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

Vaccine-Injured Child Stolen by the State and Her Caring Mother Accused of Child Abuse
Conclusion For many years, I have been writing about such cases. There are now a growing number of parents who have been falsely accused of harming their vaccine-damaged children. Sadly, this case is yet another example. Loving, caring parents are having their children taken away from them because the majority of health care professionals and social workers are burying their heads in the sand and choosing to ignore the fact that no vaccine or medication is one hundred percent safe. All vaccines have the potential to cause adverse reactions. When you have such groups as the AAPS stating, “And yet, children under the age o...
Source: vactruth.com - November 22, 2014 Category: Allergy & Immunology Authors: Christina England Tags: Christina England Top Stories Child Protective Services (CPS) Hepatitis B vaccine Kathryn Hughes medical kidnapping Michael Belkin seizure Source Type: blogs

Why Do We Advocate for Rejuvenation Research?
Yesterday, I had occasion to spend six hours or so in the emergency room of a medical center largely focused on treating serious conditions that are most prevalent in old people. A part of that experience by necessity involved listening to the comings, goings, and conversations of those present. These are not private places: they are typically divided visually by screens but with no way to avoid overhearing the staff and patients. The people there are generally not too concerned about privacy in the immediate sense in any case, having far more pressing matters to focus upon. So, by proxy, one gets to experience small and...
Source: Fight Aging! - November 21, 2014 Category: Research Authors: Reason Tags: Activism, Advocacy and Education Source Type: blogs

Research and Reviews in the Fastlane 058
This study (n=60) randomized patients in the ED getting IV opioids to morphine (0.1 mg/kg) + placebo or morphine (0.1 mg/kg) + ketamine (group 1 0.15 or group 2 0.30 mg/kg). Patients in the ketamine arm had significantly decreased pain without significant adverse effects, although the group with the higher dose of ketamine had a seeming increase in side effects without added analgesic benefit. The literature is mounting that low dose ketamine has utility in the acute analgesia armamentarium but selecting the right population will likely be key (and more is not better). Recommended by: Lauren Westafer Further Listening: Cli...
Source: Life in the Fast Lane - November 20, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Education R&R in the FASTLANE Review Source Type: blogs

Police officers’ risk of sudden cardiac death is 34-69 times higher during restraints or altercations
This BMJ study found that police officers’ risk of sudden cardiac death (SCD) was 34 to 69 times higher during restraints or altercations; 32 to 51 times higher during pursuits; 20 to 23 times higher during physical training; and 6 to 9 times higher during medical or rescue operations, as compared with routine or non-emergency activities. The researchers also found that SCD accounts for up to 10% of all U.S. on-duty police deaths.References:Law enforcement duties and sudden cardiac death among police officers in United States: case distribution study. BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6534 (Published 18 N...
Source: Clinical Cases and Images - Blog - November 20, 2014 Category: Universities & Medical Training Tags: BMJ Cardiology Stress Source Type: blogs

We owe it to our patients to put on our game faces
When you walk into the emergency room to see a trauma patient, do you remind yourself as you enter the doors, “Keep your game face on?” When you finish a difficult surgery and make your way to the waiting area to review the prognosis with the family, do you tell yourself, “Take a deep breath. You can do this?” When you steel yourself to tell one of your favorite patients some seriously bad news, do you silently whisper, “It’s going to be OK?” Yeah. Me, too. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kev...
Source: Kevin, M.D. - Medical Weblog - November 20, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Surgery Source Type: blogs

What I'm about to say
I'm appearing on a panel tonight at our great university, entitled "Doctors reading race: how conceptions of race shape medical care." Since you probably can't attend, here's the sneak preview.When I first began to study this issue, 15 or 20 years ago, there were quite a few influential studies that identified disparities in physicians' treatment decisions based on patients' race or ethnicity. For example, Latino patients with long bone fractures were less likely to be prescribed opioids in emergency departments. Doctors were less likely to take a sexual history from adolescent white adolescent girls presenting with abdomi...
Source: Stayin' Alive - November 19, 2014 Category: American Health Source Type: blogs

