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LITFL Review 271
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 271st LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Get your conspiracy theory on with The Poison Review team and their round up on what we know about ...
Source: Life in the Fast Lane - February 26, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Non-Alternative Facts About the Healthcare System
By JOE FLOWER The economic fundamentals of healthcare in the United States are unique, amazingly complex, multi-layered and opaque. It takes a lot of work and time to understand them, work and time that few of the experts opining about healthcare on television have done. Once you do understand them, it takes serious independence, a big ornery streak, and maybe a bit of a career death wish to speak publicly about how the industry that pays your speaking and consulting fees should, can, and must strive to make half as much money. Well, I turn 67 this year and I’m cranky as hell, so let’s go. The Wrong Question We are ba...
Source: The Health Care Blog - February 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

It Pays to Be a Little Antisocial when it Comes to Health Reform
By DEVON HERRICK Republicans are bickering over whether to repeal the more costly provisions of Obamacare and allow greater flexibility into the health insurance marketplace. Republican lawmakers were shocked… SHOCKED, to discover net beneficiaries of the Affordable Care Act (ACA) like receiving open-ended subsidies worth thousands of dollars – paid for by other people. Lost in the shuffle are the self-employed, small business owners and individuals whose premiums have skyrocketed – and are no longer affordable – so that others can get a sweet deal. The status quo cannot go on, of course. Premiums are skyrocketing...
Source: The Health Care Blog - February 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Devon Herrick Life Cycle Theory of Saving For Future Healthcare Needs Source Type: blogs

The Lifecycle Theory of Saving For Healthcare Needs
By DEVON HERRICK Republicans are bickering over whether to repeal the more costly provisions of Obamacare and allow greater flexibility into the health insurance marketplace. Republican lawmakers were shocked… SHOCKED, to discover net beneficiaries of the Affordable Care Act (ACA) like receiving open-ended subsidies worth thousands of dollars – paid for by other people. Lost in the shuffle are the self-employed, small business owners and individuals whose premiums have skyrocketed – and are no longer affordable – so that others can get a sweet deal. The status quo cannot go on, of course. Premiums are skyrocketing...
Source: The Health Care Blog - February 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Devon Herrick Life Cycle Theory of Saving For Future Healthcare Needs Source Type: blogs

Obese patients are among our most vulnerable
It was around 2 p.m. when a 380-pound woman came into the ED. She was in her late 30s. The physician went to see her and then ordered IV fluids, some basic blood tests, and a urine sample. At a hospital, everyone’s job is made harder when a patient is obese. Getting the patient on the bed requires more personnel. Inserting an IV — an intravenous catheter to infuse fluids or medications — takes more time. A physical exam is more difficult and invariably less precise: heartbeats and breath sounds are muffled by the layers of fat; palpating abdominal organs is practically impossible. When the nurse went into the...
Source: Kevin, M.D. - Medical Weblog - February 26, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/helena-frischtak" rel="tag" > Helena Frischtak < /a > Tags: Physician Emergency Source Type: blogs

Cathlab misadventures : ” Protected left main ” and . . , unprotected patient !
It has become fashionable for many current generation cardiologists to stent the LAD   with proximal end  liberally extending into left main shaft  in Medina 0, 1, 0 or (1,1,1 )lesions involving distal left main often  jailing the LCX . This concept came into vogue as it helped bail  out few  hemo-dynamically  unstable patients with true left main bifurcation lesions during primary PCI .Of course , it’s potentially useful strategy in  emergency , if  extended into routine situations (like all stable proximal LAD/Bifurcation ) we are bound to create few problems. Rapidly p...
Source: Dr.S.Venkatesan MD - February 26, 2017 Category: Cardiology Authors: dr s venkatesan Tags: Left main disease Left main stenting -Tips and tricks Tips and tricks in cath lab left main pci left main stenting for lad disease safety issues in left main Tips and tricks in left main disease Source Type: blogs

