the country.
In this analogy, our bombs and military are the most caustic weapons of the country’s immune system, akin to a fever of 105 degrees and impending sepsis. Does “nuke them all” work?
Diplomacy, espionage,...
Source: The Examining Room of Dr. Charles - August 16, 2014 Category: Primary Care Authors: drcharles Tags: Uncategorized Source Type: blogs
Public Distrust of Pharmaceutical Industry Could Harm Research and Development of Important Antibiotics
A recent article in Forbes argues that misplaced public distrust of the pharmaceutical industry could harm the research and development of important antibiotics. Entitled, "Pharma's Poor Reputation Doesn't Help in the Fight of Superbugs," the article examines the industry's reputation in light of the antibacterial resistance epidemic.
As a background, an April report published by the World Health Organization stated that antibiotic resistance is an increasingly serious threat in every part of the world and a "problem so serious that it threatens the achievements of modern medicine." The report gets pretty gloomy: "A post-...
Source: Policy and Medicine - August 12, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Research and Reviews in the Fastlane 039
Welcome to the 39th 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 13 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the f...
Source: Life in the Fast Lane - July 14, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Cardiology Emergency Medicine Emergency Medicine Update Featured Infectious Disease Intensive Care Pre-hospital / Retrieval Resuscitation critical care literature R&R in the FASTLANE recommendations research and revi Source Type: blogs
Research and Reviews in the Fastlane 036
This study found that a high percentage (49%) of patients with serious adverse outcomes after an ED visit for COPD were not initially admitted to the hospital. The authors used logistic regression to derive a decision instrument to aid in determining which patients with COPD exacerbation should be admitted based on risk stratification. The study does not show that admission improves outcomes but the instrument may prove useful for risk stratification if it is prospectively validated.
Recommended by: Anand Swaminathan
Emergency Medicine, Critical care, Anaesthetics
Barends CRM ,Absalom AR. Tied up in science: unknotting ...
Source: Life in the Fast Lane - June 25, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Emergency Medicine Evidence Based Medicine Featured Health Infectious Disease Intensive Care Respiratory Resuscitation critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
How social media facilitates peer review
Much has been written about how Web 2.0 tools can change the healthcare landscape. It would appear a recent set of circumstances has upped the ante.
This story begins with a recent study that attempted to tackle the problem of ICU infections. ICU infections are a challenging problem, patients who are admitted to the ICU are at risk of worsening illness and death from infections such as MRSA which can be acquired while in the ICU setting. To counteract this risk, current practice is the performance of surveillance cultures on people who are admitted to intensive care. If the person tests positive for certain infections th...
Source: Kevin, M.D. - Medical Weblog - March 12, 2014 Category: Family Physicians Tags: Social media Hospital Source Type: blogs
In memoriam: Robert C. Moellering, Jr.
This announcement arrived from Harvard Medical School:Dr. Robert C. Moellering, the HMS Shields Warren-Mallinckrodt Professor of Medical Research and a renowned infectious disease researcher, was physician-in-chief and chair of the Department of Medicine at Beth Israel Deaconess Medical Center from 1981 to 2005. He died on Feb. 24, 2014, at the age of 77.Dr. Moellering made major advances in the investigation, treatment and prevention of infectious diseases, in particular studying the mechanisms of antibiotic action and bacterial resistance to antimicrobial agents. His work led to the development of laboratory tests tha...
Source: Running a hospital - March 2, 2014 Category: Health Managers Source Type: blogs
Top stories in health and medicine, February 28, 2014
From MedPage Today:
A Targeted Treatment for Scleroderma? A monoclonal antibody that binds to the type 1 interferon-alpha receptor showed an acceptable safety profile in a phase I trial for systemic sclerosis, but efficacy was less clear.
CMS: More ‘Meaningful Use’ Exemptions Coming. Some healthcare providers struggling to meet the second stage of the incentive program for electronic health records (EHRs) may receive a bit of relief.
