One of my former partners, an extraordinarily competent internist, saved a drowned child's life by resuscitating him in the hospital emergency room. Another doctor, in the same city, lost his adolescent twin sons when they drowned in the backyard family swimming pool.
Kids drown. And when they do, it means that an opportunity to save their lives through the exercise of simple adult responsibility, was not taken. Don't let it happen to you or a member of your family or friends's kids or even a neighborhood child who has obtained access to your pool You are the responsible adult and you must act responsibly.
No children, including adolescents, should be in a pool without adult supervision.Children do not have adult judgment and they do dumb dangerous childish things: they need adult supervision.
At a party, where adults and children are swimming, the host or hostess should clearly and unequivocally and repeatedly explain that it is each parent's' responsibility to watch his or her own child and be responsible for the safety of that child. It isn't the host's responsibility, It isn't the responsibility of other parents to watch your child or of you to watch their children swimming. It isn't the responsibility of a young adolescent acting as a lifeguard. If you can't be bothered to watch your own child in the pool, get the child out of the water and to a place where he or she will be safe. And then make sure that he or she stays out of the water, regardless of the taunts of invitations of other kids.
Pay attention. Have a cell phone available, but don't use it to text or chat, or respond to calls, because you will be distracted and unlikely to be paying attention to your child. Know the address of the house or place where the kids are swimming because in an emergency, that information may save a few precious seconds. Alcohol-containing drinks will probably interfere with your ability to respond to an emergency: save the drinking for another time and place.
Adults should enforce routine safety around swimming pools, stopping potentially dangerous horseplay or behaviors which may result in injury. Don't apologize to the kids (or their parents) who complain about restrictions on dangerous behavior: explain that you are serious about the safety rules you are enforcing.
Read the material in the links above because that information may save a child's life, save you from a lifetime of anguish, and save you from financial ruin.
Take the risk of drowning in a family pool seriously. Be a responsible and caring adult.
Tuesday, May 24, 2011
Thursday, May 19, 2011
Social Media: Preparedness 101: Zombie Apocalypse
Are you zombie ready? Check out this CDC disaster preparedness article and, as it says, be safe rather than sorry. And be sure that your friends and family are prepared, too, otherwise your failure to share may leave them as zombie bait.
Friday, May 13, 2011
Food Safety: Safer Food Saves Lives, Suffering and Health Care Costs
Savings under Health Reform involve more than making health care more available, affordable/ accessible, and competent. One way to save money is to protect Americans from everyday hazards that make them sick - including our food.
We are sickened by our food. The CDC estimates that foodborne diseases "...cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60,000 hospitalizations, and 1,800 deaths." While unsafe manufacturers and food handling processors profit from their carelessness, Americans of all ages suffer and die. The public shoulders the considerable cost shift from dangerous operators in the food industry to America's families..
The Obama administration has begun the process of safeguarding our families by modernizing our food safety laws, taking steps to implement hazard analysis and risk-based preventive controls, establish safety and performance standards, provide for safe transportation of our food, provide for safe importing of food from abroad, update government's ability to recall suspect food products, and taking other overdue major steps.
Protecting our families by protecting and safeguarding our food supply makes good sense. Protecting outr health care budget by protecting and safeguarding our food supply makes good sense, too Let's be sure that our Congressmen and Congresswomen don't through up roadblocks to this important change.
We are sickened by our food. The CDC estimates that foodborne diseases "...cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60,000 hospitalizations, and 1,800 deaths." While unsafe manufacturers and food handling processors profit from their carelessness, Americans of all ages suffer and die. The public shoulders the considerable cost shift from dangerous operators in the food industry to America's families..
The Obama administration has begun the process of safeguarding our families by modernizing our food safety laws, taking steps to implement hazard analysis and risk-based preventive controls, establish safety and performance standards, provide for safe transportation of our food, provide for safe importing of food from abroad, update government's ability to recall suspect food products, and taking other overdue major steps.
Protecting our families by protecting and safeguarding our food supply makes good sense. Protecting outr health care budget by protecting and safeguarding our food supply makes good sense, too Let's be sure that our Congressmen and Congresswomen don't through up roadblocks to this important change.
