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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 3.

What Killed Joan Rivers? Piecing Together a Medical Mystery
KAREN SIBERT, MD There are minor operations and procedures, but there are no minor anesthetics.  This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers. Ms. Rivers’ funeral was held yesterday, September 7.  Like so many of her fans, I appreciated her quick wit as […] (Source: The Health Care Blog)
Source: The Health Care Blog - September 8, 2014 Category: Consumer Health News Tags: THCB Demerol Hypotension Joan Rivers Midazolam outpatient care Propofol Wellness Yorkville Endoscopy Source Type: blogs

Physician Payments Sunshine Act: Organizations Respond to CMS
  September 2nd marked the last day for comments on CMS’ proposed rule to eliminate the accredited continuing medical education (CME) exemption from Sunshine Act reporting.  In an overwhelming display of support for the exemption, over 800 comments were submitted encouraging the agency to either maintain or expand the current exclusion. -Total comments supporting maintenance or expansion of the CME exemption:  820 -Total comments supporting elimination of the CME exemption:  approximately 20 -Percentage of comments supporting the CME exemption: 98% We have followed this issue closely, and recentl...
Source: Policy and Medicine - September 8, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Anesthesia outside the operating room: A growing trend
I opened my obligatory late-afternoon email to find my work schedule for the next morning: three general anesthetics for MRIs. My heart sank. A week before, I had been assigned to the new neurosciences MRI suite for a 6-hour interventional radiology procedure, followed by another intervention in the CT scanner. My first thought: Who is trying to punish me? Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 7, 2014 Category: Journals (General) Authors: Tags: Physician Radiology Surgery Source Type: blogs

Joan Rivers Out of ICU and “Comfortable” Likely Ominous
Although we are not participating in the care of comedy legend Joan Rivers, we have noted news reports that her daughter Melissa has said her mother is out of the ICU and being kept comfortable. Rivers was hospitalized six days ago after suffering cardiac arrest and a prolonged anoxic period (brain without oxygen.) She was placed in a hypothermic coma (lowered body temperature) as is standard for the first 24-48 hours after arrest in an attempt to salvage brain and cardiac function. However, reading between the lines of this recent statement, this is likely an ominous development and could signal the start of a comfort car...
Source: Inside Surgery - September 4, 2014 Category: Surgery Authors: Editor Tags: Anesthesia Medical News Wire Uncategorized ativan comfort care dying ICU Joan Rivers morphine Source Type: blogs

Contrasting American EDs with the World’s Largest Hospital
By Zubair Chao, MD   Dr. Thomas Cook and I escaped the dry heat of South Carolina to land in Chengdu, China, home of West China Hospital, in July 2012. He was set to teach an emergency ultrasound class, and I was on a global mission as part of my emergency medicine residency.   Some say it is the largest hospital in the world, boasting 5,000 beds, nearly 100 operating suites, and a large outpatient center, which, on any given day, has about 10,000 patients.     West China Hospital   The ED at West China Hospital recently moved to its new home in a larger, more modern facility. It sees about 160,000 patients a year, wh...
Source: Going Global - September 3, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Go Mental: Head and Neck Anesthesia
As we approach the end of summer, we pay tribute to a special nerve block. This particular block is crucial for treating lower lip lacerations that may be related to slips and falls at the pool or skateboarding. We are going to ask you to go mental, as in blocking the mental nerve of the face.   The mental nerve is an extension of the inferior alveolar nerve, which branches primarily off the trigeminal nerve. It is a sensory nerve that provides sensation to the lower chin and lip. It does not supply sensory innervation to the lower teeth, although some patients report mild anesthesia to their teeth. Three branches come ou...
Source: The Procedural Pause - September 3, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Crack the Case
Conclusion The patient received antibiotics, steroids, and nebulized albuterol during his hospital admission. His symptoms and chest x-ray findings improved within 24 hours. Blood cultures were negative, and antibiotics were discontinued. He was discharged home with instructions to discontinue use of crack cocaine and given a prescription for oral steroids and an albuterol inhaler.Tags: tachycardia, scattered rhonchi, wheezing, emergency medicine, crack, cocainePublished: 9/2/2014 11:24:00 AM (Source: The Tox Cave)
Source: The Tox Cave - September 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Mini-Sims for Critical Care
Conclusion The bottom line is clear: a copy of this book should be in every ICU. We need to ‘make sim happen’ in the workplace and this book is a great entry point. However, nothing replaces the need for clear learning objectives and a skilled teacher, so I encourage clinicians to seek further training in simulation education… Books and mannequins don’t teach themselves. Disclosures The authors of the book provided LITFL with a review copy free-of-charge. The post Mini-Sims for Critical Care appeared first on LITFL. (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - August 31, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Book Review amuth samuel Charlie Corke in situ simulation mini-sims for critical care nick simpson Source Type: blogs

