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Sunday, March 25, 2012

Dimensions - what do they mean to you?

Numbers usually have some associated dimensions, so when doing dosing calculations it is important to not forget about the associated physical dimensions. Sometimes the dimensions make easy sense: Plasma concentration, for example has the dimension of something like mg/L. Makes sense? Sure. But how about AUC - the famous "area under the curve": mg/L x h Unless you are a numbers and mathematics genius, that dimension makes less sense at first site....

How about speed, say, 80 miles/h? When you see this number and I ask you "How long would it take you to go 80 miles?" - can you easily answer that? If not - here is how a former student of mine deals with this complex task:
http://www.youtube.com/watch?v=Qhm7-LEBznk#

Sunday, March 11, 2012

Are you still a nicotine addict? Read this, maybe....

FDA release today: "Tobacco use is the leading cause of preventable death in our nation. And until we dramatically decrease the access and appeal of tobacco products to youth, it will remain one of America's most pressing health problems. Today’s ground-breaking report by the Surgeon General not only documents the devastating consequences of tobacco use for our nation’s youth, but also represents a clarion call for bold action at every level of government to implement proven strategies to keep kids off tobacco."



Wednesday, March 7, 2012

Medication error risks

I just saw a report on Medscape that lists the 12 most common instrument-related errors occurring in medical practice/hospitals. Among those are medication/dosing errors when using infusion pumps. This is the text from the slideshow relating to this problem: make sure that you don't get into this sort of mess - ever!


Medication Administration Errors When Using Infusion Pumps
Mistyping information, entering it into the wrong field, and other data-entry mistakes can be dangerous or even fatal. Doctors, nurses, pharmacists, and others can contribute to errors. Medication orders may be illegible, drugs and solutions may be incorrectly prepared, and a medication may be given to the wrong patient.
"One way to avoid errors is to use a dose-error-reduction system," says Keller. "It has built-in limits, or guardrails. If a nurse enters a dose that exceeds the limit, an alert will occur to catch the error before it can happen."
It's crucial to determine the compatibility of the pumps with your safety systems. Get the names of other sites that have integrated the pump with information systems from the major providers. For staff who will be using the system, emphasize the importance of safeguards, and be aware of any resistance to new workflows and safety compliance issues. 

Sunday, March 4, 2012

Muscle cramping

This post is outside my teaching program this term, but it should be a useful reminder for all the athletes out there:

Yesterday, after a soccer game in Kingstown, I talked to a student re. muscle cramping and later revived my understanding of the underlying causes – here is my summary:

Muscle cramping during exercise seems to have two major causes (and 100 suspected causes): (1) a nerve muscle fatigue syndrome (“sick muscle”) where you have to stretch against the contraction but won't be able to control the situation such as to continue exercising and (2) inappropriate systemic fluid and sodium levels, precipitated by inadequate pre-hydration, sodium intake or intermittent fluid intake during prolonged exercise. Forget about calcium, potassium and magnesium. Sweating looses a lot of water and sodium. Just taking water or juices may suffice but could not overcome the cramping risk if too much sodium has been lost: it is better then to take salt containing sports drinks or home-made fluid (½ tsp of salt/0.5 L). Definitely do not use pop drinks containing caffeine/theophylline: these methylxanthines cause diuresis and fluid and sodium loss, exactly the opposite of what you need.

When biking around the island I noted once that I precipitated some leg cramps within minutes after taking some fresh water from roadside taps. When repeating the exercise later and taking along some Gatorade, I had no problems. Unfortunately, the roadside rum shops carry no water or sparkling water – just pops.

Happy running, biking, playing!

Saturday, March 3, 2012

Some spelling humor for you

Here is a record of a real email exchange between Professor Hans and a student:

Student: Someone left a stethescope in the van coming back from the hospital - maybe
you could send a message to the class about that?

Prof: OK, I just did. But for my benefit, what is a "stethescope"?

Student: A stethescope is used by doctors to listen to ones heart and lung sounds!

Prof: Oh, that would be a stethoscope, I know about that. But you said you found a
stethescope - and I still don't know what that would be!

Student: Haha, I see my spelling error! Sorry!

Prof: Ok, all clear. But just to be picky it should be "one's" instead of "ones".

Student: OK, thanks! If we had to go through all our mails and texts with a spellchecker
we would have little time for study!

Prof: (to himself): "Spellcheckers - alright, those are for typos. But how about knowing
some English, Hair Doctor?"

(Of course, it is a standing yoke that docters do not wright and spel good. If KMC had
continewd to eccist, we mite have stahted an englisch cuarse!)