MRSA: Physician Clean Thy Stethoscope. Stethoscopes carried more methicillin-resistant Staphylococcus aureus (MRSA) and other bacteria after a physical exam than most areas of th...
Source: Kevin, M.D. - Medical Weblog - February 28, 2014 Category: Family Physicians Tags: News Infectious disease Psychiatry Rheumatology Source Type: blogs
If I Only Knew Then, What I Know Now
What do I know now? It’s not about me.Marilyn Raichle+Alzheimer's Reading Room As much as I write about how delightful it is to visit my mother—and it is delightful—it was different and far more complex with my father.Both Alzheimer’s and Parkinson’s run in Dad’s family with Alzheimer's usually hitting around the age of 80.As Mom is sunny, Dad’s family runs darker, with anger, aggression and isolation as the common experience.But, if I knew then what I know now, my visits to my father would have been different.Dad was, by turns, totally lucid and moving in and out of dementia. He was profoundly bored, frustr...
Source: Alzheimer's Reading Room, The - February 25, 2014 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Recent FDA Moves Suggests Agency Is Again Taking Its Role of " Protecting Public Health " Seriously
As a patient with type 1 diabetes, I have found myself at odds with the U.S. Food and Drug Administration (FDA) on a number of things the agency has done in recent years (actually since the 1980s), and perhaps even more so in recent years. & nbsp;In fact, I once joked (only halfheartedly) that the acronym " FDA " stood for Fatal Drug Administration. & nbsp;Indeed, for a number of years (under the leadership of chief Dr. Andrew von Eschenbach especially, he pushed for FDA to serve what he called its " clients " , meaning the companies that the FDA regulates, rather than protecting public safety). & nbsp;Staff in areas for ...
Source: Scott's Web Log - January 28, 2014 Category: Endocrinology Tags: 2014 Antibiotics Crisco FDA Trans Fats Source Type: blogs
Why IPAB is a good idea
IPAB – the independent payment advisory board is a key feature of the ACA. This board will do what many countries already do – have an independent expert panel to assess the effectiveness of procedures, imaging studies, pharmaceuticals, etc.
Why do we need this board? We need careful assessments of new trends in medicine. Let me suggest two situations.
We have read much about increasing colonoscopy costs. We have a controversy about anesthesia – conscious sedation versus a more standard anesthesia with propofol. The former only requires the gastroenterologist; the latter adds an anesthesiologist, a...
Source: DB's Medical Rants - November 29, 2013 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Medical Rants Source Type: blogs
Gowns and gloves in the ICU: Part of the infection control solution
It’s good to see health care providers continue to work on strategies to reduce health care acquired infections. Handwashing is a key component —but hospitals struggle to achieve compliance and are now turning to patients to be the bad cop, much to my dismay.
A simple new strategy in intensive care units is showing promise: having doctors and nurses where gloves and gowns with all patients, not just those who are known to have antibiotic resistant bacteria. It takes more time and costs a bit of money, but seems to cut down dramatically on MRSA infections without generating adverse events. The study is important...
Source: Health Business Blog - October 8, 2013 Category: Health Managers Authors: dewe67 Tags: Research antibiotic resistant bacteria intensive care units MRSA infections Source Type: blogs
Funny Bone, Serious Problem
Part 2 in a Series
Elbow dislocations are quite painful and often times accompanied by other injuries. ED providers caring for a patient with an elbow dislocation must be sure to properly examine and x-ray patients prior to putting an elbow back in place. Be wary of the associated complications to dislocations including fractures and nerve or artery injury. Soft tissue damage and swelling are also very common.
Acute elbow dislocation.Photo by Martha Roberts
Like many relocations, slow and steady traction and countertraction with your magical and carefully calculated combination of sedation and analgesia is the hal...
Source: The Procedural Pause - October 3, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated joy of working in healthcare. Physicians often forget just how alien the language of medicine is to people who don't live it everyday. The best part about being a physician is not helping people recover from critical illness. The best part is not about listening and understanding with compassion and empathy. Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process. Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
