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Healthcare Update Satellite — 12-30-2013
More updates on my other blog at DrWhiteCoat.com
North Las Vegas VA Hospital emergency department repeatedly “disrespected and mistreated” a 78 year old diabetic volunteer with more than 5,000 hours of service at local VA facilities. A few weeks after two visits for a colon problem, the patient died in a hospice. When the patient’s friend went to get video of the events from the emergency department, the footage had been erased.
What types of things do Australian emergency departments see on Christmas? Stonefish stings, jet ski accidents, inhaled foreign bodies … not that different from the US, although I had no id...
Source: WhiteCoat's Call Room - December 30, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Research and Reviews in the Fastlane 079
This article is a meta-analysis looking at a relatively new technique: POC Ultrasound. This review found that for ED intubations, US had a sensitivity of 98% and a specificity of 94%. The question, however, should be whether this technique is faster than End Tidal CO2, which is extremely reliable.Recommended by: Anand SwaminathanRead More: Ultrasound for Verification of Endotracheal Tube Location (ALiEM)The R&R iconoclastic sneak peek icon keyThe list of contributorsThe R&R ARCHIVER&R Hall of famer You simply MUST READ this!R&R Hot stuff! Everyone’s going to be talking about thisR&R Landmark pap...
Source: Life in the Fast Lane - April 16, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Emergency Medicine Infectious Disease Intensive Care Pediatrics Respiratory Toxicology and Toxinology Trauma critical care Education literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
Can You Avoid Lumbar Puncture in Febrile Neonates?
I don’t have a problem with lumbar punctures in febrile neonates. In fact, my son ended up with three lumbar punctures before aging out of the febrile seizure protocols. I do have a problem, however, with doing unnecessary spinal taps. The emotional stress of a neonatal LP on parents is significant, and the physical stress of the procedure on the infant is also substantial.
The pain of the needle and the unique restraint required for the procedure are also potentially problematic. The pain of the needle can be minimized by EMLA cream (eutectic mixture of local anesthetics [lidocaine and prilocaine]) and local anes...
Source: M2E Too! Mellick's Multimedia EduBlog - May 1, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
2-Month Old Infant Suffered Apnea and Died Following 8 Vaccines
Conclusion
After watching their son get buried, Cash’s parents were thrown into a world they didn’t know much about. They were now another set of grieving parents who senselessly lost their child due to medical practices recommended under a doctor’s care.
Vaccines are being ignored when compiling infant mortality data. In 2013, Cash Dewayne Thomas was one of 23,440 babies who died in the United States before reaching their first birthday, according to the latest infant mortality data published in 2016. [19] About 11,300 newborns die within their first day of life, many soon after receiving their first hepatitis B vac...
Source: vactruth.com - June 16, 2016 Category: Allergy & Immunology Authors: Augustina Ursino Tags: Augustina Ursino Human Top Stories apnea Cash Dewayne Thomas Jesse Dewayne Thomas newborn vaccines truth about vaccines Vaccine Death Whitney Hill Source Type: blogs
Can You Avoid Lumbar Puncture in Febrile Neonates?
I don’t have a problem with lumbar punctures in febrile neonates. In fact, my son ended up with three lumbar punctures before aging out of the febrile seizure protocols. I do have a problem, however, with doing unnecessary spinal taps. The emotional stress of a neonatal LP on parents is significant, and the physical stress of the procedure on the infant is also substantial.
The pain of the needle and the unique restraint required for the procedure are also potentially problematic. The pain of the needle can be minimized by EMLA cream (eutectic mixture of local anesthetics [lidocaine and prilocaine]) and local ...
Source: M2E Too! Mellick's Multimedia EduBlog - May 1, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Nasal Endoscopy for Urgent and Complex ED Cases
Fiberoptics and endoscopy have changed the way we treat patients in the emergency department. Endoscopes are relatively easy to use, and can aid your diagnosis and treatment plan. Endoscopy may be useful in urgent cases, such as epistaxis, nasal foreign bodies, and ear debridement. It may also be helpful when dealing with more complicated presentations and critically ill patients, such as those with Ludwig's angina, epiglottis, tracheostomies, or those who need intubation.Fiberoptic tools are not just for surgeons and consultants. The endoscope has many uses in the emergency department, and we have a few tips and tricks...
Source: The Procedural Pause - October 28, 2020 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Research and Reviews in the Fastlane 038
This study, however, has major flaws and biases that question the validity of their conclusions. Only 19% of centers that were contacted agreed to contribute data to the Consortium. Additionally, the researchers do not assess the quality of the studies included in their meta-analysis. Regardless, observational data should not be used to trump the RCT data included in the recent, Cochrane review. Finally, Roche pharmaceuticals was a major sponsor of this research team. The accompanying editorial is a must-read.
