Subaqua Sternal Rubs

In a new advance in telemedicine, robotic doctors are starting to make rounds in a London hospital:

A London hospital has two new members of staff — two robotic "doctors" that can carry out ward rounds in place of human physicians.

The robots will be trialed in a general surgery ward and the accident and emergency department at St Mary's Hospital. They will also be used for surgical training for junior doctors at London's Imperial College.

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In a followup to a past post, an interesting new study is out testing a vaccine against nicotine. Though the initial study data doesn't show the greatest efficacy, it is an interesting concept. Vaccination against smoking, who whuda thunk. Far out.

An experimental vaccine against nicotine helped smokers kick the habit, Swiss researchers reported on Saturday.

Larger tests are needed but the test of heavy smokers suggested that 40 percent were able to quit smoking for nearly six months after receiving the vaccine, the researchers said.

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Cool, looks like a win-win situation for everybody. Mother doesn't miss work, kid is treated appropriately, and the Emergency Department has one less "sub-acute" patient.

ROCHESTER, New York (AP) — Marilyn Gonzalez worried that her 2-year-old was coming down with an ear infection. Rather than miss work for a doctor visit, the 25-year-old single mother of two dropped her daughter off as usual at the day care and went to work.

Little Jaeda was examined soon afterward by a University of Rochester pediatrician and given antibiotics. Using telemedicine tools wielded by a day care staffer, the diagnosis was done through the Internet.

Though there were some technical problems, sickness-related child absences dropped on average by 63 percent at the pilot centers. They serve about 950 children of mostly low-income families with little or no health insurance, according to a study published this week in the journal Pediatrics.

In addition, it said, 92 percent of parents said the hassle-free option allowed them to stay at work when they otherwise would have taken their children to a family doctor or an emergency room.

Source: CNN.com

Harmful bacteria can survive as long as 24 hours on computer keyboards, a study released Monday showed, highlighting what could be a growing threat as hospitals increase investment in technology.

The study carried out at Northwestern Memorial Hospital in Chicago found that keyboards can contaminate the fingers, bare or gloved, of a nurse or doctor, who could then transfer bacteria to patients.

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Yes, that's what I am doing - practicing my manual dexterity skills Maybe soon video gaming will be a new class in medical school? Definitely more useful than some of this stuff

THE running joke that playfully follows Dr. James Clarence Rosser Jr. when he prepares to operate at Beth Israel Medical Center in New York is that this ebullient man possesses hands too large to perform traditional surgery.

Instead, Dr. Rosser prefers laparoscopic surgery, a technique that relies on an ultra-small video camera to help him manipulate long, slender instruments inserted into patients through small incisions. It is, he said recently, as his hulking 6-foot-4 frame loomed over a surgical simulator using instruments he designed, an elegantly efficient approach to repairing the human body.

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Those now-ubiqitous camera phones are actually useful for something… Though I can't see this spreading beyond dermatology. (No pun intended.) Imagine a patient gets into a car accident, snaps a photo with his camera phone, sends it to the ED, and gets back a diagnosis: "Yup, you've got a tree impaling your chest."

Dialing for a diagnosis, doctors in Switzerland say cell phone photos of leg ulcers usually provide enough information to assess and treat most patients, saving those patients the trouble and cost of transport to the clinic.

"We were able to show for the first time that telemedicine for chronic wounds is feasible under routine conditions using this new generation of mobile telephones and direct transfer via e-mail," the researchers report in the February issue of Archives of Dermatology.

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We need one of these installed at Triage… With all the BS chest pains that we get, it would certainly help in weeding them out

What if doctors had a new way to diagnose heart disease that took only seconds and provided pictures so clear it showed every clogged artery, so detailed that it was like holding a living heart in your hand?

In fact, that new way exists and is coming into use in scattered areas of the country, and there is wide agreement that it will revolutionize cardiology.

The scans can largely replace diagnostic angiograms, the expensive, onerous way of looking for blockages in arteries, and can make diagnosis so easy that doctors would not hesitate to use them. They are expected to cost about $700, compared with about $4,000 for an angiogram.

Moreover, the scans take seconds to conduct and require no recuperation time; angiograms take nearly an hour and patients must stay in the hospital for a day. The new scans can see not just the outline of blood vessels but every detail inside and out.

Read more at the New York Times

CHRISTCHURCH, New Zealand (CNN) — Imagine a computer program so clever, it senses the level of pain a patient is in and measures the exact amount of pain relief and sedative drugs they need.

A team of New Zealand engineers and medical experts is working on a device that will be able to do just that.

They hope their development will eventually be available for commercial use, potentially saving hospitals throughout the world billions of dollars in wasted drugs. It will also help speed up patient recovery.

The project began two years ago when University of Canterbury student Andrew Rudge, 25, began searching for a subject for his PhD in mechanical engineering.

His lecturer, Dr Geoff Case, had earlier met with Dr Geoff Shaw, an intensive care specialist at Christchurch Hospital, who had told him about the inherent problems in managing critically ill patients' sedative and pain relief drug dosages.