Kids and Cutting to Air
This is a guest post written by Dr Mike Cameron FACEM, a Queensland-based emergency physician. It was the mid-1980s and I was almost at the end of my third year as a doctor. I was working in England, about an hour’s motorcycle ride North of London, in a district hospital of a few hundred beds. I remember it was cold. That night I was the Anaesthetic Senior House Officer (SHO) on call. I had done a few cases in Theatre but I had got out before midnight and things were looking pretty good sleep-wise. Labour Ward had a couple in early labour but no epidurals required. I was on a 1:2 roster, but my Registrar and I alternated...
Source: Life in the Fast Lane - August 30, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Anaesthetics Emergency Medicine child cricothyroidotomy mike cameron paediatric surgical airway trick of the trade Source Type: blogs

Balloon mitral valvotomy – the modern treatment for mitral stenosis
Inflated balloon across the mitral valve Long back, mitral stenosis (narrowing of the valve between the left atrium and left ventricle) used to be treated by a surgery known as closed mitral valvotomy in which the surgeon used to open the chest and introduce a mechanical device to enlarge the narrowed valve through the tip of the left ventricle. Currently this procedure has become obsolete and almost extinct with the development of balloon mitral valvotomy (BMV). In this procedure, balloon at the tip a long tube (balloon catheter) is used to enlarge the narrowed valve. The balloon catheter for this procedure is introduced ...
Source: Cardiophile MD - August 30, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Heart Disease FAQ Source Type: blogs

Masimo rainbow DCI-mini Hemoglobin Spot-Check Sensor Cleared in Europe, Japan
Masimo has received European and Japanese regulatory approvals to introduce the rainbow DCI-mini non-invasive hemoglobin (SpHb) sensor. Intended for infants and small kids weighing 3 to 30 kg (6.6 lbs to 66 lbs), the sensor connects to Masimo’s Pronto monitor that displays the readings. Finger sensors for hemoglobin have only been available for patients 10 kg (22 lbs) and larger, making catching anemia difficult in small kids without the drama of drawing blood. The DCI-mini is clipped onto to a child’s finger, or a toe on smaller kids, and provides spot-check readings at any time. Masimo hopes that the new dev...
Source: Medgadget - August 29, 2014 Category: Technology Consultants Authors: Editors Tags: Anesthesiology Cardiology Critical Care Pediatrics Source Type: blogs

Technology, Lower Reimbursements Reduce Number of Radiology Positions
I have blogged before about the shrinking residency and job opportunities in radiology (see: Job Prospects Dimming for Residents in Radiology; Defining the Underlying Problems; Radiology Jobs Trend Downward; Blame Technology and Reimbursement). Also see this: Job Prospects Are Dimming for Radiology Trainees. This seems to be the result of a number of factors including: (1) incumbent radiologists are able to work more efficiently due to RIS/PACS support; (2) some radiologists have reportedly postponed their retirement due to the financial downturn in 2008; (3) teleradiology enabled some radiologists to find part-time ...
Source: Lab Soft News - August 29, 2014 Category: Pathologists Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Source Type: blogs

