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

Research and Reviews in the Fastlane 034
This study was hoping to show that NAC will keep all those contrast CTs from giving our patients contrast induced nephropathy (CIN). It did not. It looks like the real answer is fluids (and that maybe we are not killing off so many kidneys anyway).  Recommended by: Zack Repanshek Pediatrics 9. Wang J, Xu E, Xiao Y. Isotonic versus hypotonic maintenance IV fluids in hospitalized children: a meta-analysis. Pediatrics. 2014 Jan;133(1):105-13 PubMed PMID: 24379232 Meta-analysis of 10 RCTs looking at maintenance IV fluids in hospitalized pediatric patients. The study found a RR = 2.24 for hyponatremia in comparing hypo...
Source: Life in the Fast Lane - June 12, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Featured Health Intensive Care Pediatrics Pre-hospital / Retrieval Renal Resuscitation Trauma critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs

Knee Replacement Surgery: A Race to the Bottom?
A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery. Anesthetic care has improved dramatically over time. Whereas initially patients who had a knee replaced would be given large doses of narcotic pain medicines (morphine) to deal with their pain, over time anesthesiologi...
Source: Waking Up Costs - June 9, 2014 Category: Anesthesiology Authors: Clark Tags: Health Care Reform Source Type: blogs

Knee Replacement Surgery: A Race to the Bottom?
A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery. Anesthetic care has improved dramatically over time. Whereas initially patients who had a knee replaced would be given large doses of narcotic pain medicines (morphine) to deal with their pain, over time anesthesiologi...
Source: Waking Up Costs - June 9, 2014 Category: Anesthesiology Authors: Clark Tags: Health Care Reform Source Type: blogs

Three Books to Prep for Change
Changing careers is scary! As I contemplate my move out of the clinical practice of anesthesia into information security consulting I have good days and bad days. And days that are both bad and good. Preparing myself mentally is key. I have had three books recommended to me that are all terrific primers for what’s ahead. I wanted to share them here. Your Job Survival Guide: A Manual for Thriving in Change Switch: How to Change Things When Change Is Hard Leading at The Edge Are there any others you recommend? (Source: Waking Up Costs)
Source: Waking Up Costs - June 7, 2014 Category: Anesthesiology Authors: Clark Tags: Career Change Source Type: blogs

Three Books to Prep for Change
Changing careers is scary! As I contemplate my move out of the clinical practice of anesthesia into information security consulting I have good days and bad days. And days that are both bad and good. Preparing myself mentally is key. I have had three books recommended to me that are all terrific primers for what’s ahead. I wanted to share them here. Your Job Survival Guide: A Manual for Thriving in Change Switch: How to Change Things When Change Is Hard Leading at The Edge Are there any others you recommend? The post Three Books to Prep for Change appeared first on Waking Up Costs. (Source: Waking Up Costs)
Source: Waking Up Costs - June 7, 2014 Category: Anesthesiology Authors: Clark Tags: Career Change Source Type: blogs

A very small shark bit my arm – Part 3
Continued from Part 2 This is typed up stuff from my journal. It took a week of voice dictation bumblings before I remembered… hey, you have one good hand and a selection of PENS! Waiting – Week 2 If you tell people you’re sensitive to the sun they kind of roll their eyes as though you said, my cat can only eat filet mignon. But I promise it’s no exaggeration to say that I burn extremely easily. The sun glares down over Australia with special kind of harshness. That is no country for Fitzpatrick Type 1′s. During the Oz visit last April, each time I stepped outside it felt like my skin had c...
Source: The Amazing Adventures of Dietgirl - June 6, 2014 Category: Other Conditions Authors: shauna Tags: Everyday Life Source Type: blogs

Feeling Mighty Unreal: Derealization in Kleine-Levin Syndrome
I went on this trip once, back to my hometown after a long absence. Have you ever felt that your surroundings seem odd and distant, and that you're completely detached from them? That the things and places around you aren't real? This can happen to me, on occasion.It did on this trip, perhaps because I've dreamed about those places so many times that the real places and the dream places are blurred in memory.Of course time marches on. The stores in the strip mall have changed, and you go to Starbucks with your father. But sometimes new and surprising things appear in the landscape.Or maybe old and unexpected things pop up ...
Source: The Neurocritic - June 1, 2014 Category: Psychiatrists and Psychologists Authors: The Neurocritic Source Type: blogs

