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 …
How soon should the dead be buried in Haiti?
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, …
EMRs can slow medical charting by requiring too much information
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 …
When are stroke patients more likely to receive clot busting drugs?
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 …
A doctor writes about his first day in Haiti
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 …
Scenes from Haiti before the earthquake, and what the future holds
Originally published 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, …
What diseases can arise from the lack of clean water in Haiti?
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 …
Tips for Haiti earthquake relief: How to find the right charity for donations
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 …
Haiti relief effort may be too late to help the earthquake victims
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 …
Why the Haiti health crisis will be worse than Hurricane Katrina’s aftermath
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 …
Cardiologists discuss how far myocardial infarction management has come
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 …
What’s the most popular way to diagnose a pulmonary embolism?
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 …
iPhone radiology app to diagnose appendicitis
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 …
How teamwork is essential in the emergency department
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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 …
Football is linked to dementia, and why it should be banned from high schools
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 …
When compassion meets progress in American health care
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
Many African-Americans in California enrolled in health maintenance organizations (HMOs) appear to prefer getting medical treatment in emergency rooms, researchers said.
One-quarter of African-Americans enrolled in Kaiser Permanente or other commercial HMOs in California, who would therefore have a range of treatment options, sought treatment in emergency rooms in 2007, …
Do HMOs drive blacks to the emergency room?
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Rapid viral diagnostic testing did not reduce the burden of treating children with respiratory symptoms and fever in the emergency department, according to a Cochrane Review meta-analysis.
Pooling the results of four trials, researchers found a significant reduction in the use of chest radiography (RR 0.77, 95% CI 0.65 to …
Why rapid viral testing for kids with URIs may not help in the ER
One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why.
Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …
Will more primary care doctors keep patients out of the ER?
by Diana Lee
A recent episode of the A&E show Intervention about a woman with occasional migraines and other serious health problems who takes up to 50 Percocet pills a day made me uncomfortable. Maybe Danielle, the woman featured in the episode, really does have migraine attacks. But she is also an addict. One condition really has nothing to do with the other. Many people with acute or chronic pain use …
Migraines and the stigma of chronic pain medication use
by Michael Kirsch, MD
The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …
Does the bulk of excessive medical care happen in the ER?
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