Chest Pain and Right Bundle Branch Block
A male in late middle age with a history of RCA stent 8 years prior complained of chest pain.  EMS recorded the following ECG:What do you see?  The computer read "Right Bundle Branch Block"There is RBBB and LAFB, which can make it difficult to see the end of the QRS.  I have annotated it here:The lines mark the end of the QRS and beginning of the ST segment.  In RBBB, there should be no ST elevation, or minimal.  In fact, V1-V3 should have some ST depression and T-wave inversion.  Here you can see abnormal (diagnostic) ST elevation and an upright T-wave in V2-V3, with diagnostic ST elevation i...
Source: Dr. Smith's ECG Blog - November 19, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs

OIG Releases Annual “Top Management and Performance Challenges” Facing the Department of Health and Human Services
Yesterday, the Office of Inspector General released their annual summary of the most significant management and performance challenges facing the Department of Health and Human Services (HHS). The 2014 Top Management and Performance Challenges lists ten issues reflecting continuing vulnerabilities that OIG has identified for HHS over recent years as well as new and emerging issues that HHS will face in the coming year. For each category, OIG outlines the challenge, the progress that has been made regarding the challenge, and recommendations they offer going forward. Our coverage highlights a number of the challenges that O...
Source: Policy and Medicine - November 19, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Strange Bedfoes Against NSA Reform Bill
Julian Sanchez The push to rein in the authorities of the National Security Agency—covertly expanded by a secret court to permit indiscriminate bulk collection of Americans’ communications  and financial records—has become a truly bipartisan affair. In a way, this is nothing new: Liberals who recall the abuses of the Hoover era have long teamed with conservatives skeptical of government power in efforts to check excessive surveillance.  With a Senate vote looming to move forward with the USA FREEDOM Act, however, a still stranger mix of opponents is seeking to block what has emerged as the primary vehicle ...
Source: Cato-at-liberty - November 18, 2014 Category: American Health Authors: Julian Sanchez Source Type: blogs

Take Heart Australia
Guest Post by Professor Paul Middleton, emergency physician and founder of Take Heart Australia I have spent the last 20 years practicing emergency medicine on the ground and in the air. I have attended countless cardiac arrests both in hospital and the pre-hospital setting; performed compressions on hundreds of chests; sent countless joules of energy through wobbling hearts, and squirted buckets of adrenaline into cannulae, IO needles and ET tubes…but I still have an empty feeling inside – I know we can do better. We hear about cardiac arrest all the time, and as clinicians working in emergency medicine and cr...
Source: Life in the Fast Lane - November 18, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: Cardiology Pre-hospital / Retrieval Website Chain of survival OOHCA Paul Middleton Professor Paul Middleton Take Heart Take Heart Australia Source Type: blogs

The religion of emergency medicine: It’s time for a reformation
Emergency medicine, like every specialty, is it’s own religion. And on many levels, it tracks right along with the progression of religions from their ancient origins to their modern incarnations. Our unique profession grew out of a pressing need for physicians who could provide immediate and life-saving care to the sick and injured, at all hours of the day or night. The goals of our early practitioners and advocates, our “patristic” and “matristic” founders was to ensure that we did the right research, trained in the right skills and brought them to a nation and world in dire need of high quality...
Source: Kevin, M.D. - Medical Weblog - November 18, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

LITFL Review 156
Welcome to the 156th 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 chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Is clot retrieval in ischemic stroke the next development? Caution in allowing one marginally positive study to change practice. Rory Spiegel implores us to study our past mistakes (NINDS-2) so as to avoid repeating them. [AS] Master your manageme...
Source: Life in the Fast Lane - November 17, 2014 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review LITFL R/V Source Type: blogs