Thursday, May 12, 2011
Scientific American: Motion Suppresses Some Of Our Brain Function
Ever wonder why your friends/family/colleagues don't notice changes? See the Scientific American blog for insight.
Tuesday, May 10, 2011
Diabetes: Beware of Your Glucose Meter Control Solution
Today, I received a call from a reputable medical supply distributor's quality assurance person in response to a letter I sent complaining that their brand of control solution for a nationally distributed brand of glucose meters and test strips gave lower values than the name brand manufacturer's control solution. While this might seem like a minimal technical issue, it has practical implications for patients who work hard (and shed blood in the process) to maintain "diabetes control" - by keeping their blood sugar within specific ranges. Too high, and kidney, visual and neurologic problems may develop; too low and the patients may suffer strokes or pass out. When patients and their physicians cannot easily tell whether glucose meters are accurate, or how inaccurate they are, trouble follows.
The conversation led me to conclude that the company was not communicating well with its customers and lettering them know up front, clearly and unequivocally that there was a problem with its control solution. Someone in the company had made the decision to obfuscate and should take public responsibility. Meanwhile, patients, physicians, Medicare (as a payer) and the FDA should ask: what is going on here? Diabetes is a common, potentially fatal and incapacitating disease which costs patients, insurers and the federal and state governments billions of dollars each year. Let's get the diabetes glucose monitor control solution issue resolved.
The conversation led me to conclude that the company was not communicating well with its customers and lettering them know up front, clearly and unequivocally that there was a problem with its control solution. Someone in the company had made the decision to obfuscate and should take public responsibility. Meanwhile, patients, physicians, Medicare (as a payer) and the FDA should ask: what is going on here? Diabetes is a common, potentially fatal and incapacitating disease which costs patients, insurers and the federal and state governments billions of dollars each year. Let's get the diabetes glucose monitor control solution issue resolved.
Monday, May 9, 2011
Presidential Election: How Will The Health Care Uninsured Vote?
In my last blog, I provided a link to information about the number of US persons who have no health insurance. The statistics show that almost 50 million Americans do not have health insurance. My question - which is not answered in my brief Google searches - is "how will the health care uninsured vote?"
If anyone has evidence-based insight into this issue, please speak up.
If anyone has evidence-based insight into this issue, please speak up.
Friday, May 6, 2011
NO HEALTH INSURANCE? - YOU ARE NOT ALONE.
HOW MANY AMERICANS DON'T HAVE HEALTH INSURANCE?
Read this and check the link to find out!
Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2010
Highlights
From January through September 2010, 49.5 million persons of all ages (16.3%) were uninsured at the time of interview, 60.8 million (20.0%) had been uninsured for at least part of the year prior to interview, and 36.1 million (11.9%) had been uninsured for more than a year at the time of interview.
From January through September 2010, the percentage of children under age 18 years who were uninsured at the time of interview was 8.2%.
Private coverage decreased among near poor adults aged 18–64 years, from 52.6% in 1997 to 34.6% in the first 9 months of 2010. The uninsured rate (43.9%) is higher than the private coverage rate (34.6%) for this population.
From January through September 2010, 59.1% of unemployed adults aged 18–64 years and 23.5% of employed adults in this age group had been uninsured for at least part of the past year. Also, 36.4% of unemployed adults aged 18–64 and 15.0% of employed adults in this age group had been uninsured for more than a year.
During the first 9 months of 2010, 24.9% of persons under age 65 years with private health insurance at the time of interview were enrolled in a high deductible health plan (HDHP), including 7.4% who were enrolled in a consumer-directed health plan (CDHP). Almost 50% of persons with a private plan obtained by means other than through employment were enrolled in a HDHP. An estimated 20.0% of persons with private health insurance were in a family with a flexible spending account (FSA) for medical expenses.
Read this and check the link to find out!
Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2010
Highlights
From January through September 2010, 49.5 million persons of all ages (16.3%) were uninsured at the time of interview, 60.8 million (20.0%) had been uninsured for at least part of the year prior to interview, and 36.1 million (11.9%) had been uninsured for more than a year at the time of interview.
From January through September 2010, the percentage of children under age 18 years who were uninsured at the time of interview was 8.2%.
