December 31st, 2011 by ChristopherChangMD in Opinion, Research
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I came across this article the other day regarding use of the daVinci robot to perform base of tongue surgery for obstructive sleep apnea.
For those who don’t know, the daVinci robot system made by Intuitive Surgical is a robotic system whereby the surgeon directs the arms of the robot to perform surgery in difficult-to-access areas of the body.
My feeling is that using a robot to perform sleep apnea surgery is way overkill akin to using a $50,000 sniper rifle to kill an ant on the wall.
Everything the daVinci robot can do can also be done without the robot with equivalent patient outcomes. In fact, Read more »
*This blog post was originally published at Fauquier ENT Blog*
December 22nd, 2011 by RyanDuBosar in Health Tips, Research
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Health care facilities should take five steps to ensure staff aren’t becoming sleep fatigued, according to a Sentinel Event Alert from The Joint Commission.
Shift length and work schedules impact job performance, and in health care, that means patient safety, the alert stated. A study of 393 nurses over more than 5,300 shifts showed that nurses who work shifts of 12.5 hours or longer are three times more likely to make an error in patient care.
Furthermore, residents who work traditional schedules with recurrent 24-hour shifts:
–make 36 percent more serious preventable adverse events than individuals who work fewer than 16 consecutive hours,
–make five times as many serious diagnostic errors,
–have twice as many Read more »
*This blog post was originally published at ACP Hospitalist*
December 14th, 2011 by AmyGivlerMD in Health Tips
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Many of my patients, over the years, have taken melatonin. Many other patients have asked me about it, but I’ve never had much to say. I hadn’t heard anything particularly bad about it, but couldn’t really recommend it. “Research melatonin” has been on my “To Do” list for a long time.
So here’s what I’ve discovered: Melatonin is a hormone. I’ve known that since medical school, of course, but that fact has struck me as peculiar these past few weeks. Why? Because it’s sold over the counter, and many people take massive amounts of it. No other hormone is available like this. The use of other hormones, such as insulin and thyroid hormone, need careful monitoring. Is melatonin so universally safe that it can be taken at any dose, for however long? The more we learn about melatonin, the less that seems to be the case. Read more »
*This blog post was originally published at Making Sense of Medicine*
November 19th, 2011 by ChristopherChangMD in Video
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Our office has produced a new video describing “where” snoring comes from determined by a simple procedure known as sedated or sleep endoscopy. At its most basic definition, snoring is noise produced from a vibrating mucosal surface in the upper airway.
Though snoring can be defined simply, the tough question is WHERE are these vibrating mucosal surfaces? Because unless one can define WHERE the snoring is coming from, successful treatment can’t be pursued definitively.
An office exam performed while a patient is awake is suboptimal as the patient is awake… and not snoring. As such, it is an educated guess where the snoring problem is stemming from.
To this end, Read more »
*This blog post was originally published at Fauquier ENT Blog*
August 19th, 2011 by MotherJonesRN in Research, True Stories
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I wonder how many cups of coffee an average night nurse consumes during their shift. Look, there’s someone we can ask, although it looks like her caffeine buzz is wearing off. Notice the telltale chin to chest head tip that gives sleep deprived nurses away. She may look like she’s charting, but she really is in a twilight sleep.
Working nights isn’t for wimps. Neither is working holidays and weekends. You are always short of help, and BIG things seem to go wrong just as the day shift staff heads out the door. I always thought that I was just paranoid about working the off shifts, but Muhammad Saleem from
RN Central sent me some information that validated my observations. I’ve posted their research results below. I’ve lived through a lot of these situations. I’ve seen seasoned nurses nod off at the desk at 3AM because they’ve been working their butts off, and I’ve worked with doctors who don’t answer pages promptly during evening hours and on weekends even though they are on call. I’ve also worked with new residences who are unable to write coherent orders until the third week of their rotation. Sometimes I’ve wondered why more things don’t go wrong in a hospital.
I think their information looks accurate. What do you think? Read more »
*This blog post was originally published at Nurse Ratched's Place*