Run your emergency department like a restaurant
Imagine you walk into a restaurant named Luigi’s. From the décor and the smell of pasta sauce coming from the kitchen, you assume that this restaurant serves Italian food. You walk forward, your name is taken and you are then told to sit off to the side and wait until your name is called so that you can get a table. Time goes by, and no one gives you any eye contact or tells you what’s going on but you’re quite hungry and so you wait. Other people go get seated ahead of you and you don’t know why. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social m...
Source: Kevin, M.D. - Medical Weblog - November 17, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

Scaring Students For Their Own Good
Jason Bedrick “I thought he was going to shoot me.” That’s the text message that a mother received from her terrified child at Jewett Middle Academy in Winter Haven, Florida. But the child wasn’t describing a psychotic school shooter. It was a drill. As the local CBS affiliate reported: Students at Jewett Middle Academy said they were terrified when police officers burst in the doors for a planned active shooter drill – but students and teachers are irked they were not told ahead of time. Seventh-grader Lauren Marionneaux told WTVT-TV that when the officers burst into her class with an AR-15, she was in ...
Source: Cato-at-liberty - November 17, 2014 Category: American Health Authors: Jason Bedrick Source Type: blogs

Let There be Light
I have been an emergency registrar approximately forever. Some people’s training years form a crisp, well defined, early-adult life phase. Mine are evolving into a meandering opus. In early 2013, awake with a newborn in the wee hours of the morning, (a highly recommended setting for major life decision making) I concocted an audacious plan to Finish My Training. Rotations, exam sittings and an interstate move all slotted in with tetris-like precision, it was brilliant in theory but too fragile for in vivo conditions. Such was the interdependency of the various elements that an unexpected delay in the completion of one co...
Source: Life in the Fast Lane - November 17, 2014 Category: Emergency Medicine Authors: Kristin Boyle Tags: Healthy Lifestyle Review Tech Tool Tech Tutes night-shift re-timer shift work shiftwork Source Type: blogs

We Still Don’t Know What’s Wrong
A few years ago, I was talking with a medical student who had just finished a shift in the ED. He was an excellent student, but today he had a string of patients who left him frustrated. The 40 year-old woman who presented with abdominal pain left the ED with a diagnosis of “abdominal pain.” We discharged the 35 year-old man who presented with a severe headache with a diagnosis of “possible tension headache.” A five year-old girl with a fever left with “fever of probable viral etiology.” We had gotten blood tests and a CT scan on the woman with abdominal pain, the results of which were normal. We had treated th...
Source: Academic Medicine Blog - November 17, 2014 Category: Universities & Medical Training Authors: David P. Sklar, M.D. Tags: Featured From the Editor ambiguity specialty choice tolerance for ambiguity Source Type: blogs

What a student learned: Medicine’s hidden curriculum
Students undergo a conversion in the third year of medical school: not “pre-clinical” to “clinical,” but “pre-cynical” to “cynical.” — Abraham Verghese, MD The scalpel hovered over the swollen, red and inflamed mass peeking through the opening in the sterile drapes. The patient lay on her side facing away from us, clutching the stiff emergency room pillow against her face and moaning as she rocked back-and-forth. Whenever the surgeon manipulated the mass, she yelped. I was a brand new medical student observing my first incision and drainage of a perirectal abscess. The surgeon sat on a rolling exam chair ...
Source: Kevin, M.D. - Medical Weblog - November 16, 2014 Category: Journals (General) Authors: Tags: Education Medical school Surgery Source Type: blogs

Vaccine-Injured Child Kidnapped from Family by Child Protective Services
Vaccine injury and medical kidnapping stories are becoming commonplace. They are often connected. One mother never thought for a second that vaccinating her child would tear her family apart. Rebekah McClain wants parents to learn what her family is almost unbelievably dealing with because they chose to vaccinate. No child deserves to suffer through this pain. This is her true story.   One Family’s Heartbreak “I have a son named Kacer Lee Harris. He was born on December 25, 2013. He is my Christmas miracle. I have been praying for years to have a child on Christmas Day. It’s all I’ve ever wanted. W...
Source: vactruth.com - November 15, 2014 Category: Allergy & Immunology Authors: Augustina Ursino Tags: Augustina Ursino Top Stories medical kidnapping Rebekah McClain Shaken Baby Syndrome (SBS) truth about vaccines Source Type: blogs

