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health and health-care by an ICU nurse

CxLxMx
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  • September 11, 2011
  • 02:42 PM
  • 1,251 views

Nurses on Sept 11: 'there were no patients'

by CxLxMx in cxlxmxrx

No doubt many nurses today are remembering the attacks on the World Trade Center on September 11, 2001. I wasn't a healthcare professional at the time. I had moved back home and was trying to figure out my next move after a web start-up I had been involved with went belly-up. My father was at the university, my mother was gardening, and my brother was at school. I got up and wandered around the house, read the newspaper. For some reason, I turned on the TV to flip through the channels and c........ Read more »

Dickerson, Jezewski, Nelson-Tuttle, Shipkey, Wilk, . (2002) Nursing at Ground Zero: Experiences During and After September 11 Word Trade Center Attack. Journal of the New York State Nurses Association, 33(1), 26-33. info:/

  • June 19, 2011
  • 07:32 AM
  • 1,412 views

2 liter bolus of fat: no hemodynamic changes

by CxLxMx in cxlxmxrx

I bring to your attention a case report of a patient who received an accidental overdose of 2 liters intravenous lipid infusion and apparently suffered no ill cardiac effects. That is, the patient received fat directly into the blood stream in a quantity equal to a family-sized bottle of soda and didn't have a "heart attack."Just as certain medications bind to proteins, which binding in the blood stream changes their availability to other tissues, certain medications have an affinity for lipids........ Read more »

Dix, S., Rosner, G., Nayar, M., Harris, J., Guglin, M., Winterfield, J., Xiong, Z., & Mudge, G. (2011) Intractable cardiac arrest due to lidocaine toxicity successfully resuscitated with lipid emulsion*. Critical Care Medicine, 39(4), 872-874. DOI: 10.1097/CCM.0b013e318208eddf  

Smollin, C. (2010) Toxicology: Pearls and Pitfalls in the Use of Antidotes. Emergency Medicine Clinics of North America, 28(1), 149-161. DOI: 10.1016/j.emc.2009.09.009  

  • March 14, 2011
  • 09:58 AM
  • 1,509 views

Open letter to ANA on genetic testing

by CxLxMx in cxlxmxrx

In reporting on the recent March 8-9 meeting of the MCG Panel of the FDA's advisory committee, I find it problematic that I have no recording or minutes of the meeting. Of the five W's of reporting, I am missing the vital Who and hoW components. So, I was taken by surprise yesterday as I was working on my call to nursing organizations to submit comments to federal docket FDA-2011-N-006 in support of patients' rights to view their own genetic information. It turns out the American Nurses' Assoc........ Read more »

  • May 8, 2009
  • 12:41 PM
  • 1,348 views

"sane and rational": an approach to swine flu

by CxLxMx in cxlxmxrx

Despite the deaths, the swine flu has not been without its humorous side. For example, in Afghanistan, Kabul Zoo quarantined that nation's only pig. The pig was a gift from China, which has taken the slightly less humorous action of quarantining a number of visitors from the Americas. Where does public health wisdom lie?Writing in Virology Journal, William R. Gallagher of the Louisiana State University Health Sciences Center has reviewed the situation up to the current time and makes recommen........ Read more »

  • April 19, 2009
  • 11:03 PM
  • 1,441 views

Bum sugar, or why bad ideas persist

by CxLxMx in cxlxmxrx

A few weeks ago, one of my instructors was telling us about the treatments they used to perform in hospitals for ulcers, which included applying sugar and placing the ulcerated part of the patient under a heat lamp. (For those non-nursing types, current treatment is re-positioning patients to relieve the pressure that causes ulcers and prevents them from healing...)I don't know where the idea that putting sugar on an ulcerated rump would make it get better, but really that's not such an interes........ Read more »

