http://www.cdc.gov/mmwr/preview/mmwrhtml/mm60e0930a1.htm?s_cid=mm60e0930a1_e&source=govdelivery
All you want to know about one of the current outbreaks of listeriosis. And more.
10/3/2011 And more.
Showing posts with label CDC. Show all posts
Showing posts with label CDC. Show all posts
Saturday, October 1, 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.
Thursday, June 17, 2010
Judge For Yourself: Health Risk Information About BP's Crude Oil Disaster
From the CDC, published today: "Occupational health and safety experts have questioned the Offshore Air Monitoring Plan for Source Control, BP’s plan to protect the health of the more than 24,400 workers cleaning up the oil spill in the Gulf of Mexico, because they say it exposes workers to higher levels of toxic chemicals than is generally acceptable. The clean-up effort exposes workers to volatile organic compounds (VOCs), which are subject to federal regulations that do not specify safety thresholds. Because of this, BP is not currently required to supply respirators, evacuate workers, or take other precautions. Critics say the plan allows workers to remain in an area where vapors are four times higher than accepted practice. “This protocol seems to be written in a way that allows them to continue to work when conditions are such that, in any other setting, you’d pull your workers or you’d put them in better protection,” said Mark Catlin, a worker safety advocate and expert who worked on the 1989 Exxon Valdez tanker spill. BP spokesman Ray Viator, however, said that the plan is aggressively monitoring toxins and protecting workers. “It’s being managed by professionals who have reviewed the plan and who are making sure it’s been implemented correctly. It involves graduated responses and we’re prepared to accelerate it if the situation arises,” he said. The Coast Guard approved the plan on May 25, and although the Occupational Safety and Health Administration (OSHA) reviewed the plan, the agency’s jurisdiction only extends three miles off-shore."
To form your own judgment on whether Americans in the affected area are receiving appropriate information from the federal government read and analyze the CDC's evaluation of the BP Gulf oil spill and consider applicable federal law pertinent to emergencies.
See Taylor's Miami Herald expert's analysis of the protection offered to works and residents of the affect area (referenced above).
And finally, if you can stomach it, take a look at Louisiana's May 5, 2010 information to its coastal citizens.
To form your own judgment on whether Americans in the affected area are receiving appropriate information from the federal government read and analyze the CDC's evaluation of the BP Gulf oil spill and consider applicable federal law pertinent to emergencies.
See Taylor's Miami Herald expert's analysis of the protection offered to works and residents of the affect area (referenced above).
And finally, if you can stomach it, take a look at Louisiana's May 5, 2010 information to its coastal citizens.
Wednesday, August 26, 2009
H1N1 Influenza - Conflicting Concerns Unclear Plans
Ten days ago, I spent several hours at an excellent Santa Clara County Public Health Department Emergency Medical Services for Medical Volunteers for Disaster Response. I won't tell you about my snazzy new federally-compliant government identification card or about the uniforms we're going to get. What I will tell you is the tone of concern that permeated the discussion of the Swine Flu pandemic. We were told that medical personnel who actually take care of patients will be high priority recipients of the H1N1 vaccine (two injections to a series - approximately 5 weeks to full immunity). Pregnant women, school children, and young people up to age 24 (perhaps to age 30) will also lead the list of those targeted for the vaccine series, along with migrant workers. Significant plans for non-hospital care of influenza patients in staffed centers for those who are sick (but not critical) are in the works, where they will be able to receive hydration and respiratory therapy. I asked whether the Medical Volunteers would receive the vaccine, since we would potentially be the staff for the centers and would need two injections and five weeks to build protective immunity, but was informed that no decision had yet been reached on that issue. We talked about Tamiflu and learned that when the commercial doses run out, there will be reserves of public health reserves to draw upon (but asked my self whether the influenza will be Tamiflu resistant by that time). The public will be advised not to go to their physicians' offices or hospital emergency departments for routine influenza care, but to be in contact with health care providers for illness that has life-threatening characteristics (high fever, dehydration, severe shortness of breath).
Incidentally the H1N1 vaccine, in my county, will be made available to the usual medical provider sources, but public announcements of vaccine availability and administration will be limited.
To my surprise, Thomas Frieden, head of the CDC provided a more reassuring picture concerning the severity of the expected US epidemic in an interview today (CDC-Frieden: or Click on Title Above for Linkage).