The RUC. "an Independent Group of Physicians?" - But It Includes Executives and Board Members of For-Profit Health Care Corporations and Large Hospital Systems
Introduction We just discussed how a major story in Politico has once again drawn attention to the opaque RUC (Resource Based Relative Value System Update Committee) and its important role in determining what physicians are paid for different kinds of services, and hence the incentives that have helped make the US health care system so procedurally oriented.  (See the end of our last post for a summary of the complex issues that swirl around the RUC.)The Politico article covered most of the bases, but notably omitted how the RUC may be tied to various large health care organizations, especially for-profit, and how the...
Source: Health Care Renewal - August 28, 2014 Category: Health Management Tags: AMA boards of directors conflicts of interest health care prices healthcare executive hospital systems perverse incentives regulatory capture RUC Source Type: blogs

My University of Michigan Experience
By: Ethel Osei-Tutu, medical student, University of Cape Coast, School of Medical Sciences, Ghana Editor’s Note: For more information on the Ghana–Michigan medical student exchange program, see “Perceptions of Ghanaian Medical Students Completing a Clinical Elective at the University of Michigan Medical School” by Abedini, Danso-Bamfo, and colleagues, published in the July issue.  The University of Cape Coast, School of Medical Sciences (UCCSMS) began a yearly exchange program with the University of Michigan (UMich) in 2012. Four final-year students from UCCSMS are selected each year based on merit ...
Source: Academic Medicine Blog - August 28, 2014 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Trainee Perspective international exchange program international medical education patient centered care University of Cape Coast School of Medical Sciences University of Michigan Medical School Source Type: blogs

How Much Is My Colonoscopy Going to Cost? $600? $5,400?
By JEANNE PINDER How much does a colonoscopy cost? Well, that depends. If you’re uninsured, this is a big question. We’ve learned that cash or self-pay prices can range from $600 to over $5,400, so it pays to ask. If you’re insured, you may think it doesn’t matter. Routine, preventive screening colonoscopies are to be […] (Source: The Health Care Blog)
Source: The Health Care Blog - August 27, 2014 Category: Consumer Health News Tags: THCB Anesthesia Billing Colonoscopy Facility fee Gastroenterology Labs pricing Source Type: blogs

The Smallest Drugs
Here is the updated version of the "smallest drugs" collection that I did the other day. Here are the criteria I used: the molecular weight cutoff was set, arbitrarily, at aspirin's 180. I excluded the inhaled anaesthetics, only allowing things that are oils or solids in their form of use. As a small-molecule organic chemist, I only allowed organic compounds - lithium and so on are for another category. And the hardest one was "Must be in current use across several countries". That's another arbitrary cutoff, but it excludes pemoline (176), for example, which has basically been removed from the market. It also gets rid of ...
Source: In the Pipeline - August 27, 2014 Category: Chemists Tags: Chemical News Source Type: blogs

This is what lifelong learning in medicine should look like
He left a little early to stop by the cath lab to see his patient before her procedure.  Cordial “hellos,” “good mornings,” and “any last questions?” were mentioned before she signed her consent.  The team was working feverishly to prepare her for her procedure.  “Have you met the anesthesiologist yet?” was next, and almost on cue, the anesthesiologist arrived and took over for a bit. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 27, 2014 Category: Journals (General) Authors: Tags: Physician Heart Source Type: blogs

Will dermal rolling get rid of acne scars? The Beauty Brains Show episode 45
What is dermal rolling? Does it really get rid of acne scars? And most importantly, is it safe and effective to do it to yourself at home?  Click below to play Episode 45 or click “download” to save the MP3 file to your computer. Show notes The Cosmetic Categories Game Tune in as I try to stump Randy in a new game that features beauty products, beauty brands and beauty ingredients. Question of the week: Will dermal rollers get rid of acne scars? Chris asks…Does dermal rolling really work to remove acne scars and can you do it at home? How does dermal rolling/micro needling work? A dermal roller is one of the device...
Source: thebeautybrains.com - August 26, 2014 Category: Physicians With Health Advice Authors: Perry RomanowskiThe Beauty Brains Tags: Claims Podcast Problems Safety Source Type: blogs