Using Mobile Technology To Overcome Jurisdictional Challenges To A Coordinated Immunization Policy
On March 20, 2014, the Government of Canada and the federal Minister of Health announced the release of ImmunizeCanada (ImmunizeCA), a smart phone application (app) designed to both provide accurate information on immunization for Canadians and allow them to track their and their family members’ immunizations. Based on a prototype developed for parents in Ontario and in partnership with the Canadian Public Health Association, our development team received funding from the Public Health Agency of Canada to build a national immunization app. Our task was to build an Apple- and Android-compatible app, containing all 13 prov...
Source: Health Affairs Blog - November 14, 2014 Category: Health Management Authors: Kumanan Wilson, Katherine Atkinson, and Jennifer Keelan Tags: All Categories Global Health Health IT Public Health Technology Source Type: blogs

Reforming Medicare: What Does The Public Want?
Is Medicare adequately meeting the needs of seniors, or are there ways that its core attributes could be improved? Numerous elected officials, policymakers, and other thought leaders have offered perspectives on ways to change the program. Few efforts, however, have been directed at understanding how the public—given accurate information, a variety of options, and a valid structure for weighing the pros and cons—would change Medicare’s basic design. The MedCHAT Project Recently, the American Enterprise Institute and the Brookings Institution co-hosted a briefing on the results of a California project that did...
Source: Health Affairs Blog - November 13, 2014 Category: Health Management Authors: Marge Ginsburg, Joseph Antos, and Kavita Patel Tags: All Categories Comparative Effectiveness Consumers Coverage Long-Term Care Medicare Policy Public Opinion Spending States Source Type: blogs

What Does Tolerance for Ambiguity Look Like?
By: Marie Caulfield, PhD, manager of data operations and services, Association of American Medical Colleges, Washington, DC Last year my daughter was admitted to a teaching hospital with a kidney infection. The medical student and residents on her treatment team recommended an MRI to rule out a possible anatomical cause. Dr. R., the attending physician, guided them through the case: the medical history did not suggest an anatomical problem, treatment would be the same regardless of the findings, and scans are uncomfortable and expensive. Dr. R. firmly said, “No MRI.” The medical student was clearly uncomfortable with l...
Source: Academic Medicine Blog - November 13, 2014 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective medical students TFA tolerance for ambiguity Source Type: blogs

What in God's Name is Going on With Healthcare IT at Cambridge University Hospitals?
This story about a  UK hospital that recently "went live"with an American electronic health record/enterprise command-and-control system (EPIC) was not only predictable, but expected considering the sorry state of the health IT industry in terms of clinical leadership and regulation.(It appears this was a "big bang" rollout, see http://www.ehi.co.uk/news/EHI/8845/cambridge-goes-for-epic-big-bang, an implementation method better suited for warehouses and widget suppliers than major hospitals.)Addenbrooke’s staff blame blood shortage on new eHospitalBy CambridgeNews  |  Posted: November 05, 2014http://www.ca...
Source: Health Care Renewal - November 12, 2014 Category: Health Management Tags: Addenbrooke Hospital Cambridge University Hospitals healthcare IT crash healthcare IT dangers healthcare IT risk Patient care has not been compromised Source Type: blogs

