Rhonchi

New York Daily News – Home – WTC air doomed ex-cop

An autopsy of a retired NYPD detective confirmed yesterday what his family and fellow cops long suspected – that James Zadroga’s death was “directly related” to the Ground Zero cleanup.

The stunning findings are believed to mark the first time the death of a cleanup worker has been officially tied to the aftermath of the terror attacks.

“It is felt with a reasonable degree of medical certainty that the cause of death in this case was directly related to the 9/11 incident,” Dr. Gerard Breton, a pathologist at the Ocean County, N.J., medical examiner’s office wrote in the Feb. 28 autopsy report.

Zadroga died on Jan. 5 of pulmonary disease and respiratory failure – and he had lung-tissue inflammation Breton attributed to “a history of exposure to toxic fumes and dust.”

…

Zadroga spent more than 450 hours at Ground Zero, digging through debris and inhaling the noxious gases that are believed to be related to death.

“On Sept. 11, 2001, James Zadroga was a 29-year-old healthy human being,” Palladino said.

But after his work at the 9/11 site, the nonsmoker’s health “began to deteriorate rapidly,” Palladino added.

Zadroga developed respiratory ailments, had difficulty breathing and was found to have fiberglass in his lungs, Palladino said.

The cop retired on a disability on Nov. 1, 2004. The 34-year-old widower died at his parents home in Little Egg Harbor, N.J., just over 14 months later.

In January, the Daily News revealed that 22 other men, most in their 30s and 40s, have died from causes their families say were accelerated by working at Ground Zero after the attacks.

Yesterday, Palladino said that nearly 400 NYPD detectives are suffering from symptoms believed to have been brought on by their work at the disaster site.

CurEvents.com – A Global Current Events Discussion Forum – Avian influenza (H5N1): implications for intensive care.
Abstract
Background As influenza A/H5N1 spreads around the globe the risk of an epidemic increases.
Discussion Review of the cases of influenza A/H5N1 reported to date demonstrates that it causes a severe illness, with a high proportion of patients (63%) requiring advanced organ support. Of these approx. 68% develop multiorgan failure, at least 54% develop acute respiratory distress syndrome, and 90% die. Disease progression is rapid, with a median time from presentation to hospital to requirement for advanced organ support of only 2 days.
Conclusion
The infectious nature, severity and clinical manifestations of the disease and its potential for pandemic spread have considerable implications for intensive care in terms of infection control, patient management, staff morale and intensive care expansion.

Complete list of plans for the Avian Flu, by state:

State Pandemic Plans | PandemicFlu.gov
Listed below are pandemic plans that are currently available on state Web sites. We will update this page as additional plans become available.

AARC Webcast Central:

Looks like a good service from the AARC. Live and archived webcasts for AARC members. The upcoming one about the issue of Mechanical Ventilation in Mass Casualty settings looks like an important one.

My buddy Hedgehog has a new group on MySpace called http://groups.myspace.com/HealthTravel for folks who are travelers in health care. If you’re an RT or other medical professional check it out.

An aerosol type I had not heard of before, from a company called Ventaira:

Pulmonary Drug Delivery Using Mystic Technology
Ventaira’s pulmonary devices, which are based on electrohydrodynamic (EHD) aerosol delivery, enable efficient, safe and consistent delivery of drugs to and through the lungs.

Ventaira inhalation devices utilizing Mystic technology (EHD), deliver a low velocity, soft (isokinetic) cloud of uniformly sized particles with over 80 percent of the drug getting to the lungs. This is accomplished without the need for liquid propellants or other pressurized systems.

The aerosol mist is delivered using the patient’s own breath (inspiration), meaning that the patient can easily control the drug delivery. The delivery mechanism is especially suited for use with young children, seniors, and patients with impaired respiratory function.

Horrible news. All RTs can tell stories about patients on Oxygen who continue to smoke despite the risk and warnings. Here’s an especially tragic story.

Reckless smoker a killer, cops say – 03/21/06 – The Detroit News
Because of his history of reckless smoking, Renwicj has been charged with second-degree murder in connection with the infant’s death, along with involuntary manslaughter and arson of a dwelling, Macomb Prosecutor Eric Smith said.

Renwick remained locked up in the Macomb County Jail on Monday in lieu of $100,000 bond after being charged Friday in 41-B District Court in Clinton Township.

“The reason for the second-degree murder charge is Renwick’s recklessness was extreme,” Smith said. “He was repeatedly warned not to smoke around the oxygen tank. And he had set several fires to his apartment before.”

Investigators interviewed a delivery person who brought oxygen tanks to Renwick’s apartment. “He was smoking a cigarette when the delivery guy came to the door,” said William Cataldo, head of the Macomb Prosecutor’s Homicide Unit. “The delivery person said he wouldn’t deliver the tank unless he put it out, and told him about how dangerous it was.”

This is a horrible, horrible story out of San Diego. It hurts me to even post about it on this blog, but the fact is it’s the story of an RT. This man’s conduct violates just about every code of professional conduct, hospital policy, law, and moral and ethical truth possible. The story makes me sick.

WTOP: Sex Abuse Charges Stun Hospital Staffers
SAN DIEGO (AP) – Camera phones are now banned at the Children’s Hospital and Health Center’s convalescent unit. The curtains around patients must be left open most of the time. And administrators are considering installing security cameras in patients’ rooms.

Bleyle, a 54-year-old respiratory therapist at San Diego’s Children’s Hospital, is charged two counts of molestation and 24 counts of child pornography involving children under his care. He is accused of molesting brain-damaged, comatose boys and girls, taking cell-phone photos of himself in the act, and posting them on the Internet.
The precautions were prompted by one man: Wayne Albert Bleyle, a respiratory therapist accused of molesting brain-damaged, comatose boys and girls, taking cell-phone photos of himself in the act, and posting them on the Internet.

“This is the worst case of child molestation imaginable,” prosecutor Laura Gunn said in court last week. “I don’t know if we’ve ever seen a case like it before where the victims were so vulnerable.”

Bleyle, 54, is in jail on $5 million bail after pleading not guilty to two counts of child molestation and 24 counts of child pornography. But Gunn said Bleyle molested many more patients over the past decade, preying on the hospital’s weakest of the weak, including youngsters who would never be able to speak.

It’s not often one sees news in the media about the difficulty in managing the ventilation of a patient. I love the line about ventilating a brick.

VOA News – Bad Bugs Need New Drugs
An aggressive staph infection called MRSA had eaten a hole in his lungs. Scott Smith says over the next two months the child had six blood transfusions. “His lungs were so bad they couldn’t supply the oxygen his body needed.” Surgeons had to insert five chest tubes in his body due to the hole that was in his lungs. “A respiratory therapist told us his lungs were so hard and infected that it was like trying to pump air into a brick,” says Scott Smith.

Nice story of a successful pulmonary rehab program:

The Advocate – Pulmonary program thrives after 10 years
…Pulmonary Rehabilitation Program, which began 10 years ago under Dr. Paul Sachs, director of pulmonary medicine at Stamford hospital. They celebrated the anniversary of the program to coincide with National Pulmonary Rehabilitation week, March 12-18.

“This program was wonderful,” said Burt, now a great-grandmother. “I still walk every day. I stick to the diet, and I feel wonderful.”

The program draws on specialists in the respiratory, physical therapy, occupational, nutritional and psychological fields, Sachs said. Patients learn to manage all aspects of living with such chronic lung diseases as asthma, bronchitis and emphysema.

“You’re working with the whole body,” said Joan Fowler, 75. “You learn how to accept what’s going on with your body and you realize, ‘I’m not the only one like this.’ “