Besides, why waste the quarters when I can wash it in the bathroom sink?
And you know you like my drying skills. :)
Wednesday, May 12, 2010
Thursday, May 6, 2010
A-Fib (On Coumadin)
A-Fib (Atrial Fibrillation) is the most common type of cardiac arrythmia. 1 in 4 Americans over 40 have a risk of developing A-Fib. You can recognize it from the moment when you go to take a radial pulse and it's nowhere near a predictable rhythm. 8% of adults over age 80 have A-Fib. Some people have spontaneous A-Fib spells, some suffer from A-Fib during exertion, and some have continuous (chronic) A-Fib. Approximately 30% of A-Fib patients don't know that they have A-Fib.
Simply, there's extra electrical impulses going on in your heart, and the atria are beating faster than the ventricles, creating arrythmia. It's not life-threatening on it's own, but it can cause palpitations, fainting, chest pain, CHF, and most importantly, strokes.
Patients with A-Fib are 7 times more likely to have strokes than the regular population. Blood can pool and clot due to inadequate contractions of the atria. A-Fib strokes are therefore typically ischemic.
35% of patients with A-Fib will suffer strokes if untreated.
15% of all stroke patients have A-Fib
25% of A-Fib stroke patients have no prior diagnosis of A-Fib
23% of A-Fib stroke patients die (compared to 8% of non-A-Fib stroke patients)
44% of A-Fib stroke patients suffer serious neurological damage
Now that I've overwhelmed you with numbers, enter Coumadin. Coumadin, or Warfarin, as we all know, is an anti-coagulant (blood-thinner). Anti-coagulants prevent clots. Therefore, your patient with a PMH of "A-Fib (On Coumadin)" most likely has chronic A-Fib and other risk factors for stroke.
Some A-Fib patients may use Aspirin, Heparin, or Dabigartan for the same effect. Aspirin is more common in younger A-Fib patients.
They may also be on medications to control their heart rate such as: Metoprolol, Atenolol, Bisoprolol, Diltiazem, Verapamil, or Digoxin. (I see the first and last regularly with my geriatric patients, even if they don't have a PMH of A-Fib. More on those some other post.)
See also:
Atrial Fibrillation - Wikipedia
Atrial Fibrillation - a-fib.com
Simply, there's extra electrical impulses going on in your heart, and the atria are beating faster than the ventricles, creating arrythmia. It's not life-threatening on it's own, but it can cause palpitations, fainting, chest pain, CHF, and most importantly, strokes.
Patients with A-Fib are 7 times more likely to have strokes than the regular population. Blood can pool and clot due to inadequate contractions of the atria. A-Fib strokes are therefore typically ischemic.
35% of patients with A-Fib will suffer strokes if untreated.
15% of all stroke patients have A-Fib
25% of A-Fib stroke patients have no prior diagnosis of A-Fib
23% of A-Fib stroke patients die (compared to 8% of non-A-Fib stroke patients)
44% of A-Fib stroke patients suffer serious neurological damage
Now that I've overwhelmed you with numbers, enter Coumadin. Coumadin, or Warfarin, as we all know, is an anti-coagulant (blood-thinner). Anti-coagulants prevent clots. Therefore, your patient with a PMH of "A-Fib (On Coumadin)" most likely has chronic A-Fib and other risk factors for stroke.
Some A-Fib patients may use Aspirin, Heparin, or Dabigartan for the same effect. Aspirin is more common in younger A-Fib patients.
They may also be on medications to control their heart rate such as: Metoprolol, Atenolol, Bisoprolol, Diltiazem, Verapamil, or Digoxin. (I see the first and last regularly with my geriatric patients, even if they don't have a PMH of A-Fib. More on those some other post.)
See also:
Atrial Fibrillation - Wikipedia
Atrial Fibrillation - a-fib.com
Tuesday, May 4, 2010
Monday, May 3, 2010
Children's Tylenol, Motrin, Zyrtec and Benadryl Recalled
Just so you're aware, ladies and gents.
Children's Tylenol and Other Drugs Recalled - NYT
The full recall list is here:
McNeill Product Recall
Don't panic. Nothing terrible has happened yet, just violations during a factory inspection leading to a voluntary recall. But if your peds patient is acting funny, and they took one of these, maybe mention it to the triage nurse? Or even better, grab the bottle, so that you or one of the ER nurses can check the product lot number. Even if it's just to tell their parent(s) that they should toss it.
Children's Tylenol and Other Drugs Recalled - NYT
The full recall list is here:
McNeill Product Recall
Don't panic. Nothing terrible has happened yet, just violations during a factory inspection leading to a voluntary recall. But if your peds patient is acting funny, and they took one of these, maybe mention it to the triage nurse? Or even better, grab the bottle, so that you or one of the ER nurses can check the product lot number. Even if it's just to tell their parent(s) that they should toss it.
Sunday, May 2, 2010
Saturday, May 1, 2010
Your daily PSAs.... :)
Four out of six patients agree, it's pneumonia season.
If I'm driving lights and sirens on the left-most lane of the highway, please merge with the lane to your right. Pulling left and stopping accomplishes nothing. I will not fit between you and the speeding traffic to my right.
If you have the bariatric stretcher in your bus, you will have at least one patient that weighs over half a ton.
Walking into the same ER four times in one day will make you wonder when you see that CHF patient you brought in at 11am in the exact same place at 6pm, and that migraine patient stops you to ask if they can get a ride home now.
If you're going into OT on a call, you will have to wait 45 mins on both ends for a lift assist.
Getting back to base 2hrs late with 700 L of O2, no NRBs and no nasal cannulas. Yes, it is most definitely pneumonia season.
Telling your partner, "Dude, you should auscultate my lungs. Now that's some freaky ronchi," will result in, "They probably caught it from you. You're seriously infecting everyone."
:)
Four out of six patients agree, it's pneumonia season.
If I'm driving lights and sirens on the left-most lane of the highway, please merge with the lane to your right. Pulling left and stopping accomplishes nothing. I will not fit between you and the speeding traffic to my right.
If you have the bariatric stretcher in your bus, you will have at least one patient that weighs over half a ton.
Walking into the same ER four times in one day will make you wonder when you see that CHF patient you brought in at 11am in the exact same place at 6pm, and that migraine patient stops you to ask if they can get a ride home now.
If you're going into OT on a call, you will have to wait 45 mins on both ends for a lift assist.
Getting back to base 2hrs late with 700 L of O2, no NRBs and no nasal cannulas. Yes, it is most definitely pneumonia season.
Telling your partner, "Dude, you should auscultate my lungs. Now that's some freaky ronchi," will result in, "They probably caught it from you. You're seriously infecting everyone."
:)
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