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Washington Landslide

Fires, floods and landslides. This year has seen it all and the year has just begun. What's in store for hurricanes or tornadoes? Are you prepared?

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First Aid Spotlight10

Teen Stows Away on a Flight to Hawaii and...Lives!

Monday April 21, 2014


That was my reaction to the 15 year old who climbed in the wheel well of a Hawaiian Airlines Jet and rode all the way to Maui. Apparently, he's fine!

This isn't a likely scenario. The air is thin. The temperatures are -80 degrees. He spent more than 5 hours in there.

He should've died.

At the very least, severe hypoxia or severe hypothermia should have left him incapacitated for longer than an hour, which is reportedly how long it took him to wake up and climb out of the plane. How about a touch of frostbite? Anyway you cut it, this kid should be dead. For such a ridiculous screwup, he's lucky beyond belief.

Santa Clara teen stowaway's survival in jet's wheelwell was literally death-defying - San Jose Mercury News.

Everything in Healthcare Affects Patient Care

Sunday April 20, 2014

A children's hospital in New Orleans admitted 5 years after the fact that 5 kids died from hospital acquired infections at its facility. It's a nightmare for any parent: take your child to the hospital only to have the hospital kill your child.

I regularly tell my team that there is nothing we do on the ambulance that isn't directly or indirectly related to patient care. It's the same in the hospital. In this case, the infections reportedly came from a fungus on bed linens. The hospital said in a statement last week that the linens were cleaned by a vendor, which doesn't change my point: everything done in a healthcare setting affects patient care.

Even work by a vendor affects patient care.

These infections started as innocuous little bumps and grew into ugly necrotizing sores. These are the types of skin infections that are regularly misdiagnosed as spider bites or stings by some other critter. Unfortunately, recognizing that they came from the hospital is nearly impossible until there are multiple patients that authorities could tie together as all having been admitted to the same facility.

By that time, the damage is done.

This story illustrates how important it is for everyone in healthcare to take his or her job seriously and how important for healthcare leaders to take every worker's contribution seriously. The folks who stock the shelves mean the difference between whether or not there are supplies ready for emergencies. And we've seen how the folks who clean the sheets could mean the difference between life and death.

Healthcare is serious business, all of it.

Opioid Antidotes for All?

Tuesday April 15, 2014

Naloxone sold over the counter? An article in the San Francisco Chronicle today talked about a new bill that would make the "overdose antidote easier to buy." AB1535 would allow naloxone (brand name Narcan) to be sold without a prescription in California. The idea is to more quickly treat patients of opioid overdoses before they die.

The most common serious opioid overdoses come from heroin, which is a narcotic deemed to have no medicinal use according to the DEA. While heroin might not be medicinal, its cousins are. You might've heard of a few of them: Oxycontin, Vicodin, Norco, methadone,  morphine, Percodan, Percocet, Darvon, Darvocet...

The list goes on.

When one overdoses on these opioids, breathing can stop. There are some other physiological signs, but the lack of breathing really gets in the way of living a full and meaningful life. Not every opioid overdose patient stops breathing, but those who do stop often don't start again.

Naloxone makes one breathe again.

It's pretty dramatic. A few seconds after receiving naloxone by injection, overdose patients take a deep breath and wake up, usually with protests of "I didn't take anything" or "I only had a few drinks." For future reference: alcohol kills in a completely different way and naloxone absolutely only works on opioids. It doesn't do jack for anything else.

And therein lies my only concern with this plan.

I don't see a ton of issues with a naloxone autoinjector lying around here and there for the heroin overdose patients to try. Indeed, these folks are professionals and so are their friends. It's entirely probable that they would be able to recognize and reverse the overdose with naloxone.

I am a little concerned about the other use mentioned in the article: prescription overdoses. People who use the medicines I listed above or any of the other countless derivatives might try to have a dose of naloxone around the house just in case. It's not that big of a deal if they're right. Naloxone would certainly fix the problem.

But folks who take these medications rarely take only these medications. And remember: naloxone doesn't do squat for anything that's not an opioid, even the stuff that's mixed with the opioids. Naloxone won't fix the acetaminophen overdose that goes with the Vicodin overdose, even though it will reverse the Vicodin. Once the Vicodin is gone, the acetaminophen will still kill the patient.

Sedatives that aren't opioids won't be reversed, either. So if valium, ambien, alcohol or carisoprodol are the drugs causing the patient not to wake  up, giving naloxone will only stall real help.

The article suggests there are only two options: take naloxone immediately at home or wait until the ER, where it might be too late. I suggest there's a third option: Call 911. Ambulances carry naloxone. They have for decades. And, paramedics are trained to recognize the signs and symptoms of an opioid overdose. If the issue is not a opioid overdose, they'll recognize that, too.

And they won't waste time trying naloxone when it's something else, like a stroke.

Are Your Kids Prepared? Here's What They Need to Know

Monday March 31, 2014

We teach kids not to get in a car with strangers. We teach them how to answer the door -- or not to -- when we're not home. We teach them to look both ways before crossing the street. We teach them not to play with matches.

That's good, but it's not enough. Your kids need to know more about safety.

What if they do play with matches? Do your kids know what to do if they catch their clothes on fire or burn themselves?

Part of growing up is becoming more independent. Your teenagers probably have cell phones. One of the reasons you purchased it for them was for safety. Did you know there's a difference between calling 911 on a cell phone and calling 911 from your house phone? Your kids need to know what to expect when they dial 911 from their cell phone -- and what will be expected of them.

They should know how to Stop, Drop and Roll if their clothes catch fire and how to treat the burns.

Small kids should know how to protect themselves from stray dogs. Bigger kids are strong enough to do CPR.

Teaching kids to avoid strangers and look both ways are both good starts on being safe, but kids can and should learn a lot more. Empower your youngster to be independent and respond to dangers quickly and decisively. They might even save you some day.

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