Small Molecules - Really, Really Small
Mentioning such a small compound as pirfenidone prompts me to put up the graphic shown below: these are the smallest commonly used drugs that I can think of. (OK, there's cocaine as a nasal anaesthetic - no, really - but that's where I draw the line at "commonly used". Nominations for ones that I've missed are welcome, and I'll update the list as needed. Note: four more have been added since the initial post, with more to come. This sort of thing really makes a chemist think, though - some of these compounds are very good indeed at what they do, and have been wildly successful. We need to keep an open mind about small mole...
Source: In the Pipeline - August 25, 2014 Category: Chemists Tags: Drug Industry History Source Type: blogs

Dealing with physicians who have lost empathy and compassion
I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. I recently had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind health care professionals what not to do to patients waking up from anesthesia. I also think my experience may serve as a reminder that it’s ok to fire your doctor when conditions warrant. Continue reading ... Your patients are rating you online: How to respond. Mana...
Source: Kevin, M.D. - Medical Weblog - August 22, 2014 Category: Journals (General) Authors: Tags: Physician GI Source Type: blogs

Peri-op Cardiac Evaluation Guidelines Updated
The ACC/AHA have just released updated guidelines on perioperative cardiac evaluation and management for non-cardiac surgery patients. …recommendations in the updated guideline address elective non-cardiac surgery, which should be delayed 14 days after balloon angioplasty, 30 days after bare-metal stent implantation, and optimally 365 days after drug-eluting stent implantation The post Peri-op Cardiac Evaluation Guidelines Updated appeared first on Waking Up Costs. (Source: Waking Up Costs)
Source: Waking Up Costs - August 20, 2014 Category: Anesthesiology Authors: Clark Tags: Anesthesia Medicine Source Type: blogs

Does anesthesia cause memory loss?
A reader searching Google using the following keywordsdoes anesthesia cause memory losswas directed to this article in the Alzheimer's Reading Room.Does anesthesia increase the odds of developing dementia later in life?Does anesthesia increase the odds of developing dementia later in life? Does anesthesia hasten memory loss in persons already living with Alzheimer's and dementia?Does Anesthesia Cause Dementia or Memory Loss in the Elderly?Bob De Marco Alzheimer's Reading RoomTo learn more about Alzheimer's and Dementia care visit the Alzheimer's Reading Room (Source: CareGiver, The)
Source: CareGiver, The - August 20, 2014 Category: Dementia Authors: Bob DeMarco Source Type: blogs

Life with chronic pain
I was very intrigued to read this article on a man's advice on living with a wife in chronic pain. I admit I might be guilty of some of the first ten myself. My husband does pick up on when I am overdoing things and cues me to take it easier.I also know sometimes when I want to do things and feel like I should do them but just don't have it in me. I try to work around it. I'll lie down for a while and then try later on. Or I'll put it off until the next day. Sometimes I ask my husband to do things for me - like making dinner - because the idea of standing in the kitchen for ten minutes just isn't a good idea.If you read hi...
Source: Caroline's Breast Cancer Blog - August 19, 2014 Category: Cancer Tags: pain levels Source Type: blogs

Top stories in health and medicine, August 19, 2014
From MedPage Today: Hospitals Question Charity for Some Patients. As more Americans gain insurance under the federal health law, hospitals are rethinking their charity programs, with some scaling back help for those who could have signed up for coverage but didn’t. Antibiotics Early in Life May Boost Obesity Risk. Exposure to antibiotics early in life may permanently alter gut microbes in a way that could increase obesity risk years later. Huge Variations in Blood Test Charges ‘Irrational’. One California hospital charged $10 for a blood cholesterol test, while another hospital that ran the same test ch...
Source: Kevin, M.D. - Medical Weblog - August 19, 2014 Category: Journals (General) Authors: Tags: News Hospital Obesity Source Type: blogs

