The effect of body mass index on intubation success rates and complications during emergency airway management.

From Internal and Emergency Medicine:

We evaluated the effect of body mass index (BMI) on intubation success rates and complications during emergency airway management. We retrospectively analyzed an airway registry at an academic medical center. The primary outcomes were the incidence of difficult intubation and complication rates, stratified by BMI. We captured 1,075 (98 %, 1,075/1,102; 95 % CI 97-99) intubations. Four hundred twenty-six patients (40 %) had a normal BMI, 289 (27 %) were overweight, 261 (25 %) were obese, and 77 (7 %) were morbidly obese. In a multivariate analysis, obesity (OR 1.90; 95 % CI 1.04-3.45; p = 0.04), but not morbid obesity (OR 2.18; 95 % CI 0.95-4.99; p = 0.07), predicted difficult intubation. BMI was not predictive of post-intubation complications. Airway management in the morbidly obese differed when compared with lean patients, with less use of rapid sequence intubation and increased use of fiberoptic bronchoscopy in the former. During emergency airway management, difficult intubation is more common in obese patients, and morbidly obese patients are more commonly treated as potentially difficult airways.

Health Concerns about Misuse of Pesticides for Bed Bug Control

From the CDC:

The Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention (CDC) are alerting the public to an emerging national concern regarding misuse of pesticides to treat infestations of bed bugs and other insects indoors. Some pesticides are being applied indoors even though they are approved only for outdoor use. Even pesticides that are approved for indoor use can cause harm if over applied or not used as instructed on the product label.

There has been a dramatic increase in the number of bed bug-related inquiries received by the National Pesticide Information Center (NPIC) over the past several years, with many involving incidents of pesticide exposure, spills, or misapplications. From January 2006-December 2010, NPIC reported 169 calls to their hotline where residents, homeowners, or pesticide applicators sprayed pesticides indoors to treat bedbugs. These cases involved pesticides that were misapplied, not intended for indoor use, or legally banned from use. Of those, 129 resulted in mild or serious health effects (including one death) for persons living in affected residences.

WHAM! Doctor Tries Comic Book To Boost Trauma Drug

From NPR:

Roberts’ comic book begins with a bomb blast and follows three rather well-chiseled emergency doctors as they make their rounds, triaging casualties and treating wounds.

In between asides that convey TXA’s correct dosing and contraindications, there is time for both a stabbing and a budding departmental romance. “We also tried to make doctors giving tranexamic acid look sexier than doctors not,” Roberts adds, laughing. “I don’t know if you noticed that one.”

txa-mangapro

GHB overdoses prompt doctor warning

From The Age:

St Vincent’s Hospital emergency doctor Jonty Karro said the hospital was concerned about a spike in overdoses of Gamma Hydroxybutyric Acid (GHB) after treating 20 patients, aged between 16 and 25, over the past three weeks.

Half of the patients required critical care including life support and intensive care treatment.

GHB is a highly toxic, illegal anaesthetic that can quickly lead to a comatose state and death through asphyxiation.

Dr Karro said the spike in overdoses could indicate that current batches of the drug were stronger or contained more harmful substances than in the past.