Imminently Croakable
Coming out of a patient's room, my eyes immediately fell on a hallway bed on which a sobbing linebacker-sized 26-year old man rocked back and forth in a fetal position. He looked sort of like “a kidney stone,” but the tech handed me an EKG chirping "chest pain." The EMR indicated he had a past medical history of asthma, hypertension, and congestive heart failure, but he didn't take any medications. He smoked but denied drug use.   The EKG was not normal. There was no worrisome ST segment elevation, but left ventricular hypertrophy with diffuse T wave repolarization abnormalities suggested longstanding poorly...
Source: Lions and Tigers and Bears - November 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Palliative Care in Emergency Medicine
Applying some principles learned in Palliative Care to every-day Emergency Medicine practice – a guest post by Professor Ian Rogers FACEM, of St John of God Murdoch Hospital and University of Notre Dame in Perth, Western Australia Earlier this year I did a sabbatical in Palliative Care. I deliberately chose to work with a purely consultative service based in a tertiary teaching hospital. They did not admit under their own bed card nor was there a hospice on site to admit to. We saw patients from all across the hospital; from outpatients to ED, from ICU to slow stream rehabilitation. My aim was to gain an understandin...
Source: Life in the Fast Lane - November 12, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: Palliative care Ian Rogers Prof Ian Rogers Source Type: blogs

It’s time to tell fast medicine to slow down
Americans tend to like fast things: instant coffee, sports cars, and speed dating. Many share a fascination with record holders, such as the world’s fastest runner or texter. And increasingly, the same goes for medicine. The number of minute clinics is exploding. Some emergency rooms now post their current wait times on roadside billboards. And increasingly, physicians and other health professionals are under pressure to increase the speed at which they see patients. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin...
Source: Kevin, M.D. - Medical Weblog - November 11, 2014 Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs

More Focus on Surprise Findings in Medical Tests
Emergency room imaging scans can unearth medical problems unrelated to a patient’s initial complaints. Health care providers are stepping up their tracking of and communication with patients about such ‘incidental findings,’ which are rarely followed up. (Source: WSJ.com: The Informed Patient)
Source: WSJ.com: The Informed Patient - November 11, 2014 Category: Consumer Health News Tags: FREE Source Type: blogs

Electronic Health Records: AMA Offers Blueprint to Improve Meaningful Use Program
Conclusion  The AMA’s blueprint comes on the heels of growing stakeholder concern about the Meaningful Use program, especially as it progresses beyond the initial stages. The AMA is frustrated by physicians’ struggles to meet the requirements and the blueprint is an opportunity to modify possible roadblocks facing EHR adoption in the United States. By offering additional flexibilities for physicians, the AMA believes the ultimate goal of Meaningful Use—improving patient care—will be realized. We will monitor EHRs and Meaningful Use as it continues to impact medical practices around the country.   ...
Source: Policy and Medicine - November 11, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Research and Reviews in the Fastlane 057
This study compared bivalirudin to unfractionated heparin with the primary combined endpoint of death, CVA, reinfarction and target lesion revascularization. In spite of the fact that the trial was designed to favor bivalirudin (open-label), the authors found an increased rate in the primary outcome in the bivalirudin group (8.7% vs. 5.7%). Further proof that just because a drug is new, doesn’t mean it’s better. Recommended by: Anand Swaminathan Trauma, PediatricsAltgärde J, Redéen S, Hilding N, Drott P. Horse-related trauma in children and adults during a two year period. Scand J Trauma Resusc Emerg Med. 2...
Source: Life in the Fast Lane - November 10, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Cardiology Education Emergency Medicine Pediatrics Resuscitation Trauma Wilderness Medicine airway brain failure critical care General Surgery hypothermia Intensive Care prehospital recommendations Review Source Type: blogs

The LITFL Review 155
Welcome to the 154th 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 chuck of FOAM. The Most Fair Dinkum Ripper Beaut of the Week Cricoid pressure/force continues to be a contentious point amongst critical care practitioners. Where did it come from? The Bottom Line review and critique the original paper by Sellick. [SO] Insight into the mind of Scott Weingart. How the master...
Source: Life in the Fast Lane - November 10, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: LITFL review LITFL R/V Source Type: blogs

