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Shihonage
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PHARM Podcast 114 : The Aikido of emergency sedation

"Shihonage" by Magyar Balázs - Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons. Hi Folks Why the Aikido reference to emergency sedation? The fundamental principle of Aikido as a martial art is the belief that both attacker and defender are free from harm. On today's show, my good friends, Casey Parker and Tim…  
prehospitalmed.com
over 6 years ago
Sinaiem dark
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endocarditis-pearls

– Janeway lesions – painless, red macule/patch, palms/soles, culture bacteria from the lesion, embolic manifestation of endocarditis  
sinaiem.org
over 6 years ago
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The Adventure of the Cardboard Box Continues - EM Nerd

For those whose beliefs are already firmly in favor of endovascular therapy for acute ischemic stroke, the publication of the MR CLEAN trial earlier this year and more recently the EXTEND-IA and ESCAPE trials only serve as a big fat, “I TOLD YOU SO!” For the perpetual disbelievers, each of these trials possesses enough flaws to discredit their findings. For the appropriately skeptical among us, though these trials initially appear to discredit our well meaning rants, on closer examination they are far more validating.  
emnerd.com
over 6 years ago
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Supportive therapy for schizophrenia | Cochrane

Schizophrenia is a severe mental illness with ‘positive symptoms’ such as hallucinations (hearing voices and seeing things) and delusions (having strange beliefs). People with schizophrenia also suffer from disorganisation and ‘negative symptoms’ (such as tiredness, apathy and loss of emotion). People with schizophrenia may find it hard to socialise and find employment. Schizophrenia is considered one of the most burdensome illnesses in the world. For some people it can be a lifelong condition. Most people with schizophrenia will be given antipsychotic medications to help relieve the symptoms. In addition to this they can also receive therapy, of which there are various types.One therapy often given to people with schizophrenia is supportive therapy, where typically after a person is established in the care of mental health services, they will receive general support rather than specific talking therapies such as cognitive behavioural therapy (CBT). For example, in consultations with health professionals there will often be time given to listening to people’s concerns, providing encouragement, or even arranging basic help with daily living. Many people with schizophrenia also receive support from their family and friends. Supportive therapy has been described as the treatment of choice for most people with mental illness and may be one of the most commonly practiced therapies in mental health services.  
cochrane.org
over 6 years ago
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Going to work in a different country? Different culture? Different language? Avoid getting tripped up as I did!

I grew up in Belgium and went to medical school in Louvain, Belgium. I came to the USA for my internship and selected a small hospital in upstate New York. What an initial culture shock that was! The first problem was the language. I knew enough "school" English to get by, or so I thought. Talking on the phone was the hardest. Initially, the nurses in the hospital thought that I was the most conscientious intern they had ever worked with. When I was on duty and the nurses called me on the phone at night, I would always go to the ward, look over the chart, see the patient and then write a note and orders, rather than just handle things over the phone like all the other interns did when called for rather minor matters. Little did the nurses realize that the reason I would get up in the middle of the night and physically go to the ward was due to the fact that I had no idea what they were talking about. I did not understand a word of what the nurses were telling or asking me on the telephone, especially not when they were using even common American abbreviations, like PRN, QID, LMP etc. [PRN (Latin) means as needed; QID (Latin) means four times a day and LMP means last menstrual period]. That problem rapidly resolved as I began to understand more and more of the English medical terms. However, there is a major difference between understanding day-to-day common English and grasping all the idioms and sayings. A rather amusing anecdote will illustrate that. About two months into my internship, I was on call at night when one of the nurses telephoned me in the early evening. A patient (Mrs X) was having a bad headache and wanted something for it. I was proud that I had understood the problem over the phone and was even more proud that I managed to order something for her headache without having to walk over to the ward. An hour or so later, the same nurse called me for the same patient because she had been constipated and wanted something for it. Again I understood and again I was able to prescribe a laxative over the phone without having to go to see the patient. A while later the same nurse called to let me know that Mrs X was agitated and wanted something for sleep. I understood again and prescribed a sleeping pill. Close to the 11pm shift change the same nurse called me once more: "Dr. LeMaire, I am so sorry to keep bothering you about Mrs X, but she is really a pain in the neck…" Immediately some horrible thought occurred to me. Here is a patient who has a bad headache, is constipated and agitated and now has a pain in her neck. These could all be symptoms of meningitis and here I have been ordering medications over the phone for a potentially serious condition. I broke out in a cold sweat and I told the nurse "I am coming." I ran over to the ward where that patient was hospitalized, went to her room and after introducing myself said "Mrs. X, the nurse tells me that you have a pain in your neck." The rest is history. The patient lodged a complaint about the nurse and me, but we both got off with a minor reprimand and in fact somewhat of a chuckle by the administrator handling the complaint. Such tripping up by the idioms and sayings can of course happen in any language. Be aware! Dr. William LeMaire  
DR William LeMaire
over 6 years ago
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Motivational interviewing for improving recovery after stroke | Cochrane

