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In this issue: New reports about proton pump inhibitors and the effects of gastric suppression, pioglitazone vs vitamin E for non-alcoholic steatohepatitis, metformin and vitamin B12 deficiency, and FDA Actions.
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Patients with neuromuscular disease who are intubated and subsequently fail multiple spontaneous breathing trials are often relegated to placement of a tracheo-stomy and continuous mechanical ventilation.
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Terragni et al performed this 4-year-long multicenter randomized controlled trial to determine whether early (6-8 days) vs late (13-15 days) tracheotomy would reduce ventilator-associated pneumonia (VAP) incidence.
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Fractures and bisphosphonate therapy, warfarin anticoagulation and influenza vaccine and cotrimoxazole, antiplatelet therapy with clopidogrel and aspirin, FDA Actions.
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Patients with acute joint pain present a diagnostic dilemma for many emergency physicians. Classically the joints are hot, swollen, and tender, with reduced range of motion. The differential diagnosis for the painful joint is extensive.
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Demonstrating that you're prepared is important when Joint Commission surveyors knock on your door, says Susan Bukunt, RN, MPA, CPHQ, senior director of clinical quality and patient safety at El Camino Hospital with two campuses in Los Gatos and Mountain View, CA. "Being able to give them what they're asking for shows them that you're ready and you take this seriously," she says.