Medical Seraches in Wolfram Alpha

From Disease a Day:

Yesterday a new search engine, called Wolfram Alpha, was launched. Unlike Google, it doesn’t give you a list of pages on the Internet that might contain the answer to what you were looking for. Instead, it uses data kept in it to compute and answer your question.

Direct from Wolfram Alpha: Examples: Health & Medicine

When are Prehospital Intravenous Catheters Used for Treatment?

From the Journal of Emergency Medicine, via Science Direct:

Prior studies have found that > 50% of prehospital intravenous catheters (i.v.s) were unutilized for treatment; however, few data are available regarding which patients benefit. The objective of this study was to examine the association between i.v. utilization in the field, paramedic primary impression, and patient presentation. Prehospital records for 34,585 patients were evaluated for i.v. placement and utilization in the field. Logistic regression was used to evaluate the association of primary impression, systolic blood pressure, heart rate, respiratory rate, Glasgow Coma Scale score, skin sign color, and capillary refill with placement and utilization. Intravenous catheters were placed in 60% of patients, but only 17% of the total was utilized. Examples of primary impressions with frequent initiation and low utilization (n = number in group, % of total with i.v. placed, % of total used): post-seizure (n = 989, 72%, 9%); weakness/dizzy/nausea (n = 3092, 69%, 20%), syncope/near-syncope (n = 2034, 81%, 26%), and abdominal pain (n = 1554, 70%, 14%). Fifty-eight percent with normal vital signs received an i.v. and 28–30% were utilized; hypotension: 80% received i.v. (odds ratio [OR] 1.211, p = 0.012), 70% utilized; hypertension: 61% received i.v. (OR 1.060, p = 0.027), 28% utilized; bradycardia: 82% received i.v. (OR 1.588, p < 0.0001), 51% utilized; tachycardia: 66% received i.v. (OR 1.152, p = 0.001), 33% utilized; bradypnea: 93% received i.v. (OR 1.638, p = 0.051), 86% utilized; tachypnea: 70% (OR 1.120, p = 0.024), 33% utilized. A Glasgow Coma Scale score < 15: 76% received i.v. (OR 1.672, p < 0.0001), 32% utilized. Abnormal skin color: 79% received i.v. (OR 1.691, p < 0.0001), 42% utilized. Certain primary impressions are associated with high i.v. initiation rates but infrequent utilization. High utilization rates were associated with hypotension, bradycardia, bradypnea, and abnormal skin signs. Study of high-frequency, low-utilization groups could reduce unnecessary i.v. placement.

Routine Laboratory Testing to Evaluate for Medical Illness in Psychiatric Patients in the Emergency Department Is Largely Unrevealing

From the Western Journal of Emergency Medicine:

Objectives: This is a prospective study of psychiatric patients presenting to the emergency department (ED) to determine the value of routine laboratory studies used to attempt to exclude concomitant medical illness.

Methods: Physical exams and laboratory tests were performed on 375 psychiatric patients presenting for “medical clearance” in the ED. Upon completion of these tests, the percentage and impact of abnormal physical exams and laboratory results were assessed.

Results: Fifty-six of 375 patients (14.9%) had a non-substance-induced laboratory abnormality. Forty-two of these 56 patients (75.0%) also had abnormal history or physical exam findings indicating laboratory screening. Ten had normal history and physical exams with insignificant laboratory abnormalities. The four (1.1% [95% CI 0.3-2.7%]) remaining patients with normal history and physical exams had abnormal urinalyses which did not affect final disposition or contribute to altered behavior.

Conclusion: Patients presenting to the ED with psychiatric chief complaints, benign histories and normal physical exams have a low likelihood of clinically significant laboratory findings.

Cervical Spine Motion During Extrication: A Pilot Study

From the Western Journal of Emergency Medicine:

Abstract: Spinal immobilization is one of the most commonly performed pre-hospital procedures. Little research has been done on the movement of the neck during immobilization and extrication. In this study we used a sophisticated infrared six-camera motion-capture system (Motion Analysis Corporation, Santa Rosa, CA), to study the motion of the neck and head during extrication. A mock automobile was constructed to scale, and volunteer patients, with infrared markers on bony prominences, were extricated by experienced paramedics. We found in this pilot study that allowing an individual to exit the car under his own volition with cervical collar in place may result in the least amount of motion of the cervical spine. Further research should be conducted to verify these findings. In addition, this system could be utilized to study a variety of methods of extrication from automobile accidents.

Evil

From CNN (emphasis added):

A 23-year-old woman suffocated her son and then buried his body beneath the sand of a playground, police in Albuquerque, New Mexico, said Thursday

Police arrested Tiffany Toribio about 4 a.m., just hours after they said they wanted to speak to her about her missing 3-year-old son, Ty.

Family members had contacted authorities, saying her son matched the description of a boy found Friday at an Albuquerque playground.

Police Chief Ray Schultz said she confessed to killing the boy soon after being apprehended.

“She placed her hand over her son’s mouth and nose and suffocated him. She had second thoughts about what she did. She performed CPR on her son, brought him back to life and then decided to go forward with that original act she had started to commit,” Schultz said.

Poll finds 1-in-4 Americans text while driving

From Mobile Crunch:

A new survey shows that 1 in 4 Americans text while driving. That’s not good news for road safety, no sir.

The survey, which was conducted by Vlingo, says that 26 percent of people admit to texting while driving—the implication is that plenty more people text while driving than admit to doing so. (Note: Polls are created with this type of “are they telling the truth?” scenario in mind, so it should make a huge impact on the final percentage.) The poll surveyed 4,800 people.

Only a few states here in the U.S. ban texting while driving, including Washington state (the first state to ban the dangerous activity) and New Jersey (home to housewives or something).

The problem is that texting while driving isn’t seen as an inherently dangerous activity, at least compared to something like drink driving; everyone knows that’s a no-no. “What’s the harm in sending out a text while I’m behind the wheel?” Well, mister-think-you’re-Fernando-Alonso, any time you take your eyes off the road that puts everyone in danger, and not just you. All it takes is one stray maneuver and you’re looking at a huge pile-up.

Venipuncture Assistant

From Medgadget:

veinviewingAccuVein, a company out of Cold Spring Harbor, New York, is releasing to market a competitor to the popular VeinViewer from Luminetx. Both systems use infrared imaging to see hemoglobin below the skin. Designed to be portable and battery operated, the AccuVein AV300 can spot difficult to find IV sites for needle placement.

Hemoglobin in the blood absorbs infrared light. When the AccuVein AV300 is held about seven inches above the skin, veins appear noticeably different than the surrounding tissue. The vasculature shows up clearly on the skin’s surface, aiding in vein location to collect a blood sample or administer IV medications.

Illinois legislation would establish network of specialist stroke centers

From the Chicago Tribune, via JEMS:

On Tuesday, the Illinois Senate voted 58-0 to establish a network of specialist stroke centers in Illinois and allow ambulances to take patients to those facilities, bypassing nearby hospitals. The Illinois House previously passed the bill unanimously, and the legislation now goes to Gov. Pat Quinn.

The new system for stroke patients would mimic how emergency care is organized for people with other substantial trauma — for instance, gunshot wounds. Generally, ambulances take these patients to hospitals with specialized trauma units instead of the nearest emergency room. Under the proposed legislation, similar arrangements would be made for stroke patients.

The goal is to minimize damage associated with this condition, the third-leading cause of death and primary source of disability in the U.S.

“We have abundant evidence that if patients are taken to a designated stroke center, they receive better care and have better outcomes,” said Dr. Mark Alberts, a professor of neurology at Northwestern University’s Feinberg School of Medicine.

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