Recommended by: Anand Swaminathan
Infection Control, Hand hygiene
D’Egidio G et al. A study of the ...
Source: Life in the Fast Lane - July 10, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Emergency Medicine Featured Infectious Disease Intensive Care Neurology Palliative care R&R in the FASTLANE Radiology Resuscitation Trauma critical care literature recommendations research and reviews Source Type: blogs
Research and Reviews in the Fastlane 120
Welcome to the 120th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check ou...
Source: Life in the Fast Lane - February 3, 2016 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Clinical Research Education General Surgery Ophthalmology Pediatrics Pharmacology Pre-hospital / Retrieval R&R in the FASTLANE Resuscitation Trauma critical care emergency Emergency Medicine recommendations resea Source Type: blogs
A man in his 70s with weakness and syncope
DiscussionBrugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year. In patients that only have this pattern induced by a sodium channel blocking agent have a lower rate of SCD (0 - 0.35% per year)[1]. Drugs that have been associated with Brugada ECG patterns include tricyclic antidepressants, anesthetics, cocaine, methadone, antihistamines, electrolyte derangements, and even tramadol. [2]. Our patient had a Brugada Type ...
Source: Dr. Smith's ECG Blog - July 22, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
Research and Reviews in the Fastlane 055
This study demonstrates a higher success rate (100% vs. 88%) and lower pneumothorax rate (0% vs. 5%) in comparing ultrasound guided versus landmark technique for placement. Although the ultrasound guided method may be technically difficult to learn and take some time investment, that time is repayed in the shorter time to accessing the vessel and lower complication rate.
Recommended by: Anand Swaminathan
Emergency medicineRosen P. The biology of emergency medicine. JACEP. 1979 Jul;8(7):280-3. PubMed PMID 449164
Peter Rosen has called this ‘the only good article I have ever written’. This is Rosen’s rati...
Source: Life in the Fast Lane - October 28, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Clinical Research Emergency Medicine Intensive Care Neurology Resuscitation Trauma critical care Education literature R&R in the FASTLANE recommendations Research and Review Source Type: blogs
Can I Get a Side of Fat with that Overdose?
An 88-year-old woman with a history of dementia presented with dizziness. Her daughter reported that she may have taken at least 12 tablets of diltiazem, which she mistook for her other medications. She is alert and oriented with normal vital signs. Her heart rate is 40 beats per minute and blood pressure is 70/45 mm Hg. Boluses of calcium gluconate and high-dose insulin therapy are initiated. The patient remains hypotensive at 80/40 mm Hg. Toxicology is consulted about intravenous lipid emulsion therapy.How does lipid emulsion therapy work?Two main theories describe the mechanism of action of intravenous lipid emulsion...
Source: The Tox Cave - April 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Medicaid Pay Increase For Hospitalists Confirmed For 2013-2014: ACA Rules We Are Qualified Primary Care Providers.
Are hospitalists going to get a Medicaid pay raise for 2013 and 2014? The answer is yes, hospitalists qualify for Medicaid parity (with Medicare) as required by the Affordable Care Act (ACA). For many states, Medicaid pays physicians and other providers a small fraction of Medicare rates. Legislation signed as part of the ACA mandates Medicaid rates to equal 100% of Part B Medicare rates in calendar year (CY) 2013 and 2014. That means if you haven't already seen increased rates, and you are a qualified physician providing qualfied primary care services, you will get increased Medicaid payments...
Source: The Happy Hospitalist - April 24, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Medicaid Pay Increase For Hospitalists Confirmed For 2013-2014.
Are hospitalists going to get a Medicaid pay raise for 2013 and 2014? The answer is yes, hospitalists qualify for Medicaid parity (with Medicare) as required by the Affordable Care Act (ACA). For many states, Medicaid pays physicians and other providers a fraction of Medicare rates. Legislation signed as part of the ACA mandates Medicaid rates to equal 100% of Part B Medicare rates in calendar year (CY) 2013 and 2014. That means if you haven't already seen increased rates, and you are a qualified physician providing qualfied primary care services, you will get increased Medicaid payments retro...
Source: The Happy Hospitalist - April 24, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Book of Nurses: Collette.
Collette lives in Adelaide, and has been nursing since 1986.
She trained in the hospital system, working through the time of “nursing changing from a vocation to a profession”.
She has worked in Emergency departments, trauma units, operating theaters, anaesthetics and recovery.
And – She is currently a patient.
In the last 10 weeks I have been a patient in 2 public hospitals I have been employed, one I currently work at.
I have spent 6 weeks in a private hospital.
As a nurse I have been saddened by the many of the nurses in the private hospital. And a few in the public hospital.
My admitting doctor men...
Source: impactEDnurse - September 3, 2013 Category: Nurses Authors: impactEDnurse Tags: ectopics Source Type: blogs
