May 18th, 2011 by Linda Burke-Galloway, M.D. in Health Tips
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At one time, a hospital would be called a 24-hour institution but now it’s a business. Within this business are shift workers that include nurses, technicians, clerical staff and even hospital employed doctors who are now called hospitalists. In a teaching hospital resident physicians also work in shifts so the responsibility of patient care is always being transferred from one group of healthcare providers to another. Do they always communicate effectively? Regrettably, “no.”
Sign-outs, handoffs, shift changes, nurses’ report. These are the multiple names for the process where a departing provider is responsible for letting the arriving provider know what’s going on with the patient. According to statistics, 80% of medical mistakes occur during shift changes and 50 to 60% of them are preventable. Listed below is an excerpt from The Smart Mother’s Guide to a Better Pregnancy that teaches pregnant moms what things should be known during a shift change. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
May 17th, 2011 by DrCharles in Health Tips
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A fever in an infant can be the first sign of an illness. While a rise in body temperature above 100.4 degrees Fahrenheit is part of a healthy immune system response, it does signal potential danger and need for further evaluation. Since a reading may lead to a call or visit to the child’s doctor or emergency room, accuracy is key. What is the best type of infant thermometer?
A digital rectal thermometer.
This is according to such authorities as the American Academy of Pediatrics, Consumer Reports, and the American Academy of Family Physicians.
The definition of a fever is important as well. According to the AAFP:
A normal temperature is about 98.6°F (37°C) when taken orally (in your child’s mouth) and 99.6°F (37.5°C) when taken rectally (in your child’s bottom). Many doctors define a fever as an oral temperature above 99.5°F (37.5°C) or a rectal temperature above 100.4°F (38°C). Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
May 10th, 2011 by Linda Burke-Galloway, M.D. in Health Tips
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If a pregnant woman finds herself scratching and itching during the third trimester, these symptoms should not be ignored. Each year, approximately 0.1 to 15% of pregnant women are affected by a liver disorder called Intrahepatic Cholestasis of Pregnancy or (ICP). ICP patients tend to develop symptoms of itchiness of their hands and feet that becomes progressively worse and then spreads all over their body. The itchiness usually worsens at night and if untreated can cause jaundice and several life-threatening complications to the unborn fetus. When a pregnant woman complaints of itchiness (pruritus) all over her body, the first order of business is to determine whether a rash is present. If a rash is absent, ICP should be suspected.
The liver is the largest gland in the body and in addition to filtering harmful substances such as alcohol it is also responsible for processing fats, carbohydrates and proteins. To process fat, the liver makes bile salts. In ICP, bile salts are increased which contributes to the symptoms of itchiness. Affected women will not only be plagued by pruritus but their unborn babies are at risk for stillbirth, preterm labor, fetal distress and abnormal heart rates. South American women and especially those from Chile have a greater risk of developing ICD as do women from South Asia and Sweden. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
April 29th, 2011 by Linda Burke-Galloway, M.D. in Health Tips, News
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The Federal Drug Administration (FDA) recently issued a new warning about a medication that has been used for years and it has sent shock waves throughout my specialty. Terbutaline is an FDA approved medication that is used for asthmatic patients or patients who have significant narrowing of the airways. However for years it has been used as an “off-label” medication to treat preterm labor but now that’s about to change. An off-label drug means it hasn’t been approved for that specific use by the FDA.
According to the FDA, the injectable form of Terbutaline should only be used for a maximum of 24 to 72 hours because the drugs association with heart problems and death. The FDA goes on to say that the oral version (pills) should not be prescribed to treat preterm labor because it’s ineffective and can cause similar problems. As an obstetrician, I feel utterly betrayed. The medication clearly had side effects that included shortness of breath and a racing heart. As resident physicians we were taught that the benefit outweighed the risks of having a premature baby and the patients should try to adjust to the medication. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
April 23rd, 2011 by KerriSparling in Opinion, True Stories
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(Alternate tittle: “Bring out yer bread!”)
Now that the little bird is the big O-N-E, we have completed one year as parents. And one year doing the gluten-free diet with our baby. This was important to me because I felt strongly about the ties between the early introduction of gluten and type 1 diabetes diagnoses. And after doing some research and discussing this as a family, Chris and I decided to keep our BSparl gluten-free for her first year.
It was pretty easy, to be honest, keeping a little baby off gluten. (Especially since she doesn’t have celiac, so our decision was elective instead of required.) The ease came mostly from the fact that BSparl breastfed for almost six months, and didn’t start on solid foods until just after she turned six months old. All breastmilk and/or formula made for a pretty streamlined food schedule for that first half year. When we introduced solid foods into her diet, we went with organic rice cereal and formula first, then mushed up fruits and assorted other mushed up items (like avocado and shredded chicken breast) mixed with food pouches like these from Ella’s Kitchen. Her diet was pretty mushy for a good long time, since it took about 8 months for her first tooth to bust through. Read more »
*This blog post was originally published at Six Until Me.*
At one time, a hospital would be called a 24-hour institution but now it’s a business. Within this business are shift workers that include nurses, technicians, clerical staff and even hospital employed doctors who are now called hospitalists. In a teaching hospital resident physicians also work in shifts so the responsibility of patient care is always being transferred from one group of healthcare providers to another. Do they always communicate effectively? Regrettably, “no.”
