Nose hair plucker arrested in ER

Ed. I couldn’t resist, the title was just too cool.

From WOODTv (seriously):

HASTINGS, Mich. (WOOD) – A man is behind bars after trying to steal some tweezers from a hospital emergency room.

Hastings police officers were called Oct. 15 to Pennock Hospital for a possible larceny report.

When they arrived they were met by an emergency room nurse who said a patient tried to steal some hemostat tweezers.

The nurse told police she dropped the tweezers on the floor while taking stitches out of the patient’s wounds. Since the tweezers were no longer sterile, the nurse left the room to get some clean ones.

When she came back, she noticed the tweezers that fell on the floor were gone.

The nurse asked the patient if he had taken them and he said, “Yes, I wanted to use them to pluck my nose hairs.”

Injured dog reports to the ED

From the News Tribune:

A little dachshund in Mendota knew just where to go when she was injured in a vicious dog attack: She headed for the emergency room.

Ultrasound evaluation of cardiac arrest patients

From Annales Françaises d’Anesthésie et de Réanimation:

Cardiac arrest is a frequent emergency for doctors and resuscitation teams. Patients displaying asystole or pulseless electrical activity are non-shockable. They have extremely poor outcomes. The use of sonographers might contribute to a better understanding of cardiac arrest (CA) etiology and facilitate its treatment. A systematic search in databases (NLM-Gateway®, CNRS-INIST/Pascal®, Science Direct®, Ovid®, and Bibliovie®) of primary documents and notices allowed us to select clinical trial studies. Editorials, case report and animals studies were excluded from the analysis. The various physiopathological and semiological status revealed by echocardiography are useful to detect the aetiology of cardiac arrest. In the very first minutes following the arrest, a significant increase of right ventricle (RV) volume suggests a pulmonary thromboembolism or a RV infarction. After 4 min of CA, a physiological increase of RV volume is observed, in relation with the pressure balance between high and low arteriovenous pressures. RV and/or left ventricle collapses are straightaway pathological whichever due to pericardic effusion, pneumothorax or schock. A synthesis algorithm dedicated to care of CA, including transthoracic echocardiography for search of curable causes, is proposed. This algorithm fulfills the ILCOR, ERC and AHA recommendations. The echocardiography should be part of ACLS, nevertheless clinical studies are needed to assess its impact on morbimortality.

Pediatric Ingestions of Hand Sanitizers: Debunking the Myth

From Pediatric Emergency Care:

Objective: Poison centers frequently receive calls concerning children who are exposed to hand sanitizers. These exposures can occur while the product is being used correctly or when a child has unsupervised access to the container. In 2007, the use of ethanol-containing hand sanitizers in the pediatric population came under media scrutiny owing to an Internet urban legend that resulted in a greater awareness of the potential toxicity of these sanitizers based on their high ethanol content.

Methods: A retrospective review of all exposures to hand sanitizers in children younger than 6 years reported to a regional poison information center from January 1, 2000 to March 30, 2007 was performed. Data reviewed included substance, age, sex, and outcome. Data were analyzed using descriptive statistics.

Results: Six hundred forty-seven cases were identified including 324 females and 323 males. Ages ranged from 1 month to 5 years with a mean of 1.89 years and a median of 2 years. Outcome data included 31 patients (4.8%) with no effect, 26 (4%) with a minor effect, 372 cases (57.5%) coded as nontoxic – expect no effect, 208 cases (32.1%) with minimal clinical effects possible, and 10 cases (1.6%) where the symptoms were judged to be unrelated to the exposure. There were no moderate or major outcomes and no fatalities.

Conclusions: Children in this age group have frequent hand-to-mouth activity and environmental curiosity making the application or availability of a hand sanitizer the perfect situation for an exposure to occur. Although ethanol-based hand sanitizers have the potential to cause toxicity, the benefits of prevention of illness outweigh the hazards when used in a supervised situation.

More on computer-aided severity scaling at dispatch

From BMC Emergency Medicine:

Background

Utilizing a computer algorithm, information from calls to an ambulance service was used to calculate the risk of patients being in a life-threatening condition (life threat risk), at the time of the call. If the estimated life threat risk was higher than 10%, the probability that a patient faced a risk of dying was recognized as very high and categorized as category A+. The present study aimed to review the accuracy of the algorithm.

Methods

Data collected for six months from the Yokohama new emergency system was used. In the system, emergency call workers interviewed ambulance callers to obtain information necessary to assess triage, which included consciousness level, breathing status, walking ability, position, and complexion. An emergency patient’s life threat risk was then estimated by a computer algorithm applying logistic models. This study compared the estimated life threat risk occurring at the time of the emergency call to the patients’ state or severity of condition, i.e. death confirmed at the scene by ambulance crews, resulted in death at emergency departments, life-threatening condition with occurrence of cardiac and/or pulmonary arrest (CPA), life-threatening condition without CPA, serious but not life-threatening condition, moderate condition, and mild condition. The sensitivity, specificity, predictive values, and likelihood ratios of the algorithm for categorizing A+ were calculated.

Results

The number of emergency dispatches over the six months was 73,992. Triage assessment was conducted for 68,692 of these calls. The study targets account for 88.8% of patients who were involved in triage calls. There were 2,349 cases where the patient had died or had suffered CPA. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the algorithm at predicting cases that would result in a death or CPA were 80.2% (95% confidence interval: 78.6% – 81.8%), 96.0% (95.8% – 96.1%), 42.6% (41.1% – 44.0%), 99.2% (99.2% – 99.3%), 19.9 (18.8 – 21.1), and 0.21 (0.19 – 0.22), respectively.

Conclusions

A patient’s life threat risk was quantitatively assessed at the moment of the emergency call with a moderate level of accuracy.

GE’s Decision Support Software

From Medgadget:

General Electric is previewing a new clinical decision support software developed with the help of Intermountain Healthcare hospital system from Salt Lake City, UT. Using years of Intermountain’s clinical data from real world situations, the software is designed to monitor dozens of patients, display live data about them, and raise alerts when certain criteria are met. The package would sit on top of an already installed electronic medical record system and would use historical data about each patient to create appropriate alerts and warnings. According to GE, the pilot software will be launched at Intermountain in November and GE will unveil the full solution at the March meeting of the Healthcare Information Management and Systems Society (HIMSS).

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