‘The Empathy Exams,’ by Leslie Jamison - NYTimes.com
Regarding the pain of others requires more than just a pair of eyes. It necessitates an act of the imagination: a willingness to think or feel oneself into the interior of another's experience, to cross between what Susan Sontag once designated as the kingdoms of the sick and of the well. This kind of empathetic border crossing can be both difficult and dangerous, the sort of journey of which one might say: "I get across quickly because I'm headed in the right direction, by which I mean the wrong direction. I'm going where no one wants to stay."This statement, actually describing a trip i...
Source: Psychology of Pain - May 27, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

The Magnesium Wars
When you get dxd with diabetes,food goes from being food to being a collection of carbohydrates,proteins,and fats.(the same, I imagine,with any GI related illness) When you have problems with maintaining electrolytes food turns into a collection of potassium,magnesium,etc.The above photo shows four types of magnesium supplement..as with insulins,not all supplements are created equal. Magonate is the rapid-acting,chug it down and in 2-3 hours your acute symptoms with subside,stuff. Slow Mag is the gentler on the stomach stuff(kind of like UltraLente-longgggg curve of action) and Milk of Magnesia is just there to get things ...
Source: The D-Log Cabin - May 21, 2014 Category: Diabetes Authors: HVS Source Type: blogs

Longevity and Long-Term Care: The Medical Crisis of the 21st Century : Part 2
Throughout the 20th century, most Americans saw “longevity” as a goal. If we took care of our bodies, we reasoned, we could “live longer and better.” But in the 21st century, I suspect that some of us will learn to fear “longevity” the way we now fear cancer. This is the second in a series of posts that will explore the anguish that some experience when they live into their late eighties and nineties–and how we, as a society, can address the hardships of “old, old age.”                                            Senile Dementia    Thanks to better diets, exercise, and advances...
Source: Health Beat - May 19, 2014 Category: American Health Authors: Maggie Mahar Tags: Knocking on Heaven's Door Alzheimer's Alzheimer's drugs Compassion and Choices fast medicine Long-term care longevity over-treatment pacemakers palliative care senile dementia slow medicine Uncategorized Consumer Reports Katy B Source Type: blogs

A Patient’s Story–How Much Can or Should– Your Doctor Tell You About Potential Risks?
Below a non-fiction story from Pulse: Voices from the Heart of Medicine, “an online magazine of personal experience in health.”  Pulse is both a magazine and an online community that provides a chance for patients, doctors, nurses, social workers to come together, and share their experiences. The magazine’s founders write: “Despite the large numbers of health magazines and medical journals, few openly describe the emotional and practical realties of health care. We at Pulse believe that our stories and poems have the power to bring us together and promote compassionate health care. “   Pulse was launched by th...
Source: Health Beat - May 18, 2014 Category: American Health Authors: Maggie Mahar Tags: endometrial cancer malpractice suit Pulse: voices from the heart of medicine shared decision making follow-up surgery lymlymphectomy/omentectomy lymph-vessel blockage lymphedema Source Type: blogs

Valerie Arkoosh, MD – Candidate for Congress (Part 3 of 3)
Valerie Arkoosh, MD, is a former Chair of Anesthesiology, a health policy expert, and a candidate for Congress running in the Democratic primary in the 13th Pennsylvania district. We recently had time to speak to Dr. Arkoosh about her career as a physician and what she hopes to accomplish if elected to Congress. Dr. Valerie Arkoosh What are the most important skills you learned as a Chair that will help you if you are elected to Congress? As an anesthesiologist you learn very early how to always appear calm! But, really, I think the skills of bringing people together who often have very different viewpoints about what need...
Source: Inside Surgery - May 10, 2014 Category: Surgery Authors: Editor Tags: Medical News Wire anesthesiologist candidate congress Pennsylvania Valerie Arkoosh Source Type: blogs