My suggestion to high risk people is that they contact their health care providers about the availability of the H1N1 vaccine from them. While children in schools, young adults in colleges, and pregnant females are likely to have ready access to the vaccine, I don't know what the picture will be for those now healthy age 30 - 65 individuals. When plans solidify, I will pass the information on to you
Wednesday, May 27, 2009
Not Your Television Hospital ER
Have you been to a metropolitan hospital emergency department recently? Did you feel that your health complaint was taken seriously and that you were taken care-of competently? If you had to be admitted, were you promptly moved from the ER to the hospital bed you needed?
The full article below, can be found at the CDC's site (http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ed_capacity/ED_capacity.htm#) and may help to explain why your experience left a great deal to be desired. It doesn't detail the history of hospitals "running" local physicians out of their ERs when they contracted with professional ER doctors to run the show, in part because of the federal ERISA requirement that a patient presenting at the ER must be evaluated and stabilized before transfer or discharge. Nor does it talk about the revenue stream generated by ERs, a complex analysis in itself.
"NCHS Health E-Stat
"Estimates of Emergency Department Capacity: United States, 2007
"On this Page
* References
* Figures
* Tables
"PDF Version (103 KB) by Linda F. McCaig, M.P.H., Jianmin Xu, M.S., and Richard W. Niska, M.D., M.P.H., F.A.C.E.P., Division of Health Care Statistics
"In 2006, the Institute of Medicine (IOM) released a report titled "Hospital-Based Emergency Care: At the Breaking Point," which identified weaknesses in the nation’s ability to respond to large-scale emergency situations, whether disease outbreaks such as pandemic influenza, naturally occurring disasters, or acts of terrorism (1). Over the last several decades, the role of emergency departments (EDs) has expanded from treating seriously ill and injured patients to providing urgent unscheduled care to patients unable to gain access to their providers in a timely fashion and to providing primary care to Medicaid beneficiaries and persons without insurance. EDs are now frequently overloaded. One of the most common factors related to ED crowding is the inability to transfer ED patients to an inpatient bed once a decision has been made to admit them (2). As the ED begins to "board" patients, the space, the staff, and the resources available to treat new patients are further reduced. A consequence of overcrowded EDs is ambulance diversion, in which EDs close their doors to incoming ambulances. The resulting treatment delay can be catastrophic for the patient. Approximately 500,000 ambulances are diverted annually in the United States (i.e., one ambulance diversion per minute) (3).
The National Hospital Ambulatory Medical Care Survey (NHAMCS), inaugurated in 1992, is the longest continuously running nationally representative survey of hospital ED utilization. The NHAMCS is conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). This Health E-stat provides ED level estimates for items that were added to the 2007 NHAMCS hospital induction interview in response to the IOM report (1).
"Although large EDs (annual visit volume greater than 50,000) in metropolitan statistical areas (MSAs) comprised 17.7 percent of EDs (data not shown), they accounted for 43.8 percent of all ED visits (Figure). The implication is that small EDs (annual visit volume less than 20,000) may not experience crowding and, therefore, have little need for some of the techniques suggested in the IOM report. The IOM recommendations are particularly important for large, urban EDs, which experience higher visit volumes.
"About one-half of all hospitals with EDs had a bed coordinator or bed czar, 58.2 percent had elective surgeries scheduled 5 days a week, and 66.1 percent had bed census data available instantaneously (Table). Electronic medical records (EMRs), either all electronic or part paper and part electronic, were used in 61.6 percent of EDs. EMR systems have also been defined as basic (patient demographics, problem lists, clinical notes, orders for prescription, and viewing laboratory and imaging results) or fully functional (prescription orders sent electronically, warnings of drug interactions or contraindications, orders for tests, out-of-range test levels highlighted, medical history and followup, and reminders for guideline-based interventions in addition to the basic elements) (4). Basic EMR systems were reported by 14.9% of EDs (data not shown); however, the estimate for fully functional EMR systems was unreliable.
"More than one-third of EDs had an observation or clinical decision unit. Admitted ED patients were "boarded" for more than 2 hours in the ED while waiting for an inpatient bed in 62.5 percent of EDs. Among EDs that "boarded" patients, 14.8 percent used inpatient hallways or another space outside the ED when it was critically overloaded. In the previous 2 years, 24.3 percent of EDs increased the number of standard treatment spaces. Although 19.5 percent of EDs expanded their physical space in the last 2 years, 31.5 percent of those that did not expand their physical space plan to do so within the next 2 years. The frequency of use of ED patient care techniques was as follows: bedside registration (66.1%), computer-assisted triage (40.0%), zone nursing (35.3%), electronic dashboard (35.2%), separate fast track unit for nonurgent care (33.8%), "pool" nurses (33.2%), full capacity protocol (21.1%), and radio frequency identification tracking (9.8%).