Are American doctors paid too much or too little?
A version of column was published in USA Today on July 2, 2014. There are some who think that I’m overpaid as a physician, and that my salary fuels rising health costs.  I can understand their point: A May 2014 survey released by the Medical Group Management Association found that internal medicine doctors like myself have a starting median annual salary of $190,000, while those of specialists like radiologists or anesthesiologists approach $300,000.  It seems like a lot of money. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out h...
Source: Kevin, M.D. - Medical Weblog - August 15, 2014 Category: Journals (General) Authors: Tags: Kevin's Take Health reform Primary care Source Type: blogs

To the ABIM: What Real Life-long Learning Should Look Like
He left a little early to stop by the cath lab to see his patient before her procedure.  Cordial "Hello's" and "Good mornings" and "Any last questions?" were mentioned before she signed her consent.  The team was working feverishly to prepare her for her procedure.  "Have you met the anesthesiologist yet?" was next, and almost on cue, the anesthesiologist arrived and took over for a bit. He (Source: Dr. Wes)
Source: Dr. Wes - August 15, 2014 Category: Cardiology Authors: Westby G. Fisher, MD Tags: ABMS American Board of Internal Medicine American Board of Medical Specialties Source Type: blogs

EMA Journal August 2014
Issue 4 (Vol. 26) of EMA Journal for 2014 was published online on 4th August. Editorial overview by Andrew Gosbell & Geoff Hughes Lifers – the loneliest doctors   (#FOAMed) In the latest dispatch from the FOAM Frontier, Spiegel (@EMNerd_), Johnston (@Eleytherius), Ercleve (@Ercleve) and Nickson (@precordialthump) takes us on board the deep space transporter Odysseus where the deep space medics, jovially known as ‘Lifers’, deal with the perils of the induced mental and physiological stasis of passengers who make the centuries long voyages through deep space. The goal of appropriate sedation and ‘quenc...
Source: Life in the Fast Lane - August 15, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: Education EMA Journal Emergency Medicine dental emergencies esop tool kit Lifers pediatric fractures Source Type: blogs

To the ABIM: What Real Life-long Learning Should Look Like
He left a little early to stop by the cath lab to see his patient before her procedure.  Cordial "Hello's" and "Good mornings" and "Any last questions?" were mentioned before she signed her consent.  The team was working feverishly to prepare her for her procedure.  "Have you met the anesthesiologist yet?" was next, and almost on cue, the anesthesiologist arrived and took over for a bit. He (Source: Dr. Wes)
Source: Dr. Wes - August 15, 2014 Category: Internists and Doctors of Medicine Authors: DrWes Source Type: blogs

Better Measurement Of Maternity Care Quality
TweetA thought-provoking paper published this month in Health Affairs shows stunning variation in rates of obstetrical complications across U.S. hospitals. This type of research is important and necessary because focusing on averages masks potentially large differences in how patient care is provided and how clinical decisions are made. From a policy perspective, it’s crucial to identify and learn from hospitals that are “positive deviants,” that is – hospitals with better-than-expected quality of care. From a pregnant woman’s perspective, having information on hospital rates of hemorrhage, infection, or lacerati...
Source: Health Affairs Blog - August 12, 2014 Category: Health Management Authors: Katy Kozhimannil Tags: All Categories Health Care Delivery Hospitals Patient Safety Quality Source Type: blogs