  • March 3, 2009
  • 03:09 PM
  • 1,862 views

Effects of night shift on metabolism

by CxLxMx in cxlxmxrx

Nursing is one of the professions that includes regular shift work. Traditionally, new nurses start off on the night shift and work their way to days as they increase in seniority and skill. In fact, on my floor, there are a number of nurses who work nights by preference. There are advantages that mainly involve different variations of not having management breathing down your neck. However, the night shift tends to be full of people who are overweight and look worn out. It isn't just my im........ Read more »

F. A. J. L. Scheer, M. F. Hilton, C. S. Mantzoros, & S. A. Shea. (2009) Adverse metabolic and cardiovascular consequences of circadian misalignment. Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.0808180106  

  • February 24, 2009
  • 12:20 PM
  • 2,187 views

Xigris : how does it work, really?

by CxLxMx in cxlxmxrx

Xigris, or "recombinant human activated Protein C," is an anticoagulant used to treat septic shock. How does Xigris work?What does Protein C do?Protein C is a key component of the body’s natural negative feedback loop for the coagulation cascade. The final steps in coagulation are the conversion of Prothrombin to Thrombin by Factor X and Factor V. Factor X is activated by Factor VIII.Thrombin produces Fibrin, which is the building block of blood clots, but it also activates Protein C (PC) b........ Read more »

  • February 10, 2009
  • 06:42 AM
  • 1,593 views

Comin' to America: Marburg Hemorrhagic Fever

by CxLxMx in cxlxmxrx

I like this understated headline from the RockyMountainNews: "Rare Marburg hemorrhagic fever shows up in Denver". Well, golly gee! Of all the fevers you don't want to just show up on your doorstep, Marburg hemorrhagic is one of the rarest. In fact, this is the first reported case in the United States. The CDC's Dr. Pierre Rollin (seen here and here doing field work in Africa... and by the way, you don't expect the first search hit for an infectious disease doctor to be IMDB...) says the pati........ Read more »

Heinz Feldmann, Steven M. Jones, Kathleen M. Daddario-DiCaprio, Joan B. Geisbert, Ute Ströher, Allen Grolla, Mike Bray, Elizabeth A. Fritz, Lisa Fernando, Friederike Feldmann.... (2007) Effective Post-Exposure Treatment of Ebola Infection. PLoS Pathogens, 3(1). DOI: 10.1371/journal.ppat.0030002  

N. Jouvenet, S. J. D. Neil, M. Zhadina, T. Zang, Z. Kratovac, Y. Lee, M. McNatt, T. Hatziioannou, & P. D. Bieniasz. (2008) Broad-Spectrum Inhibition of Retroviral and Filoviral Particle Release by Tetherin. Journal of Virology, 83(4), 1837-1844. DOI: 10.1128/JVI.02211-08  

T. Sakuma, T. Noda, S. Urata, Y. Kawaoka, & J. Yasuda. (2008) Inhibition of Lassa and Marburg Virus Production by Tetherin. Journal of Virology, 83(5), 2382-2385. DOI: 10.1128/JVI.01607-08  

  • January 29, 2009
  • 05:58 PM
  • 1,311 views

Genotype linked to longer ICU admission

by CxLxMx in cxlxmxrx

This article is still only in a provisional state, and there isn't much in it to relate to nursing practice, but I thought it was fascinating as an example of the type of issue health care, hospital administration, and the nursing professional are going to be faced with in the near future.Researchers have discovered that patients with two T alleles at 9545 in the gene that codes for Interleukin 18 have higher levels of TNF-alpha and stay in the ICU longer after cardiac surgery.Because of the who........ Read more »

David M Shaw, Ainsley M Sutherland, James A Russell, Samuel V Lichtenstein, & Keith R Walley. (2009) Novel polymorphism of interleukin-18 associated with greater inflammation after cardiac surgery. Critical Care, 13(1). DOI: 10.1186/cc7698  

  • December 29, 2008
  • 01:09 AM
  • 1,725 views

Thought & Action: multitasking, the civil class, and the scholarly voice

by CxLxMx in cxlxmxrx

2008 is drawing to a close, but not before I could read the autumn'08 issue of Thought & Action, the National Education Association's journal of higher education. This issue contains three articles related to technology (or at least modern life) and education. Although they're not presented as such, all three seem related to me.You Say Multitasking Like It's a Good ThingIn the first article1, Professor Charles J. Abaté reviews with a skeptical eye the issue of "multitasking." He identifi........ Read more »

Charles Abaté. (2008) You say multitasking like it's a good thing. Thought , 7-15.