A Trick for Ocular Anesthetic​
Watch Helen Karellas Bardis, NP, show off her pediatric pearl! This simple trick works well if you need to use ocular anesthetics for pediatric eye exams.Add a few drops of the saline directly onto the fluorescein paper, and then suck the fluid back up into the saline dropper. This way, you don't have to put a piece of paper onto a child's eye. It is far less scary to have drops administered.This trick also works with tetracaine/proparacaine for an all-in-one staining anesthetic.Watch the video.Tags: ocular anesthetic, eye, fluoresceinPublished: 2/25/2017 10:32:00 AM (Source: The Procedural Pause)
Source: The Procedural Pause - February 25, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Look At Republican Intentions? Diving Into The Leaked ACA Replacement Bill
On February 24, 2017, a draft House reconciliation bill was leaked to the media. Although I have not seen any claims that it is not authentic, it is dated February 10 and may not be the most recent draft. I have also not seen any assertion that the Congressional Budget Office has concluded an analysis of the bill and found its budgetary consequences to be acceptable to the bill’s sponsors. The draft is, however, consistent with statements that Republican leadership have recently made about their legislative program. Because the draft is the best information we have about the House Republican leadership’s proposals, I o...
Source: Health Affairs Blog - February 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Source Type: blogs

Funtabulously Frivolous Friday Five 178
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog 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 FFFF…introducing Funtabulously Frivolous Friday Five 178. Question 1 You finally manage for the first time in the year to make it to the doctors lounge and find the surgical team playing computer games. You roll your eyes and mutter something derogatory under your breath. The surgical team state that they are training. Do vi...
Source: Life in the Fast Lane - February 24, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five calcaneal fracture clubbing Devonshire colic hippocrates hippocratic fingers lead poisoning lover's fracture plaster of paris surgeons video games Source Type: blogs

Launch of Azurion: Philips ’ Next Generation Image-guided Platform
The Azurion system builds on Philips’ many decades of imaging expertise combined with a growing integrated therapy portfolio, enhanced by the 2015 acquisition of Volcano. It is is expected to form the core of Philips’ integrated image-guided systems including vascular surgery, cardiology, oncology, and neuroradiology. The new imaging platform is underpinned by Philips’ redesigned operating system, ConnectOS, which features a new user interface focused on prioritizing ease-of-use and maximizing control from multiple locations in the interventional suite. Azurion minimizes preparation time and error by allowing routin...
Source: Medgadget - February 23, 2017 Category: Medical Equipment Authors: Tom Peach Tags: Cardiology Emergency Medicine Radiology Source Type: blogs

Research and Reviews in the Fastlane 173
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 173rd 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 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid,  Justin Morg...
Source: Life in the Fast Lane - February 23, 2017 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Emergency Medicine Pediatrics R&R in the FASTLANE Urology EBM literature recommendations research and reviews Source Type: blogs

JellyBean 055 with polymath Dr Mark Wilson
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Mark Wilson; Neurosurgeon, Retrieval Physician, App Designer, Volunteer, Sceptic and Gentleman. It is hard act to follow. It is hard not to like this chap. Mark Wilson somehow found time to talk to Matt McPartlin at SMACC. He really had an awful lot to do in Dublin too. Mark was presenting, fighting, drinking, dancing, facing his PhDemons and listening to @Kangaroobeach, all of which are frankly exhausting. But then he was asking for trouble by being so good at everything and e...
Source: Life in the Fast Lane - February 23, 2017 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean Dr Mark Wilson GoodSam Source Type: blogs

An unstable wide complex tachycardia resistant to electrical cardioversion
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Source: Dr. Smith's ECG Blog - February 23, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

My Speech to The Canadian Senate Committee as an Open Letter to Every Government
Here is the edited speech I gave to the Canadian Standing Senate Committee on Social Affairs, Science and Technology, and I would turn to every government or parliament eager to reform healthcare through technology with similar advices. I hope that more and more regulatory actors will pay attention to the winds of change. Good afternoon, Mr. Chair and Members of the Committee. I’m honoured to get a chance as The Medical Futurist to share my research on how automation can change healthcare. I firmly believe that automation, especially artificial intelligence (AI), robotics and 3D printing, is essential in making healthc...
Source: The Medical Futurist - February 22, 2017 Category: Information Technology Authors: nora Tags: Future of Medicine Healthcare Design AI artificial intelligence gc4 government ibm watson Innovation regulations robotics technology Source Type: blogs

