I most commonly use a 2 inch B-bevel insulated needle for nerve blocks. It is often not convenient to dispose of the block needle right away after completing the block, so I started placing it in the barrel of the empty syringe from the plunger side and holding it in place with by depressing the plunger. Like this:
Safer for myself and my assistant (when I have an assistant).
JAMA: Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide
With a change of roughly 3 systolic points and 2 diastolic points I'm not going to stop taking my Prinivil just yet.....
The news that several Muslim physicians were allegedly involved in the UK and Scotland bombing plots did not surprise me as much as it did some others. It made me think back to a conversation I had with a Muslim anesthesiology resident shortly after September 11th.
This resident physician was from Iraq, was a doctor in Saddam's army , surrendered to Canadian troops during Gulf War I and was granted political asylum in Canada. He was very well trained and was a wonderful resident to work with--good work ethic, felt responsible to his patient, a pleasure to teach, a natural in many respects. I'd like to think we became friends during those years. In fact, he gave my an anesthetic for my own appendectomy.
We'd had several conversations about Islam previously and I asked him what he would do if Grand Ayatollah al-Sistani instructed all Shia Muslims to kill Americans? Without even a pause he answered 'I would do it.' Muslim first, doctor second.
Having settled on giving my wife the iPhone I wanted to see if I could insert her 3G SIM into the already activated iPhone so that her cellular number wouldn't change. No joy. I saw a brief message about it being the wrong SIM (even though the SIM cards appear identical on the outside). The device worked, but I had no cellular signal strength indicator or carrier name.
What I've done instead is set her original number to forward calls to her iPhone number when it's off.
Surveillance camera's in London have captured video of what looks to be another car bomb attempt near central London. This one used a Volkswagen rather than a Mercedes.
I did buy an iPhone even though I said I wouldn't (buy this first one). The line at our local ATT store was about 20 people long when I checked at 5:45 p.m. Friday on the way home from work so I waited and snagged a 4GB iPhone. It is as insanely great as the commercials make it out to be. Fast, responsive, intuitive, solid, revolutionary...all those things.
I think the real power of the iPhone is in how easily people who are not tech savvy can interact with it. If Apple is going to sell as many iPhones as they think they're going to sell it will have to be to people who are not gadget freaks. By that measure this device hit the bulls eye.
I gave the iPhone to my wife, showed her how to turn if on, and asked her to perform certain actions without telling her how. She made a call in less than 15 seconds (to me, I'm happy to say) and soon thereafter figured out how to use the contact list to call her sister. She next used Safari to go to her favorite site for weather radar images (what is it with women and weather radar?) and bookmarked it. She took my picture and added it to my card in the contacts. She then SMS's her sister, who chatted right back and she got to see that iChat-like conversation log. Next, out to the garden to take pictures of her flowers.
Every cell phone she has ever owned before this one has had these abilities (contact list, SMS, web browser, built-in camera) and they went unused in every case. Only recently did she start to watch John Stewart's Daily Show and local weather reports in Cingular Video on her V3xx. Not until she got an iPhone did she actually enjoy using all those features and even did so without prompting from me throughout the day.
Tomorrow I'm going to give it to my nine year old son and watch him interact with it. In the mean time I want to thank and congratulate Steve Jobs and everyone at Apple for this breakthrough product.
The CDC has just released Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007
I have cell phone service with Cingular/ATT and have been quite happy with them. One reason is that I can move my SIM card between different phones and am not locked in to using only one cell phone. Another was that they didn't tend to hobble their devices the way Verizon did. For example, new Verizon phones would let you use bluetooth for wireless headsets, but not for syncing. Well, I just discovered one problem with Cingular...
My new Nokia N95 (which I had to purchase for full retail since Cingular doesn't offer any Symbian smart phones) is awesome. I was trying to get Widsets to work but failed. (Widsets are small web applications that can run on the phone much like the iPhone will supposedly use Web 2.0 technology to extend its application capability.) The reason? Cingular won't let most midlets have socket connections. Hmph.
Well, I've checked my old e-mails to be sure I didn't miss something important. I didn't make the cut for the Google Health Advisory Council. (sigh)
The two House bills dealing with CRNA scope of practice have been withdrawn by their sponsors due to 'lack of support' in the House Professional Licensure Committee. Good news for now but I'm sure we'll see these efforts again...
Right on, brother:
I just stumbled upon Sermo, a web community for physicians only:
Now, if they'd only have RSS feeds....
I made a tab on my iGoogle page for just my anesthesiology-specific widgets. Take a look...
In sheep, the phosphodiesterase inhibitor sildenafil (Viagra) prevents the catastrophic changes in pulmonary artery pressure that fat embolism can cause:
Sildenafil Prevents Cardiovascular Changes after Bone Marrow Fat Embolization in Sheep.
This is the best summary I've read of the barriers to implementing significant change to our current health care system:
Sicko: Socialism in a capitalist society?:
To accomplish any meaningful reform, Americans will have to dismantle the insurance and pharma lobbies at a minimum, and begin to tackle the question of how to deliver universal health care without tying it to employment, marital status, or other qualifiers (and figure out how to put all those unemployed pharma and insurance reps to work, too). Once those lobbies have been set aside, the questions of how to implement a healthcare system which avoids the pitfalls faced by Canada, the UK and France, embraces the positives in the Cuban system, and essentially folds a socialist system into a capitalist society will have to be addressed."
[Via Kevin, MD - Medical Weblog]
