MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'emergency,'. Tue, 04 May 2010 18:20:28 +0100 http://www.medworm.com/index.php?rid=3527615&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D9339 FEMA launches New Mobile Website, http://m.FEMA.gov This mobile website makes it easier to access critical information regarding emergency preparedness and what to do before and after a disaster right on a smartphone. http://www.fema.gov/news/newsrelease.fema?id=51099 Free iPhone App for Family Reunification in Disaster Situations This new app, “Reunite”, advances capabilities of the iPhone app, “Found in Haiti”, developed by NLM during the Haiti earthquake crisis. The app is primarily intended for medical aid and relief workers that are assisting in family reunification efforts after a disaster, but may also be used by the general public to report missing and/or found people to the site. “Reunite” is available in the iTunes Store at this link: http://i... BHIC blogs http://www.medworm.com/rss/comments.php?id=3527615 Mon, 03 May 2010 15:26:00 +0100 3527615 http://www.medworm.com/index.php?rid=3526698&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F05%2Fmoney-prevents-patients-seeking-timely-heart-care.html by Crystal Phend Lack of insurance and financial concerns keep patients from treating a heart attack like the emergency it is, researchers affirmed. A delay in getting to the hospital for treatment of acute MI was 38% more likely among the uninsured and 21% more likely among insured patients with financial concerns, reported Paul S. Chan, MD, MSc, Mid America Heart Institute in Kansas City, Mo., and colleagues. (...)Read the rest of Money prevents patients from seeking timely heart care No comment | Tags: Emergency, Heart, Patient | Category: Hospital (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3526698 Mon, 03 May 2010 15:00:24 +0100 3526698 http://www.medworm.com/index.php?rid=3526749&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1102 Twice in the last few months I have encountered grief as rage.  Both were in the setting of the cardiac arrest of individuals who were already very ill.  One was aged, with severe, end-stage heart disease.  One was of middle age, but with metastatic cancer and on hospice. In one instance, family members became angry because we did not leave the body in the ER for eight hours so that everyone could come and pay their respects.  (Which I always thought was the purpose of a funeral home.)  In another, a family was angry because we did not allow everyone back into the room during the resuscitation of their cancer-stricken loved one; a resuscitation the family insisted upon, and which required rescinding hospice status.  From observing their demeanor, their presence would have caused tota... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3526749 Mon, 03 May 2010 12:54:15 +0100 3526749 http://www.medworm.com/index.php?rid=3526750&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1098 The moral implications of health-care reform.  My column in today’s Greenville News. http://www.greenvilleonline.com/article/20100502/OPINION/305020027/1016/Ed-Leap-Let-s-talk-about-what-s-moral How many health-care dollars would we save if children were all born within the confines of marriage? If their biological fathers were fathers in every sense? Evidence suggests that children with fathers involved in the home, in intact families, are not only economically more secure but healthier, safer and experience greater educational success. And how many health-care dollars would we save if men and women did not have serial sexual partners, did not contract and spread the many sexual transmitted infections that plague the country? We would certainly reduce the amount of money spent on... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3526750 Mon, 03 May 2010 00:40:36 +0100 3526750 http://www.medworm.com/index.php?rid=3524121&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1096   This is my column in May’s edition of Emergency Medicine News.  My point is, we should keep working for the sake of the sick and injured children, if for no other reason. http://journals.lww.com/em-news/Fulltext/2010/05000/Second_Opinion__Why_You_Should_Keep_Going_Back_to.7.aspx (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3524121 Sat, 01 May 2010 16:26:50 +0100 3524121 http://www.medworm.com/index.php?rid=3524117&cid=t_303806_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhaiti-life-and-death-decisions%2F2010.05.01 A premature baby and a woman giving birth must share the only oxygen tank in a hospital in the poorest part of Haiti, Port de Paix. Dr. Jon LaPook recounts the harrowing experience. Watch CBS News Videos Online (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3524117 Sat, 01 May 2010 12:00:11 +0100 3524117 http://www.medworm.com/index.php?rid=3519399&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fcardiac-arrest-resuscitation-wife-witness.html by StorytellERdoc, MD The patient arrived in cardiac arrest. He had been brought to our emergency department in the middle of the night. Although he had a significant cardiac history, he was only in his late-forties. His transport from his house to our department had been less than ten minutes and, along the way, the pre-hospital team had done an excellent job of intubating this patient and establishing an IV. His wife was with him. Less than fifteen short minutes before their arrival, her life had been altered forever when her husband had woken her, from a deep sleep, to complain that he had intense chest pain. Seconds after, she witnessed him become unresponsive. (...)Read the rest of Cardiac arrest resuscitation, with wife as witness 6 comments | Tags: Emergency, Heart, Hospital | Cate... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3519399 Thu, 29 Apr 2010 17:05:21 +0100 3519399 http://www.medworm.com/index.php?rid=3512848&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D9297 A new page of links to information on “Crude Oil Spills and Human Health” is now available from the National Library of Medicine at http://disasterinfo.nlm.nih.gov/dimrc/oilspills.html. The page has links to information on how the US responds to oil spills, state agencies in the Gulf region that respond to spills, occupational hazards for professionals and volunteers assisting with clean-up, seafood safety and more. The links under “Featured Sites” focus on the latest updates about the recent spill and subsequent controlled burning of crude oil in the Gulf of Mexico following the explosion and sinking of the Deepwater Horizon Mobile Offshore Drilling Unit oil platform. (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=3512848 Wed, 28 Apr 2010 23:30:42 +0100 3512848 http://www.medworm.com/index.php?rid=3524122&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1094 Why yes, I am judging you! This is a question from my forthcoming self-published book, tentatively titled ‘The Practice Test.’  The book will be a series of questions that I consider to be ‘board questions no one ever asks.’  The target audience is those leaving medical school or residency, but it will be equally relevant to college students going into medicine, those in practice, those whose doctors need a laugh and a boost and those whose loved ones are currently practicing in ‘the belly of the beast.’ #14 It’s not the job of the physician to judge any patient; we must be values neutral. True or False. False! What a ridiculous idea. We make judgments all the time. If you see a child who has been abused, you judge the abuser as bad. If you see ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3524122 Wed, 28 Apr 2010 01:46:10 +0100 3524122 http://www.medworm.com/index.php?rid=3509203&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D9283 http://www.safeamericaprepared.org/ The Safe America Foundation partners with corporate, governmental, public and private sector organizations, and other nonprofits to improve the safety awareness and preparedness of Americans nationwide. Some of their current programs include: 9/11 Drill Down For Safety 9/11 Drill Down for Safety is program designed to utilize existing resources for individuals and families to create local practice drills. The challenge is to engage the public in a meaningful way to enhance national preparedness in perpetual readiness drills. The four elements include: Special Needs Challenges During a Disaster Prepare for the Worst Report http://www.safeamericaprepared.org/tools/pdf/PreparefortheWorst.pdf “This newsletter is written for any individual with a disabi... BHIC blogs http://www.medworm.com/rss/comments.php?id=3509203 Tue, 27 Apr 2010 19:41:20 +0100 3509203 http://www.medworm.com/index.php?rid=3508160&cid=t_303806_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FjSIZi8S2QVs%2F In about 10% of cases the source of the bleeding isn't immediately apparent, usually because it's a small aneurysm that's hidden by some clotting, or it's a normal blood vessel that bursts. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3508160 Tue, 27 Apr 2010 18:50:51 +0100 3508160 http://www.medworm.com/index.php?rid=3524123&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1092 It’s all too easy to try and quantify everything in medicine.  We are, after all, under the widely held delusion that medicine is like physics.  A thing that follows fixed, predictable mathematical models.  A thing reproducible if only algorithm A is followed for this disease and algorithm B is followed for that disease. This belief is also held by the government, which doesn’t want to pay for re-admissions or mistakes.  Because it is believed that all things in medicine can be known from an exam, some labs, some tests and some studies. Nevertheless, things happen.  Disease are transmitted in public or by families.  Medications don’t always work.  Bodies change.  Bodies age.  Humans are non-compliant.  Humans are suffering from physiologic phenomena we can&#8217... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3524123 Mon, 26 Apr 2010 15:14:12 +0100 3524123 http://www.medworm.com/index.php?rid=3504866&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fhealth-reform-er.html by Chris Rangel, MD Contrary to popular belief, those without health insurance are not flooding emergency rooms as a consequence of being cut off from routine and preventive care. Actually, frequent visitors to the local ER are far more likely to have insurance according to a new review of 25 studies on ER use published since 1990. Frequent users account for about 8% of ED patients but 28% of visits. Although frequent users are not a homogeneous group, 60% are white and their average age is 40. Roughly 60% are enrolled in Medicare or Medicaid. The uninsured do not dominate EDs; 15% of frequent ED visitors have no coverage, the study found. Only about 2% of uninsured adults visit an ED four or more times in a year. (...)Read the rest of Health reform won’t help the ER No comment | Ta... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3504866 Mon, 26 Apr 2010 13:00:05 +0100 3504866 http://www.medworm.com/index.php?rid=3502815&cid=t_303806_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FUXoxSdre_Jk%2F I just came back home from 38th Exhibition of Inventions Geneva held in Geneva, Switzerland. Among around a thousand inventions, including 55 from class M (Medicine, Surgery, Hygiene, Orthopedics, Materials for the handicapped), I have demonstrated my CPR device (you can see it in my presentation from Amsterdam). The whole experience was truly fantastic and made even sweeter at the end, since my invention was awarded a gold medal from the international jury. Big thank you goes out to people from Noven, StivTrade, Croatian Association of Inventors, and Istrian Inventors. For a quick preview, take a look at the short video below. More media will follow. (Source: Ivor Kovic, M.D.) Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=3502815 Sat, 24 Apr 2010 21:19:46 +0100 3502815 http://www.medworm.com/index.php?rid=3499015&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fpsychiatric-patients-detained-er.html by Edwin Leap, MD Our state of South Carolina is a delight. From wonderful people to beautiful landscapes, from a vibrant Southern culture to excellent food like shrimp and grits, it’s a place I’m thrilled to live. But we do lack a few things. And one of the most striking is adequate mental health care. The state budget, like so many state budgets, has been trimming anything and everything. And of course, mental health coverage is one of those things lopped steadily away. I don’t need to tell anyone in emergency medicine that this is often a problem. (...)Read the rest of Psychiatric patients detained in the ER 8 comments | Tags: Emergency, Hospital | Category: Hospital (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3499015 Thu, 22 Apr 2010 17:00:25 +0100 3499015 http://www.medworm.com/index.php?rid=3524129&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1074 At least I take an aspirin with my crack! Not long ago, my partner cared for a patient who was experiencing chest pain. The patient had already undergone a cardiac bypass surgery.  He told my partner that he was currently using crack and methamphetamine. Now, let me ask, whether he has no insurance, private insurance, Medicaid or  Medicare, is this fair to the system?  If he gets disability, is it fair to the system?  If an insurer couldn’t deny him coverage, would that be fair to those who are paying into the system, but trying to stay healthy?  Those who will probably contribute far more than they cost the insurance pool?  (And who would certainly cost less than this ‘member of the pool.’) Would you be willing to hand him your money to cover his expenses, knowing ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3524129 Thu, 22 Apr 2010 13:30:23 +0100 3524129 http://www.medworm.com/index.php?rid=3524130&cid=t_303806_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1071 I’m always fascinated by the complaints that the emergency department is so over-used and expensive.  I admit that it is used a lot, and that care can seem expensive.  But I want to make it clear that the reasons are myriad. Whenever we in the specialty say that we feel that patients abuse our services, someone in academia reminds us that only a small number of those patients do not actually have serious illnesses.  Whether or not that’s true, one of the reasons we are over-used is due to none other than other physicians! I’ve been paying attention lately to the way physician referral patterns happen.  I suspect it’s the same in other facilities. Here’s an example.  Local physician, who does not admit to the hospital, sees patient in the office.  Patient... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=3524130 Wed, 21 Apr 2010 12:22:38 +0100 3524130 http://www.medworm.com/index.php?rid=3488239&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D9147 : Harnessing the Power of Health Information and Communication Technologies http://bit.ly/b3wuhV Outlines the preparedness challenges for people with disabilities and other at-risk groups, describes the information and communications technologies being used by healthcare providers and consumers, and gives examples of ways state governments and local communities are using technology to reach those who are most at risk. [Rural Assistance Center Health Update] (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=3488239 Tue, 20 Apr 2010 16:18:30 +0100 3488239 http://www.medworm.com/index.php?rid=3473186&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D9075 http://www.remm.nlm.gov/ REMM provides guidance for health care providers, primarily physicians, about clinical diagnosis and treatment of radiation injury during radiological and nuclear emergencies. See what’s new on REMM http://www.remm.nlm.gov/whatsnew.htm (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=3473186 Thu, 15 Apr 2010 22:49:22 +0100 3473186 http://www.medworm.com/index.php?rid=3467691&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fpatients-visit-emergency-department-insurance.html by Joyce Frieden Most patients who visit the emergency department (ED) four or more times a year have health insurance and a primary care physician, a review of the literature found. “The uninsured represent only 15% of frequent users and are no more likely to be frequent users than they are to be occasional ED users (<4 visits/year),” Eduardo LaCalle, MD, MPH and Elaine Rabin, MD, of the Mount Sinai School of Medicine in New York City, wrote online in Annals of Emergency Medicine. (...)Read the rest of Patients who visit the emergency department have insurance No comment | Tags: Emergency, Health reform, Primary care | Category: Health policy and politics (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3467691 Wed, 14 Apr 2010 12:58:10 +0100 3467691 http://www.medworm.com/index.php?rid=3464944&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D9043 Public Health Management of Disasters: The Pocket Guide http://bit.ly/c5k49W [55 page PDF] The Pocket Guide is intended to be a quick field resource for public health interventions in the days immediately preceding and following emergencies. [PHPartners http://phpartners.org/ – New Links for the week of Apr 09, 2010] Program on Reproductive Health and the Environment Reach the Decision Makers Training Program http://prhe.ucsf.edu/prhe/reachdecisionmakers.html The Reach the Decision Makers Training Program is designed to