Should Government Officials Be Held Responsible For Failing To Protect Health?
Editor’s note: This post is part of a series stemming from the Fifth Annual Health Law Year in P/Review event held at Harvard Law School on Monday, January 23rd, 2017. The conference brought together leading experts to review major developments in health law over the previous year, and preview what is to come. In May 2016, President Barack Obama observed that Flint, Michigan’s water crisis arose from a “culture of neglect” and the belief “that less government is the highest good no matter what.” The crisis, which developed after the city’s unelected emergency manager switched the water supply from the De...
Source: Health Affairs Blog - February 22, 2017 Category: Health Management Authors: Wendy Parmet Tags: Featured Population Health Public Health Flint Michigan Safe Water Drinking Act public health officials Source Type: blogs

Winter insight: NHS 111
Nuffield Trust -This briefing contains an analysis of how NHS 111 has fared, especially over the winter period. It finds that the service seems to steer people away from emergency services, though there is great variability across England.Briefing (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - February 22, 2017 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: NHS measurement and performance Source Type: blogs

Clarius Wireless, Handheld Ultrasounds Cleared in Europe
Clarius, a company based in British Columbia, Canada, received European CE Mark approval for its wireless C3 and L7 ultrasound scanners. These devices are highly portable, battery powered, and use an Android or iOS smartphone or tablet for displaying the scans. They’re even water resistant, so can be used in a wide variety of in-clinic and field applications. We were so impressed here at Medgadget that these scanners made it to our Best Medical Technologies of 2016 list. The Clarius C3 multipurpose ultrasound is designed to image the abdomen and lungs; it also incorporates a virtual phased array for quick scans of t...
Source: Medgadget - February 21, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Cardiology Critical Care Emergency Medicine Military Medicine Ob/Gyn Pediatrics Radiology Sports Medicine Surgery Urology Vascular Surgery Source Type: blogs

A Million Jobs in Healthcare ’ s Future
By PRAVEEN SUTHRUM “The Future is Here. It’s Just Not Evenly Distributed.” It’s true. Science fiction writer William Gibson said that right. We simply have to look around enough – now – to find out what the future holds. The future may never be evenly distributed. But it’s surely becoming the present faster. What would you do when… Here are a series of what-would-you-do-when questions to think about. Each of these are a reality today, somewhere. There’s more medical data than insight Kaiser Permanente presently manages 30 petabytes of data. Images. Lab tests. EHRs. Pat...
Source: The Health Care Blog - February 21, 2017 Category: Consumer Health News Authors: John Irvine Tags: Tech Uncategorized Source Type: blogs

Misleading Metrics
Editor’s Note: This essay contains excerpts from Extreme Measures: Finding a Better Path to the End of Life, coming February 21st, 2017 from Penguin-Random House. A few years ago, while at a family get-together, I sat across from a retired hospice social worker named Terry. I am a physician whose practice alternates between attending on the wards of an inner-city intensive care unit and serving as a consultant on the hospital’s palliative care team. I didn’t set out to practice this uncommon combination of medical specialties. I started out totally dedicated to using the miraculous technologies in my critical car...
Source: Health Affairs Blog - February 21, 2017 Category: Health Management Authors: Jessica Nutik Zitter Tags: End of Life & Serious Illness Health Professionals Hospitals 30-day mortality statistic advance directive Palliative Care Source Type: blogs

To BPT, or not to BPT, that is the junior doctor ’s question …
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog As my graduating peers and I embark on our medical careers, it’s a fitting time to consider which medical careers we actually desire. I’ve always had a strong sense of direction for the specialty path I wish to pursue, but at times, like now, I flirt with the idea of pursuing other avenues. It is an important issue that deserves deliberate consideration as it’s what most of us will dedicate the lion’s share of our lives to. Is being a “specialist in life” as a GP ...
Source: Life in the Fast Lane - February 21, 2017 Category: Emergency Medicine Authors: Tane Eunson Tags: Administration Medical career basic physician training BPT Source Type: blogs