"The table presents estimates of ED characteristics by ED visit volume and MSA status. When compared with small EDs, large EDs were more likely to have a bed coordinator in their hospitals (71.2% compared with 33.8%); have an observation or clinical decision unit (53.5% compared with 32.5%); "board" patients for more than 2 hours in the ED while waiting for an inpatient bed (86.5% compared with 39.0%); and use bedside registration (89.0% compared with 54.2%), computer-assisted triage (62.2% compared with 24.3%), and zone nursing (61.9% compared with 19.0%).
"EDs with over 20,000 annual visits comprised 70.5 percent of EDs in MSAs. When compared to EDs in non-MSAs, EDs in MSAs were more likely to have a bed coordinator or bed czar in their hospital (60.7% compared with 30.0%) and "board" patients for more than 2 hours in the ED while waiting for an inpatient bed (77.4% compared with 32.8%).
"Additional information about ED utilization is available from the NCHS Ambulatory Health Care website.
"References
1. Institute of Medicine. Hospital-Based Emergency Care: At the Breaking Point. Washington, DC: National Academy Press. 2006.
2. General Accounting Office. Hospital Emergency Departments: Crowded Conditions Vary Among Hospitals and Communities. Washington, DC: General Accounting Office. 2003.
3. Burt CW, McCaig LF, Valverde RH. Analysis of ambulance transports and diversions among U.S. emergency departments. Ann Emerg Med 47(4):317-326. 2006.
4. DesRoches CM, Campbell EG, Rao SR, Donelan K, Ferris TG, Jha A, et al. Electronic health records in ambulatory care -- a national survey of physicians. N Engl J Med 359:50-60. 2008."
The full article below, can be found at the CDC's site (http://www.cdc.gov/nchs/products/pubs/pubd/hestats/ed_capacity/ED_capacity.htm#) and may help to explain why your experience left a great deal to be desired. It doesn't detail the history of hospitals "running" local physicians out of their ERs when they contracted with professional ER doctors to run the show, in part because of the federal ERISA requirement that a patient presenting at the ER must be evaluated and stabilized before transfer or discharge. Nor does it talk about the revenue stream generated by ERs, a complex analysis in itself.
"NCHS Health E-Stat
"Estimates of Emergency Department Capacity: United States, 2007
"On this Page
* References
* Figures
* Tables
"PDF Version (103 KB) by Linda F. McCaig, M.P.H., Jianmin Xu, M.S., and Richard W. Niska, M.D., M.P.H., F.A.C.E.P., Division of Health Care Statistics
"In 2006, the Institute of Medicine (IOM) released a report titled "Hospital-Based Emergency Care: At the Breaking Point," which identified weaknesses in the nation’s ability to respond to large-scale emergency situations, whether disease outbreaks such as pandemic influenza, naturally occurring disasters, or acts of terrorism (1). Over the last several decades, the role of emergency departments (EDs) has expanded from treating seriously ill and injured patients to providing urgent unscheduled care to patients unable to gain access to their providers in a timely fashion and to providing primary care to Medicaid beneficiaries and persons without insurance. EDs are now frequently overloaded. One of the most common factors related to ED crowding is the inability to transfer ED patients to an inpatient bed once a decision has been made to admit them (2). As the ED begins to "board" patients, the space, the staff, and the resources available to treat new patients are further reduced. A consequence of overcrowded EDs is ambulance diversion, in which EDs close their doors to incoming ambulances. The resulting treatment delay can be catastrophic for the patient. Approximately 500,000 ambulances are diverted annually in the United States (i.e., one ambulance diversion per minute) (3).
The National Hospital Ambulatory Medical Care Survey (NHAMCS), inaugurated in 1992, is the longest continuously running nationally representative survey of hospital ED utilization. The NHAMCS is conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). This Health E-stat provides ED level estimates for items that were added to the 2007 NHAMCS hospital induction interview in response to the IOM report (1).
"Although large EDs (annual visit volume greater than 50,000) in metropolitan statistical areas (MSAs) comprised 17.7 percent of EDs (data not shown), they accounted for 43.8 percent of all ED visits (Figure). The implication is that small EDs (annual visit volume less than 20,000) may not experience crowding and, therefore, have little need for some of the techniques suggested in the IOM report. The IOM recommendations are particularly important for large, urban EDs, which experience higher visit volumes.