help your organinzation directly inform the US Environmental Protection Agency on the issues that are important to your community. Reach the Decision Makers (Reach), a project of the UCSF Program on Reproductive Health and the Environment, is an innovative science and pol... BHIC blogs http://www.medworm.com/rss/comments.php?id=3464944 Tue, 13 Apr 2010 17:37:07 +0100 3464944 http://www.medworm.com/index.php?rid=3463529&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fhealthcare-workers-er-hit-hard-h1n1.html by Michael Smith Healthcare workers in a New York City emergency department had the highest rate of infection among employees of an urban hospital system during the first wave of the H1N1 pandemic flu, researchers said. In a single-institution study using medical and administrative records, the adult emergency department had an H1N1 infection rate of 28.8% during April, May, and June of 2009, according to Robert Bristow, MD, and colleagues at New York-Presbyterian Hospital. (...)Read the rest of Healthcare workers in the ER hit hard by H1N1 No comment | Tags: Emergency, Hospital | Category: Hospital (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3463529 Tue, 13 Apr 2010 15:00:00 +0100 3463529 http://www.medworm.com/index.php?rid=3460112&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Femergency-departments-frequently-young-adults.html by Kristina Fiore Twenty-somethings rely on emergency departments (EDs) for care far more than do other age groups, researchers have found. In 2006, nearly a quarter of all young adult healthcare visits — 22.1% — took place at an ED, compared with 12.6% for children and adolescents and 8.3% for patients over 30. (...)Read the rest of Emergency departments are frequently used by young adults No comment | Tags: Emergency | Category: Hospital (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3460112 Mon, 12 Apr 2010 15:00:04 +0100 3460112 http://www.medworm.com/index.php?rid=3460118&cid=t_303806_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F04%2F11%2Fsunday-news-round-up-back-online-edition%2F I’m finally back online at home! While I’ve been away, I’ve learned adult/child CPR/AED use and infant CPR, registered to be an organ donor, listened to a lot of classical music on the radio courtesy of the local public radio station, played a lot of Rummy and lost at Lord of the Rings Trivial Pursuit (as usual), had my first lunch at Swett’s, and read B is for Beer, Warbreaker, War Dances, The Lassa Ward and half of Middlemarch. Here are some things that transpired or were written with style in the interim. First, Our Bodies Ourselves is accepting nominations for the 2010 Women’s Health Heroes awards. Nominations are due by the end of this month, so make yours today! OBOS has also launched the Word by Word campaign, in which a donation to support the organi... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3460118 Sun, 11 Apr 2010 17:02:34 +0100 3460118 http://www.medworm.com/index.php?rid=3443636&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fpatient-attacks-doctors-nurses-frequent.html With the attention focused, rightly, on patient safety, what about health care workers? It’s somewhat of a hidden phenomenon, but attacks on doctors and nurses are on the rise. (...)Read the rest of Patient attacks on doctors and nurses are more frequent 2 comments | Tags: Emergency, Patient | Category: Physician practice (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3443636 Wed, 07 Apr 2010 11:00:34 +0100 3443636 http://www.medworm.com/index.php?rid=3440725&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fhospital-admissions-require-watching-waiting.html by Edwin Leap, MD A sweet little lady came to the emergency department recently. She said she felt short of breath and sweaty at home. In the department, she looked like a rose! Normal oxygen levels, normal labs. Her chest x-ray had a faint area that ‘one might possibly imagine could perhaps be’ a pneumonia. It looked remarkably like her previous film. (...)Read the rest of Hospital admissions may require watching and waiting No comment | Tags: Emergency, Hospital | Category: Hospital (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3440725 Tue, 06 Apr 2010 17:00:46 +0100 3440725 http://www.medworm.com/index.php?rid=3440726&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F04%2Fipad-er-hands-physician-review.html by Larry Nathanson, MD I had been anxiously awaiting the arrival of my iPad. This is the form factor I have been asking (begging) of all the vendors for years. I’m very happy to say that it appears to be living up to my high expectations. (...)Read the rest of iPad in the ER, a hands on physician review 3 comments | Tags: Emergency, EMR | Category: Health IT and EMR (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3440726 Tue, 06 Apr 2010 14:57:43 +0100 3440726 http://www.medworm.com/index.php?rid=3429191&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F03%2Flesson-over-a-latte-emergiblog.html Some of our patients are made, not born… (The story you are about to read is true.) The day was uncharacteristically warm. via Lesson Over a Latte // Emergiblog. Related posts:Happy 4th Blog Birthday to Emergiblog! And, a Grand Rounds! Kim’s done an excellent job there, and is the moving... Change of Shift Begins Fourth Year: Volume Four, Number One // Emergiblog Change of Shift Begins Fourth Year: Volume Four, Number One... Change of Shift: Vol. Four, Number 4 // Emergiblog Change of Shift: Vol. Four, Number 4 // Emergiblog Welcome... Related posts brought to you by Yet Another Related Posts Plugin. (Source: GruntDoc) GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3429191 Wed, 31 Mar 2010 22:31:13 +0100 3429191 http://www.medworm.com/index.php?rid=3424795&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F03%2Fer-overuse-myth.html Overuse of the emergency department is commonly discussed during the health care conversation. Especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER. But is this a myth? That’s what two emergency physicians contend in a piece from Slate. The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits cost far more than primary care, but even this is disputable. In fact, the marginal cost of treating less acute patients in the ER is lower than paying off-hours primary care doctors, as ERs are already open 24/7 to handle life-threatening emergencies.” “Unnecessary” emergency use is no different from the perceived waste in other me... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3424795 Wed, 31 Mar 2010 11:00:19 +0100 3424795 http://www.medworm.com/index.php?rid=3420504&cid=t_303806_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F03%2F30%2Fits-not-my-emergency%2F Part one of a two part series on scene presence. A regular reader of The EMT Spot asked a great question recently. (Thanks Timothy.) “How do I keep my cool and not loose my head in stressful situations?” I want to give you a tip that has worked well for me in the past. It’s a phrase I learned as an EMT and it’s helped me on countless occasions. “It’s not my emergency.” I know. I know what you’re thinking. On the surface, “It’s not my emergency.” sounds like a very callous and uncaring thing to say. But give me a chance to explain. I was taught the phrase, “It’s not my emergency.” by a talented young paramedic who was a mentor in my early years in EMS. Since I first learned it, I’ve heard it used in a ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3420504 Tue, 30 Mar 2010 12:00:29 +0100 3420504 http://www.medworm.com/index.php?rid=3420622&cid=t_303806_125_f&fid=34820&url=http%3A%2F%2Fwww.dentalblogs.com%2Farchives%2Fadministrator%2Froot-tip-remover-by-inventdent%2F InventDent introduces the Root Tip Remover… Extracting a difficult tooth? Did you break off the root tip in the bottom of the socket? Is it too late to call the Oral Surgeon? Don’t spend thousands of dollars on expensive root removal kits! Remove root tips in minutes, and save your production for the rest of the day! The Root Tip Remover is a finger instrument that will allow you to remove root tips without causing substantial or unneeded trauma to the surrounding hard and soft tissues. Allowing for increased healing time, and a more predictable end result.  The crisscross design allows the doctor to turn the cylindrical finger grip without tearing their gloves, while maintaining enough grip to screw the Root Tip Remover down into the remaining root tip for removal. The ... dental blog for dentists about dentistry blogs http://www.medworm.com/rss/comments.php?id=3420622 Mon, 29 Mar 2010 16:49:17 +0100 3420622 http://www.medworm.com/index.php?rid=3415988&cid=t_303806_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F29%2Femergency-medicine-journal-2009-vol-27-no-1%2F Emergency Medicine Journal 2009 (Vol. 27, No. 1) content page Fade Fave: How have changes to out-of-hours primary care services since 2004 affected emergency department attendances at a UK District General Hospital? A longitudinal study Fade Skinny: The changes to the provision of out-of-hours primary care have been associated with an increase in patients with non-traumatic attendances presenting to our emergency department. This effect is most marked outside of office hours. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Accident and Emergency Departments, Athens Password, Current Awareness, E-Journals, Out of Hours, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3415988 Mon, 29 Mar 2010 10:54:02 +0100 3415988 http://www.medworm.com/index.php?rid=3405456&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8777 ebrary Launches Free Natural Disaster and Extreme Weather Searchable Information Center http://site.ebrary.com/lib/disaster In light of the recent earthquakes in Haiti and Chile, and many others who are impacted by the natural disasters and extreme weather that occur in the world each year, ebrary’s staff have been working to gather authoritative, public domain information from government websites and creating a highly interactive, searchable database using DASH! (Data Sharing, Fast) and other ebrary services.They recently announced that the result, a publicly available research center featuring hundreds of important government documents related to natural disasters and extreme weather, is now available. Crisis Communication & social media http://tinyurl.com/yzxrs6b A lot of the focu... BHIC blogs http://www.medworm.com/rss/comments.php?id=3405456 Fri, 26 Mar 2010 02:02:23 +0100 3405456 http://www.medworm.com/index.php?rid=3403882&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F03%2Fsenate-weighs-bill-proposing-to-shield-emergency-room-personnel-from-malpractice-suits-florida-miamiherald-com.html Senate weighs bill proposing to shield emergency-room personnel from malpractice suits A GOP-sponsored bill would make all emergency room medical providers — even at private hospitals — ‘agents of the state’ thus giving them sovereign immunity in medical malpractice lawsuits. BY JOHN FRANK Times/Herald Tallahassee Bureau TALLAHASSEE — Even as the GOP assails President Barack Obama’s healthcare overhaul as a “government takeover”, top Florida Republicans are pushing a measure that opponents say would do the same for the state’s emergency rooms. State Sen. John Thrasher, the Florida Republican Party chairman, is pushing legislation to make all emergency room healthcare providers — nurses, doctors and even paramedics — “a... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3403882 Thu, 25 Mar 2010 06:24:38 +0100 3403882 http://www.medworm.com/index.php?rid=3390801&cid=t_303806_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2010%2F03%2Fmy-three-shrinks-podcast-50-more-about.html In this show we continue with our guest Dr. Pat Barta of the Adventures in Telepsychiatry blog.We talk about electronic health information systems and Clink continues her rant which she started in her post Rage Against The Machine. Roy mentions the Certification Commission for Health Information Technology and the American Recovery and Reinvestment Act which provides funding incentives for doctors who use health information technology. We cover developing standards for behavioral health information technology, including personal health records which allow patients to store their own information voluntarily "in the cloud", on a server. Dr. Pat Barta talks Open source health record systems and information security.Health Data Rights is an organization that developed a proposed declaration of... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=3390801 Mon, 22 Mar 2010 13:00:00 +0100 3390801 http://www.medworm.com/index.php?rid=3383017&cid=t_303806_134_f&fid=34841&url=http%3A%2F%2Fwww.diabetesmine.com%2F2010%2F03%2Fin-case-of-emergency-this-keychain-gadget-could-be-your-lifeguard.html Let’s face it: a medical ID bracelet really doesn’t answer all the questions someone would need to ask if they found you unconscious in an emergency.  But clearly, no one wants to schlep around a binder-full of medical history when they work out or travel. A number of new tech gadgets are being developed to [...] (Source: Diabetes Mine) Diabetes Mine blogs http://www.medworm.com/rss/comments.php?id=3383017 Fri, 19 Mar 2010 13:00:32 +0100 3383017 http://www.medworm.com/index.php?rid=3378438&cid=t_303806_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fin-sickness-and-in-health-in-theory%2F Last October, my son and I were enjoying a cozy Saturday morning reading Dr. Seuss while my husband readied himself for work. Suddenly, we heard a loud thud coming from the first floor. We flew down the stairs to find my husband lying prone in the front hall. His back had given out. He’d been having back trouble for about a year, but since beginning regular physical therapy, I had deluded myself into thinking he was on the mend. What I thought now was, “Oh, shit!” This “I’ve-fallen-and-I-can’t-get-up” version of my husband was unfamiliar to me. The guy I married never gets sick. He pooh-poohs the notion of illness. In the 12 years we’ve known each other, I’ve only seen him take Tylenol twice. I’m the pill popper in the family. One four-hour visit to the ER later, th... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3378438 Thu, 18 Mar 2010 14:00:49 +0100 3378438 http://www.medworm.com/index.php?rid=3371488&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8607 Flood Preparedness MedlinePlus Health Topic Floods http://www.nlm.nih.gov/medlineplus/floods.html Links to information from the EPA, FEMA, the American Red Cross and more Spanish Language Health Topic Inundaciones http://www.nlm.nih.gov/medlineplus/spanish/floods.html From the CDC http://emergency.cdc.gov/disasters/floods/readiness.asp?s_cid=tw_epr_163 Includes Basic Steps, Supplies and Evacuation information. There are also links to Spanish,  Vietnamese and French views of this page. Helping the Helpers Help Themselves Webinar In The Wake Of Disasters -How Will You Respond? Wednesday, March 31, 2010 3:00 PM – 4:00 PM EDT Surprising as it might seem, many community organizations that provide everyday assistance to others aren’t prepared to fall on hard times themselves. When fac... BHIC blogs http://www.medworm.com/rss/comments.php?id=3371488 Tue, 16 Mar 2010 15:18:23 +0100 3371488 http://www.medworm.com/index.php?rid=3370334&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F03%2Fiphone-apps-emergency-room-wait-times-caution.html by Satish Misra Emergency rooms are notorious for their long waiting times – that’s pretty common knowledge. But now the Hospitals of Central Connecticut are looking to a new medical app for the iPhone to help improve their emergency room wait times. Having spent a fair amount of time recently working in an emergency room, I (and probably everyone with similar experiences) can assure you that no one – physicians, nurses, administrators – want it to be that way. Much effort has been made in improving patient triage, workflow management, and other areas of opportunity that could increase the efficiency with which a patient is managed when they get to the emergency room. Some emergency rooms, like Hospital of Central Connecticut, are now looking to improve efficiency even before the p... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3370334 Mon, 15 Mar 2010 18:00:10 +0100 3370334 http://www.medworm.com/index.php?rid=3366128&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F03%2Fusa-today-oped-paying-doctors-patient-satisfaction.html My latest USA Today op-ed was published this morning: Patient satisfaction surveys have drawbacks. I discuss how patient satisfaction scores affect physician salaries, which may, in turn, influence medical decision making.  Of course, patient satisfaction is important and should be measured — but it’s a mistake to use them in part to determine physician compensation. Here’s an excerpt: Quality health care sometimes means saying “no” to patients; denying them habit-forming pain medications that can feed an underlying, destructive drug addiction, or refusing to order unneeded CT scans that can facilitate harmful radiation exposure. Satisfaction scores give patients a needed voice to express their concerns, which can help medical professionals improve their pati... