This is obviously very important to our specialty since most of us work in a hospital. Fitch Ratings said its “Rating Watch” for U.S. nonprofit hospitals and health systems is over after the organizations showed improved or stable results this year. During a six-month review of 125 existing issuers, Fitch affirmed 52% of the graded facilities […]

A blood test administered within 12 hours of a suspected traumatic brain injury (TBI) could help clinicians identify injuries like hemorrhage and contusion before having to resort to CT imaging, according to the preliminary results of a study published this week in the Lancet Neurology. Jeffrey Bazarian, MD, MPH, a co-leader of the paper and a professor at […]

ASA Monitor 8 2018, Vol.82, 48-49. Review of unusual patient care experiences is a cornerstone of medical education. Each month, the AQI-AIRS Steering Committee abstracts a patient history submitted to the Anesthesia Incident Reporting System (AIRS) and authors a discussion of the safety and human factors challenges involved. Real-life case histories often include multiple clinical decisions, […]

Off-label, epidural use of Depo-Medrol (methylprednisolone acetate) injections for back pain is increasing as clinicians limit their opioid prescribing — but the treatment is risky and often ineffective — the New York Times reports. Depo-Medrol’s manufacturer, Pfizer, requested in 2013 that epidural use be banned owing to risks for blindness, paralysis, stroke, and death. The FDA declined […]

Authors: Weick, Jack, MD et al Journal of Bone and Joint Surgery: July 18, 2018 – Volume 100 – Issue 14 – p 1171-1176 Background: Prescription opioid use is epidemic in the U.S. Recently, an association was demonstrated between preoperative opioid use and increased health-care utilization following abdominal surgeries. Given that primary total knee arthroplasty (TKA) and […]

Science Daily August 2018 Twenty patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease, according to a study published today in Annals of Internal Medicine. The researchers also report that the kidney transplants for these 20 patients are functioning […]

Authors: William A. Grobman, M.D. et al N Engl J Med 2018; 379:513-523 The perinatal and maternal consequences of induction of labor at 39 weeks among low-risk nulliparous women are uncertain. METHODS In this multicenter trial, we randomly assigned low-risk nulliparous women who were at 38 weeks 0 days to 38 weeks 6 days of […]

The Jury Is Still Out Elizabeth L. Whitlock, MD, MSc1 et al JAMA Surg published online August 8, 2018. Perioperative delirium is an incredibly complex multifactorial syndrome, which despite a rapidly growing body of inquiry into its risk factors remains one of the most common complications of surgery and anesthesia. Acknowledging that most risk factors, such as underlying […]

Communication breakdown among nurses and doctors is one of the primary reasons for patient care mistakes in the hospital. In a small pilot study, University of Michigan researchers learned about potential causes of these communication failures by recording interactions among nurses and doctors, and then having them watch and critique the footage together. Several themes […]

AUTHORS Sperry JL et al. N Engl J Med. 2018 Jul 26;379(4):315-26. Prehospital administration of plasma to trauma patients at risk for hemorrhagic shock improves odds of survival, according to the Prehospital Air Medical Plasma (PAMPer) trial. Patients who received plasma also had a decreased median prothrombin to time ratio, compared with those who received […]