Hospital Medicine Alert – January 1, 2012
January 1, 2012
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Delays in Transfer for Primary PCI in STEMI
Most patients with ST-elevation myocardial infarction (STEMI) present to hospitals that are not capable of percutaneous coronary intervention (PCI). -
Hospital Organizational Characteristics Associated with Use of Daily Sedation Interruption in Mechanically Ventilated Patients
In a nationally representative sample of U.S. hospitals, reported routine use of daily interruption of sedation for mechanically ventilated patients was associated with the presence of a leadership emphasis on safety culture, receptivity of the staff to practice change, and participation in a collaborative to prevent health care-associated infections. There was no association with the number of hospital beds or with the presence of a medical school affiliation. -
ECG Review: A Wide Tachycardia of Uncertain Cause
Lead II rhythm strip from a patient with palpitations? What would you do? -
Dengue Outbreak in Kenya: Sign of a Larger Issue?
An outbreak of dengue fever in northeastern Kenya has recently sickened at least 5,000 people. -
VTE Prophylaxis in Gynecologic Surgery: Quo Vadis?
Venous thromboembolism (VTE) prophylaxis interventions in gynecologic surgery are meritorious, supported by Level 1 evidence and the subject of multiple guidelines, including those published by the American College of Obstetricians and Gynecologists. However, new evidence suggests nearly one-third of women undergoing hysterectomy in this country still receive no VTE prophylaxis, placing thousands of women at unnecessary risk for preventable morbidity. -
Early or Late Tracheostomy Placement: Optimal Timing Remains Unclear
Based on the findings of this meta-analysis of seven randomized controlled trials, early (7 days after intubation) or late (any time after 7 days) tracheostomy placement did not alter clinical outcomes in study patients, including no differences in mortality, incidence of ventilator-associated pneumonia, duration of mechanical ventilation, ICU stay, hospital stay, or sedation. -
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