Massive Pulmonary Embolism with Acute Coronary Syndrome-like Electrocardiogram
Mimicking Acute Left Main Coronary Artery Obstruction
Published online: 06 December 2011
Paolo Ciliberti, Claudio Rapezzi, Caterina Villani, Giuseppe Boriani
DOI: 10.1016/j.jemermed.2011.03.037
Journal of Emergency Medicine, The,

 http://www.jem-journal.com/article/S0736-4679%2811%2900891-2/abstract

Weinberger DM, Simonsen L, Jordan R, et al. Impact of the 2009 influenza pandemic on pneumococcal pneumonia hospitalizations in the United States. J Infect Dis 2011 Dec 7

http://jid.oxfordjournals.org/content/early/2011/12/07/infdis.jir749.abstract

The 2009 influenza pandemic had a significant impact on the rate of pneumococcal pneumonia hospitalizations, with the magnitude of this effect varying between age groups and states, mirroring observed variations in influenza activity.

Another 14 California hospitals have been ordered to pay fines totaling $850,000 in the latest round of medical errors involving immediate jeopardy to patients………

These incidents include seven retained foreign objects, including a 2.5 cm temporary pin used in a woman’s spine surgery……..

Other incidents that placed patients in immediate jeopardy of harm or death included a “Code Pink,” in which a newborn was abducted from a labor and delivery unit despite the use of a bracelet designed to signal an alarm if an infant is taken from the area; a morphine overdose which resulted in a patient’s death; and the administration of “compromised” medications and vaccines, which were incorrectly refrigerated to freezing temperatures, to an estimated 5,000 patients……”

Acute Meningitis Prognosis Using Cerebrospinal Fluid Interleukin-6 Levels
Published online: 06 December 2011
Vázquez Jorge Alejandro, Adducci Maria del Carmen, Coll Carlos, Godoy Monzón
Daniel, Kenneth V. Iserson
DOI: 10.1016/j.jemermed.2011.07.029
Journal of Emergency Medicine

http://www.jem-journal.com/article/S0736-4679%2811%2900906-1/abstract

In patients with acute bacterial meningitis, CSF cytokine concentrations are elevated. Measuring CSF inflammatory cytokine levels in patients with acute meningitis could be a valuable ED diagnostic tool. Using this tool could improve the prognosis of patients with bacterial meningitis by allowing more rapid initiation of antibiotic treatment.

http://www.medpagetoday.com/MeetingCoverage/ASHP/30046

ASHP: Pharm Residency Improves Care, Cuts Costs

Weant K, Baker S “Effect of residency training on clinical activities in an emergency department” ASHP 2011; Abstract 3-094.

By Nancy Walsh, Staff Writer, MedPage Today
Published: December 07, 2011

At the 2011 American Society of Health-System Pharmacists (ASHP):

“…..The society recommended in 2008 that pharmacy services should be available to all emergency departments, and the Institute of Medicine and the Joint Commission also have weighed in on the importance of having clinical pharmacists integrated into ED care…….”

“…….[There was] a retrospective analysis of clinical pharmacists’ activities among patients admitted to the University of Kentucky Chandler Medical Center from October 2008 to October 2010.

The hospital is a level 1 trauma center with a 65-bed emergency department that treats some 65,000 patients each year.

Two pharmacists are assigned to the department and provide coverage 12 hours per day every day of the week.

There were 5,986 clinical consultations during the study period, with the most common being for information on drug dosing (48%) and recommendations on therapeutic regimens (18%).

Each year, pharmacists with no residency training had a mean of 2,372 consultations, while residents overall had a mean of 3,029.

First-year residents had 2,664 consultations, while those in their second year had 3,467.

The average cost savings each day were:

• No residency training, $2,642
• Any residency program, $6,960
• First-year residents, $3,271
• Second-year residents, $9,058

And the mean cost savings per year were:

• No residency training, $964,585
• Any residency program $2,540,400
• First-year residents, $1,193,915
• Second-year residents, $3,306,280

Specific cost savings averaged $1,647 for each consultation that identified a potential drug interaction or incompatibility…….

For each consultation that prevented an adverse drug event, the cost saving was $1,098, while the cost avoidance whenever a medication error was prevented averaged $1,375.

“These data show support the concept that residency training can result in better patient care, provides a high-quality learning environment for pharmacists, and can be cost-effective for institutions…..”

http://www.chicagotribune.com/health/ct-x-1130-rush-tour-20111130,0,6874154.story

Chicago Tribune

New Rush hospital designed to treat infectious threats

Tower has features to address bioterrorism, deadly pandemic

By Bonnie Miller Rubin, Chicago Tribune reporter

November 30, 2011

“‘……The ambulance bays can convert into a large decontamination room. A surveillance system can track disease as it spreads across the city. Pillars in the gleaming new lobby look plain enough, but they’re equipped with hidden panels for easy access to oxygen and other gases.

Before patients can be moved there in January, hundreds of staff must be trained on all-new equipment — from a state-of-the-art patient lift to a trash chute that travels at 60 mph…..Still, it was the new ability to potentially handle a pandemic that was the most compelling aspect of the tour — and something that couldn’t have been envisioned when parts of Rush’s old ER were built more than a century ago………Three components make Rush’s ER one of the best-prepared in the nation to handle the next major infectious challenge:

• The scope and flexibility of its infrastructure, including 60 treatment bays that can be doubled to treat above and beyond the normal patient load and include public areas like the main lobby, which — thanks to those hidden panels — can accommodate even more beds.

• The ability to decontaminate large numbers of patients.

• The capability to isolate an entire quadrant, switching the airflow and pulling any killer viruses outside, high above street level, where they can’t be inhaled by humans……”

Radiological Society of North America
Source reference:
Kim N, et al “Making soccer safer for the brain: DTI-defined exposure thresholds for white matter injury due to soccer heading” RSNA 2011; Abstract SSK12-04.

“This small study suggests that increasing heading frequency in amateur soccer players may represent a form of repetitive mild trauma as it is associated with white matter injury similar to that seen in traumatic brain injury, which may be associated with cognitive impairment.”

By Kristina Fiore, Staff Writer, MedPage Today
Published: November 29, 2011

http://www.medpagetoday.com/MeetingCoverage/RSNA/29929

“….In a small study of amateur soccer players, those who headed the ball more than 1,320 times per year had a greater likelihood of tiny changes in white matter as measured on diffusion tensor imaging….”