"About one-half of all hospitals with EDs had a bed coordinator or bed czar, 58.2 percent had elective surgeries scheduled 5 days a week, and 66.1 percent had bed census data available instantaneously (Table). Electronic medical records (EMRs), either all electronic or part paper and part electronic, were used in 61.6 percent of EDs. EMR systems have also been defined as basic (patient demographics, problem lists, clinical notes, orders for prescription, and viewing laboratory and imaging results) or fully functional (prescription orders sent electronically, warnings of drug interactions or contraindications, orders for tests, out-of-range test levels highlighted, medical history and followup, and reminders for guideline-based interventions in addition to the basic elements) (4). Basic EMR systems were reported by 14.9% of EDs (data not shown); however, the estimate for fully functional EMR systems was unreliable.
"More than one-third of EDs had an observation or clinical decision unit. Admitted ED patients were "boarded" for more than 2 hours in the ED while waiting for an inpatient bed in 62.5 percent of EDs. Among EDs that "boarded" patients, 14.8 percent used inpatient hallways or another space outside the ED when it was critically overloaded. In the previous 2 years, 24.3 percent of EDs increased the number of standard treatment spaces. Although 19.5 percent of EDs expanded their physical space in the last 2 years, 31.5 percent of those that did not expand their physical space plan to do so within the next 2 years. The frequency of use of ED patient care techniques was as follows: bedside registration (66.1%), computer-assisted triage (40.0%), zone nursing (35.3%), electronic dashboard (35.2%), separate fast track unit for nonurgent care (33.8%), "pool" nurses (33.2%), full capacity protocol (21.1%), and radio frequency identification tracking (9.8%).
"The table presents estimates of ED characteristics by ED visit volume and MSA status. When compared with small EDs, large EDs were more likely to have a bed coordinator in their hospitals (71.2% compared with 33.8%); have an observation or clinical decision unit (53.5% compared with 32.5%); "board" patients for more than 2 hours in the ED while waiting for an inpatient bed (86.5% compared with 39.0%); and use bedside registration (89.0% compared with 54.2%), computer-assisted triage (62.2% compared with 24.3%), and zone nursing (61.9% compared with 19.0%).
"EDs with over 20,000 annual visits comprised 70.5 percent of EDs in MSAs. When compared to EDs in non-MSAs, EDs in MSAs were more likely to have a bed coordinator or bed czar in their hospital (60.7% compared with 30.0%) and "board" patients for more than 2 hours in the ED while waiting for an inpatient bed (77.4% compared with 32.8%).
"Additional information about ED utilization is available from the NCHS Ambulatory Health Care website.
"References
1. Institute of Medicine. Hospital-Based Emergency Care: At the Breaking Point. Washington, DC: National Academy Press. 2006.
2. General Accounting Office. Hospital Emergency Departments: Crowded Conditions Vary Among Hospitals and Communities. Washington, DC: General Accounting Office. 2003.
3. Burt CW, McCaig LF, Valverde RH. Analysis of ambulance transports and diversions among U.S. emergency departments. Ann Emerg Med 47(4):317-326. 2006.
4. DesRoches CM, Campbell EG, Rao SR, Donelan K, Ferris TG, Jha A, et al. Electronic health records in ambulatory care -- a national survey of physicians. N Engl J Med 359:50-60. 2008."
Wednesday, February 4, 2009
Costco, Kashi & Salmonella Typhimurium
A safe food supply is an essential part of our healthcare system. Salmonella typhimurium must not be in our food because it can cause sickness, and even death.
After reviewing the US government CDC site, in my pantry I found a box of Kashi chewy bars purchased from Costco, some with with the product codes listed in the recall notice and some which were OK. By clicking the widget below, you can go to the CDC site yourself and do your own check for various food manufacturers' and distributors' products. Quick tip - look for the product bar code on the package you have and then check that against manufacturers' or distributors' recall notices. Discard or return a listed recalled product, as I will do today when the box of Kashi bars goes back to Costco.
The CDC site has a more extensive recall list than your local newspaper is likely to have.
After reviewing the US government CDC site, in my pantry I found a box of Kashi chewy bars purchased from Costco, some with with the product codes listed in the recall notice and some which were OK. By clicking the widget below, you can go to the CDC site yourself and do your own check for various food manufacturers' and distributors' products. Quick tip - look for the product bar code on the package you have and then check that against manufacturers' or distributors' recall notices. Discard or return a listed recalled product, as I will do today when the box of Kashi bars goes back to Costco.
The CDC site has a more extensive recall list than your local newspaper is likely to have.
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