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Overheard At The Nursing Desk: How to Optimize Your Care While Hospitalized

It was interesting lunchtime conversation. A lone doctor listening to some highly experienced and capable nurses, reflecting on their work:

“If the patient’s nice, it’s a lot easier to want to go back in that room with them. Their reputation travels at the nurses station. But if they’re mean, well, it’s not as easy to go back in there, so I might not stop by as often.”

“I agree, it’s easier to catch flies with honey than vinegar.”

Words to live by.

*This blog post was originally published at Dr. Wes*

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*

Killed By TPN: A “Never-Ever” Hospital Event?

Recently, nine patients died in Alabama when they received intravenous nutrition that was contaminated with deadly bacteria. This type of nutrition is called total parenteral nutrition, or TPN, and is used to nourish patients by vein when their digestive systems are not functioning properly. It is a milestone achievement in medicine and saves and maintains lives every day.

What went wrong? How did an instrument of healing become death by lethal injection? What is the lesson that can emerge from this unimaginable horror?

This tragedy represents that most feared ‘never event’ that can ever occur – death by friendly fire. No survivors. Contrast this with many other medical ‘never events’ as defined by the Centers for Medicare and Medicaid Services, such as post-operative infections, development of bed sores in the hospital or wrong-site surgery. Under the ‘never events’ program, hospitals will be financially penalized if a listed event occurs. Many physicians and hospitals are concerned that there will be a ‘never events’ mission creep with new outcomes added to the list that don’t belong there. Medical complications, which are unavoidable, may soon be defined as ‘never events’.

Do we need a new category of ‘never ever ever events’ to include those that lead to fatal outcomes? Read more »

*This blog post was originally published at MD Whistleblower*

Beware Of Fake “Social Media Experts” Offering To Help You Create An Institutional Policy

They’re here: Creeping researchers who see the opportunity that’s social media.  Publications, position papers, professional guidelines and policies on social media are appearing faster than you can say ‘ARA grant opportunity.’  A simple search will show that some of these authors have little more than a token feel of what its like to be a doctor in the social space.  And they’ve got just enough of a footprint to fool the editors.  “They’ve actually got a Twitter account.  They must know what they’re talking about.”

The next time you see a policy or a guideline coming from a society or medical professional organization, deep search its authors.  Look to see if they have the experience and social scars to guide you as a professional.  If you’re a professional society or journal, be sure to do the same.  Thoroughly vetting the social media experience of authors should be part of peer review when it comes to medical research and policy generation in social media.  Otherwise expect those who have never experienced social media to position themselves as the new voice of authority. Read more »

*This blog post was originally published at 33 Charts*

iPad Cover Used In Kitchens Could Also Be Used In Hospitals

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Apple iPads are taking the clinical world by storm, but they’re not exactly built for a busy environment full of liquids, dirty hands, and pathogens. The Chef Sleeve is a plastic wrapping originally designed to help cooks prevent their iPads from getting hit by a splash of this and a dash of that. The plastic is compatible with the touch screen, provides basic protection, and won’t require you to sterilize it before bringing it home from the hospital. At $20 for 25 sleeves, your new baby can get the basic protection it deserves.

Product page: Chef Sleeve…

*This blog post was originally published at Medgadget*

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