P.M. Forni. (2008) The civil classroom in the age of the Net. Thought , 15-22.

  • November 25, 2008
  • 12:00 AM
  • 1,727 views

Fibers in the skin, but still no Morgellons explanation

by CxLxMx in cxlxmxrx

Morgellons disease is characterized by skin lesions that contain fibers of unknown origin. Morgellons is often dismissed as delusional parasitosis or Munchausen's syndrome by proxy (now boringly re-named FII, fabricated or induced illness), although the fibers represent an objective finding and their origin is contested if not unknown. Critics insist the fibers are placed or at least synthetic in origin (fabric-induced illness?), while proponents of the disease point to a number possible origi........ Read more »

Lina Almarestani, Geraldine Longo, & Alfredo Ribeiro-da-Silva. (2008) Autonomic fiber sprouting in the skin in chronic inflammation. Molecular Pain, 4(1), 56. DOI: 10.1186/1744-8069-4-56  

  • October 14, 2008
  • 05:38 AM
  • 1,718 views

Happy Open Access Day !

by CxLxMx in cxlxmxrx

Today, October 14, is the first Open Access Day--a day devoted to broadening awareness and understanding of free and available information. Open Access Day is a joint venture of the Public Library of Science (PLoS), the Scholarly Publishing and Academic Resources Coalition and Students for Free Culture. In response to the call for synchroblogging, I've decided to direct some attention to the issue of open access in nursing.Although nursing research is promoted in BSN programs and as an ingredi........ Read more »

Don E. Detmer, Meryl Bloomrosen, Brian Raymond, & Paul Tang. (2008) Integrated personal health records: Transformative tools for consumer-centric care. BMC Medical Informatics and Decision Making, 8(1), 45. DOI: 10.1186/1472-6947-8-45  

Carole A Estabrooks, Shannon Scott, Janet E Squires, Bonnie Stevens, Linda O'Brien-Pallas, Judy Watt-Watson, Joanne Profetto-McGrath, Kathy McGilton, Karen Golden-Biddle, Janice Lander.... (2008) Patterns of research utilization on patient care units. Implementation Science, 3(1), 31. DOI: 10.1186/1748-5908-3-31  

Casida, J, & Pinto-Zipp, G. (2008) Leadership-Organizational Culture relationship in nursing units of acute care hospitals. Nursing Economic$, 26(1), 7-13.

  • September 24, 2008
  • 05:11 PM
  • 1,583 views

Re-inoculation from the appendix and recurrent C. difficile infection (CDI)

by CxLxMx in cxlxmxrx

Trying to find a topic to write a review article in Bio416 Virology, I came across a post on enzyme evolution in the Discount Thoughts blog that led me to a post on the possible functionality of the appendix. Bollinger et al., writing in Journal of Theoretical Biology, propose that the appendix is a tool for creating probiotic biofilms in the large intestine as well as re-inoculating the large intestine in the event of its defloration by, for example, diarrhea. Their argument rests mostly on r........ Read more »

  • February 6, 2008
  • 12:00 AM
  • 1,777 views

Dyspnea & cadence

by CxLxMx in cxlxmxrx

I recently purchased a CD of Navy SEAL cadences to try listening to while running. For the past year or so, I've been trying to listen to mp3's of internet talk radio shows, but it doesn't do much to help. I also tried listening to Bach (I was intending to go through his whole repertoire on the treadmill), but I discovered that Bach actually inhibits athletic performance.

So, yesterday, I put on my radio shows and interspersed them with the SEAL cadences, and I had a very inter........ Read more »

Hill et al. (1998) Short-term entrainment of ventilation to the walking cycle in humans. Journal Of Applied Physiology, 65(2), 570-578.

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