Archives for August 2006

London Airport Security, August 2006

Just got off the phone with a brother in law who flew home last week from London, about 2 days after the latest terrorist threat.

The scene as he describes it:

We weren’t allowed to take anything on the plane with us.  We were given clear plastic bags, and were told we could take our ID’s, our plane tickets, one car key only.  I had a small pack of gum, individually wrapped, and a travel-sized Kleenex.    They made me toss the gum, and had me remove every single sheet of the kleenex, throw out the wrapper, then I could take them. 

A lot of passengers were really stressed after getting through security, and the duty-free shops were hit hard for their liquor.  Which seemed like a good idea, until the second security checkpoint before boarding.  No booze.  The passenger ahead of us made an issue of it, and was told “You don’t have to get on this plane”, so his newly purchased alcohol went into the trash.

I’m not flying for a while, and I’m not afraid of flying.

code:theWebSocket has moved

The wandering Alwin has wandered again, after his domain name was hijacked.  He’s now at:

the RSS is


Please adjust your browsing habits accordingly.

Dr. Pou isn’t innocent, says this emailer

In the email last night (I wrote this person back, and got permission to post this):

I am a home health worker in Washington State.

We fight every day for the well being of our clients.

We deal with docs all the time that think it’s the “time” for the patient, or that they just have “the dwindles”.

With care and intervention they’ve done very well.

Healthcare providers need to be honest.

Real grunt docs fight for the vulnerable not kill them.

You are not God. You are not invincible. If you can’t take the heat get out of the way of those of us who can.

These people had a right to life, not execution.

When more of the truth comes out, we won’t be suprised at the “uppitty” attitude these killers will spout.

Dr. Pou was weak, should not of been in charge.


Where to begin.  I’ll start with a presumption of innocence, and that the facts presented in the indictment aren’t terribly damning.

I’m glad I wasn’t in Dr. Pou’s shoes, and doubt there’s any actual wrongdoing there in NOLA.  This email, however, shows some disagreement.

Perhaps you would like to retort?

Concentrated Navelgazing

This is a totally geeky post for those with weblogs and the desire to have a good desktop WYSIWIG editor.  Feel free to skip it.


Microsoft (obscure shop in the Northwest) has released their Windows Live Writer (Beta), and it’s good.  Really good.  It’s for posting to several of the most popular types of blog tools, and it found my MT blog perfectly.

Movable Type is a good blog tool, and I keep coming back to it, but the blog entry editor built in (and the WYSIWIG plugin) lack some usability.  We work around, but keep looking for alternatives.  This Windows Live Writer is a terrific answer (so far).  Yes, it pushes the Windows Live product(s), and I don’t use any of them, so feel free to ignore them if you don’t need them.  Computerworld has a better review than I could do, so read it when you’re ready.  One thing they didn’t mention is that your post preview is perfect, showing just like it would as a new post in your blog.  Really neat.  And the built-in spellcheck isn’t shabby,

Perfect?  No.  Pretty darn good?  Yes.  I’ll be using it.


Oh, there’s no mac version.  But you have MarsEdit for the mac, so don’t worry about it.

Medblogs Grand Rounds 2:47

This week at Hospital Impact:

…  So for this edition of grand rounds, I wanted to write a letter to my new son, Timothy. One day, when he is old enough, I hope he’ll read this and learn about how healthcare used to be way back in 2006….

Another in a terrific series.  Enjoy.

Does this mean I can be a Beautiful Blogger?

In the mail:

am I beautiful yet?

Hmm. I’ll pass, but some others might be interested.

Has diagnostic imaging use in the ED increased since 1995?

Yes, decidedly:

via JAMA:

The interesting parts of the explanation:

…In 2004, more ED visits included imaging procedures than in 1995 (43% versus 38% of visits, respectively). During 1995-2004, the number of MRI or CAT scans nearly quadrupled, and the number of ultrasounds more than doubled. The overall number of ED visits increased by 14%.

I see this as more access to technology more than anything else. The rule today: if there’s a test for it, just get the test.

Acronym of the Shift

Tonight, I was reviewing the records sent with a patient from their nursing home. Typed records, of the official sort.

Under allergies: “NKFDA”

Now, I know what NKDA means: No Known Drug Allergies.

I had a guess what the extra F stood for, but was too polite to say it out loud.

It made me chuckle a bit, though.

