Archives for January 2005

2004 Best Medical Weblog Award Winner!


2004 Medblogs Awards

The 2004 Medical Weblog Awards

We are very proud to present the winners of The 2004 Medical Weblog Awards in the following four categories:
The Best Medical Weblog of 2004: GruntDoc
The Best New Medical Weblog (established in 2004): The Cancer Blog
The Best Clinical Sciences Weblog: CodeBlueBlog
The Best Health Policies/Ethics Weblog: symtym

I’m extremely gratified at winning, and lack the right words for the occasion. I’m astonished someone other than my mom reads this, and thank you all, especially those who took the time to vote.

The winners of the other fields are excellent blogs, and are way, way better than this one. I encourage everyone to go and visit them (but then come back here).

For the record, both GruntDoc and Symtym are graduates of the Fresno Emergency Medicine Residency, and if that’s not a dynasty, it has no meaning. I’m sure they’ll be adding this fact to their recruiting brochures tomorrow.

Wholehearted thanks to Drs. Ostrovsky, Geldard, and Choi for this contest. I don’t think they anticipated shenanigans, but that’s what they got, and they are to be commended for fixing the problems and moving forward. For the record, my thumbwrestling challenge stands. I hope to see you all on the speaking tour.

Also, many thanks to the sponsors, Steve Hoffman with MedScape and MedGadget (a subsidiary of EchoJournal).

Again, thank you all, and please come back!
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MedBlogs Grand Rounds XVII

Waking Up Costs

Welcome to Medical Weblog Grand Rounds XVII with a theme of medical errors.

Good roundup, with XML links to make linking easier!

Emergency Department Errors: No Help Here

From the most recent Academic Emergency Medicine (Volume 12, Number 1 57-64) comes an article with a very intriguing title: Patient Concerns about Medical Errors in Emergency Departments. As a practicing EP I’m very interested in ED errors and their prevention. Unfortunately, there’s nothing here to help; fortunately, no-one but residency directors reads this journal anyway. (But more than read this site, so my snarkyness loses edge).

The article itself isn’t bad, but the problem is that the “errors” that are presented are heresay and unsubstantiated, leading to the conclusion that the ED is a hugely error-prone place to be. It may or may not be, and this isn’t going to settle the matter.
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Most interesting blog link (to me)

…is this blog, ScoreCard Signals. It’s in Japanese. The blogger is a Hospital Manager in Osaka, Japan, and his blog has very pretty graphics. I presume the text is good, too, but that’s just a guess.

A Word of thanks to the Computer backup gods

Tonight, while trying to teach my old blog new tricks, I managed to corrupt my .htaccess file. If you aren’t now giggling or having tears stream down your face, good, that means you’re normal.

For the rest of us, I lucked out: I had a recent full backup and was able to restore just that file from the backup. Hallelujah.

I will now go and faint for a while.

Last 2 days to vote

…for the medical weblog awards. There are 4 categories, and a lot of excellent blogs. Voting ends on Sunday, so if you haven’t already, go and vote for somebody!

Asphyxiation, not Bleach Toxicity killed 12 year old

Via CNN, which has the editor’s tease title:”Police: Girl died after mother forced her to drink bleach

BIRMINGHAM, Alabama (AP) — A woman angry with her 12-year-old daughter for having sex forced the girl to drink bleach and sat on her until the child died, a police detective said.

Archie is charged with capital murder in the asphyxiation death of her daughter Jasmine. If convicted, she could be sentenced to death or life in prison without parole.

She said she poured bleach into Jasmine’s mouth and the child vomited, he said, then sat on her until she stopped breathing, Cotton testified.

Asphyxiation is not that uncommon a way to die, though this is certainly an extreme event.

What this is not is bleach toxicity. Household bleach is less than 6% hypochlorite, and according to my toxicology reference text is a “mild gastrointestinal irritant”:

“…little or no effect in small ingestions. In moderate to large ingestions, gastrointestinal effects such as diarrhea, constipation, stomach cramps, or vomiting may occur. The effects are usually mild and rarely require medical intervention”.

Though, as a parent, if you caught your child drinking bleach, then vomiting, you’d be forgiven for being alarmed (but not forgiven for letting your kid get to bleach in the first place).*

If it is your kid, call poison control for your area (you have their number, right there on the fridge, right?). More than likely they’ll tell you to have the patient drink some milk, and wait it out. (This is NOT medical advice: I’m a doctor, but I’m not YOUR doctor).**

So, bleach didn’t kill this poor child, asphyxia did. I don’t know if CNN was just sloppy here, or if this was intentional to make this report more dramatic. The cynic in me says the latter.

Wow, suddenly I feel like CodeBlueBlog!
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Toronto ENT Study

Warning: Adult humor (without use of four letter words) follows:

This HAS to be a joke, right?

A study many would enroll in, 'For Science

Post and pic via: Hello World Blog

Update: Fake per Snopes, but I don’t care. It’s still funny.

Shoe Covers

One of the things I do at work gets more comments (well, more neutral comments) than anything else I do, and it’s that I always wear shoe covers. Always.

I didn’t always wear shoe covers, and when people ask me why, I tell them the story: One evening I was interviewing a nice lady, and she had a half-cup of water beside her. She shifted a little and dumped that water directly into my shoe. I decided then and there that since I couldn’t predict when my shoes would be targeted, I’d just wear them all the time.

Keep 'em clean

Since I’ve started, my shoes haven’t gotten slimed in the usual way (but I’ve had to change shoe covers during a shift), and as a happy side-effect my shoes stay a lot cleaner, and I worry less about the germs from the hospital I track home.

Frankly, I don’t know why everyone doesn’t wear shoe covers in the hospital.

