Hospital Medicine Alert – October 1, 2009
October 1, 2009
View Issues
-
Practice Makes (Almost) Perfect: Reducing Catheter-related Bacteremia Using Simulation-based Training
In order to reduce the rate of catheter-related bloodstream infections (CRBSIs) in intensive care units, Northwestern Memorial Hospital implemented patient-care bundles in all ICUs in August 2005. -
Respiratory Therapist-driven Protocol for Non-ICU Surgical Patients Reduces ICU Use and Decreases Costs
Initiation of a respiratory therapist-driven protocol for assessment and management of risk for respiratory complications in the study hospital's neurosurgery step-down, trauma/surgery step-down, and trauma/surgery general units was followed by an increase in the number of patients receiving respiratory treatments, but decreases in ICU and hospital stays and overall hospital costs. -
Cleaning Stethoscopes with Ethanol-based Cleaner vs. Isopropyl Alcohol — Which Is Better?
This study showed that cleaning a stethoscope with an ethanol-based foam hand cleaner is as effective as wiping it with an isopropyl alcohol pad. -
Unexplained Cardiac Arrest Evaluation
In this paper, Krahn et al, from a Canadian consortium, report on the results of systematic evaluations in patients with unexplained cardiac arrest due to ventricular tachycardia or ventricular fibrillation. -
Whole Blood in the Management of Hypovolemia Due to Obstetrical Hemorrhage
The concept of abandoning the use of whole blood in favor of packed cells for the treatment of hypovolemia in obstetric hemorrhage should be questioned in view of this study's suggestion of a lower rate of acute tubular necrosis in patients treated with whole blood. -
Vancomycin Loading Doses in Morbidly Obese Patients
In January 2009, the publication of an updated vancomycin monitoring guideline gave clinicians a set of recommendations on: 1) timing of monitoring, 2) optimal trough concentration, 3) dosing to achieve optimal trough concentrations, 4) loading doses for complicated infections, 5) criteria for monitoring, and 6) frequency of monitoring.