June 2010

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Supplemental oxygen during cardiac arrest resuscitation

in Conditions | no responses

by Michael SmithAdministering high concentrations of supplemental oxygen during resuscitation after cardiac arrest is associated with increased inhospital mortality, researchers said.So-called blood hyperoxia resulting from being given pure oxygen after cardiac arrest was associated with an 80% increase in the risk of death, compared with patients whose blood gases were normal on admission to the intensive care unit (ICU), according to Stephen Trzeciak, MD, of Cooper University Hospital in Camden, ...

Lifestyle tips for aging family members

by | in Patient | no responses

Thanks to modern medicine, more people are living longer, but a longer life isn’t always a healthier one. According to the American Cancer Society, about 77 percent of people diagnosed with cancer are 55 or older.Living a healthy lifestyle is important to reducing cancer risks. But as we age, it’s sometimes easy to forget the importance of exercise, proper nutrition and stress management, which is why I like to solicit ...

Being sick is not always abnormal

by | in Patient | 5 responses

"You can't afford to be sick!"I hate these ads.You've seen them. They're in newspapers and regional magazines across the country. Some smiling mom and her cute kid. It's an ad for some local clinic, always with a tagline like "You can't afford to be sick!" or "You don't have time to be sick!"And they list things they treat, like headache, sore throat, ankle sprain, runny nose, and skinned knees. They ...

Difficult needs to be embraced in medicine

by | in Physician | 5 responses

When I was a second-year medical student I remember thinking, after meeting with an attending physician in a physical diagnosis class, how impossible it seemed that my brain would ever contain as much medical knowledge as his.And even if somehow one day it did, how would I ever be able to call on it, manipulate it, twist it, bend it, and turn it upside down with the same apparent ease ...

Obese patients present challenges in the ICU

by | in Physician | 7 responses

Obesity is a huge healthcare problem in the United States.It has reached the proportions of an epidemic and continues to get worse. Multiple medical problems including heart disease, hypertension, diabetes, sleep apnea and cancer are closely associated with obesity. The patients with extreme obesity can reach a body weight of five, six or seven hundred pounds and even higher. Riddled with chronic medical conditions, these patients often end up in ...

Healthcare reform’s focus on outcome and how that affects doctors

by | in Policy | 15 responses

With the signing of national healthcare reform into law, the U.S. healthcare system faces almost immediate -- and substantial -- transformation. I spent a recent Sunday reading all that I could find in order to get my arms around this massive piece of legislation and to understand its health policy implications.Here is my view from 50,000 feet.I needn't list all of the aspects relating to expanded coverage and insurance reform ...

Doctors are stuck in the same system as patients when they get sick

by | in Patient | 9 responses

I’ve had disgusting congestion in my nose/sinuses for the past month or so.I’ve never had a sinus infection in my life despite having horrible allergies to dust. I take Claritin every day for my allergies. But this time, the issues just wouldn’t go away. I needed to go see a doctor. So last night around 8pm I made an appointment with Dr. Samuel Grubman via ZocDoc for 9am this morning. ...

Doctors should ask patients whether they text and drive

in Physician | 12 responses

It's time to ask patients whether they text and drive.An important perspective piece from the New England Journal of Medicine urges doctors to include that question during preventive health exams.The data surrounding texting and driving is grim:

Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions. ...

Nurses are underappreciated but key to patient care

by | in Patient | 5 responses

"No man, not even a doctor, ever gives any other definition of what a nurse should be than this -- 'devoted and obedient.' This definition would do just as well for a porter. It might even do for a horse. It would not do for a policeman." -Florence Nightingale, 1859 Please take a moment to celebrate the nurses in your life. Florence Nightingale was the first to publicly decry the sorry ...

7 disruptive changes that will affect medicine

by | in Policy | 4 responses

Generally we prefer calm seas but often they don’t get us anywhere.We need disruptions, transformations to make the changes necessary for real progress in medicine. Sometimes it is a new technology; sometimes a cultural change. But then a refinement may occur. The refinement may not seem like a “disruption” but indeed it can be because the refinement may create a demand for change.Here a few more disruptive changes or refinements ...