5 ways to ease the integration of NPs and PAs
I talk a lot with different physicians about integrating NP/PA providers into their practice.  I am frequently astonished by the level of reluctance, resistance and downright animosity from these physicians.  Many times a doctor will have a medical “horror story” with the NP/PA  playing  the  villain.  One bad encounter or event seems to  justify a complete rejection of the many positive attributes and contributions of these NP/PA providers, and negates the many studies that reveal comparable and safe care and outcomes.  Besides I have a few horror stories of my own, and guess who the villains are? Continue rea...
Source: Kevin, M.D. - Medical Weblog - November 10, 2014 Category: Journals (General) Authors: Tags: Policy Emergency Nurse Primary care Source Type: blogs

The Last Puzzle Piece
By: Vera P. Luther, MD, assistant professor, Department of Internal Medicine/Infectious Diseases, Wake Forest University School of Medicine My family has a tradition of working together on jigsaw puzzles during holidays and summer vacations. It’s a fun activity that involves teamwork. We enjoy the discovery of interesting shapes and making connections between pieces and groups, but it’s hard to deny that certain satisfaction in placing the last piece of a jigsaw puzzle, a special honor reserved for the youngest member of the family. The practice of medicine and working with people, each wonderfully complex and unique, ...
Source: Academic Medicine Blog - November 10, 2014 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective medical students TFA tolerance for ambiguity Source Type: blogs

Implementing Health Reform: Defining Group Health Plans And More
A primary goal of the Affordable Care Act is to extend individual health insurance coverage through the exchanges and the premium tax credits to Americans who would otherwise be uninsured.  But most working-age Americans and their families remain insured through employer-sponsored group coverage. While seeking to expand individual coverage, therefore, the ACA also attempts to preserve group coverage. Employers and those who advise employers have, however, sought to break down the barrier between group and individual coverage. That is, they have tried to figure out how employers can subsidize individual coverage for their ...
Source: Health Affairs Blog - November 9, 2014 Category: Health Management Authors: Timothy Jost Tags: All Categories Employer-Sponsored Insurance Health Reform Medicaid Policy States Source Type: blogs

Medicine cannot be reduced to just a job. Here’s why.
A few months ago I was paged by a medical student in the emergency room at ten o’clock. I had just changed my clothes, and before my pager went off my attention had been squarely fixed on the newest Jack Reacher novel. You can usually tell when someone is going to ask you to come into the hospital from home, because there are two or three apologies before any details about the case come out. Eventually she got to the part where the patient was bleeding in his mouth, so I called my attending to give him the story and we decided to go in. He offered to stop by my house so we could ride in together, which I accepted bec...
Source: Kevin, M.D. - Medical Weblog - November 9, 2014 Category: Journals (General) Authors: Tags: Physician Cancer Medical school Residency Source Type: blogs

Kaci Hickox: Public health and the politics of fear
Steven H Miles, M.D. Kaci Hickox is a nurse who went to Sierra Leone with Doctors without borders to treat the emergency with Ebola. She is professionally brave, articulate and well trained. Sierra Leone, with 5000 cases, is one the epicenters of the Ebola epidemic.[1] [2] She was last exposed to patient care on October 21.[3] On Friday October 24, she returned to the United States, entering at Newark International Airport in New Jersey. There she was met by a disorganized set of officials who tried to determine what to do with her.… (Source: blog.bioethics.net)
Source: blog.bioethics.net - November 7, 2014 Category: Medical Ethics Authors: Steven Miles Tags: Featured Posts Public Health Source Type: blogs