What injured squid can teach us about irritability and pain - LA Times
A new study involving injured squid and hungry sea bass may help explain why we are so grumpy and irritable when we are in pain. For many of us, the unpleasantness of being in pain often goes beyond the agony of the injury. If we are in excruciating discomfort, suddenly it seems everything bothers us -- sounds are too loud, lights are too bright, and even a gentle touch can be uncomfortable. "One of the effects of pain is the peripheral sensory system becomes hyperactive," said Edgar T. Walters, who studies pain and neural plasticity at the University of Texas Medical School at Houston. "People in pain ar...
Source: Psychology of Pain - May 9, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Battle of the Bulge: Olecranon Bursitis
Olecranon bursitis, also called baker’s or Popeye elbow, can be a painless or an irritating condition involving the bursa located near the proximal end of the ulna in the elbow over the olecranon. Normal bursae sacs generally are filled with a small amount of fluid, which helps the joint remain mobile. The sac can swell under the soft tissue from overuse or when the area sustains an injury from a bump or fall.   Normal bursae are usually small, but they can grow to be quite large, swollen, and occasionally even infected when they become irritated or inflamed. The swelling is obvious because the space in this area is lim...
Source: The Procedural Pause - May 6, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work
It’s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction, “burn out” and even suicide. In fact, some believe that up to a third of the US physician work force is planning to leave the profession in the next 3 years – an alarming statistic. Direct primary care practices are touted as the best way to restore patient and provider satisfaction. Those brave enough to cut out the “middle man” (i.e. health insurers, both public and private) find a remarkable reduction in billing paperwork, unrecovered fees, an...
Source: Better Health - May 5, 2014 Category: American Health Authors: Dr. Val Jones Tags: Expert Interviews Health Policy Opinion Anesthesiologists Freedom Hospitalists ICU Intensivists Job satisfaction Locum Tenens Physicians Temp Work Source Type: blogs

I am not a chicken
One of my favorite books is ‘Orbiting the Giant Hairball‘ by Gordon MacKenzie. Subtitled “A Corporate Fool’s Guide to Surviving with Grace,” my favorite chapter is titled ‘A Chicken’s Fate’. In it, the author described his fathers’ discovery that chickens can be mesmerized: The cousin led the way to the ramshackle chicken coop out behind the farmhouse. There he selected a fine white hen. He carried her under his arm to the front of the house, produced a piece of chalk and drew a short line on the porch. He stood the creature over the chalk line and held her beak to it. ...
Source: Waking Up Costs - May 3, 2014 Category: Anesthesiology Authors: Clark Tags: Anesthesia Medicine Source Type: blogs

I am not a chicken
One of my favorite books is ‘Orbiting the Giant Hairball‘ by Gordon MacKenzie. Subtitled “A Corporate Fool’s Guide to Surviving with Grace,” my favorite chapter is titled ‘A Chicken’s Fate’. In it, the author described his fathers’ discovery that chickens can be mesmerized: The cousin led the way to the ramshackle chicken coop out behind the farmhouse. There he selected a fine white hen. He carried her under his arm to the front of the house, produced a piece of chalk and drew a short line on the porch. He stood the creature over the chalk line and held her beak to it....
Source: Waking Up Costs - May 3, 2014 Category: Anesthesiology Authors: Clark Tags: Anesthesia Medicine Source Type: blogs

I am not a chicken
One of my favorite books is ‘Orbiting the Giant Hairball‘ by Gordon MacKenzie. Subtitled “A Corporate Fool’s Guide to Surviving with Grace,” my favorite chapter is titled ‘A Chicken’s Fate’. In it, the author described his fathers’ discovery that chickens can be mesmerized: The cousin led the way to the ramshackle chicken coop out behind the farmhouse. There he selected a fine white hen. He carried her under his arm to the front of the house, produced a piece of chalk and drew a short line on the porch. He stood the creature over the chalk line and held her beak to it....
Source: Waking Up Costs - May 3, 2014 Category: Anesthesiology Authors: Clark Tags: Anesthesia Medicine Source Type: blogs