Addressing Patients ' Social Problems Can Reduce ED Visits and Healthcare Costs
A recent article discussed how addressing the social problems of hospital emergency department (ED) super-users can results in substantial savings for hospitals (see:Tackling Patients ’ Social Problems Can Cut Health Costs). Below is an excerpt from it:[S]uper-utilizers of healthcare services] cost public and private insurers dearly — making up just five percent of the U.S. population, but accounting for 50 percent of health care spending. As health care costs continue to rise, hospitals and doctors are trying to figure out how to find these patients and get to the root of their problems. ...
Source: Lab Soft News - February 21, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Delivery Hospital Financial Source Type: blogs

The Snowbird Lifestyle: Healthy Anti-Aging Solution or Horrifying Misadventure?
photo:wikimediaBy Crabby McSlackerSo what's a snowbird? (Besides, apparently, a ski resort in Utah?)I'll offer one definition of a snowbird:a species of silver-crested North American, usually of advancing years, that migrates annually for the winter from colder northern climates to warmer southern ones. Best known for upsetting local ecosystems and annoying year-round inhabitants.Regular readers may be aware that my wife (aka "The Lobster") and I are a couple of those dreaded snowbirds. Yet: we are not all that old. Nor, we hope, are we all that annoying.And it's not just us: Snowbirds seem to be getting younger. Maybe it'...
Source: Cranky Fitness - February 21, 2017 Category: Consumer Health News Authors: Crabby McSlacker Source Type: blogs

Like a bridge over troubled waters
aka Cardiovascular Curveball 014 A 38yo man presented to ED with a 2 hour history of central crushing chest pain. His past medical history included haemochromatosis and a negative stress echo done one year ago following an episode of chest pain which the patient describes as different to the pain that bought him to the emergency department today. An ECG is done: Q1. Describe this ECG. + Reveal Answer expand(document.getElementById('ddet317893350'));expand(document.getElementById('ddetlink317893350')) The ECG demonstrates underlying sinus rhythm with a rate of 75 bpm and normal axis. antero-lateral ST elevation. au...
Source: Life in the Fast Lane - February 20, 2017 Category: Emergency Medicine Authors: Tom Cassidy Tags: Cardiology ECG Investigation Acute MI BER bridge bridging cardiovascular curveball myocardial bridge STEMI Source Type: blogs

Quarterly performance of the provider sector as at 31 December 2016
NHS Improvement - This publication brings together data on the performance of NHS providers over quarter three of 2016/17. If finds that the demand for emergency treatment coupled with a significant reduction in bed available has led to providers collectively underperforming against several key health care standards. This sustained focus on providing emergency care has led to a loss of income for providers with a deficit of £886m reported at the end of the quarter.ReportSummary (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - February 20, 2017 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: NHS finances and productivity NHS measurement and performance Source Type: blogs

LITFL Review 270
Welcome to the 270th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Ashley Liebig delivers a powerful, poignant and thought provoking talk on the golden fleece, the golden hour and the golden rule. [AS] The Best of #FOAMed Emergency Medicine Moises Gallegos introduces a new mnemonic for the management options o...
Source: Life in the Fast Lane - February 19, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

One day. Two lessons learned.
My colleague, Dr. L.T. Kim, was off this week and I covered for him. On Friday afternoon, I dealt with two of his patients and learned — or relearned — two important lessons. I saw a man with thoracolumbar back pain. He had fallen off a ladder a few years earlier and suffered from recurring bouts of back pain — sometimes with tingling in both legs. He had been to the emergency room after a particularly bad episode. Dr. Kim saw him in a follow-up and ordered an MRI of his thoracic spine. I saw him to review the results. The MRI showed more or less garden-variety degenerative changes, but nothing that would explain all...
Source: Kevin, M.D. - Medical Weblog - February 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag" > A Country Doctor, MD < /a > Tags: Physician Primary care Source Type: blogs

