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Patient Eats Toxic Chemical, Emits Hazardous Gas In Hospital

Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death.

Which makes the ‘gas effect’ seem really odd, but possibly explainable.

A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor.

The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon.

via Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press | freep.com.

Two thoughts: 1) I sincerely hope this patient recovers, and 2) if this is just upper GI bleed smell someones’ going to have rotten egg smell on their face.

I looked up superwarfarins, found a couple of interesting case reports, but none that talk about abnormal gases.

(For the uninitiated, the smell of digested blood is amazingly awful. It’ll make experienced, hard ED staff retch). I can understand why the smell would set off alarms, except that it’s not that uncommon, so it shouldn’t be a surprise.

It’ll be interesting to see what come of this.

Lighting matches in the hospital is a nono, by the way.

*This blog post was originally published at GruntDoc*

Deep Thoughts: Wisdom From The ER

If you’re alleging assault, don’t get loud with the Officer there to take a report. Especially if you have Felony warrants.

*This blog post was originally published at GruntDoc*

License Plate Of The Day

Texas, ah luv u

*This blog post was originally published at GruntDoc*

How To Gross Out A Medical Student

We have (mostly) non-EM studs rotate through our ED on their sometimes mandatory, sometimes killing a month elective ED tour. There is little reason for EM destined students to rotate in our place, as we don’t have a residency and we’re not part of the club of EM residency directors ( i.e. letter of rec writers). So, usually not EM hard chargers. Nothing wrong with that, but they’re not my cuppa tea.

Today’s lesson: shoulder reduction for the non-EM Stud, and for me in What We Do Isn’t Usual.

As is our norm, after a thorough Hx, PE, Xrays and Time Out, was in on a 2 doc reduction; One does the sedation, one the reduction. I don’t typically have students follow me: I don’t dislike the students, but I don’t have them. Personal preference.

Today, a shoulder reduction. My colleagues’ student. Not destined for a life in the ED (already matched, not in a remotely EM specialty). My colleague is on the sedation, and I’m on the reduction. I, after discussing the technique, in my presence and under my direction, allowed the stud the first attempt at reduction after sedation. No go. Good effort, not enough muscle. Read more »

*This blog post was originally published at GruntDoc*

First Monetary HIPAA Fine Issued

Via the Threatpost article “HIPAA Bares Its Teeth: $4.3m Fine For Privacy Violation“:

The health care industry’s toothless tiger finally bared its teeth, as the U.S. Department of Health and Human Services (HHS) issued a $4.3 m fine to a Maryland health care provider for violations of the HIPAA Privacy Rule. The action is the first monetary fine issued since the Act was passed in 1996.

A copy of a penalty notice against Cignet depicts a two-year effort in which HHS struggled with what appears to be a dysfunctional Maryland provider unaware of the potential impact of HIPAA non-compliance, and unwilling or unable to cooperate with HHS in any way.

When first reading the title I was willing to rail against HIPAA, as I’m tired of it. Then I read the post. Wow. It’s like a test case designed to see just how far you could push HHS, and frankly how incompetent you can be while pushing. Seems HHS was having trouble getting Cignet’s attention. I bet they have it now.

*This blog post was originally published at GruntDoc*

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