Can You Avoid Lumbar Puncture in Febrile Neonates?
I don’t have a problem with lumbar punctures in febrile neonates. In fact, my son ended up with three lumbar punctures before aging out of the febrile seizure protocols. I do have a problem, however, with doing unnecessary spinal taps. The emotional stress of a neonatal LP on parents is significant, and the physical stress of the procedure on the infant is also substantial.     The pain of the needle and the unique restraint required for the procedure are also potentially problematic. The pain of the needle can be minimized by EMLA cream (eutectic mixture of local anesthetics [lidocaine and prilocaine]) and local anes...
Source: M2E Too! Mellick's Multimedia EduBlog - May 1, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Male Scent May Compromise Biomedical Research | Science/AAAS | News
Jeffrey Mogil's students suspected there was something fishy going on with their experiments. They were injecting an irritant into the feet of mice to test their pain response, but the rodents didn't seem to feel anything. "We thought there was something wrong with the injection," says Mogil, a neuroscientist at McGill University in Montreal, Canada. The real culprit was far more surprising: The mice that didn't feel pain had been handled by male students. Mogil's group discovered that this gender distinction alone was enough to throw off their whole experiment—and likely influences the work of other researcher...
Source: Psychology of Pain - April 29, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Valerie Arkoosh, MD – Candidate for Congress (Part 2 of 3)
Dr. Val Arkoosh is an Anesthesiologist by training and a current candidate for Congress in the Pennsylvania 13th Congressional District. We recently had the chance to speak to Dr. Val to get her thoughts on being a doctor and being a candidate. Why did you decide to leave full time clinical practice at Jefferson and go to into administration? The position I left Jefferson to take was a pretty exciting one. You might remember that Allegheny opened this hospital for women. It was PCOM’s old hospital on City Ave. And they opened it up and reconfigured I to be a hospital for women. So they moved all the OB GYN, gyn onc ,brea...
Source: Inside Surgery - April 27, 2014 Category: Surgery Authors: Editor Tags: Interviews 13th candidate congress Hahnemann Pennsylvania Tenet Source Type: blogs

Commissioning guide: provision of general children’s surgery
Royal College of Surgeons (RCS) - This commissioning guidance does not focus on single-condition care pathways, but covers the provision of treatment for the wide range of children’s conditions that may require elective surgical intervention and/or anaesthesia for planned procedures and investigations. Guidance RCS - publications (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - April 23, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Commissioning Source Type: blogs

Valerie Arkoosh, MD – Candidate for Congress (Part 1 of 3)
Valerie Arkoosh, MD, is an Anesthesiologist, past President of the National Physicians Alliance, and a candidate for Congress running in Pennsylvania’s 13th Congressional district, located in Northeast Philadelphia and Montgomery County. We recently spoke to Dr. Arkoosh about her roles as a physician and health policy expert. Where were you born and raised? I was born and raised in Omaha, Nebraska. Where did you go to college and what was your major? Northwestern University and I got a BA in Economics. Why did you choose Economics and not a more traditional pre-med major? I knew I wanted to go to medical school but I al...
Source: Inside Surgery - April 21, 2014 Category: Surgery Authors: Editor Tags: Interviews Anesthesiology candidate congress National Physicians Alliance Northwestern Source Type: blogs

Deadly Medicines and Organised Crime: a review
This is a web version of a review of Peter Gotzsche’s book. It appeared in the April 2014 Healthwatch Newsletter. Read the whole newsletter. It has lots of good stuff. Their newsletters are here. Healthwatch has been exposing quackery since 1989. Their very first newsletter is still relevant. Most new drugs and vaccines are developed by the pharmaceutical industry. The industry has produced huge benefits for mankind. But since the Thatcherite era it has come to be dominated by marketing people who appear to lack any conscience. That’s what gave rise to the Alltrials movement. It was founded in January 2013...
Source: DC's goodscience - April 16, 2014 Category: Science Authors: David Colquhoun Tags: Academia badscience Big Pharma blogosphere Martin Keller Peter Gotzsche Pharmaceutical Industry Richard Eastell Source Type: blogs

Surge in Prescriptions for Opioid Painkillers for Pregnant Women - NYTimes.com
Doctors are prescribing opioid painkillers to pregnant women in astonishing numbers, new research shows, despite the fact that risks to the developing fetus are largely unknown. Of 1.1 million pregnant women enrolled in Medicaid nationally, nearly 23 percent filled an opioid prescription in 2007, up from 18.5 percent in 2000, according to a study published last week in Obstetrics and Gynecology, the largest to date of opioid prescriptions among pregnant women. Medicaidcovers the medical expenses for 45 percent of births in the United States. The lead author, Rishi J. Desai, a research fellow at Brigham and Women's Ho...
Source: Psychology of Pain - April 14, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