Inside EMS Podcast: Pediatric Edition
On this week’s episode of Inside EMS, we welcome pediatric guru Dr. Peter Antevy, inventor of the Handtevy Pediatric Emergency System, to the Guest Table. Check it out, and give us your thoughts. (Source: A Day In the Life of An Ambulance Driver)
Source: A Day In the Life of An Ambulance Driver - February 19, 2017 Category: Emergency Medicine Authors: ambulancedriverfiles Tags: Inside EMS Pediatrics Podcasting Source Type: blogs

Telemedicine encounters inherenty sacrifice quality
The boom in telemedicine is here, and understandably so.  The “consumer” is in control now, and they sure don’t want to be “patient” anymore.  When Americans want care, they want it cheap, and they want it now.   Telemedicine has grown to accommodate 7 million annual patient encounters, up from 350,000 five years ago.  What savvy health care administrator doesn’t see numbers like that and get dollar signs in his eyes?  Couple telemedicine’s growth with its low overhead, and it is clearly an up-and-coming source of low-cost revenue.  Still yet, questions remain.  Isn’t “clinician” accuracy negati...
Source: Kevin, M.D. - Medical Weblog - February 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/thomas-paine" rel="tag" > Thomas Paine, MD < /a > Tags: Physician Emergency Source Type: blogs

Telemedicine encounters inherently sacrifice quality
The boom in telemedicine is here, and understandably so.  The “consumer” is in control now, and they sure don’t want to be “patient” anymore.  When Americans want care, they want it cheap, and they want it now.   Telemedicine has grown to accommodate 7 million annual patient encounters, up from 350,000 five years ago.  What savvy health care administrator doesn’t see numbers like that and get dollar signs in his eyes?  Couple telemedicine’s growth with its low overhead, and it is clearly an up-and-coming source of low-cost revenue.  Still yet, questions remain.  Isn’t...
Source: Kevin, M.D. - Medical Weblog - February 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/thomas-paine" rel="tag" > Thomas Paine, MD < /a > Tags: Physician Emergency Source Type: blogs

The untold story of Match Day emotion
It’s Match Day.  Standing with my medical school class in the lobby of our medical education center, there is a palpable energy. It had been a long journey. After reluctantly leaving CA for NY I had finally completed four grueling years. The entire time I was laser focused on doing well enough to make it back to California. The four years came and went in a flash, and without hesitation, I will say that the last two years had been some of the most rewarding and fun years of my life. Working hard in the hospital and playing even harder in the city had made for an interesting work life balance. So here I am standing i...
Source: Kevin, M.D. - Medical Weblog - February 19, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/zahir-basrai" rel="tag" > Zahir Basrai, MD < /a > Tags: Education Residency Source Type: blogs

No Longer There
The phone is ringing.The phone is ringing.THE PHONE IS RINGING!I sometimes feel my heart race. In the middle of the night. When I get a phone call. Or during the day. While taking a leisurely walk with my family by the lake. The sun streaming through clouds on a brisk morning, interrupted by a fall in room 36. An abrasion. A cardiac arrest.  One phone call on top of another, Occasionally so many that the calls on hold are dropped. Or not so occasionally.During dinner. While in the shower. Sitting on the toilet. Day and night. A faint pain in the ear where the blue toot...
Source: In My Humble Opinion - February 19, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs

Doctors revived after suicide tells all
In this podcast, I share insights from a doc who barely survived his suicide attempt plus simple ways to prevent the next suicide. Listen in. You may save a life. Dear Pamela, I’ve never been so happy to fail at something in my life. Four weeks ago today I died. Cardiopulmonary arrest in jail. Why was I in jail? My wife alerted the police. Sheriff deputies were upset when I did not pull over to talk to them after overdosing. After boxing me in, they threw me from my truck into the slushy street and tased me. After charging me with a felony and two misdemeanors, they nearly provided the perfect assist to my suicide. Throu...
Source: Kevin, M.D. - Medical Weblog - February 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/pamela-wible" rel="tag" > Pamela Wible, MD < /a > Tags: Physician Emergency Source Type: blogs

