Emergency Pulse

FYI

H1N1: When to See a Doctor | KCRG-TV9 | Cedar Rapids, Iowa News, Sports, and Weather | Local News.

Karma’s a bitch!

Woman Makes Fake 911 Call, Then Calls Again as Garage Door Crushes Her in Fatal Mishap - Local News | News Articles | National News | US News - FOXNews.com.

 FYI

US rolls out massive swine flu vaccination campaign | KCRG-TV9 News, Sports, and Weather Cedar Rapids, Iowa.

We have begun to see quite an increase in our influenza patients this past week. Apparently almost all of the Influenza is the H1N1 variety (swine flu). Unfortunately for us in the department, we have NOT been vaccinated yet. So, I expect that staff will begin to come down with this illness as well. Which in NOT GOOD. We have enough problems staffing the department as it is without this! UGH!
The H1N1 virus seems to be more dangerous than our run of the mill seasonal influenza. More of the healthy individuals are becoming very sick and dying. It is a little more than scary.
Here is a synopysis of the recommendations from the CDC website:

Interim Recommendations for Clinical Use of Influenza Diagnostic Test for the 2009-2010 Influenza Season (9/29/09)

Testing Decisions:

Most people with clinical illness consistent with non-complicated Influenza who reside in an area where influenza viruses are circulating do not need diagnostic testing for clinical management.

- Test who? Hospitalized patients
- Do not test unless you’re going to use Tamiflu or Relenza
- Be aware that sensitivities to Rapid Influenza Diagnostic Tests (RIDT) is 10-70% (not good) and that the RIDT cannot distinguish between 2009 H1N1 (formerly novel influenza A or swine flu) and seasonal influenza (H1N1 or H3N2)

As of 09/19/09 99% of circulating influenza in the U.S. is 2009 H1N1.
Clinical Presentation is similar to seasonal H1N1 and includes abrupt onset of fever, cough, sore throat, myalgias, arthralgias, chills, headaches, and fatigue. Vomiting and Diarrhea are reported more with 2009 H1N1 than seasonal H1N1. It also can present with fever.

- CDC recommends early empiric antiviral treatment for suspected or confirmed in hospitalized patients and those with high risk factors.

Use of Diagnostic Tests:

Once influenza is documented in a community most patients with uncomplicated illness consisted with influenza can be diagnosed clinically and do not require rapid testing. Keep in mind that if you do order a test in most likely will be negative if symptoms have been present greater than three days.

A positive influenza can be assumed to be the 2009 H1N1 strain.

Updated Interim Recommendations for Obstetrical Health Care Providers relating to use of Antiviral Medication in the Treatment and Prevention of Influenza in the 2009-2010 Season.

1) Pregnant females are at higher risk of severe complications and death from influenza (both 2009 H1N1 and seasonal influenza)
2) Treatment with Tamiflu or Relenza is recommended during any trimester for 5 days.
3) Post exposure of pregnant females should be considered if they have been exposed. Duration is 10 days.

Prostate cancer is the most commonly diagnosed cancer in men, and second only to lung cancer in the number of cancer deaths.  Screening is controversial.  Read more below:

CDC Features - Prostate Cancer.

Before you move in with your partner you should definitely have a heart to heart about your financial goals and your relationship with money.  Some are spenders, some savers, some in between, but you can be sure that if you aren’t matched well financially as well as socially, your relationship may be doomed.  Check out this article below:

3 Money Questions to Ask Before Moving In Together - FOXNews.com.

Note To Cabbie:  Crack Kills!

A couple wack jobs deserve jail time; maybe they will pray their way out?

Wisconsin Parents Face 25 Years in Prison When They’re Sentenced in Daughter’s Prayer Death

This past 8 months or so we have went through 3 of our 3 new PA hires.  I am not sure why they are all leaving, but I gather that it is a combination of difficult work schedules (evenings and weekends), not enough pay, stressful work conditions, and a bad fit into the department.  Not everyone is cut out for this type of work.  It is stressful, whether dealing with difficult patients and/or difficult co-workers.  One thing to remember when you are having a bad day, just think of all those individuals who would kill to get any job right now.  Being a health care worker is hard, but we are generally well compensated and are in demand.  So, if you are a mid level provider and want a job, send me a line!