Shaw told Case that current methods of assessing pain and agitation in patients were very subjective and often resulted in over-sedation.

The two main consequences of this were extended stays in intensive care units and increased drug use — both of which were costly.

Rudge, along with a group of other students, set to work on seeing if automatic detection would be possible, using complex mathematic formulas.

Once he established the science behind the idea was possible, he built a prototype, which involved a sensor that detects what level of agitation a patient is experiencing, using a digital video camera.

His research group is currently perfecting the sensor and the science that measures the amount of drugs that should be administered.

Read more at CNN.com

Not only would this device save money by reducing the amount of wasted medication, but it would hopefully solve the medical establishment's problem of creating narcotic junkies out of people that become addicted to the pain medication as a result of over-dosing. Maybe drug-seekers would think twice of calling an emergency ambulance at 2 in the morning to give them a taxi ride to the Emergency Department for their "hit," if this computer determined that they were in no more acute pain than me after lifting and carrying them, and thus denied them their narcotic fix. One can only hope.

From the Florida Times-Union:

Some doctors will be making house calls — online — under a new program from Blue Cross and Blue Shield of Florida. The Jacksonville-based health insurer is launching the first program in the state to reimburse physicians for online medical consultations.
Patients will be able to confer with doctors on non-urgent matters, receive lab results, request prescription refills, schedule appointments and request referrals.

Under the Blue Cross program, patients and physicians must have an existing relationship and both agree to communicate online. To access their physician, a patient logs in and is prompted to answer a series of questions or fill in the blank about their current health, medications, symptoms and other concerns. The doctor must respond within eight to 12 hours in order to be paid. Patients pay for the online consultation as they would for a standard office visit under their plan.

Personally, I love electronic communication, and think it's great. (Note weblog). Emailing results to patients, appointment reminders and the like definately make things easier and more streamlined. But patient logs in and is prompted to answer a series of questions or fill in the blank about their current health, medications, symptoms and other concerns??? I mean for this, you really don't need the doctor at all. You could just write a program where the patient inputs their symptoms and the computer spits out a diagnosis and recommended treatment. Is that where we are going with this? Not that I am worried about job security, as I doubt, at least in my lifetime, that you could ever run a code with a mouse (EM), or repair intrabdominal bleeding due to a GSW (Trauma — and yes, they have robots doing surgery now, but there is still a physician somewhere in the world controlling that robot.) I just think that patients still prefer the human touch of someone actually caring for them, which is something no computer could ever do. And no matter how well programmed, I don't think it could match a clinician's good medical judgement. Not to mention the lack of a physical exam. I know that in the US there is less and less emphasis placed on good physical diagnosis skills with the increasing reliance on technology, but not to have an exam at all?

What do you all think? Is such an online program acceptable for routine matters, such as medication refills, or would you be satisfied using it to explain your symptoms and obtain a diagnosis transmitted to you on your computer screen?

KANSAS CITY, Missouri (AP) — At St. Luke's Hospital, each of the 14 new neurology intensive care rooms has a feature that's becoming standard in the health care industry: a patient lift system that can handle 600 pounds.

Hospital officials had the equipment installed out of safety concerns — it can take five or six nurses to lift extremely overweight patients, said Jennifer Ball, a patient care director with St. Luke's.

"I think we're seeing more (obese patients) and people are more conscientious about it," she said.

Severely overweight people tend to have more health problems and they often can't fit in standard beds or wheelchairs built for 300-pound people. The $3 billion market for hospital beds, wheelchairs and other equipment designed for plus-size patients is rapidly growing as more Americans become obese.

The government estimates about two-thirds of Americans are overweight or obese; 31 percent fall into the obese category.

Kinetic Concepts Inc. of San Antonio said its line of specialty hospital beds and mattresses, including those for obese patients, took in $282 million last year, a 6 percent increase from the year before.

More on CNN.com

However, it doesn't help it EMS can't get them out of the house. For the second time this month, a story about a 600-lb gentleman who called 911 due to difficulty breathing, and ended up dying because it took 2-hours to get him out of his bedroom. (Interesting side note, story is out of CT, but they show a MAST Ambulance, which is out of Kansas City, KS.) Firefighters ended up cutting out the bedroom window and lowering him down a ladder on his front door as a makeshift, as the standard ambulance stretcher wouldn't hold him. As sad as this is, it points to a growing problem is this country, that is just growing out of control. Medical services are trying to cope, but obviously ther is still work to be done. They are making ambulances now that have cranes on the back of them to lift obese patients in, as well as "oversize" stretchers. However, few EMS agencies have them. If the obesity epidemic continues, what's next? Are we going to start taking patients to the hospital in the back of dump trucks? How about a few less Big Mac's? And before you go off on me that it's all hereditary, last summer I was called to the home of a 600+ lb gentleman in cardiac arrest, with not less than 20 Burger King bags strewn on the floor all around him. What does that tell you?