Interesting Health NEWS today

Whenever I read the paper (and if I have a pen to hand) I tend to highlight interesting quotes and healthcare related stories. Here is everything in the news today I found reading various papers. 

Facts on asthma
Asthma costs the UK 1.1 billion pounds a year.
It causes three deaths a day while more than 270 people are admitted to hospital a day because of it.
The UK has one of the highest Asthma burdens in the world, >18million people.
SMART INHALERS (for example) will be hugely benficial in the future keeping track of patient adherence and reminding patients to take their medicine, reducing exacerbations.

We need a new health tax?
Various GP surgeries, A&E departments and Units are being closed around the country to avoid a predicted 20 billion pound shortfall in 2020. Dr Dan Poulter MP reckons a new health tax or rise in national insurance could relieve the pressure on NHS budget.

Readmissions mean higher death rates?
A study presented at European society of Cardiology in Rome over the weekend compared patients being admitted 1 to 3 times to those being admitted 4 to 7 times over the study period (500,000 patients in the study). The results showed those who were admitted more (4-7 times) had almost 20% increased risk of dying.
Advice was to make sure patients were taking the correct medication after discharge and diagnosed properly. (duh?)

Ipad vs Midazolam
Results presented at the World Congress for Anaesthesia in Hong Kong showed that tablet devices with 'age appropriate games' are at least as effective than midazolam in in dropping anziety levels prior to paediatric surgery.
The Ipad group had higher parental satisfaction and nursing staff satisfaction rates than the midazolam group. Dr Chassard involved in the study quoted by the Independant "electronic devices are a non-pharmacological tool that can reduce stress around the time of the operation without any of the side effects of sedatives".

101 year old transplanted kidney
We dont know why but some transplanted kidneys are able to resist rejection. While on average most are rejected after 12-15 years. Sue Westhead (68yrs) has the worlds oldest which she received in 1973 from her 57yr mother.
3000 people are on the transplant waiting list.
58,000 are effected by kidney failure, mainly caused by diabetes and high blood pressure.
No one really understands why chronic rejection occurs, is it poor lifestyle choices?
2000 transplants a year are from deceased donors and 1000 from living donors

Sources: The Metro, London evening standard, the independant, i newspaper. 

The Play that Goes Wrong performing at The Royal Variety Performance

A taster of what I mentioned in the last post, the play is in fact funnier.

End of the summer, The play that goes wrong!

So tomorrow I'll be hopping on the plane back to Italy to start and hopefully finish my final year of med school. It's been a long road and after receiving this wonderful email just a few days ago I am excited for a future in the NHS and as a Doctor.

So the hopefully if I'm not to busy on the wards and in the library I will be regularly posting on my blog some hopefully interesting and educational stuff this year. My email is isntthtpleasant@gmail.com and I'm keen for any ideas or questions about the blog, also if anyone wants a free tour around Milan, just drop me a line.

On another note, I saw this play in London over the holidays and it is incredible!
http://www.theplaythatgoeswrong.com/london
It's a simple comedy all based around a play about a murder that all goes wrong and its absolutely hilarious, I was laughing from start to finish and it suitable for all ages (I took my summer school kids there).

CPR It's easy actually

So continuing on from my last post on first aid although slightly on a tangent, I just want to drop some points on CPR (cardiopulmonary resuscitation). Its actually easy and could well help YOU save a life one day.
Vinnie Jones gives a breakdown in the video above;

Call an ambulance!*
120 compressions a minute (to the tune of 'staying alive' by 'the beegees')
If you are out on your own without a ventilator, no breaths
Compress the sternum (the bony middle of the chest)
About 5cm deep or 2inches
Two hands with arms straight and locked, use your back
Allow chest to fully recoil after each compression
Dont stop until the ambulance arrives

*(and get someone if available to find a public defibrillator and follow the instructions on the case)

Charlie chaplins 'The Dictator' speech is really moving and still applies today

First Aid Saves lives! part one Airways

Just got back from a mandatory first aid course at work, being a medical student and having done first aid courses before, it was easy to think I already knew it all. I was surprised at how much I learnt from the experience. 
The first thing I learnt was some shocking statistics;

• Two thirds of people in the British public couldn't save a life in the event of an emergency.
• over a quarter of people who said they knew first aid would of done the wrong thing in an emergency (for example if someone was choking they would put their fingers in the persons throat to relieve the obstruction (pushing the obstruction further down))
• In the UK, less than one in ten will survive a heart attack while in Norway over 25% will, most likely due to the fact most people in Norway are able to perform CPR (First aid training being mandatory in Norwegian schools). 

I'll try an give a concise summary here about what was covered. also big thanks to Actual First Aid for the excellently run course. 

When approaching an emergency or an unconscious individual the mnemonic to use is:

DR ABC

D is for Danger. 

First, make sure its safe to approach, we dont want to generate another casualty for the ambulance to deal with. A classic example would be a car crash situation and oncoming traffic, a second crash?

R is for Response

You need to determine if the casualty is conscious, check this by asking a simple question."are you ok", perhaps they cannot respond verbally, so ask "can you open your eyes". if there is no response, you should call for help and contact the emergency services and move onto ABC. 

A is for Airway

The tongue is an incredible muscle, unlike the muscles in your arms and legs, the tongue is only attached at one point. The picture below highlights the tongue (purple) and its singular attachment at the bottom of the mouth in a cadaver. When someone loses consciousness the tongue relaxes completely and falls back slightly covering up the airway (not the thin route to the airway in the cadaver).(By the way its impossible to swallow your tongue, just try it).

The airway can be opened by gently tilting the head back by applying pressure to the forehead with your hand. HOWEVER, its possible in many situations that the casualty may have sustained a spinal or cervical spinal neck injury. In this case movements of the head and neck are to be avoided if there is any suspicion of neck injury. So how do you open the airway?
The best way to open the airway in this case would be by dislocating the jaw and bringing the jaw forward the so called 'jaw thrust' maneuver.
This is performed by placing three fingers behind the angle of the jaw close to the ear and with your thumbs applying pressure to the cheek bones below the eye, you pull the jaw forward and out so that the head doesn't move. (the movement of the jaw, pulls the attached tongue forward as well, allowing air to pass).

B is for Breathing
not breathing? you should consider CPR see part two...

C is for Circulation
no pulse? you should consider CPR see part two...