Flu and You 2, 2004-05

Every once in a while I feel like actually blogging something medical.
CDC – Influenza (Flu) | Weekly Report: Influenza Summary Update 52, 2004-2005 Season

During week 52 (December 26, 2004-January 1, 2005)*, influenza activity continued to increase mostly in the eastern United States. Three hundred nineteen (12.1%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories were positive for influenza viruses. Fifty percent of all isolates this season have been reported from the Mid-Atlantic and New England surveillance regions**. The proportion of patient visits to sentinel providers for influenza-like illness (ILI) is above the national baseline. The proportion of deaths attributed to pneumonia and influenza is below the national baseline. New York, Vermont, and New York City reported widespread influenza activity, 12 states reported regional influenza activity, and 13 states and the District of Columbia reported local activity. Twenty-two states reported sporadic influenza activity and 1 state did not report.

CDC Flu Week 52, 2004

emphasis mine

Also, it’s nearly all type A flu, with 82% being type A.

Still not too late to get your flu shot.

MedBlogs Grand Rounds XVI

Chronicles of a Medical Mad House: Grand Rounds: Welcome to Scut Hall

As the Bloggers entered Scut hall a hush filled the air and anticipation descended upon the Housestaff. As the *Commish made his way to the podium to anounce the commencement of these Grand Rounds it became clear that this was no ordinary day. And as the gavel pounded our eyes lit with anticipation, the Grand Rounds were officially in session.

Read and enjoy.

Hot Wheels Airplane, and Fine Print

From my brother, the AG:

One of (nephew’s) new Hot Wheels is an airplane with several lines of incredibly tiny text on one wing. The macro mode of our new Nikon is even better than a super-magnifying glass, so you can read it:

There's Always Small Print
click photo to see fine print

If you can read this type you possibly
have way too much free time and you
should consider getting a hobby like
flying an airplane just for the heck of
it. It might start you thinking about
trying other new things. Who knows
you might just be the next real flying ace.

Note to MSNBC:

To: MSNBC News
Fr: GruntDoc
Re: Military Nomenclature

Please note that members of the Armed Forces are identified commonly by service (i.e., Soldier=Army, Sailor=Navy, Marine=Marine, Airman=Air Force, etc.), and additionally by rank (not at issue here).

Therefore, when you describe members of the US Navy as “Soldiers” in the subtitle of your article on the recent grounding of a US submarine, you might appear to be out of touch with, well, centuries of service tradition.

Soldier, Sailor, whatever

There are indeed occasions wherein Soldiers might be passengers (“Combat Cargo”) aboard Navy ships, but this seems not to be the case.

I am glad the remainder of the article describes Navy men as Sailors, perhaps making this only a gigantic typo, and not a sign of cluelessness. Perhaps.

Update: fixed.

Iraq C-130 Crash Photos

Forwarded to me are these photos of a C-130 crash in Iraq, with a narrative:

“A lack of communication”
Last week one C-23 Sherpas flew into a US operated airfield in Iraq during the day and saw there was construction equipment on the runway. Yet there was no NOTAM (notice to airmen). A trench was being dug in the runway, and it was not marked. It’s a long runway and they just landed beyond the construction. They filed a safety hazard report that was immediately forwarded to our higher headquarters and to the Air Force wing based here.

Well, it seems the construction continued and still was not marked or NOTAMed or anything. A C-130 landed on the runway the night of the 29th and didn’t see the construction. It wound up going through what is now a large pit on the runway. A few pictures are attached. The C-130 was totalled.

There were several injuries to the crew and the few passengers that were on board but luckily nobody was killed. Quite the set of failures somewhere in the system regarding this improper construction and no notifications about it.

the Big Picturethe left viewthe right view

rear viewtire tracks and aluminum
I have used photoshop to lighten all but the overview images, as a lot of detail was lost in the dark. No other alterations were made.

Bush pushes for medical malpractice limits

Bush pushes for medical malpractice limits – Health-Care – Economy

President Bush traveled Wednesday to an Illinois county tagged by critics as the nation’s worst for frivolous lawsuits, setting the stage for a series of congressional measures designed to limit litigation against doctors and businesses.

In a speech in Madison County, across the Mississippi River from St. Louis, Bush charged that “frivolous lawsuits” were driving good doctors from their practices, leaving patients to scramble for adequate health care and pushing up medical costs for all Americans.

Bush implored Congress to pass legislation that would put a cap of $250,000 on non-economic damages in medical malpractice cases.

“What’s happening all across this country is that lawyers are filing baseless suits against hospitals and doctors. That’s just a plain fact,” Bush said. “And they’re doing it for a simple reason. They know the medical-liability system is tilted in their favor.”

Bush also used the visit to reiterate a call for other measures that backers say will hold down frivolous lawsuits, including legislation that would shift many class-action lawsuits from state courts to the federal bench and action to resolve thousands of asbestos-related lawsuits…

It’s way past time.

For a look into Madison County, the venue for President Bush’s speech: American Spectator – Tort Reform?s Ground Zero

Madison County is one of those little rotten boroughs that — with the help of the trial lawyers — has turned lawsuits into a cottage industry. At last count close to 20 percent of the asbestos lawsuits in the nation were being heard before a single Illinois state judge in Madison. Out-of-state corporations as diverse as Prudential, Ford, AIG, Philip Morris, General Motors, and dozens of others have had to troop down to Madison County before judges and juries obviously intent on stripping them of their worldly goods.

My biggest worry is that this will lead the fight into arguments about individual venues and their problems, avoiding addressing the Lawsuit Lottery mentality gripping America.

When Lotteries were being pushed in Texas (“It’s for The Children and The Schools”, remember that?), the detractors of state-sponsored gambling were marginalized as nuts, or worse. I now have an entirely different outlook on lotteries and the ‘something for nothing’ mentality they contribute to.