Little Benefit Seen, So Far, in Electronic Patient Records

From the NY Times:

The nation is set to begin an ambitious program, backed by $19 billion in government incentives, to accelerate the adoption of computerized patient records in doctors’ offices and hospitals, replacing ink and paper. There is wide agreement that the conversion will bring better care and lower costs, saving the American health care system up to $100 billion a year by some estimates.

But a new study comparing 3,000 hospitals at various stages in the adoption of computerized health records has found little difference in the cost and quality of care.

“The way electronic medical records are used now has not yet had a real impact on the quality or cost of health care,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health, who led the research project.

RhinoChill for Therapeutic Hypothermia

Ed. I’d not heard of RhinoChill, mentioned in the AHA study post, so I decided to investigate.

From BeneChill, the manufacturer’s website:

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BeneChill’s mission is to develop novel cooling technologies to improve patient outcomes after acute ischemic events such as cardiac arrest, stroke, and traumatic brain injury.

The RhinoChill System has been developed as a means of initiating and providing therapeutic cooling with limited delays. It is non-invasive, easy-to-use, portable, and requires no external power. RhinoChill is designed to overcome limitations of other temperature reduction technologies—limitations that prevent early and rapid initiation of patient cooling.
Surface cooling devices such as water-filled blankets and pads, while easy to apply, are inefficient, cumbersome, require large refrigeration units and may interfere with patient management.
Intravascular cooling devices which cool the blood, while more efficient than surface cooling devices, are invasive, require large refrigeration units, and need to be placed by specially trained physicians under restricted conditions. The invasive nature of these devices carries risk of additional complications.

The RhinoChill System uses the nasal cavity for cooling. This is advantageous due to the nasal cavity being:
A natural orifice into the body
In close proximity to the brain
A natural heat exchanger

Use of the nasal cavity enables treatment by non-specialized medical personnel using non-sterile technique in any environment.

PocketCPR for iPhone / iPod touch for free

From DealNews

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The iTunes App Store offers downloads of PocketCPR for iPhone / iPod touch for free. That’s $6 off and the lowest price we could find for this accelerometer-based CPR training tool.

Note from the developer’s site: “The Pocket CPR for iPhone is currently for training and practice purposes only. The application is not yet cleared by the U.S. FDA for use in an actual rescue.”

AHA Conference: Support for Therapeutic Hypothermia

AHA: Cooling Cardiac Arrest Victims’ Brains Before Admission Appears Beneficial

From MedPage Today:

Cooling the brain of a person shortly after an out-of-hospital cardiac arrest may improve the chances of survival without brain damage, researchers reported here.

Across 15 EMS systems in Europe, patients who had intranasal brain cooling within 10 minutes of CPR initiation were more likely to have good neurological function at discharge than those who received standard treatment (45.5% versus 17.6%, P=0.01), according to Maaret Castrén, MD, of the Karolinska Institute in Stockholm.

Brain-cooled patients also demonstrated significantly better survival to discharge (59.1% versus 29.4%, P<0.05).

In patients who had CPR started more than 10 minutes after the arrest, there were trends toward a benefit in the intranasal cooling group, although the study was not powered for efficacy outcomes, Castrén reported at the American Heart Association meeting.

The PRINCE (Pre-resuscitation Intranasal Cooling Effectiveness) study set out to assess the safety and feasibility of using an intranasal cooling device during CPR in the pre-hospital setting.

The device, called RhinoChill, is noninvasive and introduces a volatile coolant that evaporates and removes heat through nasal prongs. It is battery powered and does not require refrigeration.