Sunday, February 25, 2007
YouTube: Site-Rite Instructional Video
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The AHRQ published Making Health Care Safer: A Critical Analysis of Patient Safety Practices in 2001. Chapter 21 deals with Ultrasound Guidance of Central Vein Catheterization. I thought I'd include a link to a YouTube video that shows how this device is used:
Although the device has advance considerably since then (see below), the images it provides are still pretty much the same.
I will often use the device to locate and mark an internal jugular vein before draping the patient as I find the use of the needle guide extremely cumbersome.
[Site-Rite]
Thursday, February 22, 2007
NIDA: Drugs, Brains, and Behavior - The Science of Addiction
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The National Institute on Drug Abuse just published a booklet intended to help patients understand drug addiction titled The Science of Addiction.
"As a result of scientific research, we know that addiction is a disease that affects both brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease. Scientists use this knowledge to develop effective prevention and treatment approaches that reduce the toll drug abuse takes on individuals, families, and communities."
Wednesday, December 28, 2005
Epocrates Online Free
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A reminder from The Palmdoc Chronicles that Epocrates Online Free is online and, well, free.
Wednesday, November 23, 2005
MMWR Available Via Really Simple Syndication (RSS) Feeds
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"MMWR now offers RSS feeds, a free, automated method to receive all MMWR publications. Through RSS, new reports and publications are fed to your desktop or browser-based news reader when they are posted online. Headlines are presented in the RSS feeds, with links to the full reports and publications on the MMWR website. RSS feeds to MMWR publications are available at http://www.cdc.gov/mmwr/rss/rss.html"
[CDC]
Sunday, November 20, 2005
EFF: Legal Guide for Bloggers
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Electronic Frontier Foundation: Legal Guide for Bloggers
"The goal here is to give you a basic roadmap to the legal issues you may confront as a blogger, to let you know you have rights, and to encourage you to blog freely with the knowledge that your legitimate speech is protected."
[Via O'Reilly Radar]
Thursday, March 24, 2005
CDC: Disinfectants and Their Properties
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The CDC published (as an appendix to another report) a guide on which disinfectant work for what organisms:
"All surfaces should be cleaned thoroughly before disinfection. For basic disinfection, a 1:100 dilution of household bleach (i.e., 2.5 tablespoons/gallon) or a 1:1,000 dilution of quaternary ammonium compounds (e.g., Roccal-D® or Zephiran®) may be used. This appendix includes instructions for disinfection when a particular organism has been identified. All compounds require a contact time of >10 minutes."
Wednesday, December 15, 2004
Health, United States, 2004 with Special Feature on Drugs
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Health, United States, 2004 with Special Feature on Drugs
""Health, United States, 2004, is the 28th annual report on the health status of the Nation and is submitted by the Secretary of the Department of Health and Human Services to the President and Congress. It assesses the Nation’s health by presenting trends and current information on selected determinants and measures of health status in a chartbook followed by 153 trend tables organized around four major subject areas: health status and determinants, health care utilization, health care resources, and health care expenditures.""
Guidelines: Coronary Artery Bypass Grafting
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Guidelines updated for Coronary Artery Bypass Grafting (CABG):
" "Key Points
- Off-pump CABG, which avoids aortic cannulation and cardiopulmonary bypass, is now available in many hospitals. However, three randomized trials comparing neurologic outcomes after off-pump and on-pump CABG provide insufficient evidence to warrant the conclusion that the off-pump procedure is better for limiting neurologic complications.
- The authors note that long-term data from trials of angioplasty versus CABG (most notably the BARI trial) continue to show significant advantages with CABG for preventing death and repeat revascularization in diabetes patients.
- Since 1999, both stent use and left internal mammary-artery grafting have become more common. The most recent randomized trial data show that rates of death, MI, and stroke remain similar for CABG recipients compared with stent recipients. The authors also mention that CABG's advantage over stenting for preventing repeat revascularization has narrowed, but remains significant.
- In a class I recommendation, the authors write that aspirin is "the drug of choice" for prophylaxis against early saphenous-vein graft closure and should be continued indefinitely.
- There is a new class I recommendation for statin therapy in all CABG patients, unless contraindicated.
- Hormone replacement therapy should no longer be initiated in women after CABG.
- The new guidelines emphasize the importance of understanding how newer antithrombotic and antiplatelet therapies affect bleeding risk in acute coronary syndrome patients who undergo CABG. For example, the authors have made a class I recommendation that clopidogrel be withheld for 5 days before CABG, if clinical circumstances permit.
- Several new sections have been added, including those about off-pump techniques, robotic coronary bypass, and the value of clinical guidelines and pathways for guiding postoperative care and improving outcomes." "
[Via Medscape Headlines]
What Is the Rhythm?
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Medscape: What Is the Rhythm? Part of their ECG of the week series.
Wednesday, December 1, 2004
Big Red Palm
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""The Big Red Book comes to your Palm with the release of AHFS DI (AHFS Drug Information) by Skyscape
 First published in 1959, the 'Big Red Book,' as it's come to be known, has gone the extra mile for pharmacists and healthcare professionals seeking answers to the most detailed questions. It provides more extensive evidence-based data than any other drug reference and is now available for the PDA.
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""
[Via The Palmdoc Chronicles]
I prefer this text for looking up drug information and find the information it contains much more useful. It seems as though the PDR contains every possible complication as a CYA for the drug maker. The AHFS book doesn't give me that impression.
Thursday, October 14, 2004
BMJ--Lessons from the withdrawal of rofecoxib
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British Medical Journal: Lessons from the withdrawal of rofecoxib:
""Suggested measures to ensure drug safety before definite licensing of a drug:
- Legal requirement for drug companies to register all randomised controlled trials prospectively
- Legal requirement for drug companies to make all data on serious adverse events from clinical studies publicly available immediately after study completion
- Continuously updated systematic reviews of adverse events based on published and unpublished data from randomised controlled trials and observational studies
- Phased introduction of new interventions in independent, large scale, randomised trials before definite drug licensing
- Clear cut financial firewalls between pharmaceutical companies and researchers performing systematic reviews and clinical studies
""
Wednesday, October 13, 2004
NEJM -- Controlling Health Care Costs
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Just released by the New England Journal of Medicine--Controlling Health Care Costs (no registration required for this article):
""Every year, without fail, spending for services covered by private health insurance increases. Sometimes health care spending grows slowly, as it did in the mid-1990s during the managed-care boom. But more often, it increases rapidly, as it is doing now--in part because of the managed-care bust. Presidential candidates do not want to venture beyond platitudes concerning costs because they risk being accused of taking things away from people. Both President George W. Bush and Senator John F. Kerry have served up proposals designed to ease voters' angst about the affordability of health care, but neither proposal, as it has been elaborated through September, gets at the core issues involved in controlling the growth of health care costs.""
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Dec Mar
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