The Great Plavix Disaster

Really interesting reading about the business and politics behind a popular drug, and why the cost of Plavix will be coming down soon.The Great Plavix Disaster

I’ve been remiss in not covering the Plavix situation, which is quite a story. The huge-selling anticoagulant is marketed in the US by Bristol-Meyers Squibb and in the rest of the world by Sanofi-Aventis…

It’s worth the time.

Once Again Technology Fails

via Emergency Medicine Doc (catchy title) Once Again Technology Fails

The other day I saw a patient with abdominal pain.’ The patient had the pain for some time.’ They had a CT scan of the abdomen at an outpatient radiology facility the day before.’ I asked if she knew the result, and she said, ‘No, but can’t you just pull it up off of your computer?’ The answer of course was ‘No.’’

I see this all the time, as well. One of the consequences of this inability to share information is extra testing, repeating CT’s, etc.

It’s easy to blame HIPAA for this, and I will, but it’s also a true failure of imagination and effort.

Change of Shift is up…

Its a nursing thing

Welcome to Change of Shift. As usual the posts are wonderful and the submissions will not disappoint. I enjoyed the recent Grand Rounds’ format of a stroll through a Garden, so I am adopting the style. However, I thought it appropriate to walk readers through a college campus, after all, I am a nursing student!

Nursing Grand Rounds, the next chapter.

Cristiano da Matta Update

MedBlogger Survey

In the mailbag:

Envision Solutions, LLC and The Medical Blog Network Kick Off Comprehensive Study of Global Healthcare Blogging Community

The Taking the Pulse of the Healthcare Blogosphere survey will track the demographics and opinions of healthcare bloggers from around the world.
New York, NY — July 31, 2006


– Envision Solutions, LLC and The Medical Blog Network [TMBN] have launched the Taking the Pulse of the Healthcare Blogosphere survey. The study is the first systematic attempt to gather comprehensive opinion and demographic data from the global community of healthcare bloggers. Envision Solutions and TMBN expect to re-field the survey in the future.

– The healthcare blogosphere is rapidly growing in size and importance. However, little is known about the activity and opinions of large numbers of healthcare bloggers.

– The 2006 edition of the survey will run from July 31 to September 29. It is open to individuals and organizations that devote at least 30% of their blogging time to healthcare-related topics. To learn more about the survey, please go to:

– Envision Solutions and TMBN will release the preliminary results of the survey in the late fall. The final results will be presented at Healthcare Blogging Summit 2006 taking place in Washington, D.C. on December 11.

– Envision Solutions and TMBN will collect and analyze data provided by a global sample of healthcare bloggers willing to take the survey. While the data is expected to provide new insights into the attitudes and behaviors of this community, we acknowledge that we may be surveying the most active bloggers and caution against applying the data to the overall healthcare blogopshere.

– Envision Solutions is a healthcare marketing communications consultancy. The Medical Blog Network is the worlds largest community of healthcare bloggers. TMBN connects bloggers, their audiences and the healthcare industry via a number of hosting and promotional services.

I took the survey, it’s not painful, and as warned it did take about 10 minutes.

MedBlogs Grand Rounds 2:46

Mexico Medical Student ? Grand Rounds Vol 2, No. 46

Welcome to Grand Rounds Vol. 2 No. 46! For the first time, Grand Rounds comes to you from Mexico…

A South of the Border collection of the best of the medblogosphere.

Some Nurse Love

The word nurse appears in at least 120 different posts on this blog (I just counted). In exactly one of those posts I took nurses (in general, as a group, which was overstating things a bit) to task for some odd behavior I’d observed.

Guess which post I’ve been hearing about, at length, from my nursing colleagues? This one, for those who haven’t already guessed. It’s peeved several of them, which I would find amusing except they’re angry way out of proportion to the offence. Humor is individual, and there’s some individuals I work with who didn’t find it humorous.

So, for the thin-skinned and those with short memories, here’s a couple of blog posts wherein I’ve demonstrated some of my feelings for my nurse colleagues:
A break, too late
My Side

I appreciate everything the nurses do for me, and they do a lot. In no particular order, nurses do/have:

  • caught allergies I missed
  • gotten that bit of history that makes things make sense
  • alerted me to a subtle finding that changes the disposition
  • talked to the family and kept them informed so they’re happy
  • ordered that lab I’d left off by accident
  • not yelled at me for the third set of added-on orders
  • reviewed my orders and found that omission that would cause a problem later
  • carried out orders they didn’t want to, because the patient needed it
  • taught me something about a medication
  • got that IV in the septic drug abuser with no veins

…and on and on.

I respect all of you.

And it’ll be a while before I write about nurses again.