Research and Reviews in the Fastlane 043
This study claimed a sensitivity and specificity of 100% in this group of patients questioning the traditional “CT, LP” approach to managing patients with clinical suspicion for SAH. However, the study has flaws and we eagerly await external validation. Recommended by: Salim R. Rezaie Emergency Medicine Williams CM, Maher CG, Latimer J et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014 Jul 23. pii: S0140-6736(14)60805-9. doi: 10.1016/S0140-6736(14)60805-9. PMID 25064594 Should we continue to give paracetamol for lower back pain? In this Austral...
Source: Life in the Fast Lane - August 12, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: Anaesthetics Emergency Medicine Infectious Disease Intensive Care Neurology Pediatrics Pre-hospital / Retrieval R&R in the FASTLANE Radiology Toxicology and Toxinology critical care literature recommendations research and reviews Source Type: blogs

A primer on the anesthesia care team model
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Daily, and often several times a day, I am asked by patients about my role as a physician anesthesiologist.  Occasionally the answer involves reiterating to patients that an anesthesiologist is a physician.  Once we get into the discussion, patients are also surprised to learn that as part of an anesthesia care team (ACT), although I am frequently in their operating room and always available, I may not be physically present in their OR throughout the entire procedure.  This is usually when confused or frightened faces appear before...
Source: Kevin, M.D. - Medical Weblog - August 10, 2014 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

Online Bidding for Best Price for Orthopedic Surgery with Medibid
I have posted a number of previous notes about so-called medical tourism whereby U.S. consumers seek medical care abroad for a reduced price (see, for example: Two Drivers for Medical Tourism: Public-Private Partnerships and Medical Insurance Participation). A total hip replacement is available at hospitals in India for a fraction of the cost in the U.S. Obviously, the people who seek such services are uninsured or under-insured. A new and interesting option for reduced price surgery at U.S. facilities is available via a web site called Midibid. This was discussed in a recent article (see: Patients Seeking Chea...
Source: Lab Soft News - August 8, 2014 Category: Pathologists Authors: Bruce Friedman Tags: Cost of Healthcare Health Insurance Healthcare Business Healthcare Delivery Medical Consumerism Source Type: blogs

That's "informed" consent
My friend and colleague, Doug Hanto (a world class transplant surgeon) reports on Facebook about the birth of his grandson at St. Vincent Carmel Hospital in Indiana:Interesting. Lindsay is about to have a C-section this morning, and we will welcome John Douglas into the world. The nurse handed Lindsay informed consent for C-section, anesthesia, blood transfusion, circumcision, and HBV vaccine with no explanation. Like signing the agreement you have to sign when updating your OSX or windows software. They all say "Your physician has explained ..." No one has explained anything. Trust is alive and well in the real world. Thi...
Source: Running a hospital - August 8, 2014 Category: Health Managers Source Type: blogs

Back Pain Doctor Sarasota Fl
Failed back syndrome, or lumbar post-laminectomy syndrome, is the term given to patients who have had back surgery for back pain, but continue to have pain after surgery. Even worse, their back pain can be worse after the surgery. The main problem is the fact that low back pain is not an indication for back surgery – any more than neck pain is an indication for neck surgery (failed neck surgery: cervical post-laminectomy syndrome). Surgery done for the sole purpose of relieving neck or back pain is doomed to failure. Many spine surgeons make the false assumption that if a patient has back pain and there is a spine MR...
Source: Sarasota Neurology - August 7, 2014 Category: Neurologists Authors: Dan Kassicieh, D.O. Tags: Back Pain Platelet Rich Plasma Back Pain Doctors Back Pain Specialist joint pain Sarasota Neurology Surgery Source Type: blogs

