BMHGT.com — BMHGT Medical Staff Website

Guidelines for the Submission of Tissue Specimens for the Pathologic Evaluation of Influenza Virus Infections Apr 30, 2009
Case Definitions for Investigations of Cases Apr 30, 2009
Screening in Regions with Few or no Reported Cases Apr 29, 2009
Specimen Collection, Processing, and Testing for Suspected Infection Apr 29, 2009
Biosafety Guidelines for Lab Workers May 1, 2009

Treatment Guidance

Antiviral Recommendations Apr 29, 2009
Facemask and Respirator Use Apr 27, 2009
Reducing Risks in the Community Apr 26, 2009
Emergency Use Authorization (EUA) of Medical Products Apr 29, 2009

Travel & Travel Industry Guidance

Flight Crews Arriving from Affected Areas Apr 30, 2009
Identifying Passengers Who May Have Swine Influenza Apr 28, 2009

Emergency Personnel Guidance

EMS and 9-1-1 Personnel: Managing Confirmed or Suspected Infections Apr 29, 2009
Psychological Support for Essential Workers During a Pandemic Apr 30, 2009

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April Interesting Case Conference

by admin on April 21, 2009

April 29th Interesting Case Conference is on peri-operative anticoagulation.

Perioperative Anticoagulation Slides

Aspirin, plavix, and ticlid, oh my, what should my upcoming surgery patient do?

Some links of interest:

Clot Care.com Online Resource

No need to stop taking aspirin in days leading to CABG surgery

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

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Intracranial Neurointerventional Procedures

by admin on April 14, 2009

AHA/ASA information on endovascular intracranial neurointerventional procedures published April 9, 2009 in Circulation.

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Quality Care Dangerous?

by admin on April 10, 2009

The April 8th Wall Street Journal contained an interesting editorial on the utility of “quality metrics” in health care entitled ‘Why Quality Care is Dangerous’.

By JEROME GROOPMAN and PAMELA HARTZBAND

Dr. Groopman, a staff writer for the New Yorker, and Dr. Hartzband are on the staff of Beth Israel Deaconess Medical Center in Boston and on the faculty of Harvard Medical School.

The Obama administration is working with Congress to mandate that all Medicare payments be tied to “quality metrics.” But an analysis of this drive for better health care reveals a fundamental flaw in how quality is defined and metrics applied. In too many cases, the quality measures have been hastily adopted, only to be proven wrong and even potentially dangerous to patients.

Health-policy planners define quality as clinical practice that conforms to consensus guidelines written by experts. The guidelines present specific metrics for physicians to meet, thus “quality metrics.” Since 2003, the federal government has piloted Medicare projects at more than 260 hospitals to reward physicians and institutions that meet quality metrics. The program is called “pay-for-performance.” Many private insurers are following suit with similar incentive programs.

Continue with article on the WSJ site …

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Stroke Information ABCD^2

by admin on March 18, 2009

ABCD^2 (ABCD squared) post TIA stroke risk assessment tool

AGE: greater than or equal to 60 years – 1 point

Blood Pressure when first assessed after TIA. Systolic greater than or equal to 140, diastolic greater than or equal to 90 – 1 point

Clinical Features: unilateral weakness – 2 points, isolated speech disturbance – 1 point, other – zero

Duration of TIA symptoms: greater than or equal to 60 minutes – 2 points, 10 to 59 minutes – 1 point, <10 minutes zero

Diabetes present – 1 point

Estimated two day stroke risks determined by the ABCD^2 score:

Score 6 to 7: High two day stroke risk (8.1%)
Score 4 to 5: Moderate two day stroke risk (4.1%)
Score 0 to 3: Low two day stroke risk (1.0%)
Score < 1: Very low two day stroke risk (0.0%)

Reference: Johnston, SC, et.al. Validation and Refinement of scores to predict very early stroke risk afer TIA. Lancet 2007: 269:283.

BMHGT Stroke Information Page

Early Stroke Management Guidelines AHA/ASA

Stroke Prevention Recommendation Update AHA/ASA

Stroke syndromes, mimics & chameleons

NIH Stroke Scale

TPA for Acute Ischemic Stroke NEJM 1995

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