Doctor revived after suicide tells all
In this podcast, I share insights from a doc who barely survived his suicide attempt plus simple ways to prevent the next suicide. Listen in. You may save a life. Dear Pamela, I’ve never been so happy to fail at something in my life. Four weeks ago today I died. Cardiopulmonary arrest in jail. Why was I in jail? My wife alerted the police. Sheriff deputies were upset when I did not pull over to talk to them after overdosing. After boxing me in, they threw me from my truck into the slushy street and tased me. After charging me with a felony and two misdemeanors, they nearly provided the perfect assist to my suicide. Thro...
Source: Kevin, M.D. - Medical Weblog - February 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/pamela-wible" rel="tag" > Pamela Wible, MD < /a > Tags: Physician Emergency Source Type: blogs

MKSAP: 74-year-old woman with altered mental status
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old woman is evaluated in the emergency department for several hours of altered mental status. She is from out-of-state and is visiting with relatives. One of her young relatives was recently ill with gastrointestinal symptoms. The patient developed anorexia 3 days ago and vomiting 2 days ago. She has been unable to tolerate any liquid or solid foods for the last 24 hours. Medical history is significant for type 2 diabetes mellitus, hypertension, hyperlipidemia, and hypothyroidism. Medications are aspi...
Source: Kevin, M.D. - Medical Weblog - February 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Source Type: blogs

Masimo MightySat Rx Oximeter Cleared in Europe to Measure Breathing Rate
Masimo has announced that European regulatory authorities have given clearance for its MightySat Rx fingertip pulse oximeter to be used to measure the respiration rate of patients, in addition to all the other measurements it performs. The respiration rate from the pleth (RRp), as Masimo calls it, notices how the respiratory cycle changes the nature of the pulses detected by the oximeter. While it’s accurate in most patients, it’s contraindicated for those that move a lot and those with certain conditions that produce irregular breathing. It’s compatible for use in children and adults, and the device can ...
Source: Medgadget - February 17, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Cardiology Critical Care Emergency Medicine Pediatrics Source Type: blogs

DOT Telemedicine Backpack, an All-in-One Solution Brings Remote Doctors Anywhere
A company called swyMed out of Lexington, Massachusetts is releasing a portable telemedicine solution designed to link patients with doctors, whether they are at home, in an ambulance, or in a hard to reach location. The plug-and-play solution can be quickly deployed to begin a consultation, particularly important in emergency scenarios. The DOT Telemedicine Backpack features a rugged tablet with a high-definition camera and a screen that works well in full sunlight. Two modems provide redundancy in case of connectivity troubles and four built-in antennas help maximize the range of the system. There are two digital scopes...
Source: Medgadget - February 17, 2017 Category: Medical Equipment Authors: Editors Tags: Cardiology Emergency Medicine Military Medicine Telemedicine Source Type: blogs

Aligning Philanthropy To Support Locally Driven Health Interventions Addressing Upstream Issues
We hear much about American health and health care being in crisis. Health care in the United States is increasingly expensive for everyone—consumers and government alike—but it doesn’t make us healthy. Despite that, there are “bright spots” of change where communities are coming together in new ways to solve their most pressing health problems. These collaborations begin with the premise that the subject of health and wellness isn’t just about health care. Although health care can often heal us, it can’t overcome poverty, substandard housing, lack of transportation, or an unhealthy environment. What happens ...
Source: Health Affairs Blog - February 16, 2017 Category: Health Management Authors: Amy Slonim Tags: Costs and Spending Featured GrantWatch Public Health Source Type: blogs

Once upon a time, being a doctor was great. Not anymore.
Gather round kids! Let Grandpa Doctor Leap tell you a few things about the old days of doctoring in the emergency room: Back in the good old days, medicine was what we liked to call “fun.” Not because it was fun to see people get sick or hurt or die, but because we were supposed to do our best and people didn’t wring their hands all the time about rules and lawyers. Sometimes, old Grandpa Leap and his friends felt like cowboys, trying new things in the ER whether we had done them before or not. Yessiree, it was a time. We didn’t live by a long list of letters and rules — we knew what was important. And we...
Source: Kevin, M.D. - Medical Weblog - February 16, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Source Type: blogs