Physician Payments Sunshine Act: Over 100 Medical Associations and Societies Urge CMS To Reconsider CME Exemption and Open Payments Timeline
Medial associations and specialty societies have been understandably frustrated with the way the Physician Payments Sunshine Act has rolled out so far. Yesterday, over 100 medical societies including the American Medical Assocation--49 state medical societies and 64 medical specality societies--sent a letter to Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services (CMS) asking for redress over three problematic issues: (1) the expansion of reporting requirements for educational activities, (2) Open Payments’ condensed timeframe for physician registration, and (3) the complicated r...
Source: Policy and Medicine - August 6, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Interview with Jim Welch, EVP, Sotera Wireless
This interview is with a long established thought leader in patient monitoring and alarm notification, Jim Welch. Jim has demonstrated a knack for bringing a fresh approach to long-term persistent problems in monitoring, nursing vigilance and patient care. At Sotera Wireless, Jim’s had a chance to re-imagine patient monitoring in low acuity settings with predictably innovative results. At the AAMI 2014 conference, I had the opportunity to attend the breakfast symposium where Jim presented, Transforming Care in Non-ICU Settings through Disruptive Continuous Monitoring Technology. The following discussion centers on patien...
Source: Medical Connectivity Consulting - August 4, 2014 Category: Technology Consultants Authors: Tim Gee Tags: Clinical Alarms Company Profiles Patient Safety alarm notification Source Type: blogs

Twenty Twitter Rules
We present one side (the coherent one) of a tête-à-tête between Gregory Miller, MD and Matt/Mike Dawson, recorded sometime between sudoku-smackdown and coffee-time… …I applaud you for taking on the huge field of Social Media. Blogs are easy to figure out. Most people don’t want to start a blog or write an ebook. What I think is lacking (or at least *I* haven’t seen it) is “How to use Twitter to improve your medical practice.” I agree that Twitter is extremely useful in medicine as the speed-dating version of blogs. It has the advantage of being easily digested...
Source: Life in the Fast Lane - August 4, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: FOAM Social Media Web Culture Greg Miller MD Gregory Miller matt dawson Rules Twitter Twitter rules Source Type: blogs

The execution in Arizona: There’s no mystery why it took so long.
There’s no mystery about why the July 23 execution of Joseph Wood in Arizona took so long. From the anesthesiologist’s point of view, it doesn’t seem surprising that the combination of drugs used — midazolam and hydromorphone — might take nearly two hours to cause death. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 2, 2014 Category: Journals (General) Authors: Tags: Meds Medications Source Type: blogs

Opening narrowed heart valves without surgery
Opening narrowed heart valves without surgery is by dilating them with balloons introduced into the heart through blood vessels. The procedure is known as balloon dilatation or balloon valvotomy. Four Valves in the Heart There are four valves for a normal heart. The mitral valve or bicuspid valve separates the left atrium (upper chamber) from the left ventricle (lower chamber). The aortic valve separates the left ventricle from the aorta, the largest artery of the body carrying oxygenated blood. The tricuspid valve separates the right atrium from the right ventricle and the pulmonary valve separates the right ventricle fr...
Source: Cardiophile MD - August 2, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Source Type: blogs

Funtabulously Frivolous Friday Five 101
It is 393 days since the last instalment of Funtabulously Frivolous Friday Five (FFFF episode 100) and since the last posting we have been inundated with a steady trickle of email protestation. The arbitrary threshold for re-instatement was forcibly fixed for Fifty, and thus the 50th email became the straw that broke the authors back and we return once again to the arcane world of the Who, What, Where, Why and When of medical trivia. Bring back Funtabulously Frivolous Friday!! I, and my colleagues miss it!! …from a cardiology nurse, who enjoys more than cardiology! – madeupquote.com Question 1 What was the...
Source: Life in the Fast Lane - August 1, 2014 Category: Emergency Medicine Authors: Niall Hamilton Tags: Frivolous Friday Five FFFF medial quiz Medical Trivia Mrs. Winslow's Soothing Syrup Source Type: blogs

Unusual calls in cardiology : A Pacemaker lead and a clavicle fracture !
A tense anesthetist  calls for help ! I had an unusual cardiac consult last week .A middle aged man who was to undergo routine ortho surgery wanted  a cardiac clearance. It was  a through and through fracture of clavicle , why do they need a cardiology opinion , it seemed a  simple  procedure I asked over phone The anesthetic  fellow who was  in charge of the patient told me ,”There is a wire just going parallel to the clavicle sir .I  believe it is pacemaker lead” I agreed to see the patient immediately This was the X-ray It was obvious why they got tensed up  as the pacemaker wire criss -crossed sur...
Source: Dr.S.Venkatesan MD - July 31, 2014 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