A Five-Dimensional View of Pain | Pain Research Forum
Leaders of a major effort to systematically classify all common chronic pain conditions expect to have the first stage completed by mid-July 2014. The Pain Taxonomy, a project of the ACTTION public-private partnership, and the American Pain Society is one of two independent initiatives launched last spring to fill a widely perceived need for an updated evidence-based approach to improve diagnosis, treatment, and research of chronic pain (seePRF related news story). Key issues and decisions of the initial consensus meeting held in May 2013 are summed up in the March 2014 issue of The Journal of Pain. The paper also des...
Source: Psychology of Pain - April 8, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Cockroach in the Ear
I took a surprisingly enjoyable course in medical entomology as an undergrad at Ohio State University. Admittedly, decades later, the only things I remember from that course are that only four of the 4500 species of cockroaches are classified as pests: the German, Asian, American, and Oriental cockroaches.   The majority of cockroach species live in their natural habitats in woods, tropical forests, or deserts, but these four have taken up residence with humans and have become serious pests. They may have distinctly cosmopolitan names, but it is believed that they all started in Africa. Their mouths can chomp through card...
Source: M2E Too! Mellick's Multimedia EduBlog - April 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Can we measure diastolic blood pressure by palpation ?
Learned physicians will agree, BP recording by classical auscultatory   method  is  not always an  easy task ! Such an important clinical sign is left to the whims and fancies of human ear’s ability to detect  of low pitched vibrations emanating from deep seated brachial artery .(5 phases of Korotkoff ) Since  Korotkoff sounds are low frequency sounds , it is best heard with bell of the stethoscope ? How many of us do it ? There is little surprise , two BP  recordings  rarely  match even if it’s performed minutes  apart  ! While phase one is easily identified , the gap between phase 4 and 5 can be v...
Source: Dr.S.Venkatesan MD - March 31, 2014 Category: Cardiology Authors: dr s venkatesan Tags: Clinical cardiology blood pressure measurment how to measure diastolic bllod pressure by palpation korrotkoff sounds measuring bp without stethoscope Source Type: blogs

Clinical efficacy of a computerised device (STA™) and a pressure syringe (VarioJect INTRA ™) for intraligamentary anaesthesia
ConclusionWe recommend including specific trainings in intraligamentary anaesthesia in the dental curriculum. (Source: Dental Technology Blog)
Source: Dental Technology Blog - March 25, 2014 Category: Dentists Source Type: blogs

EHR recall: Use of this affected product may cause serious adverse health consequences, including death
Here is another example of a grossly defective health IT product, this from last year but only posted by FDA publicly on 3/14/2014 at http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm389356.htm: "There was an occurrence where the patient case data did not match the patient data when the case was recalled in the Anesthesia Care Record (ACR) in that it included data from another case. Use of this affected product may cause serious adverse health consequences, including death."One wonders why problems like this are found in the field when real patients are involved, not in the testin...
Source: Health Care Renewal - March 24, 2014 Category: Health Medicine and Bioethics Commentators Tags: FDA recall healthcare IT defects healthcare IT risk McKesson McKesson Anesthesia Care Source Type: blogs

Ketamine - A Professor Writes
For the past six months, I've fielded increasingly more questions about ketamine.My patients: "Will ketamine help me?" My colleagues: "Is ketamine safe for my patients?"Ketamine is an FDA- (Food and Drug Administration) approved drug for anesthesia during surgery and for pain relief -- in adults and children. Several studies (including one report published recently) have shown its rapid, positive effects in depression as well as rapid effects in obsessive-compulsive disorder (OCD) -- a persistent and often disabling disorder in which individuals have repetitive thoughts and behaviors.Because ketami...
Source: PharmaGossip - March 24, 2014 Category: Pharma Commentators Authors: insider Source Type: blogs

Non-drug approaches for people with fibromyalgia
No-one wants to be told their pain is “in your head”. But given our increasingly sophisticated understanding of pain neurobiology, there’s plenty of reason to agree that thinking, feeling and doing things differently makes life far more rewarding and rich than feeling helpless, fatigued and sore. Some proponents of purely biomedical interventions, notably musculoskeletal physicians, argue that if only the “source of the nociception” was found, the nerve “zapped” or anaesthetised, then all this psychosocial claptrap could be safely ignored. I think this belief shows ignorance and pe...
Source: HealthSkills Weblog - March 23, 2014 Category: Occupational Therapists Authors: adiemusfree Tags: Coping strategies Pain Pain conditions Research Therapeutic approaches biopsychosocial CBT Chronic pain Cognitive Behavioural Therapy fibromyalgia pain management Source Type: blogs

Physicians specializing in the patient experience
Imagine — where would elective surgery be today if patients still worried about operating rooms exploding or developing liver and kidney failure from anesthesia? Having major surgery would be a very different experience without anesthesia.  Before the advent of safe anesthesia techniques, the world of surgery was basically limited to amputations and other attempts at life-saving maneuvers.  Dr. Bigelow’s publication describing the safe administration of ether changed everything, and the New England Journal of Medicine called this the most important article in its history.  With this article, the science and ...
Source: Kevin, M.D. - Medical Weblog - March 22, 2014 Category: Family Physicians Tags: Physician Surgery Source Type: blogs