Healthcare providers still aren’t washing their hands enough

in Physician | 2 responses

by Chris EmeryNurses and other healthcare providers complied with hand hygiene guidelines less than half of the time before participating in medical procedures, results of a new study showed.Compliance was better after procedures, with 72% following guidelines after procedures compared with 41.7% before procedures, according to a report published in the May issue of Applied Nursing Research.Overall compliance with hand hygiene guidelines was just 34.3%."It is important to note that ...

California pertussis epidemic may be caused by vaccine refusal

in Conditions | 11 responses

by John GeverCalifornia is facing what could be the state's biggest outbreak of pertussis since 1958, its top public health official said."Whooping cough is now an epidemic in California," said Mark Horton, MD, MSPH, director of the California Department of Public Health, in a statement. "Children should be vaccinated against the disease and parents, family members and caregivers of infants need a booster shot."As of June 15, 910 cases had ...

Social media in crisis management and public health emergencies

by | in Social media | no responses

In Boston we took the availability and quality of our tap water for granted until May 1, 2010, when a major water pipe break interrupted water service to two million Greater Boston residents.Information spread quickly to citizens about the problem and what to do, all the more notable because the water main break occurred on a Saturday. In this age of consumer paranoia about withheld information, the Massachusetts Water Resources ...

Patients need to know about CT scan and X-ray radiation

in Conditions | 16 responses

Americans get the most radiation in the world.That fact is hardly surprising, when you consider the number of medical tests patients endure.According to a story from the Associated Press, "the U.S. accounts for half of the most advanced procedures that use radiation, and the average American's dose has grown sixfold over the last couple of decades."Doctors often don't keep track of the number of scans and radiation exposure patients ...

Academic and private practice doctors should not be adversaries

by | in Physician | one response

During my entire career I have seen unwarranted and unseemly squabbling between town and gown. I often hear the gown side insult the town side.While I went straight into academic medicine, I did moonlight in community hospitals. For the past 6 years I have taught part time in a community hospital and part time in an academic VA hospital. I find recent negative comments about academic medicine unfortunate just like ...

Op-ed: Restrictions on physician hours may not improve patient safety

in Education | 17 responses

A version of this op-ed was published on June 2nd, 2010 in USA Today.During medical training, I routinely stayed awake for more than 30 hours straight to care for my patients in the hospital. I strove to be the tireless physician who would be with his patients until they went home.  It turns out I may have jeopardized their safety instead.For many years, the medical ...

Injectable heroin or methadone for addiction treatment

in Meds | 2 responses

by Charles BankheadHeroin addicts had almost a threefold increase in negative urine specimens when treated with supervised heroin injection rather than with oral methadone, data from a British study showed.Overall, 72% of patients had negative specimens at least 50% of the time compared with 27% of patients assigned to oral methadone, according to the report published in the May 29 issue of The Lancet.Treatment with injectable heroin almost doubled the ...

Shop for benefits, not premiums, when looking for health insurance

in Policy | 2 responses

by Ray CarlsonWhen discussing health insurance plan strategies with clients, there can sometimes be an awkward pause in the conversation after asking the client if they checked to see if their own doctor is in the network of the health insurance company whose plan they are applying for.It’s possible that many first time shoppers for individual health coverage are applying for health plans without first verifying if a family physician ...

Patient handoff video that every medical intern needs to see

in Education | 4 responses

Patient handoffs increase the risk of medical errors.As I wrote recently in USA Today, as residency hours are restricted, more of these handoffs will take place. It's imperative that this source of error be minimized.Vineet Arora, associate director at the University of Chicago's Internal Medicine residency, is one of the nation's authorities on patient handoffs. She recently made a video for the incoming interns about the ...

Choose primary care and follow your heart, not your brain

by | in Physician | no responses

Reams have been written on how medical students ought to select their field of medicine.There are even personality-type tests that ask questions about what kinds of situations you like, how you react to problems, and your working style that purport to predict for which specialty you are suited. (I came up as an oncologist or a nephrologist.)Others have opined that once you crunch the lifetime salary numbers, and then compare ...

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