Private coverage decreased among near poor adults aged 18–64 years, from 52.6% in 1997 to 34.6% in the first 9 months of 2010. The uninsured rate (43.9%) is higher than the private coverage rate (34.6%) for this population.
From January through September 2010, 59.1% of unemployed adults aged 18–64 years and 23.5% of employed adults in this age group had been uninsured for at least part of the past year. Also, 36.4% of unemployed adults aged 18–64 and 15.0% of employed adults in this age group had been uninsured for more than a year.
During the first 9 months of 2010, 24.9% of persons under age 65 years with private health insurance at the time of interview were enrolled in a high deductible health plan (HDHP), including 7.4% who were enrolled in a consumer-directed health plan (CDHP). Almost 50% of persons with a private plan obtained by means other than through employment were enrolled in a HDHP. An estimated 20.0% of persons with private health insurance were in a family with a flexible spending account (FSA) for medical expenses.
Tuesday, May 3, 2011
Voluntary Coumadin Recall
http://www.fda.gov/Safety/Recalls/ucm253523.htm :
Bristol-Myers Squibb Initiates a Nationwide Voluntary Recall of Coumadin® (Warfarin Sodium) Crystalline 5 mg Tablets, Lot Number 9H49374A
When I clinically practiced as an hematologist, I dealt with a variety of anticoagulants, both as an initiator of treatment and as a consultant called when things went wrong. I have seen anticoagulants, such as warfarin (trade name - "Coumadin") and heparin (and its derivatives) save lives, and I have seen them cause severe bleeding (and other) complications including death. In practice, I constantly kept in mind the 2% case-fatality rate associated with warfarin and the particular risk that was seen in frail elderly women for whom it was prescribed.
The indications for warfarin treatment usually involved the formation of blood clots in the venous system and the risk that a clot would dislodge, travel to the lungs as a pulmonary embolism, and cause death or severe lung damage. At Stanford, I trained with hematologist Professor Edward Hershgold, who taught us great respect for warfarin, expounding on accumulated clinical research with this drug, and drilling us on its ability to induce anticoagulation slowly (over 7-10 days), sometimes when laboratory tests suggested that it had more quickly achieved its intended effect.
In my consultant practice, I saw the dark side of warfarin when physicians who used warfarin infrequently did not carefully and fully educate their patients on the proper use of warfarin, dietary management, the risks of drug interactions with medications commonly prescribed by physicians, and the requirement for frequent laboratory testing of the"prothrombin time" and "INR" in following the appropriateness of the anticoagulation level achieved. In our health law practice, we saw physicians charged with being inconsistent in testing their patients for anticoagulation and then properly communicating with their patients about the results of their tests and prescribing instructions, sometimes with serious adverse consequences which endangered their medical licenses.
With all of those considerations in mind, I highlight a voluntary Coumadin recall of one lot of Coumadin by its manufacturer Bristol-Myers Squibb as as a precautionary measure based on the company’s testing of tablets from a returned bottle. A single tablet was found to be higher in potency than expected.
If any of my readers take Coumadin or have friends or family taking Coumadin, I suggest that they refer to the link to the FDA release and follow the recommendations in that FDA release. For those who require anticoagulation, the dose (generic or brand name) must be just right, not too high or too low.
FOR IMMEDIATE RELEASE - May 2, 2011 - Bristol-Myers Squibb initiated a voluntary recall of one lot of 1,000-count bottles of Coumadin® (warfarin sodium) Crystalline 5 mg tablets. Bottles of 1,000 tablets are distributed to pharmacies for further dispensing to patients in prescription quantities. The lot number affected in the U.S. is 9H49374A with an expiry date of September 30, 2012. The recall is a precautionary measure based on the company’s testing of tablets from a returned bottle. A single tablet was found to be higher in potency than expected.
Coumadin is prescribed to treat or prevent blood clots. A decrease of active ingredient may increase the risk of clots which could lead to heart attack or stroke and if there is too much active ingredient, there is an increased risk of bleeding.
Patients who may have 5 mg tablets should not interrupt their therapy but should seek advice from their pharmacist to see if they have tablets originating from the affected lot and if so, should consult their physician for appropriate medical advice.
