We thought we had this down, right? We take low dose aspirin every day to help fight our risk of cancer and heart disease. Wrong. At least according to a recent analysis of nine trials involving more than 100,000 people. Aspirin can lower our risk of first heart attack or stroke by 10%. Of course, discussing your medication regimen with your health care provider is essential prior to making any changes.
Watch potassium levels after heart attacks
Findings related to potassium levels in a new study by the in the Journal of the American Medical Association challenge the current clinical guidelines. Monitoring potassium levels post MI (myocardial infarction AKA heart attack) is routine. Current guidelines recommend serum levels of 4.0 - 5.0 mEq/L. The study found better survival among those people whose level was 3.5 - 4.5 mEq/L. Will the guidelines change based on this study?
Acute limb ischemia: step-by-step approach
Acute limb ischemia is recent onset (less than 14 days) of decreased limb perfusion that endangers life and/or limb. It is a medical emergency whose management options depends on the individual case. American Journal of Medical Sciences has a guide for medical/surgical management.
Does your doctor understand what you're telling him?
Research showed empathy, the ability to understand a person's situation, perspective and feelings, has declined in medical students and residents. The future physicians are showing signs of not being able to relate to their patients.
High blood pressure still out of control
Despite updated guidelines on the treatment of hypertension, the American Heart Association recently found uncontrolled blood pressure was common. There have been improvements in identification of hypertensive patients and increased numbers of hypertensives taking medications. The AHA concluded additional efforts were required to treat hypertension.
Is that lab coat making me sick?
Yes. Up to 60% of hospital staff's uniforms are colonized with potentially pathogenic bacteria including drug-resistant bacteria. Source: American Journal of Infection Control
C. Diff can be spread without touching a patient
A small study from the American Journal of Infection Control showed Clostridium difficile spores were just as likely to be found on a gloved hand after it contacted an environmental surface (bed rail, bedside table, telephone, call bell) as after it contacted commonly examined skin sites (chest, abdomen, hand). While this is a small study, the results are powerful. Environmental contamination is a significant factor in spreading a serious, sometimes fatal, infection. What do facilities do to proactively prevent environmental contamination?
Nurses are #1, again!
The most recent Gallup poll regarding the most trusted professions has ranked nursing as #1. Nursing has consistently maintained this #1 rating since it was added to the list in 1999.
Better Nurse Staffing = Better Outcomes
We already knew this, right? So, why aren't facilities decreasing the nurse:patient ratio? Because it is expensive. Research shows nurses provide cost effective care compared to other health care professionals. It also supports better outcomes are associated with lower nurse:patient ratios. Be a savvy health care consumer. Inquire about a facility's nurse:patient ratio before consenting to have elective surgery there.
CDC on Health Care Associated Infections
The most deadly of health care associated infections is the central line associated bloodstream infections. These infections carry mortality rates up to 25%. These infections are commonly acquired in intensive care units (ICU), inpatient wards and hemodialysis facilities. A recent article by the CDC in Annals of Emergency Medicine compared rates of bloodstream infections associated with central lines in those clinical settings between 2001 to 2009 . There was a 58% reduction in infection rates in the ICU representing 6,000 lives saved. However, the inpatient and hemodialysis areas continued to show high infection rates. Hemodialysis centers had the highest infection rates. CDC recommended reduction of central line use for hemodialysis and improved maintenance of the lines should they need to be used.
Preventing Pressure Ulcers in Elderly ED Patients
An abstract presented at the Canadian Agency for Drugs and Technologies in Health symposium in August 2011 concluded the use of foam pressure-redistribution foam mattresses was cost effective in prevention of pressure ulcer development. This proved true even for short ED stays, i.e. less than one hour. How are clinical providers putting this evidence into their practice in this high pressure ulcer risk population?