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3366128 Mon, 15 Mar 2010 13:00:45 +0100 3366128 http://www.medworm.com/index.php?rid=3354316&cid=t_303806_87_f&fid=38113&url=http%3A%2F%2Fblogs.consumerreports.org%2Fhealth%2F2010%2F03%2Femergency-life-supportwhat-every-parent-should-know.html If a child stops breathing, and their heart stops beating, you need to act fast. Every cell in the body needs oxygen to survive, and if the blood stops bringing fresh oxygen, the cells begin to die. That can quickly lead to brain damage and death. So every parent should know how to provide life support for a child, until the emergency medical services arrive. This is what the American Heart Association’s guidelines recommend: Check the child for movement and response to your voice If the child isn’t moving or responding, call for help and start life support. If possible, get someone else to call 911. Ensure the child is lying face up on a hard surface. Check their mouth and throat are not blocked. Tilt their head backward slightly and lift their chin. Cover the child’s mout... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=3354316 Thu, 11 Mar 2010 16:00:00 +0100 3354316 http://www.medworm.com/index.php?rid=3343855&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8485 U.S. Health System Not Meeting the Needs of People Living With Chronic Conditions http://www.rwjf.org/pr/product.jsp?id=50968 Chronic Care:  Making the Case for Ongoing Care, a 2010 update of the Robert Wood Johnson Foundation’s 2002 chartbook, examines the impact of chronic conditions on individuals and their caregivers, as well as the inadequacies of the U.S. health care system to meet their needs. The data highlight the current problems encountered by people living with chronic health conditions. Most significantly, “care provided in the current acute, episodic model is not meeting the needs of people with chronic conditions and often leads to poor outcomes for patients with chronic conditions,” writes Gerard Anderson, Ph.D., author of the chartbook and former director of RWJF’... BHIC blogs http://www.medworm.com/rss/comments.php?id=3343855 Mon, 08 Mar 2010 18:21:36 +0100 3343855 http://www.medworm.com/index.php?rid=3339626&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F03%2Fct-scans-diagnose-chest-pain-er.html by John Mandrola, MD During residency, there was always a case of misdiagnosed chest pain to discuss in conference.  Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent, but repetitively observed, phenomenon. So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a vexing problem. Chest pain diagnosis is like appendicitis; there are always small numbers of unusual cases in which an accurate diagnosis proves elusive.  In medicine, there is no such thing as perfection in diagnosis and no better example exists than chest pain. Chest pain is ubiquitous — hundreds of patients per day from all walks of life with all manner of co-morbidities present daily to the ER.  The stories vary, ECG&#82... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3339626 Sat, 06 Mar 2010 20:00:55 +0100 3339626 http://www.medworm.com/index.php?rid=3336533&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8435 National Public Health Leadership Development Network Annual Conference http://www.heartlandcenters.slu.edu/nln/events.html April 27-30, 2010, Nebraska City, NE. The theme of the conference is Innovation 2010/Vision 2020: Creating the Future of Leadership Development. Webinar: The Public Health Role in Climate Change: Communication and Effective Messaging Strategy https://cc.readytalk.com/cc/schedule/display.do?udc=859t8qs55w7u March 11, 2010, 12:00-1:00 PM EST. The session will cover the challenges related to communicating about climate change and how public health professionals can be effective messengers. APHA’s Get Ready Campaign: Set Your Clocks, Check Your Stocks http://www.getreadyforflu.org/clocksstocks/index.htm APHA’s Get Ready campaign reminds everyone to check prepa... BHIC blogs http://www.medworm.com/rss/comments.php?id=3336533 Fri, 05 Mar 2010 21:17:06 +0100 3336533 http://www.medworm.com/index.php?rid=3323955&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8339 National Library of Medicine (NLM) Resources for recovery and response to the earthquake in Chile are up http://sis.nlm.nih.gov/dimrc/earthquakes.html (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=3323955 Wed, 03 Mar 2010 03:11:40 +0100 3323955 http://www.medworm.com/index.php?rid=3322360&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F03%2Femergency-medicine-bloggers-life-in-the-fast-lane.html Prompted by a series of tweets and buzzes pertaining to the knowledge base of Emergency Medicine bloggers we felt it was time to overhaul our ‘BlogRoll‘ and create a separate table for the Emergency bloggers, their twitter handles and RSS feeds. via Emergency Medicine Bloggers | Life in the Fast Lane. Nice list!  If you find an omission, please leave it there, and not here. Related posts:Sam Ko’s Emergency Medicine Blog: Ten Emergency Medicine Websites I Love and Will Marry Sam Ko’s Emergency Medicine Blog: Ten Emergency Medicine Websites I... Living the Scientific Life (Scientist, Interrupted): Finnish Emergency Medicine: An American’s Experience Living the Scientific Life (Scientist, Interrupted): Finnish Emergency Medicine: An... We’re Failing Our Resident... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3322360 Tue, 02 Mar 2010 03:44:16 +0100 3322360 http://www.medworm.com/index.php?rid=3316948&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8291 The following online medical information resources are available at no cost, thanks to the generosity of participating publishers. Most of these resources are usually available only by paid subscription. Publishers have made these resources available for health care providers responding to the Haiti earthquake. [from the Disastr-Outreach-Lib Listserv] Emergency Access Initiative, http://eai.nlm.nih.gov. This online collection provides access to 200+ popular medical journals. It also includes over 60 e-books, including the Merck Manual, Harrison’s Internal Medicine, basic textbooks, drug handbooks, and titles on emergency medicine, infectious diseases, toxicology, post-disaster public health and more.  Emergency Access Initiative is a collaborative effort between the U.S. National Librar... BHIC blogs http://www.medworm.com/rss/comments.php?id=3316948 Sun, 28 Feb 2010 20:00:08 +0100 3316948 http://www.medworm.com/index.php?rid=3314603&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fhaiti-earthquake-broken-health-infrastructure.html by Erin Marcus, MD Dr. Barth Green co-founded Project Medishare, which has worked in Haiti for two decades. He led the first team of U.S. physicians to Port-au-Prince after the earthquake and, together with the University of Miami’s Global Institute, spearheaded the development of a 240-bed tent hospital that is now the country’s largest functioning urgent care hospital. His group is working with the U.S. government to establish Haiti’s first rehabilitation hospital. Green spoke with Erin N. Marcus on Feb. 5th. How would you describe the country’s health infrastructure before the earthquake? There are wonderful doctors and nurses in Haiti. But as far as a real health infrastructure, it didn’t exist, because they didn’t have the funding. They haven’t had the resources, the tec... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3314603 Sat, 27 Feb 2010 12:00:48 +0100 3314603 http://www.medworm.com/index.php?rid=3314605&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fpatient-satisfaction-scores-affect-physicians.html by Edwin Leap, MD I am very blessed. The hospital where I practice, while concerned with patient satisfaction, does not worship at its altar. That is, so far our administrators seem to understand that people will occasionally be angry or unsatisfied, and that such dissatisfaction is within the realm of real life. We still have people storm out of the emergency department, prattling on about lawyers and lawsuits, promising to go to another hospital in the future (which we heartily encourage). On the whole, we do a bang-up job of keeping the right people happy, and an adequate job of making the right people unhappy. But it saddens me to hear about so many physicians, all across the country, who are slaves to Press-Ganey scores and other patient satisfaction tools. These poor, beset practiti... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3314605 Fri, 26 Feb 2010 18:00:14 +0100 3314605 http://www.medworm.com/index.php?rid=3311675&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F02%2Fabem-is-over-reaching-their-role.html The American Board of Emergency Medicine (ABEM) describes itself as: Welcome to the American Board of Emergency Medicine (ABEM) public website.  ABEM certifies qualifying physicians who specialize in Emergency Medicine and is a member board of the American Board of Medical Specialties (ABMS).  ABMS certification is sought and earned by physicians on a voluntary basis. ABEM and other ABMS member boards certify only those physicians who meet high educational, professional standing, and examination standards.  ABEM and other ABMS member boards are not membership associations. The thing I’d like to bring your attention to is that it’s a Voluntary organization.  For a voluntary organization they’re adding lots of requirements without asking members… Since most o... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3311675 Thu, 25 Feb 2010 21:37:33 +0100 3311675 http://www.medworm.com/index.php?rid=3303906&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8249 http://hurricanes.ii.fsu.edu/index.html Florida’s individual public libraries provide a range of useful hurricane and disaster preparation and recovery services to their communities but their individual efforts are often isolated and unavailable to the rest of the library community. There has been no systematic effort to identify the roles, best practices, activities, tools and resources developed by local public libraries for their communities and to make them available to the larger library profession. All public library managers could help their communities respond better if they had the benefit of some portion of their fellow library managers’ disaster experience. This project will reduce the state’s overall risk by raising the capacity of all the state’s public libraries to me... BHIC blogs http://www.medworm.com/rss/comments.php?id=3303906 Wed, 24 Feb 2010 14:38:17 +0100 3303906 http://www.medworm.com/index.php?rid=3302383&cid=t_303806_109_f&fid=34786&url=http%3A%2F%2Fdrmichelletempest.blogspot.com%2F2010%2F02%2Faccident-emergency.html This photograph was taken whilst I was working in A&E with a team of other doctors and nurses. In the dying days of this current Labour government the National Audit Office reported that only one hospital in England and Wales can report to have full consultant cover 24/7. Staff on the frontline know that the Labour legacy is a health emergency. (Source: The Psychiatrist Blog) The Psychiatrist Blog blogs http://www.medworm.com/rss/comments.php?id=3302383 Wed, 24 Feb 2010 13:08:00 +0100 3302383 http://www.medworm.com/index.php?rid=3299638&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8227 http://www.ahrq.gov/prep/acfselection/ A public health emergency can strain the capacity of hospitals and other traditional venues for medical services. In such emergencies, it may be necessary to select alternate facilities for providing medical care. The report listed below, and the related interactive computer tools, will help institutions and communities select alternate care facilities and determine which patients to send to them. The two new interactive tools are Disaster Alternate Care Facility Selection Tool and an ancillary tool, Alternate Care Facility Patient Selection Tool. The Report: Cantrill SV, Pons PT, Bonnett CJ, Eisert S. Disaster Alternate Care Facilities: Report and Interactive Tools. Prepared by Denver Health under Contract No. 290-20-0600-020. AHRQ Publication No. 09... BHIC blogs http://www.medworm.com/rss/comments.php?id=3299638 Tue, 23 Feb 2010 16:44:29 +0100 3299638 http://www.medworm.com/index.php?rid=3298260&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fer-triage-patient.html by John Schumann, MD The ER is the portal of entry to our hospitals now, for better and for worse. On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and are triaged appropriately to their destination. A good ER evaluation should answer the following questions: 1. What’s the nature of the illness? Are we dealing with the heart, the brain, or an abdominal organ? Is the cause an infection, a blockage, or a blood clot? 2. Based on #1, where will the patient best be situated? Will the patient need intensive care, or will the “regular” floor be sufficient to attend to the issues at hand? Should the patient be admitted to a surgical team or a medical (non-surgical) team? Depending on the hospital, does the ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3298260 Mon, 22 Feb 2010 20:00:31 +0100 3298260 http://www.medworm.com/index.php?rid=3287691&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Ftexting-cell-phone-common-hospitals.html by Edwin Leap, MD The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind me of what I was supposed to be doing. I’m not really a fan of texting, though my wife and oldest son seem to communicate that way quite effectively. It’s like having two telepathic alien species, who talk to one another across the ether while the rest of us are stuck in neolithic spoken tongues. I understand the appeal of those little devices. Sometimes, though I really don’t need it, I find myself coveting a ’smart-phone.’ The younger physicians I meet have instant access to what is, apparently, all of the medical knowled... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3287691 Thu, 18 Feb 2010 18:00:48 +0100 3287691 http://www.medworm.com/index.php?rid=3283473&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fresidency-programs-prepare-doctors-real-world.html According to a recent editorial from Emergency Medicine News, emergency residency programs are doing a poor job preparing their emergency residents for the real world. The authors note that a typical, large urban academic emergency department comprise less than 5 percent of U.S. ERs, and that “residency programs train physicians in some of the most inefficient EDs in the land. Relative value units of emergency medicine work per hour in the teaching hospital setting is typically half that seen in private practice.” I think this applies to primary care residencies, as well. Many academic medical practices cannot replicate the pace and volume that a typical private practice experiences. Compounded with the lack of any formal business training that doctors today need, it’s n... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3283473 Thu, 18 Feb 2010 12:00:25 +0100 3283473 http://www.medworm.com/index.php?rid=3279976&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F02%2Fthe-laurinburg-exchange-shooting-at-scotland-memorial-hospital.html Scotland Memorial Hospital was locked down Monday morning after a shooting left a patient in critical condition and another man in police custody. The 3 a.m. shooting appears to have stemmed from a brawl at a McColl, S.C. night club, according to Laurinburg police. Authorities say it involved the victim, his girlfriend and the daughter of the shooter just a few hours earlier…. via The Laurinburg Exchange – Shooting at Scotland Memorial Hospital. This exact scenario is why most hospitals have some system to anonymize victims of violence in the ED, and sometimes throughout their hospital stay.  (We have one, and I’m not letting its incredibly complex code out…). That doesn’t make them either invisible or bulletproof, and we’ve seen a few examples of our t... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3279976 Wed, 17 Feb 2010 01:42:12 +0100 3279976 http://www.medworm.com/index.php?rid=3277238&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D8087 Earthquake Preparedness: Lessons Learned from Haiti and California http://www.citizencorps.gov/news/webcasts/earthquakewebinar.shtm Date and Time: Thursday, February 18th @ 2-3pm EST Presenters: Mark Benthien and Steve Willey The Community Preparedness Webinar series focuses on bringing together government and community leaders to involve citizens in all-hazards preparedness and resilience. The recent 7.0 earthquake that shook Haiti less than 800 miles from Miami, FL, has raised awareness that such an event could occur in America. Presenting on the topics of education, preparedness, training, and community involvement will be Mark Benthien, Director for Communication, Education and Outreach (CEO) for the Southern California Earthquake Center and Executive Director of the Earthquake Countr... BHIC blogs http://www.medworm.com/rss/comments.php?id=3277238 Tue, 16 Feb 2010 14:37:29 +0100 3277238 http://www.medworm.com/index.php?rid=3275797&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F02%2Frichardwintersmd-skipped-a-beat.html The handle bar of the snowmobile fractured his ribs. Nice guy. Mid-60s. Talkative and generous in his remarks. It occurred yesterday. He thought it would heal by itself. Didn't want to bother us. But now he was a little breathless. His lung was punctured. His skin was full of air. It crackled and popped as I rubbed the betadine on his chest in preparation for the procedure…. via richard[WINTERS]md: Skipped a beat.. He doesn’t post much, but when he does, it’s usually good. Please check it out, and if you like it, leave him a comment you came from here, and thank him for getting me into blogging… Related posts:Guest Post from Dr. Richard Bukata In an effort to get the word out about their... I need a new explanation Because mine no longer makes sense to pe... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3275797 Tue, 16 Feb 2010 07:28:09 +0100 3275797 http://www.medworm.com/index.php?rid=3266863&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fhaiti-disaster-relief-efforts-applied-domestically.html by John Schumann, MD Like most people, I’ve found the news and images coming from Haiti in the aftermath of the January’s earthquake appalling and upsetting. The sheer amount of devastation and orders of magnitude loss of life make the story compelling by itself. Coupled on top of Haiti’s ignominious history, the situation touches us for its Job-like quality: ”How much misery can one people withstand?” I’ve been pleased at the outpouring of support for Haiti. Part of me feared a sense of ‘crisis fatigue’ after the pacific tsunami and Hurricane Katrina, in addition to the fact that our economy is so weak. And, let’s be honest–Haitians are very much ‘others’–darker skinned, with a French-sounding language that likely doesn’t play well in more conservative/isol... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3266863 Thu, 11 Feb 2010 22:00:06 +0100 3266863 http://www.medworm.com/index.php?rid=3262563&cid=t_303806_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F02%2F10%2Fat-our-bodies-our-blog-emergency-contraception-a-panel-discussion-at-wellesley-and-spanish-language-posts%2F At Our Bodies Our Blog, I have a post on an emergency contraception drug working its way through the approval process in the U.S. and info on an upcoming panel discussion in Wellesley, MA on new mammography and breast self-examination recommendations featuring speakers from the National Women’s Health Network and Black Women’s Health Imperative. I’m also really thrilled to see more Spanish-language posts going up – here’s the Spanish version of a recent one of mine on the reversal of the HPV vaccine requirement for U.S. immigrant women. Thanks to our volunteer translator! Filed under: Boobs, Cancer, Events & Observances, Government, HPV, Women's Health (Source: Women's Health News) Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3262563 Thu, 11 Feb 2010 00:29:18 +0100 3262563 http://www.medworm.com/index.php?rid=3262557&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fearthquake-affect-future-haitian-american-community.html by Erin Marcus, MD Marleine Bastien is the founder and executive director of Fanm Ayisyen Nan Miyami–Haitian Women of Miami–www.fanm.org, which advocates for the rights of Haitian women. She is also a congressional candidate for U.S. House District 17, representing Little Haiti and other neighborhoods in Miami. Erin N. Marcus spoke with Bastien on Jan. 22 about the Haiti earthquake. What has FANM been doing since the earthquake? As soon as we heard about it, we headed to the Haitian Community Center. The next day we organized all the groups under the leadership of the Haitian-American grassroots coalition, an umbrella of 15 different organizations that I co-founded. By Thursday we had our first relief center open. Now, we’re getting water, clothing, foods, dried beans, tent... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3262557 Wed, 10 Feb 2010 18:00:36 +0100 3262557 http://www.medworm.com/index.php?rid=3254491&cid=t_303806_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2010%2F02%2Fwhats-psychiatric-emergency.html People have been writing in to respond to my Emergency! post and asking what constitutes an emergency in psychiatry. Some people are worried that I'll be taken advantage of if I'm too easy to schedule emergent appointments.So what's a psychiatric emergency?First, let me say that by design, I keep my life a little lose. I don't like scheduling far in advance, I don't have a secretary, I try to be accommodating and mostly this works for me. Once in a great while I feel like people are playing musical appointments and I vaguely wish it weren't so, but you can't have your cake and eat it to (unless you buy two cakes, and that might well be an option). So people who miss a lot of appointments, I tell them to call when they want to come in. You want to return in 3 months? You think I know my sch... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=3254491 Tue, 09 Feb 2010 00:52:00 +0100 3254491 http://www.medworm.com/index.php?rid=3254510&cid=t_303806_109_f&fid=34786&url=http%3A%2F%2Fdrmichelletempest.blogspot.com%2F2010%2F02%2Fdo-we-have-enough-staff-in.html The Northern Echo report that accident victims are dying unnecessarily at some of the region’s hospitals, according to a study by the National Audit Office (NAO). The NAO investigation found that many die because they suffer injuries at night or at weekends, when emergency consultants are not on call to provide the rapid diagnosis and treatment. This is more evidence that the Labour Party have not understood the NHS and have neglected our front line services here in the North East. (Source: The Psychiatrist Blog) The Psychiatrist Blog blogs http://www.medworm.com/rss/comments.php?id=3254510 Mon, 08 Feb 2010 22:17:00 +0100 3254510 http://www.medworm.com/index.php?rid=3254470&cid=t_303806_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2010%2F02%2F08%2Fmastering-the-head-to-toe-assessment%2F You probably practiced your head-to-toe assessment a bunch in your EMT class. Maybe more than any other skill in the EMT curriculum. If your class was or is anything like mine (as a student or a teacher) you performed the head-to-toe assessment again and again. As much as we practice this skill in EMT class, I often wonder why so many EMT’s have such bad head-to-toe skills out on the street. It seems that, once we get out on the street, the systematic, thorough head-to-toe assessment falls out of favor and quickly gets replaced with the faster, more direct focused assessment. That works just fine most of the time. If it didn’t, I figure it probably wouldn’t be such a universal phenomenon. (For the record, have you ever worked somewhere where this wasn’t the case? ... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3254470 Mon, 08 Feb 2010 21:46:07 +0100 3254470 http://www.medworm.com/index.php?rid=3251156&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fforget-patient-algorithms-care.html The common thought among health reformers is that we spend too much on care, and the additional care patients receive doesn’t necessarily help them. What inevitably follows is a discussion on how to streamline care, yet maintain quality. To that end, most hospitals and emergency rooms are using algorithm-based care based on the best available evidence. Where doctors actually had to hand write admission orders, they are now checked off – like a menu at a restaurant. But sometimes diagnosis requires more nuance. How do you know, for instance, that the patient really has pneumonia as you’re running down the pneumonia checklist? That’s a question that Stanford physician Abraham Verghese asks as well: Indeed, the push for efficiency and “quality” has every ho... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3251156 Mon, 08 Feb 2010 12:00:06 +0100 3251156 http://www.medworm.com/index.php?rid=3248511&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fbiggest-risk-soldiers-fighting-overseas.html Originally published in MedPage Today by John Gever, MedPage Today Senior Editor More than 85% of American military medical evacuations from the Middle East were not the direct result of enemy action, but the result of non-battle injuries and disease, researchers said. Of some 34,000 military personnel in Iraq and Afghanistan who shipped out for medical reasons from 2004 to 2007, only 14% had been wounded or injured in combat, according to Steven P. Cohen, MD, of Johns Hopkins, and colleagues. The most common reasons for medical evacuation were non-battle related musculoskeletal and connective tissue disorders, accounting for 24% of evacuations, the researchers wrote in the Jan. 23 issue of The Lancet. Combat injuries were the second most common, followed by neurological disorders (10%) ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3248511 Sat, 06 Feb 2010 20:00:16 +0100 3248511 http://www.medworm.com/index.php?rid=3243741&cid=t_303806_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F02%2F05%2Fmajor-trauma-care-in-england%2F Title: Major trauma care in England (Executive Summary) Skinny: National Audit Office report that finds unacceptable variation in major trauma care in England.  Care for patients who have suffered major trauma, for example following a road accident or a fall, has not significantly improved in the last 20 years despite numerous reports identifying poor practice, and services are not being delivered efficiently or effectively. Survival rates vary significantly with a range from five unexpected survivors to eight unexpected deaths per 100 trauma patients, reflecting the variable quality of care. The NAO estimates that 450 to 600 lives could be saved each year in England if major trauma care was managed more effectively. Best outcomes are delivered by services led by consultants experienced i... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3243741 Fri, 05 Feb 2010 11:53:51 +0100 3243741 http://www.medworm.com/index.php?rid=3243788&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F02%2Fohio-com-akron-general-puts-er-wait-times-on-billboards-internet.html Trying to avoid a painfully long wait in the ER? One local hospital system is publicly sharing the current average wait time to see a doctor at all its emergency departments. Akron General Health System recently began advertising up-to-the-minute wait times for its emergency rooms on billboards throughout town. Six digital billboards in Akron are automatically updated every 20 minutes to show current average wait times to see a doctor … The average times are computer generated, based on current patient information from the health systems’ electronic medical records… via Ohio.com – Akron General puts ER wait times on billboards, Internet. I think this isn’t terrible, as long as there’s some education that a) these are average times and that b) if you have... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3243788 Fri, 05 Feb 2010 07:00:59 +0100 3243788 http://www.medworm.com/index.php?rid=3243831&cid=t_303806_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2010%2F02%2Femergency.html I often get calls from patients who want to come in "as soon as possible." Especially new patients, but sometimes established patients. I try to be as flexible and accommodating as possible, but sometimes it gets a bit inconvenient. Now I'm in confabulation mode, but I'm curious about readers' opinions of how one should respond to emergencies. Often, I offer an appointment asap and the person requesting it can't make it and asks for another time. So it becomes a bit of juggling of priorities. And I'm left wondering how much the doc should be thinking about juggling (if at all). So let me fly some scenarios by you, and I'm curious as to what you think. The details are all confabulated, but the essence of the stories have gone down in some form over the past few years. For both the doc and ... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=3243831 Fri, 05 Feb 2010 01:16:00 +0100 3243831 http://www.medworm.com/index.php?rid=3239588&cid=t_303806_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FTbQk7cB8bOc%2F Organizers have published the video of my talk from recently held Mobile Monday Amsterdam event titled Mobile Health. Be sure to watch it and let me know what you think. Mobile Monday Amsterdam now has their own YouTube channel, so you can watch all those brilliant talks from their previous and future events. Tweet This Post (Source: Ivor Kovic, M.D.) Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=3239588 Wed, 03 Feb 2010 18:26:30 +0100 3239588 http://www.medworm.com/index.php?rid=3235772&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Fdead-buried-haiti.html Originally published in MedPage Today by Crystal Phend Aid appears to still be trickling in to Haiti, making little headway against the swelling need for food, water, and medical care after last Tuesday’s earthquake. With a projected death toll between 100,000 and 200,000, the dead bodies piled in the streets — and reportedly even being incorporated into roadblocks by angry Haitians — are a concern. Most media reports have acknowledged that the bodies pose more of a psychological than a public health threat. One interview aired on my local National Public Radio station, though, was disconcerting in its emphasis on disposal of bodies as part of the initial urgent response to the disaster. A few media reports have followed suit, such as the Toronto Sun, which included &#... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3235772 Wed, 03 Feb 2010 16:00:00 +0100 3235772 http://www.medworm.com/index.php?rid=3235815&cid=t_303806_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FTo4UBjifATo%2F Medical evacuation flights from Haiti to the U.S. started up again after HHS officials said hospitals can receive federal payments equal to 110% of Medicare rates for providing care to Haitians. A flight last night took 17 patients to Palm Beach, according to the Miami Herald. (That’s one of the arrivals in the photo.) The medical evacuations had stopped last Wednesday after Gov. Charlie Crist had said that Florida hospitals – the destination of the vast majority of Haiti earthquake victims – were reaching the saturation point. The feds yesterday activated more provisions of the National Disaster Medical System to help U.S. hospitals provide care to “critically ill survivors” from Haiti. The NDMS is a voluntary system under which U.S. hospitals set aside some of their acute-care ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3235815 Tue, 02 Feb 2010 18:00:11 +0100 3235815 http://www.medworm.com/index.php?rid=3231481&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F02%2Fwere-failing-our-residents-training-ed-docs-for-the-real-w-emergency-medicine-news.html Emergency Medicine News: February 2010 – Volume 32 – Issue 2 – p 5, 24, 25, 26 Residents training in large urban centers typically see more than 200 patients a day. They have access to all subspecialty care, typically available 24 hours a day. Residents have around-the-clock access to angioplasty, interventional radiology, hand surgeons, neurosurgeons, and plastic surgeons. Most practice emergency medicine with cardiologists and neurologists in the building or a short phone call away. Decision-making is shared, and occurs with a relative surplus of information and opinions and in a milieu of shared risk. In reality, though, these very large and highly-specialized EDs with Level I trauma comprise less than five percent of U.S. EDs, according to the American College of Surg... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3231481 Tue, 02 Feb 2010 16:58:01 +0100 3231481 http://www.medworm.com/index.php?rid=3231413&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F02%2Femrs-slow-medical-charting-requiring-information.html by Edwin Leap, MD We have a new EMR system. I like it because I type well. I’m facile at using a keyboard and touch-screen. Not everyone in my group is so blessed, and we’ve had some difficulties using the voice-transcription software. Nevertheless, my gut tells me that in a month or two more, we’ll be getting along with our new system swimmingly. It’s the sort of thing I have wanted for a while, since I truly hate to dictate; and especially hated dictating the information the nurses had already entered into the computer! However, I have an issue. Not so much with our EMR, but with all EMR. I have an issue with the deeply-held delusion that computerization will automatically improve charting and patient care. Some time ago, the inimitable, world famous blogger Dr. Wes told me that... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3231413 Mon, 01 Feb 2010 20:00:05 +0100 3231413 http://www.medworm.com/index.php?rid=3228852&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7879 Add the Health Resources for Haiti Widget to your website. Find the code on the National Library of Medicine Disaster Information Management Research Center website http://disaster.nlm.nih.gov/ Emergency Access Initiative Updates:  http://eai.nlm.nih.gov There are now over 65 reference books libraries and hospitals affected by the earthquake in Haiti.  