HAMILTON-H900 Humidifier with Built-In Condensation Prevention Technology
Hamilton Medical (Bonaduz, Switzerland) has unveiled a new clinical humidifier. The device was designed to reduce the number of cables used, to integrate components into a simpler system, and to help control condensation and “rain-out” within the tubing. Since a cool tube having warm humid air moving through it will form condensation on its walls, the device integrates heating coils within the tubing so that the temperature of the air stays constant throughout its journey. The device can be controlled through a touch interface or can also be connected and operated through a compatible ventilator. The HAMILTON...
Source: Medgadget - March 20, 2014 Category: Technology Consultants Authors: Editors Tags: Anesthesiology Critical Care Source Type: blogs

The “Punch” Line
Q: How do you get a room full of little old ladies to all use obscene language at the same time? A: Yell “BINGO!” When elderly patients blurt out obscenities, most of the time it takes everything I can do not to laugh out loud. No offense intended. I just get flashbacks of my mom sitting and putting her fingers in her ears while watching scenes in certain movies or seeing her gasp in shock if an F-bomb catches her off guard. I don’t expect to hear obscenities from someone who just rolled by me with a walker. For example, a while ago I posted a story about one lady from a nursing home who caught me off guard with an M...
Source: WhiteCoat's Call Room - March 19, 2014 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs

Evoked Potential Assessment Device Prevents Arms and Legs from Falling Asleep During Surgery
All of us have fallen asleep on an arm or sat too long on a twisted leg only to get up and feel like the limb itself has fallen asleep. Nerves can get stretched and compressed, and blood vessels squeezed, and, if a person’s position is not corrected soon enough, it can lead to permanent tissue damage, compartment syndrome and such . This scenario can happen during surgery, but since the patient is anesthetized and can’t feel, the situation usually goes undetected and can lead to significant damage. A new product from SafeOp, a company out of Hunt Valley, Maryland has received FDA clearance for “positionin...
Source: Medgadget - March 19, 2014 Category: Technology Consultants Authors: Editors Tags: Anesthesiology Cardiac Surgery Neurology Ob/Gyn Orthopedic Surgery Thoracic Surgery Vascular Surgery Source Type: blogs

A Medical Device Recall of an EHR-like Product
The recent recall (links below) for McKesson’s Anesthesia Care system raises interesting questions about potential information system failure modes as well as what system/software functions cross the imaginary line between unregulated EHRs and regulated medical devices. First the facts. The FDA announced McKesson’s voluntary recall of its Anesthesia Care system in several on-line (here, here and here)  postings. This trio of postings is interesting because the first links only to the second, the second does not link to either of the other two. The third also does not link to the other two, and was not part of any of t...
Source: Medical Connectivity Consulting - March 19, 2014 Category: Technology Consultants Authors: William Hyman Tags: Healthcare IT Standards & Regulatory EMR regulation FDA recall Source Type: blogs

10 Steps To Finding A Good Doctor And Having A Great Healthcare Experience
I’m excited to announce that US News and World Report has invited me and some other social-media savvy physicians to participate in a live Twitter chat about how to find a good doctor. The chat will be held on Thursday, March 20th at 2pm EST. You can join the conversation by following the #DoctorFinder hashtag or take the pre-chat poll here. Most people, including physicians, rely on personal references to find a good doctor. But what do you do when you’re far from home, or you don’t know anyone with firsthand knowledge of local doctors? My parents recently asked me to recommend a physician for them in a...
Source: Better Health - March 18, 2014 Category: Health Medicine and Bioethics Commentators Authors: Dr. Val Jones Tags: Announcements Health Tips #DoctorFinder Best Doctors Doctor Finder Doximity eDocAmerica Healthgrades.com How To Find A Good Doctor Twitter Twitter Chat Twitterview US News And World Report Vitals.com Source Type: blogs

Hospital Quality Measures: Value Based Purchasing 2.0 (The Funny Version).
For years, hospital quality measures have been tracked by private and government insurance programs to try and improve the healthcare services received by their beneficiaries.  The most recent example is the Value-Based Purchasing Program (VBP) initiative by The Centers For Medicare & Medicaid Services (CMS).  How does CMS describe VBP?"Under the Program, CMS will make value-based incentive payments to acute care hospitals, based either on how well the hospitals perform on certain quality measures or how much the hospitals' performance improves on certain quality measures from their performance during a basel...
Source: The Happy Hospitalist - March 14, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs

