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Latest Posts

The New Way To Find A Vein: Vein Lights For IV Access

Here’s how we used to find a difficult vein.  If a floor nurse could not get an IV in, they asked one of their colleagues to try.  If their colleague could not find the impossible-to-locate vein, they contacted an ICU nurse.  If the ICU nurse couldn’t get one, sometimes an ER nurse or a flight nurse would try.  If they still couldn’t get an IV, then I would be paged to ask if they could get an order for an anesthesiologist to try.  And if the anesthesiologist couldn’t figure out how to find a difficult vein, we got a PICC line with the PICC nurse or with the radiologist or I placed a central line if the patient could not wait for a PICC line.
That’s how we used to find a difficult IV.

How do we find one now?  If you’re on the floor, you use one of these cheaper vein lights to find the difficult vein and place your IV.  However, if you work in Happy’s ER, now you have a $6,000 Star Trek looking vein finder for those dehydrated nursing home patients and cracked out meth heads. Read more »

*This blog post was originally published at The Happy Hospitalist*

More Care Can Lead To More Complications

I have a patient that comes in every so often that demands a PICC line (peripherally inserted central catheter).  PICC lines are convenient for patients and nurses and doctors because they can be used to obtain blood without needing to stick the patient on a daily basis.  They can be kept in for weeks and weeks and weeks with proper care.  They can maintain adequate IV access when old ladies and drug addicts present with poor veins.  Often they save the patient during acute decompensations of their critical illness.  However, they come with frequent complications.  I have had my share of patients return to the hospital with sepsis from their PICC line. Read more »

*This blog post was originally published at A Happy Hospitalist*

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

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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