Unity Farm Journal - 5th Week of July 2014
The great thing about running a farm is that every day is filled with the unexpected.Sunny, our new baby alpaca did not consume her first meal of mother’s milk in time to receive the antibodies that are necessary to keep her healthy.   She was not gaining weight.   We had only one choice - a transfusion of alpaca plasma containing IgG (about $150).     We drove to Tufts Veterinary School and picked up 500cc of plasma.   There are two ways to transfuse a baby alpaca - jugular vein IV or peritoneal infusion.   Inserting an IV in a baby alpaca is like wrestling an alligator.  We chose the ...
Source: Life as a Healthcare CIO - July 31, 2014 Category: Technology Consultants Source Type: blogs

Fire!
Earlier this month, Modern Healthcare published a story about the slow movement by hospitals to prevent operating room fires. An excerpt:Despite a slew of news accounts about patients being set on fire in operating rooms across the country, adoption of precautionary measures has been slow, often implemented only after a hospital experiences an accident. Advocates say it's not clear how many hospitals have instituted the available protocols, and no national safety authority tracks the frequency of surgical fires, which are thought to injure patients in one of every three incidents. About 240 surgical fires occur every year,...
Source: Running a hospital - July 30, 2014 Category: Health Managers Source Type: blogs

Evidence from UK Casts Doubt on Assertion that Electronic Cigarettes are a Gateway to Youth Smoking Addiction
The Centers for Disease Control has asserted that electronic cigarette use among youth is a gateway to a lifetime of addiction to smoking. This assertion, which has been picked up by politicians and health groups throughout the country, is being used to justify extreme proposals, such as those to ban e-cigarette advertising and to ban all e-cigarette flavorings.But is there any truth to the assertion that electronic cigarettes are a gateway to youth smoking? New evidence from the UK suggests not. Despite the widespread proliferation of electronic cigarettes throughout England during the past few years, and a concomitant in...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - July 28, 2014 Category: Addiction Source Type: blogs

No Mystery: Arizona Execution Lengthy Due to Drug Choice
By KAREN SIBERT, MD There’s no mystery about why the July 23 execution of Joseph Wood in Arizona took so long. From the anesthesiologist’s point of view, it doesn’t seem surprising that the combination of drugs used—midazolam and hydromorphone—might take nearly two hours to cause death. Here’s why. The convicted murderer didn’t receive one component of […] (Source: The Health Care Blog)
Source: The Health Care Blog - July 26, 2014 Category: Consumer Health News Tags: THCB Agonal breathing anesthesiology Benzodiazepines Clayton Locket death penalty Hydromorphine Joseph Wood Lethal injection Source Type: blogs

Comfortably Numb
At the dentist, waiting for the fifth round anesthetic injections to take effect. This should do it. I can chew off my own lower lip now. (Source: Dr. X's Free Associations)
Source: Dr. X's Free Associations - July 25, 2014 Category: Psychiatrists and Psychologists Authors: DrX Tags: Front Page Source Type: blogs

3 ways to master the art of teaming in medicine
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. As a physician anesthesiologist in a community hospital setting for more than 25 years, the quest for mastery keeps my practice from getting stale or boring. I relish the technological innovations in the past decade: the video laryngoscopes and ultrasound-guided nerve blocks that allow my skills and competencies to be ever-challenged. There is a magnetic draw to new procedural techniques, such as trancatheter aortic valve replacements (TAVR), which allow us to provide previously untenable options to patients. Continue reading ... Your...
Source: Kevin, M.D. - Medical Weblog - July 24, 2014 Category: Journals (General) Authors: Tags: Physician Hospital Surgery Source Type: blogs