Patients who have dental extractions before cardiac surgery are still at risk for poor outcomes
To pull or not to pull? That is a common question when patients have the potentially dangerous combination of abscessed or infected teeth and the need for heart surgery. In such cases, problem teeth often are removed before surgery, to reduce the risk of infections including endocarditis, an infection of the inner lining of the heart that can prove deadly. But Mayo Clinic research suggests it may not be as simple as pulling teeth: The study found that roughly 1 in 10 heart surgery patients who had troublesome teeth extracted before surgery died or had adverse outcomes such as a stroke or kidney failure. The findings are pu...
Source: Dental Technology Blog - March 13, 2014 Category: Dentists Source Type: blogs

This Was Just a Flesh Wound. Get Over It Already!
I am constantly amazed by my own stubbornness. I am even stubborn in the face of facts. What are facts, after all, to goals and wishful thinking? Fah! I spit upon them!People tried to tell me that the surgery I underwent on my elbow last Thursday was a big deal. They tried to explain things to me. I'm sure I even listened. However, all that stuck in my head was “This is no big deal.” I mean, I've had moles removed before. This was just a bursa that developed under my skin due to that car accident I was in last year. It was growing and interfering with arm movement, and painful and unsightly to be sure, but they'll just...
Source: The Splintered Mind by Douglas Cootey - March 11, 2014 Category: Mental Illness Tags: ADHD Journaling Therapizing Writing Source Type: blogs

Incessant Regular Wide Complex Tachycardia
A male in his 50's presented after a witnessed syncopal episode. He reported multiple syncopal events over the last 1-2 months with increasing frequency, as well as recent fatigue.  He had a remote history of in-hospital cardiac arrest during surgery.  He had no anginal symptoms, no CP or SOB.  Prehospital tracings were concerning for monomorphic sustained regular wide complex tachycardia with repeated runs of bigeminy, and no clear evidence of a current of injury.In the ED, he had VT on the monitor, and the following 12-lead ECG:There is a regular monomorphic wide complex tachycardia with no P-waves. The co...
Source: Dr. Smith's ECG Blog - March 11, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs

Aviation and anesthesiology: The importance of training
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Comparisons between the airline industry and anesthesia care are common.  One of the most commonly heard analogies is that the takeoff and landing of a jetliner are similar to induction and emergence during a general anesthetic.  But there are other equally important analogies between the two professions.  Today, payers, health care organizations and medical providers are focused more than ever on cutting costs.  In this environment, it is helpful to look at other similarities between aviation and anesthesiology. Continue reading ....
Source: Kevin, M.D. - Medical Weblog - March 8, 2014 Category: Family Physicians Tags: Physician Surgery Source Type: blogs

Tramadol: Uses, Side-Effects, and Interactions
When it comes to pain pills, tramadol is one of the most common prescription painkillers currently prescribed by doctors. It is often used to manage severe pain and it is readily available.  In fact, you can even buy tramadol online in the UK without a prescription.  At least, you don’t need a prescription when you start the process. In reality, however, the legitimate sites that let you buy tramadol with no prescription have doctors who issue a prescription for the purchase. I found out that some pharmacies in the UK even include a doctor’s prescription in the cost of the medication.  Visit this site for more infor...
Source: Mental Nurse - March 7, 2014 Category: Nurses Authors: Author037 Tags: Health Source Type: blogs

What A Fabulous Collection Of Techno Inventions In Healthcare That Might Actually Not Be Worth It!
This appeared a little while ago.ECRI Cautions Hospitals About Tech HypeCheryl Clark, for HealthLeaders Media , February 12, 2014 Independent research from the non-profit ECRI Institute aims to distinguish between must-have hospital technologies and manufacturer hype.A device that allows untrained nurses to sedate colonoscopy patients without an anesthesiologist, hospital gowns woven with infection-fighting copper, and oral drugs embedded with sensors are among the emerging technologies senior executives may be pressured to bring into their hospitals and healthcare systems.But the 2014 edition of the ECRI Institute's annua...
Source: Australian Health Information Technology - March 7, 2014 Category: Technology Consultants Authors: Dr David More MB PhD FACHI Source Type: blogs