Author: joe

patientsfirstma.org details hospital staffing levels (including RTs)

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This is an interesting use of the net to give patients information about how hospitals work. I know many times we would be understaffed and be working extra hard, but RTs generally work as teams and can call in one or two people and the slack will get picked up. Nurse staffing is much more acute. Still, nice to see they’re including information about other ancillary services. The site is at http://www.patientsfirstma.org/

Mass. hospital website is set to detail nurse staffing levels – The Boston Globe

The hospital project is impressive in its detail. For each unit at each hospital, consumers can see the average number of patients per day, the number of registered nurses, licensed practical nurses, and nursing assistants working each shift, and any other staff available on each shift, such as a nutritionist or respiratory therapist. There also is a bottom-line number: the average number of hours a registered nurse or licensed practical nurse spends daily with each patient.

The site includes this definition of an RT:

Respiratory Therapy
These individuals perform testing and provide respiratory treatments to diagnose and manage the care of patients with lung and breathing problems. They also monitor and maintain respiratory equipment, and provide patient education.

The information about RT staffing levels seems to be pretty general. Staffing plans are listed but not staffing levels for Respiratory Therapists.

Inhaled Insulin to Treat Diabetes

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This is interesting. I had not heard that you could deliver insulin in a nebulized / aerosolized form. Intriguing. Pulmonary insulin delivery – which products will triumph?

The big companies currently pioneering pulmonary delivery of insulin are Pfizer, Eli Lilly/Alkermes and Novo Nordisk/Aradigm.Leading the pack is Exubera, which Pfizer now owns after buying the rights off Sanofi-Aventis for $1.3 bn this month.

Exubera is a fast-acting powdered insulin that is inhaled into the lungs before each meal, using a device the size of a torch. Both the formulation and device were developed by Nektar Therapeutics.

With a 2–3 year lead on other such products in clinical development, Exubera should make it to the market first, proving to be a sure-fire blockbuster for Pfizer.

In clinical trials Exubera was as effective as injected insulin, however, it has been shown to cause a short-term decrease in lung function and concerns over the long-term affect of inhaling insulin into the lungs has led to ongoing delays in US Food and Drug Administration (FDA) approval of the product.

In September 2005, an FDA Advisory Committee finally recommended approval of Exubera for the treatment of adults with type 1 (insulin-dependent) and Type 2 diabetes (non-insulin-dependent).

However, in October, the FDA extended its original review period of the drug by three months while it considers additional data submitted on its potential to decrease users’ lung capacity.

More on Exubera, it’s a “an inhaled, rapid-acting, dry-powder insulin”, and more about the Nektar delivery device. And this is what it looks like.

Update: LA Times Article on Exubera.

Deficit Reduction Act of 2005

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If passed, will pays less for home O2…

WHSV | One Act, One Less Breath
An act of Congress could take many people’s breath away, literally. A section of the “Deficit Reduction Act of 2005” will force patients who are on home oxygen to foot more of the bill. Currently, Medicare pays for the machine, supplies, and maintenance of the tanks; but the bill will stop the coverage after three years. This leaves many wondering what they would do without it.

“If I didn’t have it I’d be laying out on the floor passed out waiting for someone to find me which may never happen,” said Linda Kidd of Harrisonburg.

Linda Kidd has been depending on an at home oxygen tank for more than 10 years. Medicare covers the cost now but not if a new bill come through Congress.

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Respiratory Therapy for President Ford

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Former President Gerald Ford is getting some RT care for his pneumonia:

thedesertsun.com | Doctors to decide if Ford can go home
Doctors are “currently in the process of assessing” former President Gerald Ford to see if the 92-year-old can leave Eisenhower Medical Center, his chief of staff said this morning.

Ford has been in the Rancho Mirage hospital since Saturday, getting IV antibiotics and respiratory therapy to help him recover from pneumonia complications.

“He is doing well and continuing to respond to treatments,” Chief of Staff Penny Circle said this morning.

By late afternoon, Circle said he was getting “continuing respiratory therapy using treatment measures that are not easily available at home.”

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Avian Flu

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Avian Flu May Be the Next Pandemic (site also has video of this talk)

A deadly influenza outbreak may be on the horizon. Since 1997, a strain of avian flu known as H5N1 has spread rapidly among birds in East Asia, reaching as far north as Siberia. If this strain, which has killed 55 percent of its known human victims, mutates into a virus easily transmitted by people, the resulting pandemic could kill millions and would have staggering global social and economic impacts. “It is not if it is going to happen. It is when, and where, and how bad,” said Dr. Michael Osterholm at the first meeting sponsored by the Wilson Center’s new Global Health Initiative on September 19. “Welcome to my nightmare,” warned Helen Branswell, a Canadian medical reporter speaking at the conference. Read the complete event summary.

And on a lighter note: Avian Flu information for Kids!

Fun! Well, maybe not.

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What is a rhonchi?

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rhonchus (singular) or rhonchi (plural):

“A coarse rattling sound somewhat like snoring, usually caused by secretion in a bronchial tube.

[Latin, a snoring, from Greek *rhonkhos, variant of rhenkos, rhenkhos, from rhenkein, to snore.]”

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Pulmonary Function May Stay Stable after Lung Cancer Treatment

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Pulmonary symptoms and function decline slightly after combined chemotherapy and chest radiotherapy for limited-stage small cell lung cancer (SCLC) and remain stable for five to 15 years, according to a report in the November issue of Chest.

“Patients with limited stage SCLC have potentially curable disease with only a small decrement in their lung function that remains stable over a long period of time,” Dr. Janet N. Myers from Uniformed Services University of the Health Sciences, Bethesda, Maryland told Reuters Health. “Physicians should not have a great deal of angst about treating these patients for fear of long term complications.”

Alpha One Antitrypsen Deficiency

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Vail Daily News for Vail and Beaver Creek Colorado – News

In Denver, a respiratory therapist suggested a blood test. A positive result would explain everything. And what if it is? Canada wanted to know. What is the cure?”There is no cure,” replied the therapist. “Only a lung transplant.”

Dean Canada is among an estimated 100,000 Americans who were dealt a pair of bad cards, two corrupted genes that produce a condition called Alpha One Antitrypsen Deficiency.

This disorder causes the livers of its victims to work improperly. The liver prevents the release of a protein needed for healthy functioning of the lungs. Most victims begin suffering when they are 39 or 40.

More at http://www.alphaone.org/

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