Psychological problems such as depression and anxiety are common complications following stroke that can cause stroke survivors to lack the motivation to take part in activities of daily living or rehabilitation. Motivational interviewing is a counselling method that is designed to help people to change their behaviour through discovering and resolving their conflicts by a standardised communication skill. It provides a specific way for enhancing their expectations and beliefs of recovery following stroke. We wanted to know whether motivational interviewing was an effective treatment to improve activities of daily living after stroke.  
cochrane.org
over 6 years ago
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A Foundation for Neonatal Care

This authoritative guide offers a vital overview including the recent fundamental changes in the care of newborn babies. As well as medical staff, key roles are now played by senior nurses, clinical nurse specialists, pharmacists, advanced neonatal nurse practitioners, nurse consultants, midwives, dieticians, physiotherapists and speech therapists. The involvement of such a diverse range of professional cultures in such a rapidly developing area often leads to competing priorities, complicated by a lack of established guidelines. There is also the added challenge of fetal medicine - an important emerging allied specialty new to many healthcare professionals. This book assists all professionals involved in the provision of neonatal care in understanding the genetic, physiological and biochemical mechanisms which have either led to or are associated with the clinical conditions affecting their patients. With comprehensive chapters on fetal medicine, genetics, inherited biochemical disorders, fundamental physiological concepts, the cardiovascular, renal and respiratory systems, bacterial and transplacental infections, pharmacokinetics, nutrition, and an overview of haemostasis, A Foundation For Neonatal Care aids understanding of the continuum of developmental physiology and pathology which is now required of neonatal care providers.  
books.google.co.uk
over 6 years ago
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Bullying of hospital's emergency staff 'endemic' - BBC News

A "culture of bullying, harassment and inappropriate behaviour" affects staff at all levels in one unit of Wales' biggest hospital, an inquiry finds.  
bbc.co.uk
over 6 years ago
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California ends vaccine exemptions on grounds of belief—will other states follow?

After a bitter battle, California has ended vaccine exemptions on the basis of religion or personal belief. Under the new law, signed by Governor Jerry Brown on 30 June, unvaccinated children in the state will not be allowed to attend school, day care programs, and nurseries, unless they have a medical reason, such as an allergy, for not receiving a vaccination. Previously, just two other US states, West Virginia and Mississippi, limited exemptions to medical reasons.  
feeds.bmj.com
over 6 years ago
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WHO 'unfit for health emergencies' - BBC News

The Ebola crisis proves the World Health Organization (WHO) lacks the "capacity and culture" to deal with global health emergencies, says a damning independent report, commissioned by the WHO itself.  
bbc.co.uk
over 6 years ago
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WHO is unfit for health emergencies, says independent panel

The World Health Organization lacks the capacity and culture to deal with health emergencies, an independent report into WHO’s handling of the Ebola epidemic has found.1  
feeds.bmj.com
over 6 years ago
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WHO is unfit for health emergencies, says independent panel

The World Health Organization lacks the capacity and culture to deal with health emergencies, an independent report into WHO’s handling of the Ebola epidemic has found.1  
feeds.bmj.com
over 6 years ago