The health and care of older people in England 2017
This report discusses the immense challenges facing older people who need care, the numbers of whom increase every day, and the impact of the failure to provide it on their health and wellbeing, as well as the NHS. It calls for an emergency injection of funds in the spring budget for social care and for the development of a long-term solution to the care crisis.ReportPress release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - February 16, 2017 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: NHS finances and productivity Social care Source Type: blogs

TRIAD VIII: Nationwide Multicenter Evaluation to Determine Whether Patient Video Testimonials Can Safely Help Ensure Appropriate Critical Versus End-of-Life Care
Conclusions: For most scenarios, consensus was not attained for code status and resuscitation decisions with stand-alone LW and POLST documents.  Adding VMs produced significant impacts toward achieving interpretive consensus. (Source: blog.bioethics.net)
Source: blog.bioethics.net - February 15, 2017 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care medical futility blog syndicated Source Type: blogs

JellyBean 054 Bits and Bumps with Dr Penny Wilson
Bits and Bumps on and off the road. The Nomadic GP has dropped anchor. After a serpentine route around some very beautiful locations Dr Penny Wilson has found a place to put down some roots. At least for a while. In Broome. And why not? It has been quite a journey so far involving fame and femininity, mis-quotes and misogyny, genitalia and generalism. Twenty years of schooling and they put you on the day shift. And then some one says: “Sorry….. but are you really a doctor?” Penny Wilson burst onto the scene a few years back when an article that she wrote on her NomadicGP blog hit a nerve. The nerve in question is ab...
Source: Life in the Fast Lane - February 15, 2017 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean Bits and Bumps Dr Penny Wilson just a GP Source Type: blogs

Buprenorphine Overdose After Naltrexone Treatment
Naltrexone induces mu-receptor hypersensitivity.  Buprenorphine’s protective ‘ceiling effect’ may not prevent overdose in patients with this ‘reverse tolerance’. A new patient described his recent history of respiratory failure several days into buprenorphine treatment.  He was told by his doctors that he experienced an allergic reaction to Suboxone. The rarity of buprenorphine or naloxone allergy led me to look deeper into his history, and my conclusion differs from what he was told by his last treatment team. The patient, a man in his mid-50s, has a history of significant opioid use over t...
Source: Suboxone Talk Zone - February 15, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Buprenorphine Induction pharmacology receptor actions side effects Suboxone tolerance buprenorphine induction buprenorphine overdose naltrexone treatment Suboxone after vivitrol Suboxone allergy Source Type: blogs

The Future Of Essential Health Benefits
The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and Congress seek to repeal and replace the law. Essential Health Benefits, which define what health care benefits plans in the Marketplaces and certain other health plans must cover, go to the heart of what it means to have health insurance and what health care we, as a society, want to ensure people can access. Today, critics of the EHB cite them as a cause of high health insurance costs and as an example of federal overreach. They say the EHB are too expansive a...
Source: Health Affairs Blog - February 14, 2017 Category: Health Management Authors: Ian Spatz and Michael Kolber Tags: Costs and Spending Following the ACA Insurance and Coverage habilitative care maternity care Mental Health States Substance Use Disorders Source Type: blogs

How much are patients to blame for ER overuse?
The U.S. rings the bell on health care spending, and some point fingers at patients themselves. But why do patients choose the paths they choose? Just about every shift, I and my coworkers shake our heads, and wonder what may be driving our patients’ decisions. Parents who haven’t yet tried a drop of acetaminophen bring kids in at 2 a.m. with fevers. Patients show up with nose bleeds that have already stopped bleeding out in the car. Sprained ankles roll in by ambulance. ER old timers (I guess me too now) can often be heard saying “when I was a kid there’s no way my parents would’ve taken me in for that.” It’...
Source: Kevin, M.D. - Medical Weblog - February 14, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/sam-slishman" rel="tag" > Sam Slishman, MD < /a > Tags: Physician Emergency Source Type: blogs