In addition, NLM thanks the participating publishers for their generous support of this initiative:  American Academy of Pediatrics, American Association for the Advancement of Science, American College of Physicians, American Society of Health-Systems Pharmacists, ASM Press, B.C. Decker, BMJ, Elsevier, FA Davis, Mary Ann Liebert, Massachusetts Medical Society, McGraw-Hill, Merck Publishing, Oxford University Press, People’s Medical Pub... BHIC blogs http://www.medworm.com/rss/comments.php?id=3228852 Mon, 01 Feb 2010 16:30:03 +0100 3228852 http://www.medworm.com/index.php?rid=3228856&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7847 Last November, Google introduced “Google site templates” http://tinyurl.com/yg6tro5; one of the first templates released was developed by the Stanford Social Innovation and Entrepreneurship Program to be used by public health departments to communicate with the public during public health emergencies. View the template at http://sites.google.com/site/einfopht/ View the users guide at http://sites.google.com/site/einfophu/ (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=3228856 Mon, 01 Feb 2010 14:34:22 +0100 3228856 http://www.medworm.com/index.php?rid=3218138&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7807 Health Information in Haitian Creole Refugee Health Information Network (RHIN) is a national collaborative partnership managed by refugee health professionals whose objective is to provide quality multilingual, health information resources for those providing care to resettled refugees and asylees. They have a link to Haitian Creole materials on the home page. To check it out go inline to the RHIN homepage (http://www.rhin.org) and click on Health Information in Haitian Creole in the Featured Resources section at the upper left side of the page. In addition to the language materials, there are links to provider resources, such as the “Haitian Cultural Backgrounder” and the “Haiti Adoptive Parents Fact Sheet”. Haiti Relief Toolkit http://www.k4health.org/toolkits/ha... BHIC blogs http://www.medworm.com/rss/comments.php?id=3218138 Fri, 29 Jan 2010 02:58:55 +0100 3218138 http://www.medworm.com/index.php?rid=3216528&cid=t_303806_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F28%2Fhealth-service-journal-2010-21st-january%2F Fade Fade: Rise in acute admissions will be ‘unsustainable’ for PCTs Fade Skinny: Just 10 per cent of primary care trusts have successfully reduced emergency admissions to their local acute trusts. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: Acute Services, Current Awareness, Emergency Admissions, Journals, Primary Care Trusts (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3216528 Thu, 28 Jan 2010 12:07:35 +0100 3216528 http://www.medworm.com/index.php?rid=3208503&cid=t_303806_114_f&fid=34963&url=http%3A%2F%2Fsymtym.net%2F2010%2F01%2Faccess-standards-unintended-consequences%2F State adopts nation’s first health care access standards—Sacramento Business Journal The rules require health maintenance organizations to ensure they have enough doctors and other providers to meet the following time frames: Triage or screening by telephone 24/7 Wait times of no longer than 30 minutes for telephone triage A wait of no more than 10 minutes to speak to a HMO customer service representative during normal business hours 48 hours for urgent–care appointments that do not require prior authorization 96 hours for urgent–care appointments requiring prior authorization, including specialists 10 business days for non–urgent primary care appointments 15 business days for non–urgent appointments with specialists 10 business days for non–urge... symtym blogs http://www.medworm.com/rss/comments.php?id=3208503 Tue, 26 Jan 2010 03:24:57 +0100 3208503 http://www.medworm.com/index.php?rid=3205934&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7753 The National Library of Medicine (NLM), in partnership with members of the Professional & Scholarly Publishing division of the Association of American Publishers announce the availability of free full-text articles from over 200 biomedical journals and over 30 select reference books for libraries and hospitals affected by the earthquake in Haiti. The collection is also intended for healthcare personnel responding to the disaster. The Emergency Access Initiative collection is a combination of common biomedical journal titles and reference books, and also emergency medicine related titles.  The Emergency Access Initiative serves as a temporary collection replacement and/or supplement for libraries affected by disasters that need to continue to serve medical staff and affiliated users. ... BHIC blogs http://www.medworm.com/rss/comments.php?id=3205934 Mon, 25 Jan 2010 21:27:41 +0100 3205934 http://www.medworm.com/index.php?rid=3201721&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fstroke-patients-receive-clot-busting-drugs.html Originally published in MedPage Today by Todd Neale, MedPage Today Staff Writer Patients suffering an acute ischemic stroke are about 20% more likely to receive clot-busting therapy with tissue plasminogen activator (tPA) if they arrive at the hospital on the weekend, a retrospective study showed. However, there was no difference in rates of inhospital mortality based on the time of admission, Abby Kazley, PhD, of the Medical University of South Carolina in Charleston, and colleagues reported in the January issue of Archives of Neurology. “Just because patients present on the weekend doesn’t necessarily mean that they’re going to get less aggressive or less quality care than they might otherwise,” Kazley said in an interview. Previous studies have shown that quali... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3201721 Sat, 23 Jan 2010 20:00:42 +0100 3201721 http://www.medworm.com/index.php?rid=3197601&cid=t_303806_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FhJC7gK7pQqQ%2F The USNS Comfort, a converted supertanker that is now a Navy hospital ship, opened its 12 operating rooms and 1,000 beds to Haiti earthquake victims even before it dropped anchor off Port-au-Prince. Patients started landing Tuesday night via helicopter, including some that had been temporarily cared for on the aircraft carrier USS Carl Vinson. Among the first dozen patients, one was 82 years old; another was 72 hours old, the Miami Herald reported today. Sailing from its home port of Baltimore, the Comfort arrived short-handed, with about 350 crew members still expected to arrive in the next few days to bring the ship up to capacity, the Baltimore Sun said. The ship, which was launched as a supertanker in 1976 and converted to a hospital ship in 1987, normally has a crew of 61 civilians, 2... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3197601 Thu, 21 Jan 2010 21:34:09 +0100 3197601 http://www.medworm.com/index.php?rid=3195097&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7713 Haiti Earthquake – Links to resources on recovery http://disaster.nlm.nih.gov/dimrc/haitiearthquake.html From the National Library of Medicine, Disaster Inormation Management Research Center The page lists new web pages about the Haiti earthquake situation from both government agencies and non-governmental organizations (NGOs). There is also a section on Haitian Creole and French-language materials. Links to background information on earthquakes and subsequent health issues, such as public health assessments, emergency surgical care, and  management of dead bodies, are included. The page will continue to expand and will add a section on hazards from concrete dust and other airborne particulates from the collapsed buildings and subsequent clean-up activities. Please let me know if yo... BHIC blogs http://www.medworm.com/rss/comments.php?id=3195097 Thu, 21 Jan 2010 15:11:31 +0100 3195097 http://www.medworm.com/index.php?rid=3193664&cid=t_303806_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F21%2F8597%2F Title: Swine flu and employment Skinny: Discusses the impact of swine flu (H1N1) on employment. The pandemic has raised some challenging issues in the workplace and the article addresses some of these issues. Most practices will have issues maintaining a service, and article encourages practice managers to carry out a staff audit to minimise the chances of being caught out by staff absences. Includes a background history to the outbreak of swine flu. Posted in Emergency Planning, General Practice, Influenza, Journals, Management Tagged: Audit, H1N1, Influenza, Practice Management, Swine Flu, Workforce Planning (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3193664 Thu, 21 Jan 2010 11:11:46 +0100 3193664 http://www.medworm.com/index.php?rid=3193690&cid=t_303806_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F0Xg-S2TxqyU%2F You’re a TV correspondent on the scene in Haiti, reporting on the devastation following the Jan. 12 earthquake. But you’re also a doctor in the place where there’s an intense need for people to treat the injured. How do you keep the normally distinct roles of doctor and journalist separate? The biggest broadcast networks and CNN all have doctor-journalists on the ground in Haiti who have ended up providing emergency care in addition to performing reporting duties, the Los Angeles Times and the Washington Post report. Their medical rounds have included splinting bones, helping deliver babies and performing operations. Reporters usually try to avoid becoming part of the story they’re covering and most journo-docs told the papers they didn’t plan to be aid giver... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3193690 Wed, 20 Jan 2010 20:44:05 +0100 3193690 http://www.medworm.com/index.php?rid=3189080&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fdoctor-writes-day-haiti.html by Jonathan Crocker, MD From Cange, Central Plateau Haiti 01-18-10 We arrived at Cange, in the Central Plateau, the heart of operations for Partners In Health/Zamni Lasante, yesterday. As we expected, things are incredibly busy. People are still arriving from Port au Prince. Those who have been fortunate enough to survive their injuries this long are now running into complications of wound infections, some of which have turned septic, and venous blood clots (from immobility and trauma). Patients have completely filled the hospital and we have set up makeshift wards in a nearby church and school. We have surgical and non surgical personnel working tirelessly. We are doing lots of wound evaluation, injury stabilization, and post-op care. We are planning to get the more complicated surgery ca... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3189080 Tue, 19 Jan 2010 21:49:40 +0100 3189080 http://www.medworm.com/index.php?rid=3186811&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7703 From the National Library of Medicine NLM has an Earthquake topic page on MedlinePlus in English, http://www.nlm.nih.gov/medlineplus/earthquakes.htm,  and in Spanish, http://www.nlm.nih.gov/medlineplus/spanish/earthquakes.html Health Information in Haitian Creole (Kreyol),” http://www.nlm.nih.gov/medlineplus/languages/haitiancreole.html and in French,  http://www.nlm.nih.gov/medlineplus/languages/french.html.  Information in multiple languages is also available from the Refugee Health Information Network, http://rhin.org The Hesperian Foundation (http://www.hesperian.org)  publishes texts available in English and Haitian Creole for download for free including Where There is No Doctor and Where Women Have No Doctor. Global Call to Action: Nurses to Aid in Haiti Volunteer & Di... BHIC blogs http://www.medworm.com/rss/comments.php?id=3186811 Tue, 19 Jan 2010 17:11:48 +0100 3186811 http://www.medworm.com/index.php?rid=3185335&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F01%2Fem-blog-em-blog-our-mythbuster-confronts-dr-fish-by-joseph-leibman%25c2%25a0md.html We left the Mythbuster confronted by the evil Dr. Fish the urologist in the Saint -We Never Change Anything in Years hospital. The Mythbuster doesn't lose a step in dealing with a threatening urologist armed with a 100 french cathether. “Urologist, Huh? Still think you get anything by hydrating renal colic patients? Well look at the Journal of Endourology 20(10) 713 . Flooding patients does nothing for pain perception or lessening of narcotic needs. Sure if the patient is vomiting or dehydrated, but this practice does nothing for stone passage” Dr. Fish flinched. via EM Blog – EM-Blog – Our Mythbuster Confronts Dr. Fish by Joseph Leibman, MD. Pretty good! Related posts:(A different) Dr. RW on Hugh Hewitt’s blog: Townhall.com::Blog Townhall.com::Blo... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3185335 Mon, 18 Jan 2010 18:54:15 +0100 3185335 http://www.medworm.com/index.php?rid=3185260&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fscenes-haiti-earthquake-future-holds.html Originally published in MedPage Today by Michael Smith I remember walking through the squalid downtown of Port-au-Prince and coming across a woman sitting by the roadside selling carefully washed tin cans. That was how she made her meager living. There were scenes that were more appalling — a man on a street corner with his head split open by a machete, a corpse on a pile of burning tires. This was in late 1987, when hopes for freedom and democracy after decades of brutal dictatorship was rudely shattered by election-day violence. In the days before the election, gunfire and explosions echoed in the night but the people I talked to were optimistic about the future. In fact, on the morning of election day, I spoke to people in long line-ups waiting to vote at polling stations that ha... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3185260 Mon, 18 Jan 2010 18:29:09 +0100 3185260 http://www.medworm.com/index.php?rid=3179666&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7679 As we are all watching the disaster and relief efforts unfold in front of us, I am surounded by colleagues in Boston attending the Americal Library Association. I learned of two tools created by libraries in Massachusetts to assist people in learning more about this effort. From the University of Massachusetts at Amherst comes the library guide “Disaster in Haiti” http://guides.library.umass.edu/haiti From Boston Public Library comes an informational page “Crisis in Haiti” http://www.bpl.org/news/haiti.htm With these two web pages, you can learn more about Haiti, stay up to date on the news about the disaster, and learn about legitimate ways to help. (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=3179666 Sun, 17 Jan 2010 11:51:21 +0100 3179666 http://www.medworm.com/index.php?rid=3180294&cid=t_303806_114_f&fid=34963&url=http%3A%2F%2Fsymtym.net%2F2010%2F01%2Fangioedema%2F For me the core of Emergency Medicine is what we term the ABCs—airway, breathing, and circulation. Our mission is simply establish and maintain the ABCs, and you will maintain life. Of course most of Emergency Medicine does not involve the ABCs—in fact, quite the opposite, primary and chronic care consumes an ever increasing percentage of our ER time. But when you get a case of the ABCs—you remember why you chose this specialty. All who practice Emergency Medicine have the type of cases they like and those they don’t. I’ve always been intriqued with angioedema—suddenness, insidiousness, progressiveness, and potential for life–threat. It’s the enemy you never underestimate and never turn your back on. In the last month I’ve had 4 cases: ... symtym blogs http://www.medworm.com/rss/comments.php?id=3180294 Sun, 17 Jan 2010 04:40:16 +0100 3180294 http://www.medworm.com/index.php?rid=3178733&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fhaiti-earthquake-media-coverage-impeding-rescue-crews-supplies.html Originally posted in MedPage Today by Bjoern Kils The 7.0 magnitude earthquake struck Haiti’s Porte-au-Prince at 4:53pm on January 12, 2010. Just 20 hours later, CNN’s Anderson Cooper was updating the AC360 blog from the Dominican Republic, while making his way to an airfield to board a United Nations helicopter to take him and his crew into Haiti. While the media plays a central role in disseminating information to the masses — especially during crisis — I was wondering why TV crews were being shuttled towards the epicenter instead of packing those UN choppers with search and rescue crews, doctors, and supplies. There are many reports of emergency response teams ready to deploy but without a way to the island — the bottleneck being the damaged Port-au-Prince... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3178733 Sat, 16 Jan 2010 16:00:53 +0100 3178733 http://www.medworm.com/index.php?rid=3178735&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fdiseases-arise-lack-clean-water-haiti.html Originally posted in MedPage Today by Michael Smith, MedPage Today North American Correspondent The lack of clean water in the stricken Haitian capital fosters conditions that may spawn an epidemic of enteric disease. “Having large numbers of people in close proximity and not using appropriate sanitation can potentially spark those epidemics, particularly if people are forced to drink surface water,” said Rebecca Dillingham, MD, of the University of Virginia in Charlottesville, who works closely with an infectious disease clinic near the heart of Port-au-Prince. Waiting in the wings are diseases caused by bacteria, such as Salmonella typhi and less invasive salmonella microbes, as well as protozoans, such as cryptosporidium. Those pathogens constantly circulate in the crowded ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3178735 Sat, 16 Jan 2010 03:08:00 +0100 3178735 http://www.medworm.com/index.php?rid=3175815&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Ftips-haiti-earthquake-relief-find-charity-donations.html by Erin Marcus, MD It’s impossible to watch coverage of the immense suffering in Haiti and not want to help. But many charitable groups seem to have sprung up since the disaster, and it’s tough to know which ones will be most effective at getting your donation to those most in need. To try to sort out the difference between the major aid groups, I asked Haitian-American community organizers, as well as physicians I know who frequently volunteer in Haiti, for their impressions. I also reviewed the reports posted on the Web sites of Charity Navigator and the American Institute of Philanthropy, two well-regarded independent nonprofit charity evaluators. Below is what I’ve learned about some of the major charities operating in Haiti. I’m biased toward groups that have been on the groun... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3175815 Fri, 15 Jan 2010 15:28:31 +0100 3175815 http://www.medworm.com/index.php?rid=3175817&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fhaiti-relief-effort-late-earthquake-victims.html Originally posted in MedPage Today by Michael Smith, MedPage Today North American Correspondent Two days after a powerful earthquake shattered Haiti’s capital city, relief workers are finding it tough to provide needed medical care, coordination for the efforts is lacking, and time is running out for those trapped in the rubble. “The window they talk about is 48 to 72 hours,” said Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health. “Every passing hour is going to see people dying who if they had been pulled from the rubble yesterday would have made it,” Redlener told MedPage Today. The stark reality is that — despite a global response to the plight of battered Port... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3175817 Fri, 15 Jan 2010 03:32:11 +0100 3175817 http://www.medworm.com/index.php?rid=3171830&cid=t_303806_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F01%2F13%2Fat-our-bodies-our-blog-emergency-contraception-for-military-women%2F At Our Bodies Our Blog, I have a post about proposed legislation to make emergency contraception available at all military health centers (as well as a somewhat cleaned up version of my post on the Florida court-ordered bed rest case – I can’t even say how much I love having an editor at OBOB). Posted in Abuse, Rape, & Safety, Access, Rights, & Choice, Birth, Contraception, Ethics, Laws, Legislation, & Courts, Pregnancy (Source: Women's Health News) Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3171830 Thu, 14 Jan 2010 00:31:21 +0100 3171830 http://www.medworm.com/index.php?rid=3171821&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fhaiti-health-crisis-worse-hurricane-katrinas-aftermath.html Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent The powerful earthquake that hammered Haiti Tuesday afternoon has created a medical nightmare, those familiar with the country say. “I can’t even imagine the kind of horror we’re going to see in the next two to three weeks,” said Steven Williams, MD, an internist at Allegheny General Hospital in Pittsburgh who lived in Haiti for three years and has been a visiting doctor there for 20. In the days to come, Williams told MedPage Today, Haitians and the international community will try to cope with enormous numbers of dead and injured in a country that had almost no medical resources to start with. “On a good day in Haiti,” Williams said, “there’s... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3171821 Thu, 14 Jan 2010 00:17:38 +0100 3171821 http://www.medworm.com/index.php?rid=3167120&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F01%2Fspinal-immoblilzation-a-risk-factor-for-death.html Hmmmm: Emergency spine immobilization may do more harm than good, study says January 11, 2010 | 3:57 pm When emergency responders reach a gunshot or stabbing victim, they try to immobilize the spine to reduce the danger of paralysis upon movement of the victim. That effort, however, can have a fatal toll. A study published in the Journal of Trauma has found that, among these types of trauma victims, those whose spines are held still are twice as likely to die as those whose spines aren’t immobilized. Read the news article, but they’re talking only (apparently, I don’t get this journal) about penetrating trauma. Those discussing the article wonder if the reason for the increased mortality is “Stay and Play” vs “Load and Go”, the two basic prec... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3167120 Wed, 13 Jan 2010 06:31:04 +0100 3167120 http://www.medworm.com/index.php?rid=3167197&cid=t_303806_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F01%2F12%2Fintroducing-the-psych-central-community-connection%2F It’s a proud day for our Psych Central family. Today, we officially announced the creation of the Psych Central Community Connection, Psych Central’s new non-profit arm. What is the Psych Central Community Connection? The Connection is our non-profit that makes micro grants (also called personal grants) available to Psych Central members in emergency financial need. These micro grants (of $500 or less per individual) are for immediate personal/family need that might make the difference between homelessness and staying in one’s home, heat in the winter or freezing cold, or keeping the electricity turned on. They were previously referred to as “Community Fund Drives” and, indeed, we will continue to rely on our community of kind-hearted members to offer matchi... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3167197 Tue, 12 Jan 2010 21:10:37 +0100 3167197 http://www.medworm.com/index.php?rid=3163724&cid=t_303806_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F12%2Finformatics-in-primary-care-2009-vol-17-no-3%2F content page Fade Fave: use of electronic patient record (EPR) system data for emergency care, quality improvement and research – things not to take for granted Fade Skinny: This issue continues the discussion within our journal about how we can legitimise the use of the routinely collected data for research. We have some of the best long-term computer records in the world – which are potentially goldmines for research. However, we are currently working through how to codify this process. (NHS Athens is required to access this article online) Posted in Athens Password, Current Awareness, E-Books, Journals Tagged: Athens Password, Current Awareness, E-Journals, electronic patient records, Emergency Care, Quality, Research (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3163724 Tue, 12 Jan 2010 13:50:22 +0100 3163724 http://www.medworm.com/index.php?rid=3159660&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fcardiologists-discuss-myocardial-infarction-management.html Originally published in MedPage Today by Peggy Peck, MedPage Today Executive Editor “What we did for patients with acute MI was place them in a cool, dark place. Give them morphine for pain and lidocaine to prevent arrhythmias and hope for the best.” The speaker is Steven Nissen, MD, director of Cardiovascular Medicine at the Cleveland Clinic. He is describing standard care 25 years ago when he was a fellow at the University of Kentucky. “When someone came in with a big infarct — if he survived — we sent him home with a big infarct and waited for more infarcts,” Nissen told MedPage Today. In the intervening years, the world of cardiology has changed radically and myocardial infarction has gone from a sure killer to a treatable event in which the prognosi... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3159660 Sun, 10 Jan 2010 20:00:57 +0100 3159660 http://www.medworm.com/index.php?rid=3156459&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F01%2Fthe-foreign-body-that-didnt-exist.html Except, of course, that it did… A patient comes in with the entirely understandable complaint of “I have a fishbone lodged in my throat”. Came straight from dinner to the ED. When I ask a stupid question I’m given a stupid answer: “It feels like…a fishbone…”. Duh on me. Now, I went to a pretty good EM residency, and while there I learned two things: the books say fishbones don’t show up on x-rays of the neck, and, fishbones sometimes show up on x-rays. I’m about 70% positive in my career… So, I got an xray. See if you can spot the fishbone (hint: there’s an arrow pointing at it…) So, it’s there… Now what… There are very few wrong answers. Call ENT, etc. My answer: go get it. With another doc gi... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3156459 Sat, 09 Jan 2010 11:47:34 +0100 3156459 http://www.medworm.com/index.php?rid=3150398&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7555 Public Library Receives FEMA Funding http://tinyurl.com/yjeuhx9 The Cedar Rapids Public Library received notice Wednesday that FEMA approved the second appeal for temporary relocation assistance following the flood of 2008, stating that the library does, in fact, provide essential community services. [from American Libraries Direct 1/6/2010] Information Management and Communications in Emergencies and Disasters Website: http://new.paho.org/disasters/index.php?lang=en PDF:  http://bit.ly/8TE0Zw In Spanish: http://new.paho.org/disasters/?lang=es This manual focuses on operational aspects of disaster and emergency response as well as preparing for disasters. It addresses plans for communicating with the public during emergencies and techniques for producing, exchanging, and distributing info... BHIC blogs http://www.medworm.com/rss/comments.php?id=3150398 Thu, 07 Jan 2010 15:39:28 +0100 3150398 http://www.medworm.com/index.php?rid=3149056&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F01%2Fit-took-a-trainee.html …to remind me I have one of the coolest jobs in the world. I came in to start my shift, and the department was abuzz.  Thoracotomy!  Some kind of trauma, open chest, etc.  Big mess is all I saw, and thought about the low yield and hazards. That’s what I thought about: big futile mess. Later, as I was getting coffee (yes, I’m back on the sauce), I asked two EMT trainees, in passing, if they’d seen anything interesting. Their enthusiasm was palpable, and it was because they’d seen the spectacle.  They were completely energized, exited about Emergency Medicne, and will easily finish their studies solely on adrenaline. It made me consider my first thoracotomy (fear and perspiration, mostly, with the awesomely frightening yet thrilling ‘am I actually doin... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3149056 Thu, 07 Jan 2010 07:00:17 +0100 3149056 http://www.medworm.com/index.php?rid=3149057&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F01%2Fbest-triage-chief-complaint-of-the-night.html “Pt got a Hini shot today and now feels bad”. Took me a couple of seconds to figure out it wasn’t a hiney shot, it was H1N1.  Which was not given in said region. Related posts:It’s H1N1, not swine flu I got a nice email from the American Meat Institute... Social and medical history, all rolled into one Response to the question “when was your last tetanus shot”,... Related posts brought to you by Yet Another Related Posts Plugin. (Source: GruntDoc) GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3149057 Thu, 07 Jan 2010 01:00:10 +0100 3149057 http://www.medworm.com/index.php?rid=3142545&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2010%2F01%2Fvaginal-bleeding-algorithm-for-the-ed.html Via ER Stories, a reminder of the flow chart every EM resident is taught… Nicely done… HT: MovinMeat Related posts:Musings of a Dinosaur: Resident Work Hour Restrictions: My Solution Musings of a Dinosaur: Resident Work Hour Restrictions: My Solution... The Swann Dr. Ganz has died at 90. William Ganz, Catheter Inventor,... Related posts brought to you by Yet Another Related Posts Plugin. (Source: GruntDoc) GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3142545 Tue, 05 Jan 2010 01:50:15 +0100 3142545 http://www.medworm.com/index.php?rid=3142485&cid=t_303806_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F04%2Fconservatives-draft-manifesto-2010-chapter-one-our-reform-plan-for-the-nhs%2F Title: Conservatives Draft Manifesto 2010 Chapter One Our Reform Plan for the NHS The Skinny: First shot in the general election campaign as the Conservative Party issue Chapter 1 of their draft manifesto which details proposed NHS Policy.  Widely presaged in the mass media over the weekend.  If elected they plan to: Scrap process targets Ensure innovation by ensuring NHS Providers become autonomous NHS Foundation Trusts Make NHS data on performance freely available to all Focus on key areas such as cancer/stroke survival and infection control Enable patient rating of the quality of services Ensure patients have choice of providers meeting NHS standards Putting patients in charge of their own records and which providers they wish to share them with Open up the NHS to private and third ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3142485 Mon, 04 Jan 2010 21:48:24 +0100 3142485 http://www.medworm.com/index.php?rid=3138993&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fpopular-diagnose-pulmonary-embolism.html Originally published in MedPage Today by Chris Emery, MedPage Today Contributing Writer Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found. Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report published online Dec. 22 in the American Journal of Roentgenology. Other diagnostic techniques were used less regularly, with magnetic resonance imaging (MRI) used infrequently and ventilation-perfusion scintigraphy typically used in patients with renal failure or allergies to the iodine-based contrast material used for CT. “The results of this study... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3138993 Mon, 04 Jan 2010 16:00:28 +0100 3138993 http://www.medworm.com/index.php?rid=3137480&cid=t_303806_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F01%2F02%2Ften-years-in-womens-and-reproductive-health-a-bloggy-look-back%2F What with the new year and decade and all, it seems appropriate to engage in a bit of reflection. First, the blog itself. This year will mark the 5th anniversary of Women’s Health News – I first posted on May 19, 2005, although that was at the blogspot location. While this little blog is not among what most people would name as the top medical or top feminist blogs, I don’t worry too much about traffic, or increasing traffic, so long as at least a a few people are finding it useful and I’m not too overworked to deal with it. So, I expect to continue on for a bit longer. Will it make it to the decade mark? Who knows. I do sometimes find the lack of comments discouraging, but it is what it is. If there is anything you’d like to see covered more often, or less of... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3137480 Sat, 02 Jan 2010 18:04:27 +0100 3137480 http://www.medworm.com/index.php?rid=3135479&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2010%2F01%2Fpopular-medical-health-blog-posts-2009.html Thank you all for making 2009 the most successful year ever on KevinMD.com, with over 1.3 million visits, and 2.2 million pageviews. Here are the most popular blog posts of 2009. Enjoy, and I wish everyone a Happy New Year. Regular blogging will resume on January 4th, 2010. 1. How did Michael Jackson die, and the medicine behind sudden cardiac death 2. How long are you contagious after being infected with H1N1 influenza? 3. Two nurses face jail time for reporting a doctor to the Texas Medical Board 4. How do I prevent and treat swine flu, and, is a pandemic imminent? 5. Did propofol, or Diprivan, kill Michael Jackson? 6. Why pregnant women should get the H1N1 flu vaccine 7. Vicodin and Percocet banned and taken off the market, or is a black box warning more likely? 8. How was Nadya Sule... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3135479 Fri, 01 Jan 2010 12:00:38 +0100 3135479 http://www.medworm.com/index.php?rid=3126633&cid=t_303806_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FMcez8peU6jI%2F I discovered Informed Pocket Guides almost two years ago and have been a huge fan ever since. The first product I got was the Emergency & Critical Care Pocket Guide. I believe the fact that I take extra care this little/big guide is always in my bag when I go to work, says it all. It is small, light and compact, yet it has all the necessary reference information you might need in medical emergencies. It is especially useful if you work in the field. Emergency & Critical Care Pocket Guide has almost 200 pages and covers the following topics: Current ACLS Algorithms, Lab Values, Metrics, Notes Emergency, ACLS Drugs & Top Prescription Drugs IV Drips, Drug Infusions, Dosages Poisons & Overdose / ‘Rave’ Drug 12-Lead ECG Section & Acute MI Medical Emergenci... Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=3126633 Tue, 29 Dec 2009 02:01:37 +0100 3126633 http://www.medworm.com/index.php?rid=3118830&cid=t_303806_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2009%2F12%2F23%2Fback-up-your-birth-control-this-new-years-eve-a-message-from-granny%2F The video below* is a kind of funny approach to promoting safer sex (and advance planning for said safer sex). It features several women reading text messages aloud, messages that have been erroneously sent by their grandchildren in the midst of New Year’s Eve partying and are often awkward or sexual. The key point is that it’s easy to accidentally text your grandmother during such celebrations (possibly while inebriated**, I’m guessing), and other things – such as your contraception – can easily go wrong, too. As it notes, condoms break, pills are forgotten, so you should back up your birth control. If you go to the associated website, dontdroptheball.org (from the National Institute for Reproductive Health), it becomes clear that they’re suggesting ac... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3118830 Thu, 24 Dec 2009 02:19:25 +0100 3118830 http://www.medworm.com/index.php?rid=3096775&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F12%2Fphysician-burnout-operating-room-emergency-department.html It’s no secret that burnout is prevalent among primary care doctors, with 30 percent wanting the leave the field within five years. It gets no better in other specialties. I recently read that, frighteningly, almost 9 percent of surgeons admitted to a lapse in medical judgment within the past 3 months, in part due to the fact that nearly 40 percent admitted to burnout. The author of that post, an emergency physician, wonders what the burnout rate is in an ER environment: Working in an emergency department is a mixture of exhilaration and challenge, which creates both physical and mental stress. Yet we know that patients in the emergency room need their treating physicians to be attentive, alert and at the top of their game. Professional satisfaction in the medical field is rapidly d... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3096775 Thu, 17 Dec 2009 12:00:43 +0100 3096775 http://www.medworm.com/index.php?rid=3086123&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7381 Free Flu Resources http://www.flu.gov/outreach/h1n1.html?WT.mc_id=fluOutreach_Nov09&WT.mc_ev=click See  cultural and language materials from Flu.gov on  vaccines and fighting the flu. Includes seasonal and H1N1 flu information. [HHS Center for Faith-based & Neighborhood Partnerships] SaludToday The Redes En Acción research team has unveiled a new Latino health Web site and blog, SaludToday, to promote healthier lifestyles among Latinos. SaludToday is an interactive, online forum dedicated to stimulating an ongoing discussion among Latino families, community leaders, health researchers and others. By 2050, it is estimated that about one in every three peo-ple in the U.S. will be Latino. Yet Latinos suffer greatly from health disparities – differences in the burden of certain d... BHIC blogs http://www.medworm.com/rss/comments.php?id=3086123 Mon, 14 Dec 2009 19:57:57 +0100 3086123 http://www.medworm.com/index.php?rid=3082420&cid=t_303806_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FvzElwuSoeIE%2F Doctors Without Borders/Médecins Sans Frontières (MSF) is an international medical humanitarian organization created by doctors and journalists in France in 1971. Today, MSF provides aid in more than 60 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters. Thanks to Mark Hopkins, the director of Living in Emergency documentary, and his crew you have a chance to see what work for Doctors Without Borders really looks like in the field. Living in Emergency was filmed in war zones of Libera and Congo with unprecedented access to field operations. The story follows four volunteer doctors as they struggle to provide emergency medical care under extreme c... Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=3082420 Sat, 12 Dec 2009 15:59:32 +0100 3082420 http://www.medworm.com/index.php?rid=3080481&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7337 Second FEMA Community Preparedness Webinar This webinar series provides up-to-date information on community preparedness topics and resources available to citizens, community organizations, and Citizen Corps Councils. This live webinar is scheduled for Monday, December 14th at 2pm EST and will provide information on the Resolve to Be Ready 2010 campaign hosted by FEMA. It will feature a presentation followed by a question and answer period. http://www.citizencorps.gov/news/webcasts/resolvetobeready.shtm For an archived recording of the first webinar on volunteer liability go to:  http://www.citizencorps.gov/news/webcasts/liability.shtm For more information about the webinar series: http://www.citizencorps.gov/news/webcasts.shtm CDC Public Health Image Library Widget CDC’s Public Health... BHIC blogs http://www.medworm.com/rss/comments.php?id=3080481 Fri, 11 Dec 2009 21:20:59 +0100 3080481 http://www.medworm.com/index.php?rid=3076859&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7323 What Might Health Reform Mean for Women of Color? Today’s Topics In Health Disparities Webcast December 15, 2009, 1 p.m. ET The Kaiser Family Foundation’s next live, interactive webcast in its Today’s Topics In Health Disparities series on Tuesday, December 15, at 1 p.m. ET will examine aspects of the current Senate and House health reform bills that particularly impact women of color. Women tend to be greater users of the health care system than men, have higher rates of some chronic illnesses, and have unique reproductive health care needs. http://www.kff.org/minorityhealth/rehc121509webcast.cfm [Kaiser Family Foundation email] Know What To Do About the Flu Webinar Wednesday, December 16,12 – 1 PM ET Join the webinar as experts from the U.S. Department of Health and Human Se... BHIC blogs http://www.medworm.com/rss/comments.php?id=3076859 Thu, 10 Dec 2009 22:13:29 +0100 3076859 http://www.medworm.com/index.php?rid=3071155&cid=t_303806_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fsw7IBW4Idyw%2F The following guest post by Peg Willingham, Senior Director for External Affairs for Aeras Global TB Vaccine Foundation, is part of Disruptive Women’s “The Value of Health: Creating Economic Security in the Developing World” series. Shortly, I will be heading to Cancun, Mexico, for the 40th Union World Conference on Tuberculosis and Lung Health.  The meeting will bring together hundreds of dedicated researchers, project implementers, World Health Organization officials and advocates who have committed themselves to stopping tuberculosis, which is second only to HIV/AIDS as the most infectious disease killer globally.  Yet decades after the first meeting of this august body, we are still using the same outdated, inefficient and marginally effective tools to fight TB.  M... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3071155 Wed, 09 Dec 2009 13:58:39 +0100 3071155 http://www.medworm.com/index.php?rid=3071183&cid=t_303806_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F12%2F08%2Fthe-art-of-the-nasopharyngeal-airway%2F I would surely rank the nasopharyngeal airway (NPA) as one of the most under-rated / under-utilized pieces of equipment in the EMT bag of tricks. They’re useful, simple and versatile. As a group, we tend to do a pretty good job oxygenating our patients, but I think we drop the ball on BLS airway adjuncts. Most of our unresponsive or semi-responsive patients should be arriving at the ER with an NPA in place. If you’re bagging a patient they should have one … maybe two NPAs in place. They’re fast, they’re friendly, they work much better on the semi-conscious and they don’t stimulate the gag reflex quite like their cousin the oropharyngeal airway. They also stay in place better, leaving the mouth open for examination and advanced airway techniques. I... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=3071183 Tue, 08 Dec 2009 16:44:57 +0100 3071183 http://www.medworm.com/index.php?rid=3067041&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2009%2F12%2Fsyncope.html Always nice to have an etiology… Sinus arrest without an escape rhythm... Related posts:Day by Day: Don’t Mess with Texas Mr. Muir at Day by Day… ...Washington adventure day 1 evening and day 2 Got to Washington, met up with two other classmates and...Who are my readers? Unscientific poll results Earlier I asked who my readers were, and had a... Related posts brought to you by Yet Another Related Posts Plugin. (Source: GruntDoc) GruntDoc blogs http://www.medworm.com/rss/comments.php?id=3067041 Mon, 07 Dec 2009 22:21:09 +0100 3067041 http://www.medworm.com/index.php?rid=3048053&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F12%2Fiphone-radiology-app-diagnose-appendicitis.html Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a patient remotely, wherever they may be. Using a $20 iPhone application called OsiriX, radiologists made correct diagnoses of appendicitis in 124 of 125 computed tomography (CT) scans, Asim Choudhri, MD, of Johns Hopkins University in Baltimore, and colleagues reported here at the Radiological Society of North America meeting. “This new technology can expedite diagnosis and, therefore, treatment,” Choudhri said. “We knew that recent advances in handheld device technology allowed viewing of medical imaging. But it is unpr... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3048053 Wed, 02 Dec 2009 16:00:59 +0100 3048053 http://www.medworm.com/index.php?rid=3045927&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7161 Emergency Preparedness Videos in ASL, documents in Braille and large print http://www.accessibleemergencyinfo.com On the website you will find videos with ASL interpreters advising how to prepare for 18 Topics. The videos also have an audible voice over and text appearing along side the interpreter. Along with the videos we have also included the Emergency Preparedness Guide formatted in Braille, large print, and regular font for download. All of the information is free for public use, any organization may link to the website and use the information to inform the public. Automatic captions on YouTube The  preliminary roll-out of automatic captioning in YouTube was recently announced. This innovation  takes advantage of  speech recognition technology to turn the spoken word into text ca... BHIC blogs http://www.medworm.com/rss/comments.php?id=3045927 Tue, 01 Dec 2009 21:14:32 +0100 3045927 http://www.medworm.com/index.php?rid=3044670&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F12%2Ffailing-address-poverty-homelessness-undermine-health-reform.html Will the billions we’re thinking of spending on health care reform matter if we don’t address poverty and homelessness? Surgeon Amina Merchant has her doubts in a Washington Post opinion piece. She observes something that’s rarely mentioned, namely, that some patients abuse the health system to their benefit: “I am suicidal with a plan,” they say. People know that that phrase is a key to the psychiatric ward. After it is uttered, the hospital is obliged to house them overnight — provide them a warm bed with a blanket and healthy meals. What would cost someone perhaps a hundred dollars in a basic hotel ends up costing taxpayers thousands — because the hospital must provide not only a bed and food but staffing for its emergency room, a psychiatric co... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=3044670 Tue, 01 Dec 2009 12:00:24 +0100 3044670 http://www.medworm.com/index.php?rid=3026892&cid=t_303806_137_f&fid=35426&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheAlzheimersReadingRoom%2F%7E3%2Fwxm0IDYALkk%2Fafter-visit-to-emergency-room-most.html This study shows that many patients walk away from important clinical encounters confident that they know what happened and why, but with little reason to be so confident.” The researchers measured the extent to which patients’ reports agreed with their doctors’ records in four areas: diagnosis, emergency care that was given, post-ER care needs and what kinds of symptoms or signs would require the patient to return to the ER or seek immediate care. Only 22 percent of patients’ reports were in complete harmony with what their care teams reported on all four counts. Fifty-eight percent of patients understood at least two of the four areas, but 20 percent were off on three or four areas of their care and follow-up needs. After asking patients about their diagnosis, care and post-E... Alzheimer's Reading Room, The blogs http://www.medworm.com/rss/comments.php?id=3026892 Wed, 25 Nov 2009 14:55:17 +0100 3026892 http://www.medworm.com/index.php?rid=3018994&cid=t_303806_88_f&fid=38264&url=http%3A%2F%2Fms2group.blogspot.com%2F2009%2F11%2Facute-ed-decompression-plans.html This is part of the support material for the ER Overcrowding Solutions Presentation at the bottom of this Post...-Very few Emergency departments and ancillary support interfaces adjust their staffing patterns to have more resources or most efficient members working the days of the week the ED is expected to have more demand. In addition, all departments have what is known as “fatal staff combinations” that should never be allowed to form. For example…having your slowest ED Physicians, your most inexperienced midlevel providers, your less effective charge nurse, your most novice ED techs and the least efficient X-ray Techs all working together a Monday afternoon is hardly a sound strategic choice. Unfortunately, these fatal combinations are allowed to form often and repeatedly in most... Emergency Room Efficiency blogs http://www.medworm.com/rss/comments.php?id=3018994 Mon, 23 Nov 2009 03:40:00 +0100 3018994 http://www.medworm.com/index.php?rid=3013717&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D7019 Inventory of Program Evaluation Tools and Guidelines http://www.fhi.org/training/en/tools_guidelines/index.html Inventory of guidelines, frameworks, and manuals that provide users with instructions and step-by-step guidance to conduct program evaluations and inform program design and improvement. CDC Video Podcast: H1N1 Flu Vaccine – Why the Delay? http://www2c.cdc.gov/podcasts/player.asp?f=262894 This video explains how flu vaccines are made, manufactured, shipped, and how people can find vaccines in their area. Highest Rates of Obesity, Diabetes in the South, Appalachia, and Some Tribal Lands http://www.cdc.gov/media/pressrel/2009/r091119c.htm Wide sections of the Southeast, Appalachia, and some tribal lands in the West and Northern Plains have the nation′s highest rates of ... BHIC blogs http://www.medworm.com/rss/comments.php?id=3013717 Fri, 20 Nov 2009 16:54:59 +0100 3013717 http://www.medworm.com/index.php?rid=3005488&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D6993 Google Maps flu shot locator http://tinyurl.com/ydbgfq2 The new Google tool offers a Flu Shot Locator map which will show you where you can get the seasonal (red) & H1N1 (blue) or both vaccines.  Just type in the address of interest & it’ll show you where you can find them. [DISASTR-OUTREACH-LIB] ebrary Launches Free H1N1 (Influenza) Searchable Information Center ebrary®, a leading provider of digital content products and technologies, announced that it has created a publicly available research center featuring a highly interactive, searchable database of documents pertaining to the H1N1 influenza pandemic. Available  at http://h1n1.ebrary.com, the new site contains a growing selection of reports, papers, newsletters, posters, and other important materials from government ... BHIC blogs http://www.medworm.com/rss/comments.php?id=3005488 Wed, 18 Nov 2009 16:40:53 +0100 3005488 http://www.medworm.com/index.php?rid=2997087&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D6945 WISER is the the Wireless Information System for Emergency Responders. It was designed to assist first responders in hazardous material incidents. WISER provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression advice. An update for WISER for Windows 4.3 is now available. Included in this update is a fix for the Protective Distance mapping issue that has surfaced. Users of WISER for Windows are encouraged to update to the very latest version of the application (4.3.208 – Nov. 10, 2009). WISER for Windows http://wiser.nlm.nih.gov/downloads_windows.html?email= can be downloaded from the WISER web site http://wiser.nlm.nih.gov/ (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=2997087 Mon, 16 Nov 2009 15:41:42 +0100 2997087 http://www.medworm.com/index.php?rid=2995734&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2009%2F11%2Fi-need-a-new-explanation.html Because mine no longer makes sense to people… Many of the abscesses I drain require wound packing (I generally use 1/4” iodoform gauze, so these aren’t giant cavities), and during the procedure I tell the patient why I’m doing a wound packing, and what to expect. When we’re done with the procedure, until yesterday I used to tell patients to remove their packing in 3 days “Like you’re starting a lawn mower, just get it out”.  That’s when the nurse laughed, and said her mower is an electric start. I asked the patient if they’d ever started a lawn mower, and the answer was no. So, what shall I use as a universally understood analogous action to smoothly but quickly pull something?  Zipper?  I’m coming up blank… Related posts:Hit & Run – Rea... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=2995734 Mon, 16 Nov 2009 07:00:00 +0100 2995734 http://www.medworm.com/index.php?rid=2993854&cid=t_303806_123_f&fid=39037&url=http%3A%2F%2Fblogs.drgreene.com%2Fblog%2F2009%2F11%2F14%2Fwhen-should-you-go-to-the-doctor-or-emergency-room-for-the-flu%2F 540 children in the US have died so far this year from known or suspected H1N1 flu. This tragic number is more than six times higher than in an entire typical flu year, and the current flu season may only be getting started. This tragic number is very low, however, compared to the more than [...] (Source: Conversations with Dr Greene) Conversations with Dr Greene blogs http://www.medworm.com/rss/comments.php?id=2993854 Sat, 14 Nov 2009 19:21:56 +0100 2993854 http://www.medworm.com/index.php?rid=2989091&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F11%2Funiversal-health-coverage-sustained-longterm.html With health reform looking more likely, it’s worth looking at the Massachusetts model to predict what’s going to happen nationwide. I’ve written several times that the lack of primary care access will simply shift newly insured patients to already crowded emergency departments, where care is exponentially more expensive. And in the end, it is that lack of spending control that will make the costs of universal coverage unsustainable. According to recent data, well, we’re pretty much on that path. In an article from American Medical News, a poll of Massachusetts emergency physicians stated that, “42% of the 138 physicians surveyed said emergency care had ’somewhat increased’ since the reforms took effect, and 22% said such care had ’significan... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2989091 Fri, 13 Nov 2009 12:00:53 +0100 2989091 http://www.medworm.com/index.php?rid=2989092&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F11%2Fteamwork-essential-emergency-department.html by Edwin Leap, MD I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and gruffed and marched off to see the patient who had so selfishly interrupted my planned escape. (Disclaimer: I later apologized to the very correct Ginger, who had every reason to come and get me.) Facing me was a woman in her 60’s with a tongue the size of my nurse’s head. Well, not quite, but it was sufficient to fill her entire mouth. This, of course, can sometimes be incompatible w... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2989092 Thu, 12 Nov 2009 20:37:06 +0100 2989092 http://www.medworm.com/index.php?rid=2984739&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F11%2Fdecision-test-difficult-choice.html Ordering that head CT scan is the easy way out. In a piece from Newsweek (via Bryan Vartabedian), Yale emergency physician Christopher Moore details a common scenario: should he order a CT scan in an asymptomatic 15-year old who was hit in the back of the head while playing soccer? Dr. Moore encapsulates his thought process: “In a case like this, evidence shows the chance of a life-threatening injury is vanishingly small. [But] since we’re dealing with radiation, a CT scan isn’t harmless: some estimates put the long-term risk of cancer death from a single CT as high as one in 1,000—a risk that’s greater in younger patients who have longer to live.” Cost doesn’t factor in the decision making process. There is no mention of “rationing.” The ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2984739 Thu, 12 Nov 2009 12:00:10 +0100 2984739 http://www.medworm.com/index.php?rid=2984801&cid=t_303806_88_f&fid=38958&url=http%3A%2F%2Fwww.yourerdoc.com%2Fnaked-side-effects-of-ambien%2F I believe this could be a new protocol for cardiac stress testing. Recently on the late shift, the nurses on the telemetry unit were alerted to an elderly female patient who was having tachycardia. Her heart rate had been steady at around 80, but for no clear reason it accelerated to about 150 beats per minute. The charge nurse walked quickly over to investigate. The patient noted that she had been having some insomnia, so she decided to read her romance novel. Suddenly, she had a very realistic hallucination. “What did you see dear?” asked the nurse. “Well, it was a very good looking man, who just walked into my room and asked where the grocery store was. And, he was . . . completely naked.” She admitted. The nurse reassured the patient that it was nothing, and tuc... Your ER Doc blogs http://www.medworm.com/rss/comments.php?id=2984801 Thu, 12 Nov 2009 00:49:34 +0100 2984801 http://www.medworm.com/index.php?rid=2984778&cid=t_303806_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FojaUvnHLdk8%2F Michael Crowley, senior editor at The New Republic, recounts some nightmare episodes with the 911 Emergency Response System in the current issue of Reader’s Digest.  Here’s an excerpt: If there’s one thing we think we can count on, it’s that a frantic call to 911 will bring a swift and effective response.  Government’s first priority, after all, is protecting its citizens.  But a spate of recent cases reveal shocking flaws in our national emergency response system–at a cost measured in lives. One of those cases involved a young college student at the University of Wisconsin.  She dialed 911 and then hung up without saying anything.  Before the line was disconnected, however, there were screams and sounds of a struggle caught on tape.  The operator ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2984778 Wed, 11 Nov 2009 20:07:46 +0100 2984778 http://www.medworm.com/index.php?rid=2968647&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D6815 NLM Radiation Event Medical Management System (REMM) wins Web Health Award The National Library of Medicine (NLM) Radiation Event Medical Management System (REMM) http://www.remm.nlm.gov/, a web site produced by the US Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR), has won a bronze in this year’s Web Health Awards in the category of web sites produced by the government for health professionals.   http://www.healthawards.com/wwwha/ss2009winners/mp_web.html The Web Health Awards is a program that recognizes the best Web-based health-related content for consumers and professionals. It is organized by the Health Information Resource Center (HIRC) , a national clearinghouse for consumer health information programs an... BHIC blogs http://www.medworm.com/rss/comments.php?id=2968647 Fri, 06 Nov 2009 21:10:14 +0100 2968647 http://www.medworm.com/index.php?rid=2958785&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F11%2Ffootball-linked-dementia-banned-high-schools.html by Brian E. Moore, MD Two neuropathologists are prominently spotlighted in an article by Malcolm Gladwell in the October 19 issue of The New Yorker. The article explores a provocative question raised by autopsy results on football players: namely, should football be illegal? Featured are Dr. Ann McKee, neuropathologist at the Veterans Hospital in Bedford, Massachusetts and Dr. Bennet Omalu, forensic neuropathologist and San Joaquin Valley (CA) chief medical examiner. Drs. McKee and Omalu have done some interesting autopsy work which suggests that chronic traumatic brain injury leading to dementia suffered by football players is much more common, even among high school players, than previously realized. What’s alarming is the presence of abnormal collections of a protein known as tau, one... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2958785 Tue, 03 Nov 2009 19:00:11 +0100 2958785 http://www.medworm.com/index.php?rid=2956081&cid=t_303806_10_f&fid=34467&url=http%3A%2F%2Fnnlm.gov%2Fmcr%2Fbhic%2F%3Fp%3D6765 Dec. 1-3, 2009 Washington Marriot Wardman Park 2660 Woodley Road NW Washington, D.C. 20008 The Congress http://www.ama-assn.org/go/thirdcongress is a forum for leaders and other stakeholders to formulate essential elements of a comprehensive disaster medicine and public health preparedness system.  Hosted by the AMA in cooperation with partners from all sectors, this year’s conference will focus on establishing a framework for catastrophic health events -distinct from day-to-day clinical and public health interactions – that enables all health professionals to appropriately respond to disasters or large scale health emergencies. (Source: BHIC) BHIC blogs http://www.medworm.com/rss/comments.php?id=2956081 Tue, 03 Nov 2009 13:58:52 +0100 2956081 http://www.medworm.com/index.php?rid=2954519&cid=t_303806_88_f&fid=38959&url=http%3A%2F%2Fwww.epmonthly.com%2Fwhitecoat%2F2009%2F11%2Fdefeating-the-stabenow-bill-was-that-good-or-bad%2F Mark Plaster here, author of EP Monthly’s Night Shift column, guest blogging on WhiteCoat’s Call Room. On October 21, the Senate defeated the procedural vote to close debate (cloture) on the bill to eliminate the sustainable growth rate formula (SGR), thus killing the bill. Was that a bad thing or a good thing?  That depends.  In the short term, it looks like a very bad thing for physicians.  After all, if the SGR isn’t eliminated aren’t we slated to get whacked by a 21% across the board drop in Medicare fees at the end of the year?  The bill, introduced by Debbie Stabenow (D-Mich.) called for the SGR to be reset to zero and would have eliminated the $245 billion “debt” the government owed to physicians.  “What debt?” you may be asking.  To answer that, you wi... WhiteCoat's Call Room blogs http://www.medworm.com/rss/comments.php?id=2954519 Tue, 03 Nov 2009 04:39:03 +0100 2954519 http://www.medworm.com/index.php?rid=2939295&cid=t_303806_88_f&fid=34491&url=http%3A%2F%2Fgruntdoc.com%2F2009%2F10%2Freviewing-the-great-er-caper-just-to-be-sure.html Kevin, MD linked to this, and I really must comment. Here’s the abstract, and I hope you’ll read it all: For years I’ve heard friends describe experiences of being caught in a web of excessive and unnecessary medical testing. Their doctors ordered test Z to investigate a seemingly incidental finding on test Y, which had come about because of a borderline abnormality on test X. I often wondered why test X was done in the first place. As a primary care physician, I would have treated them for the likely diagnosis and done diagnostic tests — especially a series of diagnostic tests — only if they didn’t respond as expected…. Naturally, I’d express sympathy or outrage, whichever the speaker seemed to expect, but internally I’d pat myself o... GruntDoc blogs http://www.medworm.com/rss/comments.php?id=2939295 Thu, 29 Oct 2009 06:24:53 +0100 2939295 http://www.medworm.com/index.php?rid=2934605&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fincentives-promote-unnecessary-excessive-tests-er.html A professor of medicine visits the emergency department with a seemingly routine case of shingles, and gets the million dollar workup. Writing in the Washington Post, Jack Coulehan describes how he was subjected to neurology and ophthalmology consults, several MRIs, and a CT scan. All for shingles, a disease that is diagnosed clinically, and treated with an anti-viral medication, pain relievers, and in some cases, steroids. Soured from the experience, Dr. Coulehan writes that “I’ve lost the smugness and condescension I often felt when listening to others’ stories about being trapped by the system and manipulated into excessively complex and specialized medical situations. Unlike most of my patients, I actually knew what my diagnosis was and what to do about it, but I lear... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2934605 Wed, 28 Oct 2009 11:00:26 +0100 2934605 http://www.medworm.com/index.php?rid=2924884&cid=t_303806_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2FECvAfey4NnU%2F According to news reports, President Barack Obama has declared an H1N1 emergency in the United States. This move was declared earlier today. By making this declaration, medical resources can be distributed as they are needed, including off-site in non-traditional methods of delivery. There are still people who feel that the H1N1 influenza is being blown out of proportion and this will be the biggest non-event in history, but let’s look at the facts: Flu season, which runs from November until March, kills many people every year. Flu season hasn’t even really officially begun yet, and yet, the U.S. has seen 22 deaths directly attributed to H1N1, as reported by the Centers of Disease Control: 2009 – 2010  22 (18 confirmed H1N1)** 2008-2009  147 (76 confirmed H1N1)* 2007-2... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2924884 Sun, 25 Oct 2009 00:22:16 +0100 2924884 http://www.medworm.com/index.php?rid=2924758&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fh1n1-rapid-tests-poor-sensitivity.html Originally published in Journal Watch Infectious Diseases by Stephen G. Baum, MD Rapid tests for seasonal influenza generally have relatively low sensitivity; their sensitivity for detecting the 2009 H1N1 virus seems even worse. Many respiratory pathogens can produce an influenza-like illness. With a sensitive and specific rapid test for influenza, the onset of outbreaks could be established and patients could receive appropriate antiviral treatment. Reverse-transcriptase PCR (RT-PCR) can yield results rapidly and is potentially the most sensitive test, but delays associated with shipping of specimens and laboratory-based testing limit the real-time value of this test. Although widely used in emergency departments and physicians’ offices, antigen-based rapid assays have shown a sensi... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2924758 Sat, 24 Oct 2009 19:00:08 +0100 2924758 http://www.medworm.com/index.php?rid=2924946&cid=t_303806_137_f&fid=35426&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheAlzheimersReadingRoom%2F%7E3%2FJabyy4HKlUM%2Fobama-declares-h1n1-virus-national.html President Obama has signed a proclamation declaring the H1N1 influenza a national emergency. The proclamation will give doctors and hospitals more options for handling the pandemic. President Barack Obama declared the swine flu outbreak a national emergency and empowered his health secretary to suspend federal requirements and speed treatment for thousands of infected people. The declaration that Obama signed late Friday authorized Health and Human Services Secretary Kathleen Sebelius to bypass federal rules so health officials can respond more quickly to the outbreak, which has killed more than 1,000 people in the United States. This is a developing story, more shortly. Also see -- 60 Minutes H1N1 is Spreading Fast and Can Be Fatal (Video and Text Versions) President Obama declares H1... Alzheimer's Reading Room, The blogs http://www.medworm.com/rss/comments.php?id=2924946 Sat, 24 Oct 2009 17:16:06 +0100 2924946 http://www.medworm.com/index.php?rid=2923217&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fcompassion-meets-progress-american-health-care.html by Edwin Leap, MD Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have. I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern medicine. Not for its importance, necessarily, but for its strategic location in the health-care system. That is, almost every specialty, almost every kind of human illness or injury, ultimately finds its way to an emergency department. Therefore, I have seen the good and bad of American medicine. I have seen fantastic physicians and mediocre ones. I have cared for patients in ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2923217 Sat, 24 Oct 2009 11:00:14 +0100 2923217 http://www.medworm.com/index.php?rid=2908532&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Finterruptions-doctors-patients-affects-care.html Getting interrupted while in the doctor’s office can be annoying, both for the patient and physician. In an essay in The New York Times, pediatrician Rahul Parikh notes that, in an average primary care office visit, doctors were interrupted twice. And in the ER, “emergency room doctors experienced an average of 10 interruptions an hour, compared with 4 an hour for primary care doctors.” Having a computer in the room, and entering data in the electronic medical record, was the most frequent cause. And indeed, that’s only going to get worse as more practices go digital. Not only does patient satisfaction suffer from interruptions, Dr. Parikh extrapolates data from airline pilots, writing, “dire consequences may occur when the train of thought is broken during c... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2908532 Tue, 20 Oct 2009 11:00:41 +0100 2908532 http://www.medworm.com/index.php?rid=2905001&cid=t_303806_125_f&fid=38161&url=http%3A%2F%2Fwww.dentalheroes.com%2Fdental-emergencies-americans-unprepared%2F New York, NY (October 16, 2009) Although 72 percent of Americans have fillings, caps or crowns and one in six had a dental emergency during the past 12 months, most are not prepared to deal with a dental emergency, according to a recent survey conducted by Majestic Drug Company, a leading provider of oral care products. Interestingly, in the national survey of 1,000 Americans, those with a lower income (less then $35,000) were more likely to have had a dental emergency in the past 12 months (vs. 14 percent of those who make $100,000 or more). Of those who had a dental emergency, 23 percent involved a loose crown or cap, 10 percent involved a lost filling, while 72 percent said their dental emergency involved something else. Among those who had a dental emergency involving a loose crown/ca... Dental Heroes blogs http://www.medworm.com/rss/comments.php?id=2905001 Mon, 19 Oct 2009 06:00:56 +0100 2905001 http://www.medworm.com/index.php?rid=2904874&cid=t_303806_88_f&fid=38961&url=http%3A%2F%2Fquantavie.net%2F2009%2F10%2Fnon-medical-apps%2F RedLaser is a very useful non-medical iPhone app…when in the ER at the bedside and faced with “I took this”: and there’s a bar code redlaser the barcode and get the answer at the bedside: Zhang Nao (camphor), Bo He Nao (menthol), Dong Qing Yu (methyl salicylate)—seizures and salicylate poisoning are the potential problems. (Source: quanta vie) quanta vie blogs http://www.medworm.com/rss/comments.php?id=2904874 Sun, 18 Oct 2009 23:04:32 +0100 2904874 http://www.medworm.com/index.php?rid=2904832&cid=t_303806_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Femergency-department-boarding-undesirable-events.html Originally published in Journal Watch Emergency Medicine by Richard D. Zane, MD, FAAEM Nearly 30% of ED boarders at a single tertiary care hospital experienced undesirable events. Emergency department boarding — inpatients in the ED awaiting a hospital bed assignment — is common across the U.S. Although boarding is inconvenient and demoralizing for both patients and providers, few studies have examined outcomes of boarding. In this retrospective chart review of 151 ED-boarded patients who were admitted to a single tertiary care hospital in Boston during 3 days in 2003, the authors measured the frequency of undesirable events, which were defined as deviations from hospital-based standards (missed relevant ED treatment, home medications, or laboratory evaluations) and adverse events (... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2904832 Sun, 18 Oct 2009 19:00:34 +0100 2904832