Federal officials said they have become increasingly concerned about the risks of transmitting blood-borne viruses when diabetics are assisted with testing their blood sugar levels and insulin injections, and equipment is unsafely reused with multiple patient. Outbreaks of hepatitis B associated with blood sugar monitoring have been identified with increasing regularity, particularly in long-term care settings such as nursing homes and assisted living facilities, where residents often require assistance with testing and insulin injections, according to the U.S. Centers for Disease Control and Prevention. In the past 10 years, at least 15 hepatitis B outbreaks have been associated with providers failing to follow basic principles of infection control when assisting with blood glucose monitoring. Because of underreporting and under-recognition of infection, the number of outbreaks likely has been underestimated, the CDC says. Safe use of diabetes management equipment is a major concern as more Americans are diagnosed with the disease and as aging boomers move into assisted living facilities, said Joe Perz, an epidemiologist in the CDC's Division of Healthcare Quality Promotion. "This is what we call infection control 101," he said. "One of the most common myths is that contamination is limited to the needle. An insulin cartridge is a form of syringe. And a syringe and needle should be seen as a single device. One can contaminate the other."
During cardiac arrest time is of the essence, but a longer period of cardiopulmonary resuscitation may be no better than a shorter one, a study finds. The study, released Wednesday in the New England Journal of Medicine, compared outcomes of 9,933 cardiac arrest patients, about half of whom had 30 to 60 seconds of initial CPR from paramedics, or three minutes of the procedure, before heart rhythms were analyzed. In both groups, 5.9% of patients survived and were discharged from the hospital in acceptable health. Resuscitation guidelines released in 2005 from the American Heart Assn.-International Liaison Committee on Resuscitation recommended that emergency responders do CPR for two minutes before evaluating heart beats. In 2010 the guidelines became less stringent, acknowledging that evidence didn't necessarily support doing CPR for a longer amount of time. The study also found that patients who received CPR from a bystander may do better if they then had shorter CPR from a paramedic. "Our study definitely shows that there is a no advantage to a longer period of initial CPR," said Dr. Ian Stiell, the study's lead author, in a news release. Although the study didn't evaluate people who didn't receive any CPR before having their cardiac rhythms analyzed, the authors wrote it's still essential to give CPR for some time while defibrillator pads are being readied.
When New York City Mayor Michael Bloomberg instructed five hospitals to evacuate their patients from Hurricane Irene's path, one replied it couldn't follow his order. Administrators from New York University-Langone Medical Center explained that six patients in the intensive care unit were so sick that moving them might kill them, and so the mayor's office gave permission to keep them in the hospital throughout the storm. It then fell to Elaine Rowinski, nurse manager of the intensive care unit, to find seven nurses willing to stay at the hospital, right in the hurricane's predicted path and just 100 yards from the East River, which many feared would overflow. It turned out she had nothing to worry about. "I could have had 20 nurses if I'd needed them," she said. "That's how many called me up to volunteer." Rowinski stayed at the hospital all weekend as the doctors and nurses who also stayed listened to the wind and the rain through the boarded-up windows."I had no qualms about staying, no fears at all," she said. "We train for these disasters."
Expensive technologies like proton beam therapy and hot chemo baths are among the reasons America's health care spending is rising at an unsustainable clip and making the federal deficit so hard to tame. But two of the nation's top healthcare economists are expressing doubts that accountable care organizations -- one of Obama administration's most-hyped mechanisms to save money -- will be able to overcome the medical system's lust for the new new thing. Established through last year's health law, ACOs are networks of doctors and hospitals that would collaborate to provide quality care at lower cost, with the motivation of keeping a share of the savings they deliver to Medicare and private insurers.
A Madison, WI, clinic is contacting 2,345 of its diabetic patients to determine whether a nurse may have exposed them to blood-borne illnesses, including HIV and Hepatitis B and C, over the past five years. "An internal review found that a former Dean Clinic employee was inappropriately using these devices during some patient visits between 2006 and 2011," the clinic said in a statement. In teaching patients how to administer finger sticks and insulin shots to themselves, the nurse changed the needle with each patient but reused the rest of the device, which could put patients at a slight risk of blood transfer from one person to another. The practice devices she used were not even intended for to be tried on people, the hospital said. "That demonstration pen is intended to be used not on people but rather into an inanimate object, such as a pillow or an orange," Mark Kaufman, MD, Dean's CMO, told ABC's affiliate WKOW. The clinic, which is part of a larger medical system in southern Wisconsin, reported that each patient who received insulin training by this nurse would receive a phone call or letter explaining the wrongdoing. The hospital said it would provide the necessary blood tests, follow-up care and support free of charge.
The number of medications on the Food and Drug Administration's shortage list keeps growing. And while calcium chloride and potassium phosphate aren't drug names the average American would recognize, they're critical to patients visiting the emergency room every day. "It seems more and more frequently that we're being alerted to some shortage of a medication that really has been a staple in the emergency department," according to Dr. Bill Frohna, the chairman of Emergency Medicine at Washington Hospital Center. The shortage hasn't yet adversely effected patients at his hospital, the largest private hospital in Washington, D.C. But, like nearly every other hospital in the United States, it's struggling to come up with workarounds for the shortage list.