The other day at an interdisciplinary rounds meeting at the hospital, one of our nurses who is also an emergency medical technician mentioned that in Britain injured patients receive tranexamic acid before arriving at the hospital because it reduces death from bleeding. "What's that?" I said. I kind of barely remembered hearing this medication's name associated with the treatment of a rare disease, but not treatment of trauma. So I was guessing ...

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Much has been written about how Web 2.0 tools can change the healthcare landscape.  It would appear a recent set of circumstances has upped the ante. This story begins with a recent study that attempted to tackle the problem of ICU infections. ICU infections are a challenging problem, patients who are admitted to the ICU are at risk of worsening illness and death from infections such as MRSA which can be ...

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March 2nd through the 8th was National Patient Safety Awareness Week -- I don’t really know what that means either.  We seem to have a lot of these kinds of days and weeks -- my daughters pointed out that March 4 was National Pancake Day -- with resultant implications for our family meals. But back to patient safety and National Patient Safety Awareness Week. In recognition, I thought it would be useful to ...

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An innovative study in JAMA Internal Medicine on surrogate decision making has profound implications for how we take care of older hospitalized patients.  The study, by Lexy Torke and colleagues at Indiana University, systematically described the involvement of surrogates in decision making for hospitalized patients. Surrogate decision making refers to the phenomenon in which someone other than the patient is making or helping to make the key medical decisions.  In older ...

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From MedPage Today:

  1. Calcium, Vitamin D Benefit Older Women. Postmenopausal women had significant improvement in their lipid profile with long-term calcium and vitamin D supplementation, data from the Women's Health Initiative (WHI) showed.
  2. Telemonitoring Cuts ICU Time, Boosts Outcomes. Remote monitoring in the intensive care unit was associated with lower mortality and shorter stays.
  3. Smart Phones and Not So Smart Parenting. Using ...

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I’ve been working with the latest electronic medical record (EMR) for almost a year now. You know the one. There are many positive changes, to be sure. It has helped me more than a few times with calculating doses for kids’ medications. I can now easily check in on my patients’ progress when they are admitted to the hospital. And, of course, the notes are far more legible. But what do ...

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A few years ago when I went skydiving for the first time, I learned about the backup parachute. This is a second chute, just in case the first one failed. While no one wants to think about the primary parachute failing, it was comforting to know we were prepared ... just in case. That’s kind of how I see end of life care planning, while we don’t want to think ...

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Comcast recently announced it is merging with Time Warner, the 2nd largest cable company in the US. Together, this deal nets Comcast an estimated 57% of the cable subscriber marketplace and heralds a new oligarchy in US media and entertainment. It’s big news for Comcast, but  aren’t as excited. Why? Because both Comcast and Time Warner have been consistently rated the worst providers of customer service in the cable industry. Now as they ...

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His nurse paged me at 9pm: Mr. L wants to leave against medical advice (AMA). As the covering doctor, I dreaded the impending standoff even more than usual. I emerged from the elevator minutes later to find that the gaunt octogenarian had advanced from his isolation room, passed the nurse's station and the unit doors, and arrived at the elevator bay to greet me. Security guards hovered at a cautious distance ...

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Communication is critical to success in medicine.  Our patients depend on us to help them understand their disease and the risks that it may pose.  In previous blogs I have commented on how vital effective communication can be in determining outcome -- much of my writing has focused on the success associated with outpatient doctor-patient relationships. We now know that when doctors and patients engage, patients become invested in their ...

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