Are Alphanumeric Pagers Obsolete? That Depends.
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Ever since I was an intern I've worn a pager while at the hospital--and at a lot of other times, too. They used to be as big as a pack of three by five cards, but now they're quite tiny (think matchbox). But it's still an item you have to remember to put on each day, an item that weighs on your waistline. Back when there were only pagers that wasn't a big deal. Wearing a pager was a status symbol.
But now that belt or waistline space is more crowded. There's probably a cell phone and a PDA. There may also be a Spectralink phone or two for in-hospital calls. If you're really important, you may have more than one or two pagers. It's enough to make your scrubs sag.
Someone explained to me once (and I don't have a reference for this) that FCC law prevents device manufacturers from integrating a digital pager into another electronic device such as a cell phone or pda and that this was done to protect the paging industry. Is that true? Does anyone know?
My group still carries pagers because we know they always work, no matter where we are. In a surgery center in the basement of a medical office building or far out of town, away from cell towers, the digital pager will let us know someone wants to talk to us.
As the Palmdoc Chronicles points out in his post titled Alternative to Paging, there are more options than there used to be: SMS/Texting, Push E-mail, IM, Push to talk. To the best of my knowledge, however, none of them offer the reliability of paging. If someone needs to be intubated, or needs an epidural, or is coding, 'Sorry, did you IM me? I didn't get it' isn't going to cut it.
The one upgrade I would love to have to our pagers is the ability to send text messages over them. For example, instead of getting paged to '3968', calling that number only to be asked to go do an epidural in labor room 8, I could just receive the message on the pager: 'Epidural labor 8.' See? Our pagers are hospital provided and the service I describe costs more. I have not been sufficiently persuasive in my appeals to get them to spring for the extra feature. When I offered to pay for the cost of the alphanumeric service over and above what regular digital paging service costs, I was told we can't do that either because they can't 'split out' a subgroup of the pagers.
Now, I realize I'm just an unfrozen caveman anesthesiologist, but if you know that 40 pagers are using a service that costs ten dollars more per month and I cut you a check for $400 each month, wouldn't that make us even?
"Ladies and gentlemen of the jury, I'm just a caveman. I fell on some ice and later got thawed out by some of your scientists. Your world frightens and confuses me! Sometimes the honking horns of your traffic make me want to get out of my BMW.. and run off into the hills, or wherever.. Sometimes when I get a message on my fax machine, I wonder: "Did little demons get inside and type it?" I don't know! My primitive mind can't grasp these concepts."
(Another Reason Why) I Like Desflurane
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I've
posted before on why I think the desflurane Tec 6 vaporizer is a good design (it doesn't need to be turned off to be refilled). I'd like to add another reason to the list: it has alarms.
The Desflurane Tec 6 has a 'low agent' alarm and a 'no output' alarm, in addition to the ability to detect when it has been tipped (and therefore shouldn't be used). The other common agent, Sevoflurane, is delivered via a vaporizer that has none of these things. I am personally aware of two cases where no volatile anesthetic was delivered despite the vaporizer being 'open'. Two cases that would have been uneventful if desflurane and a Tec 6 vaporizer had been used. I'm going to ask the Society for Technology in Anesthesia listserv if there is any reason the Sevoflurane vaporizer couldn't have these features.
DaVinci Surgical Robots. A Hospital CEO Asks Advice.
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Running a hospital: da Vinci Uncoded -- or, Surgical Robots Unite!
"Here you have it folks -- the problem facing every hospital, and especially every academic medical center. Do I spend over $1 million on a machine that has no proven incremental value for patients, so that our doctors can become adept at using it and stay up-to-date with the "state of the art", so that I can then spend more money marketing it, and so that I can protect profitable market share against similar moves by my competitors?"
I just discovered this blog today via Medgadget and am already impressed. The large health system our group works in purchased a DaVinci last year. I don't know outcomes yet but it was apparent to me before the purchase that it was largely driven by regional competition in Central Pennsylvania. I think it's telling that many of the institutions which were the early adopters no longer use the systems.
I'm hoping to pick one up cheap in a couple of years so I can do labor epidurals from home. ;-p
Bring Your Own Applications--Portableapps.com
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PortableApps Suite | PortableApps.com - Portable software for USB drives
" PortableApps Suite™ is a collection of portable apps including a web browser, email client, office suite, calendar/scheduler, instant messaging client, antivirus, sudoku game, backup utility and integrated menu, all preconfigured to work portably. Just drop it on your portable device and you're ready to go."
Hospital computers tend to have Internet Explorer as the only web browser. It works (mostly), but it's not as secure, extensible, fast, standards-compliant as, say, Firefox. Besides that, I use Firefox at home and like to have the same bookmarks available. Portableapps.com allows me to carry my own apps in on a USB thumb drive.
VeinViewer
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"
VeinViewer Shipped!
"The VeinViewer, a device that reveals the underlying venous anatomy for easy IV placement, is now being shipped, according to RedHerring.com....Note to nurses on the floor: call VeinViewer and not an on-call anesthesiologist.
Company website | Video of VeinViewer
"
[Via Medgadget]
Google That Medal Count
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Just Google 'Olympic Medals' to see the top three countries in the medals race.
via [LifeHacker]
High Tech Noise Canceling Stethoscope
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Also via A Chance To Cut is a Chance to Cure, a pointer to a new stethoscope: 3M Littmann Electronic Stethoscope Model 3000
Listening to a patient's heart and lungs before anesthesia is something I don't do nearly enough. This may just be the gadget that makes it fun again...
For OR Nurses: iPod 101
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"Just in time for the Holiday season Apple has posted iPod 101...[which] covers everything you might want to know about the iPod, but were afraid to ask (or perhaps didn't know you should want to ask)."
[Via TUAW]
Greg Pierce: Pragmatic Security
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Greg's "Pragmatic Security," for the Rest of You ;-):
" Greg has just published a very pragmatic set of instructions to help "friends and family of geeks" deal with security issues on the internet. Very good recommendations, all of them, and so I'd like to ask all of my friends and family to go check them out. He obviously spent a lot of time writing that essay, and I believe that most will find it an 'easy read'.
He admits it's not a complete solution to everyone. It's a plan to get started. I think it's a good plan.
The most important issue he left out, in my opinion, is the huge number of "phishing" email messages being sent out these days (these are attempts to trick you out of your username and password). Nobody is safe from these, many of them are just too good. I wrote up a little blurb and posted it in a reply to Greg's message, so please include it in your reading. "
[Via Truer Words - A Journal]
My take on the rumored iPhone
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Podcasts. Everybody's talking about music, but I'd listen to podcasts (like this Make podcast on biodiesel). Any good medical podcasts out there yet?
IBM To Launch Electronic Medical-Record-Sharing Project
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InformationWeek: IBM To Launch Electronic Medical-Record-Sharing Project > April 27, 2005:
"IBM wants to help pave the way for the free exchange of electronic health-care records that today are trapped in hundreds of disparate hospital, physician, and health insurance systems.
By the end of the year, IBM will launch a pilot system, the Interoperable Health Information Infrastructure, that will link IBM sites in San Jose, Calif.; Rochester, Minn. (home of the Mayo Clinic); and Haifa, Israel, to demonstrate how electronic medical records based on open standards could move from one health-care provider to another and follow a patient around the world. "