Bristol-Myers Squibb is committed to ensuring patient safety and is working to resolve this issue quickly and appropriately. The company has notified the U.S. Food and Drug Administration (FDA), and will issue recall communications to all physicians and other customers involved.
Any adverse reactions may be reported to the FDA's MedWatch Program by fax at 1-800-FDA-0178, by mail at MedWatch, HF-2, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787, or on the MedWatch website at www.fda.gov.
Health care professionals and customers may call the following for assistance if they have further questions about the recall:
For information related to this recall:
Stericycle, Inc.
1-866-918-8739
Bristol-Myers Squibb Initiates a Nationwide Voluntary Recall of Coumadin® (Warfarin Sodium) Crystalline 5 mg Tablets, Lot Number 9H49374A
When I clinically practiced as an hematologist, I dealt with a variety of anticoagulants, both as an initiator of treatment and as a consultant called when things went wrong. I have seen anticoagulants, such as warfarin (trade name - "Coumadin") and heparin (and its derivatives) save lives, and I have seen them cause severe bleeding (and other) complications including death. In practice, I constantly kept in mind the 2% case-fatality rate associated with warfarin and the particular risk that was seen in frail elderly women for whom it was prescribed.
The indications for warfarin treatment usually involved the formation of blood clots in the venous system and the risk that a clot would dislodge, travel to the lungs as a pulmonary embolism, and cause death or severe lung damage. At Stanford, I trained with hematologist Professor Edward Hershgold, who taught us great respect for warfarin, expounding on accumulated clinical research with this drug, and drilling us on its ability to induce anticoagulation slowly (over 7-10 days), sometimes when laboratory tests suggested that it had more quickly achieved its intended effect.
In my consultant practice, I saw the dark side of warfarin when physicians who used warfarin infrequently did not carefully and fully educate their patients on the proper use of warfarin, dietary management, the risks of drug interactions with medications commonly prescribed by physicians, and the requirement for frequent laboratory testing of the"prothrombin time" and "INR" in following the appropriateness of the anticoagulation level achieved. In our health law practice, we saw physicians charged with being inconsistent in testing their patients for anticoagulation and then properly communicating with their patients about the results of their tests and prescribing instructions, sometimes with serious adverse consequences which endangered their medical licenses.
With all of those considerations in mind, I highlight a voluntary Coumadin recall of one lot of Coumadin by its manufacturer Bristol-Myers Squibb as as a precautionary measure based on the company’s testing of tablets from a returned bottle. A single tablet was found to be higher in potency than expected.
If any of my readers take Coumadin or have friends or family taking Coumadin, I suggest that they refer to the link to the FDA release and follow the recommendations in that FDA release. For those who require anticoagulation, the dose (generic or brand name) must be just right, not too high or too low.
FOR IMMEDIATE RELEASE - May 2, 2011 - Bristol-Myers Squibb initiated a voluntary recall of one lot of 1,000-count bottles of Coumadin® (warfarin sodium) Crystalline 5 mg tablets. Bottles of 1,000 tablets are distributed to pharmacies for further dispensing to patients in prescription quantities. The lot number affected in the U.S. is 9H49374A with an expiry date of September 30, 2012. The recall is a precautionary measure based on the company’s testing of tablets from a returned bottle. A single tablet was found to be higher in potency than expected.
Coumadin is prescribed to treat or prevent blood clots. A decrease of active ingredient may increase the risk of clots which could lead to heart attack or stroke and if there is too much active ingredient, there is an increased risk of bleeding.
Patients who may have 5 mg tablets should not interrupt their therapy but should seek advice from their pharmacist to see if they have tablets originating from the affected lot and if so, should consult their physician for appropriate medical advice.
Bristol-Myers Squibb is committed to ensuring patient safety and is working to resolve this issue quickly and appropriately. The company has notified the U.S. Food and Drug Administration (FDA), and will issue recall communications to all physicians and other customers involved.
Any adverse reactions may be reported to the FDA's MedWatch Program by fax at 1-800-FDA-0178, by mail at MedWatch, HF-2, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787, or on the MedWatch website at www.fda.gov.
Health care professionals and customers may call the following for assistance if they have further questions about the recall:
For information related to this recall:
Stericycle, Inc.
1-866-918-8739
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