Marijuana “Edibles” Make Candy Complicated
Pop Quiz! Question: If you look at the candy in the check-out aisle in your local store, an average chocolate bar is 1 serving, and an average bag of candy-covered chocolates (which has about 30 candies) is also 1 serving. What is the average serving of a marijuana edible chocolate bar or bag of a candy that has been infused with THC—the active ingredient in marijuana? Answer:  There is no average serving. Yes, it was a trick question.  But that’s kind of what marijuana edibles are…tricky.  At least for a person who doesn’t use marijuana regularly. For example, in Colorado, a single serving of an edible marijuan...
Source: NIDA Drugs and Health Blog - November 7, 2014 Category: Addiction Authors: The NIDA Blog Team Source Type: blogs

Ebola Shows America Needs Better Disaster Preparedness
Crafting an effective, whole-community strategy to respond to Ebola could stop the spread of the disease now and lay groundwork for responses to future outbreaks and other emergencies. In the long run, this could make public preparedness and resilience valuable assets for the U.S. (Source: The RAND Blog)
Source: The RAND Blog - November 7, 2014 Category: Health Management Authors: RAND Corporation Source Type: blogs

Entrepreneur Develops DIY Medical Imaging
Entrepreneur Jonathan Rothberg has raised $100 million to create a medical imaging device the size of an iPhone that can portray a moving 3-D image of what’s inside a person, according to MIT Technology Review. (http://bit.ly/1Em60Gu.)   The technology, which relies on a new kind of ultrasound chip, could eventually lead to new ways to destroy cancer cells with heat or deliver information to brain cells. The imaging system is being developed by Butterfly Network, but Mr. Rothberg won’t allude to how the device will work or what it will look like. Details will come out in the next 18 months when he is ready to sell it...
Source: Technology & Inventions - November 6, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Deliberation and Bioethics Education: A Case Study of Public Health Emergency Response
This morning, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) turned its attention to its next report topic: deliberation and bioethics education.  The Bioethics Commission advises President Obama and his administration on issues arising from advances in biomedicine and related areas of science and technology and, in so doing, educates the nation […] (Source: blog.bioethics.net)
Source: blog.bioethics.net - November 6, 2014 Category: Medical Ethics Authors: Mary Darby Tags: Health Care ethics education liveblog Liveblog Coverage syndicated Source Type: blogs

Can surgery residency programs be ranked?
In September, Doximity, a closed online community of over 300,000 physicians, released its ratings of residency programs in nearly every specialty. Many, including me, took issue with the methodology. Emergency medicine societies met with Doximity’s co-founder over the issue and echoed some of the comments I had made about the lack of objectivity and emphasis on reputation. 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 - November 6, 2014 Category: Journals (General) Authors: Tags: Education Residency Surgery Source Type: blogs

Healthcare Update Satellite — 11-04-2014
Back with more of the Ebola Chronicles … Ebola fears causing discrimination problems all over the US. Thomas Duncan died from Ebola. Now his fiancee is having difficulty finding a place to live as landlords are refusing to rent to her. People of African descent are facing discrimination just because they are from Africa. Mothers of some school children told one African cafeteria worker to leave the school because she “might have Ebola.” In Liberia, bleeding patients are often refused medical care due to Ebola fears. The picture at the link shows a picture of a woman who was bleeding heavily from a miscarr...
Source: WhiteCoat's Call Room - November 4, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

Research and Reviews in the Fastlane 056
This article offers solutions in which he calls for a shift in the research mentality. The pearls: Focus on replication of research findings (and reward this) Broad collaboration and data sharing Altering the reward system for publication and academic advancement (i.e. reward not the number of publications but their impact; focus on the quality of peer review) Recommended by Lauren Westafer Resuscitation, Emergency MedicineSmekal D et al. CPR-related injuries after manual or mechanical chest compressions with the LUCAS™ device: A multicentre study of victims after unsuccessful resuscitation. Resuscitation 2014. PMID ...
Source: Life in the Fast Lane - November 4, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care Neurology Neurosurgery R&R in the FASTLANE Resuscitation Wilderness Medicine acute coronary syndrome airway blood transfusion critical care ENT Review Source Type: blogs

