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School Nurse Gives Some Insight Into Her Job

Well, what better time to post my interview with Erin at Tales of a School Zoned Nurse than now, when everyone’s headed back to the classroom?

Erin is a school nurse in the “cash strapped state of California.”  Her position covers two elementary schools and a middle school – almost 2000 students!!  She has been blogging since last year and her blog has definitely become one of my favorites.

She says she was never too set on working in a hospital.  After nursing school, she worked at a couple of summer camps, which gave her the idea to look into being a school nurse. She was hired right away and “leapt in without a second thought.”  She is starting her second year in this position.

Erin’s daily schedule is quite varied: Read more »

*This blog post was originally published at code blog - tales of a nurse*

Reducing The Use Of CT Scans In Children

Well, this is satisfying. Over the years, in our ER we have mirrored the nationwide trend and have significantly increased the utilization of CT scans across the board. The reasons are manifold. Some cite malpractice risks, and indeed in our large group we have had one lawsuit for a pediatric head injury and another for a missed appendicitis which probably did contribute. But, in my opinion, there have been many other drivers of the increased use. For one, CTs have gotten way, way better over the last 15 years, which quite simply has made them a better diagnostic tool. They’ve also gotten way faster. As the facilities have invested in CT scanners, they have increased their capacity and increased their staffing, so the barriers to their use have rapidly diminished. I am so old that I remember when ordering a CT involved calling a radiologist and getting their approval! No more of that, I can tell you.

But a couple of years ago, we really started paying attention (perhaps belatedly) to Read more »

*This blog post was originally published at Movin' Meat*

Managing Labor Pain Without The Use Of Drugs

No one likes pain, least of all pregnant women. Although obstetricians do a great job providing prenatal care and childbirth deliveries, there is always room for improvement regarding patient education.

The management of labor pain is usually delegated to the Anesthesia Department within a hospital or an ambulatory center. The goal of anesthesia is to eliminate physical pain and any suffering that might be a result of pain. However pain and suffering may not always be about cause and effect. To quote the literature, “Although pain and suffering often occur together, one may suffer without pain or have pain without suffering.” Some women want to eliminate pain and others view it as a normal process. However, to the well initiated, it is well known that women who are in pain and “suffering” do not progress as quickly in labor as those who are pain free. For those pregnant moms who would prefer not to have “drugs” here are some options however, please keep in mind that information regarding the safety and effectiveness of these methods is “scientifically” limited, meaning the subjects involved in medical studies to prove whether these methods work or not are small. Having said that, listed below are some of the most popular ways to reduce pain without drugs, however, please consult your physician or healthcare provider prior to using them. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Swimming May Not Be As Safe For Your Children As You Think

Lifeguard standing duty poolside.As summer continues in North America, and for anyone who goes near the water during any time of year, prevention of drowning is very important. The American Academy of Pediatrics (AAP) takes its responsibilities on this issue seriously, and in 2010 issued a policy statement on prevention of drowning. This is a remarkable and well-thought out document that addresses all of the important issues associated with risk for and prevention of drowning. The online version of the policy statement, along with updated information and services, is available on the web.

The document points out that, historically, drowning has been the second leading cause of unintentional death in individuals aged one to 19 years, causing more than 1,100 deaths per year in the United States alone.

The AAP defines drowning as “the process of experiencing respiratory impairment from submersion/immersion in liquid.” It does not imply any particular outcome. Persons may “drown” and survive. The categories of outcomes include:

  • death
  • no morbidity
  • morbidity (moderately disabled, severely disabled, vegetative state/coma, and brain death)

There is a discussion of entanglement in drains, particularly in females who are underwater with long hair near a suction outlet. Inflatable pools pose a particular hazard if they are not fenced.

The AAP has previously taken the stance that children are not developmentally ready for swimming lessons until after their fourth birthday. They based this opinion on factors including: Read more »

This post, Swimming May Not Be As Safe For Your Children As You Think, was originally published on Healthine.com by Paul Auerbach, M.D..

Kids Gone Wild: Intimidation Of Parents In The ER

Ah, the benefits of sand therapy!

Time for little Bettina’s daily afternoon face plant!

Not only does it appear my colleague is about to lose her grip on her patient, I’m concerned about her choice of body mechanics.

I predict a lumbar strain in 3…2…1……

(This photo is from the Library of Congress collection.)

**********

I love my pediatric patients. While it is hard to see children feeling sick, they can be bright spots in occasionally hellacious shifts.

I’ve blogged before on my observation that the kids seem to be the adults in the some families.

  • They don’t want to undress for an exam, so they fight the parents who are helpless in the face of taking a shirt off a three-year-old.
  • They have to be restrained so they don’t run rampant in the ER, and they slap their parent across the face. The parent doesn’t respond.
  • They are told they need to cooperate with a procedure and they answer their parent with a loud, clear, “F*** YOU!” At the age of five. The parent retreats. Read more »

*This blog post was originally published at Emergiblog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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