LifeFlow Rapid Infuser for Sepsis and Shock Rolling Out in U.S.
410 Medical, a company out of Durham, North Carolina, is releasing in the U.S. its LifeFlow Rapid Infuser for treating patients afflicted by sepsis or shock. The device can help infuse 500 milliliters of crystalloid fluid into a patient within two and a half minutes, including in both adults and children, and an entire liter can be delivered within five minutes. The FDA cleared device has so far been tested at the WakeMed Health & Hospitals in Raleigh, North Carolina. “I had a chance to use LifeFlow today to treat a critically ill two-year-old. The child presented lethargic, with high temperature and heart rate;...
Source: Medgadget - February 14, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Critical Care Emergency Medicine Military Medicine Pediatrics Source Type: blogs

Let ’s Work Together To Improve Care For Older Adults With Complex Needs
In the three minutes it takes to read this blog post, an average of twenty-one people will turn age sixty-five, joining the largest cohort of older adults that our country has ever known. The simple truth is that we are living and working longer, which also means that we are redefining the meaning of “later life” and that older people are enriching our communities and society in new and vital ways. But many of us won’t enjoy a gentle retirement. Older adults are arguably the fastest growing subset of what are increasingly called “complex” patients—those with significant health and social needs, often including ...
Source: Health Affairs Blog - February 14, 2017 Category: Health Management Authors: Terry Fulmer Tags: Costs and Spending GrantWatch Organization and Delivery Quality Source Type: blogs

Worst case scenario planning for IVF patients
For most IVF doctors and patients , failure is a taboo word.It's something which no one wants to talk about, because everyone wants to discuss only the chances of success. This is obviously far easier to do and much more pleasant, but I don't think evading hard issues really makes a lot of sense. I think it's always important to protect your downside before considering the upside.Not only is this far more sensible, it helps you create a safety net. Being prepared for the worst improves your emotional resilience and ensures that you don't go to pieces in case your cycle fails. Some patients think their world will end i...
Source: Dr.Malpani's Blog - February 14, 2017 Category: Reproduction Medicine Source Type: blogs

Mobile Apps Are Reflecting the Changing Role of the Patient in the Healthcare Ecosystem
By ALINE NOIZET The 4th edition of Trophées de la Santé Mobile took place last week in Paris which showcased the best French healthcare mobile apps in different categories. The winning apps were clearly showing the changing role of the patient in the healthcare ecosystem. The patient is at the center, more informed, and plays an important role in his or her own health. Since the patient has a better understanding of his or her own health, they can detect a disease earlier, co-create their own treatment with the doctor, and adjust it based on the information being continuously collected through apps or wearables. The wi...
Source: The Health Care Blog - February 14, 2017 Category: Consumer Health News Authors: Matthew Holt Tags: Uncategorized Source Type: blogs

2017 update on the changing use of “blood thinners” for AF
Times have changed in the treatment of patients with atrial fibrillation (AF). First some background: The first of the four pillars of AF care is stroke prevention. The only proven means to protect patients with AF from stroke is use of drugs that block clotting factors–or anticoagulants. Some people call these drugs blood thinners. I don’t. That’s because they don’t thin the blood. They inhibit proteins in the blood that form clots; viscosity of the blood is not affected. Blockade of clotting factors works because static blood in the fibrillating (non-contractile) atria increases the probability of...
Source: Dr John M - February 14, 2017 Category: Cardiology Authors: Dr John Source Type: blogs

New President And CEO Of Robert Wood Johnson Foundation Named
Richard Besser, a physician, has been named the new leader of the Robert Wood Johnson Foundation (RWJF), the “largest charitable foundation devoted exclusively to health and health care” in the United States, according to a February 13 press release. Besser, who is currently the chief health and medical editor at ABC News, is a former acting director of the Centers for Disease Control and Prevention (CDC). He also served as director of the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response. Besser is now a professor of pediatrics at Columbia University, as well as a Distinguished Visiting Fel...
Source: Health Affairs Blog - February 13, 2017 Category: Health Management Authors: Lee-Lee Prina Tags: Featured GrantWatch Public Health Source Type: blogs