Health Affairs Event Reminder: Collaborating For Community Health
Policymakers are paying increasing attention to the relationship between the characteristics of communities and the health of the people living in them. The November 2014 issue of Health Affairs, “Collaborating For Community Health,” examines new possibilities created by alignment of the fields of health and community development. These possibilities come from both sides, including recent changes in the community development field that have set the stage for the new focus on improving health, as well as new approaches to health care financing that create incentives for improving health outcomes. You are invited...
Source: Health Affairs Blog - November 4, 2014 Category: Health Management Authors: Chris Fleming Tags: All Categories Nonmedical Determinants Policy Prevention Public Health Source Type: blogs

Physician ratings reward doctors in narrow practice
Admit it, we all do it. All physicians check their quality ratings on the various online sites. If the site allows comment, we read the comments. If we get a bad rating, we try to figure out who was the patient. Isn’t that the chronic back pain patient who was addicted to painkillers and got mad at me because I wouldn’t renew their prescription? What did I do wrong? Did my receptionist have a bad day and yelled at a patient? Did I seem tired and disinterested because I was up all night doing emergency surgery? Continue reading ... Your patients are rating you online: How to respond. Manage your online reputati...
Source: Kevin, M.D. - Medical Weblog - November 4, 2014 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

Social Services And Community Health: Health Affairs’ November Issue
The November issue of Health Affairs includes a number of studies looking at how social services and community support programs can improve the health of local residents. Other subjects covered: the potential for pay-for-performance payment models to create a market that values health, not just health care; how one safety-net accountable care organization is uniquely improving care coordination; a three-year progress report on a regional health collaborative; and more. This issue of Health Affairs is supported by The Kresge Foundation, the Robert Wood Johnson Foundation, and the Annie E. Casey Foundation. It will be discus...
Source: Health Affairs Blog - November 3, 2014 Category: Health Management Authors: Chris Fleming Tags: All Categories Children Disparities Medicaid Nonmedical Determinants Pharma Policy Source Type: blogs

Chaos and Tragedy in a Cambodian ED
By Remi Kessler & Natalie Catherwood   Ms. B was middle-aged and lying on a gurney without a sheet in the grossly under-resourced ED of the largest public hospital in Phnom Penh, Cambodia. She clearly had an altered level of consciousness, and she was not attached to the monitor that was behind the bed. Her open shirt exposed her to the entire ED, but her family had other concerns.   They were quick to leave as we made our way toward the bed. It became evident that she had not been seen by a doctor, despite her deteriorating condition and her family's persistent anxiety. We saw her chest rise and fall irregularly wit...
Source: Going Global - November 3, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Lumbar Puncture Made Simple
Part 2 of a Three-Part Mini-Series on Lumbar Puncture   This month we are back (no pun intended) with the second part of our mini-series focused on perfect patient positioning and lumbar puncture (LP). Part one can be found at http://bit.ly/ProceduralPause.   Now that you have the proper skills to position your patient for an LP, the procedure should be pretty simple, right? The answer is yes! We want you all to be experts. We know that you can and will master an LP after reading these short and sweet LP guidelines and clinical pearls.   Lumbar puncture in the emergency department. Manual of Clinical Anesthesiology;...
Source: The Procedural Pause - November 3, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

To Bind or Not to Bind?
An 88-year-old man with a history of congestive heart failure, hypertension, and diabetes mellitus presented to the ED from a nursing home with altered mental status. EMS reported that the patient has had a decreased appetite, diarrhea, and weakness for three days. His initial vital signs were temperature 97.9°F, heart rate 79 bpm, blood pressure 116/64 mm Hg, respiratory rate 16 bpm, and pulse oximetry 98% on room air. His physical exam was remarkable for a depressed level of consciousness. Lab findings showed a creatinine of 2.6 mg/dl, a BUN of 60 mg/dl, and normal potassium and magnesium. His ECG is shown below.   ...
Source: The Tox Cave - November 3, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs