Think about how we perceive certain shades across marketing, social media, businesses, etc.! We are influenced far more subliminally than we realize.
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Tips on Phlebotomy
I was assigned to report about Phlebotomy in our hospital tomorrow and I just want to share some of the contents of what I will be reporting. These tips may be helpful for you! :)
- The secret to being a good phlebotomist is not to look for the vein, but to feel for it and you fill find it.
- If you are having trouble getting blood, then please suck up your pride and ask someone else. It is okay to have an off day.
- Smile and talk to your patient. If you act confident and calm, you will help your patient feel at ease.
- If you can’t find a suitable vein in the bend of the arm, it’s okay to draw from an alternate site. But remember not to draw from anyone’s foot if they are diabetic.
- One of the preconditions for dealing successfully with difficult patients is an initial analysis of the possible reasons for their behaviour.
- Rotating the patient’s wrist gently in either direction while palpating can move the vein away from a close by tendon or bone, reducing the risk of hitting something other than the intended vein.
- If the patient feels dizzy or faint in the middle of the venipuncture procedure, special precautions should be taken immediately. The procedure should be discontinued at once and the patient should be asked to place the head between the knees. After a brief resting period, the patient should be asked to lie down on the examination table. Chances are, the patient recovers after a period of monitoring and agrees that the procedure will be continued.
- To put an apprehensive patient at ease, tell them that you’re going to count to 3 and that they should take a deep breath at that time. Wait for them to start to take the breath and stick them at the same time. Their mind will be at taking the breath that they won’t be thinking about the stick. Make sure not to hesitate when sticking. The slower you are at inserting the needle, the more it will hurt the patient. Be swift!
- No fist pumping! Having the patient making a fist and holding it for better vein fill as opposed to pumping the fist. Pumping can increase the potassium level.
- Direct pressure is best in reducing formation of a hematoma. Keep your finger on the phlebotomy site after the draw instead of letting the patient do it. Your finger was there first! Tape the cotton ball down tight for added pressure. And don’t let them bend their arm up either.
- Most injections or draws are all in your mind. If you know you can get it, chances are you will! You must do it in your head first. Start by visualizing.
- When drawing on a patient with “rolling veins”, ask them to lay their arm down, but instead of palm up, have them twist their wrist palm down. Great for elderly patients!
From what I’ve found, talking with them and smiling will ease their tensions. Even cracking a joke is marginally effective, since it makes them more comfortable with the person who’s about to stick a needle into their arm.
If you think you’re about to stick a difficult patient, be kind and reciprocate with open body language.
Prognosis for Life
Ad vitam (life) : medical opinion as to whether the disease can lead to death of the individual or not.
- Sanam (healthy)
- Bonam (good)
- Malam (bad)
- Dubia (doubtful)
Dubia ad sanam/bonam (doubtful, tend to good)
Dubia ad malam (doubtful, tend to bad)
Ad functionam (function)
Ad sanationam (healthy)
Dubia ad malam can include the 6 D’s: Death, Disease, Disability, Discomfort, Dissatisfaction, and Distiution
Advancements in Prevention
“AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE.”
– Ben Franklin, “On Protection of Towns from Fire,” The Philadelphia Gazette, February 4, 1735
While Ben Franklin’s famous insight about prevention was advocating for fire safety, it also applies to preventing disease and premature death. Here are some highlights in the advancement of prevention throughout history.
1000: First attempts at smallpox inoculation documented in China and India
1796: First-ever vaccine invented by Edward Jenner — for smallpox.
- Prior to 1796, smallpox caused 7.7% (1 in 13) of all deaths.
- 1980: Smallpox declared eradicated worldwide.
1918–1920: Global Influenza outbreak causes ~50 million deaths.
- 1945: First influenza vaccine licensed in the U.S.
- 2017–18: Flu shot prevents ~6.2 million cases and 5,700 flu-related deaths in U.S.
1952: Jonas Salk invents first effective vaccine for polio, a highly contagious virus that can cause paralysis and kill ~5% of children and ~30% of adults who are infected.
- 1957: Albert Sabin develops vaccine for three types of polio virus.
- 1994: Polio eliminated in the Americas. By 2018, polio is eliminated or interrupted in most of the world. Global cases reduced from 350,000 in 1988 to 29 in 2019.
1971: Measles, mumps, rubella vaccine licensed, inducing 94% to 96% immunity.
- Before the vaccine, measles killed an estimated 2.6 million people each year. In 2018, measles killed 140,000 people globally.
1981: First official reporting in Los Angeles of acquired immunodeficiency syndrome (AIDS).
- 1984: Scientists identify human immunodeficiency virus (HIV) as the cause of AIDS. The U.S. government announces goal of a vaccine within two years.
- 1992: AIDS is No. 1 killer of U.S. men aged 25–44.
- 1997: AIDS deaths decline by 47% from previous year due to a combination of drugs to suppress growth of HIV.
- 2009: Clinical trials of HIV vaccine show modest preventive effect, but not enough for widespread vaccination.– Vaccine development continues due to HIV’s frequent mutations and the challenge of identifying an immune response effective at controlling the virus.
- 2012: U.S. Food and Drug Administration (FDA) approves PrEP (pre-exposure prophylaxis), which reduces risk of contracting HIV if exposed. For the first time, the majority of people eligible for treatment are receiving it (54%).
- 2019: Annual HIV infections have decreased by more than 66% since the 1980s. Approximately 38 million people are infected with HIV globally, including 1.2 million in the U.S.
2006: FDA approves Gardasil, a vaccine that protects against human papillomavirus (HPV). Approximately 14 million Americans contract HPV annually, which can cause several types of cancer.
- HPV causes ~35,000 cancer cases in the U.S. annually. HPV vaccine can prevent more than 90% of these cancers.
- Since the vaccine was deployed, infections causing most HPV-related cancers have dropped 86% in teen girls. Among vaccinated women, cervical precancers caused by HPV have dropped 40%.
- About 35,000 cancer cases linked to HPV develop in the U.S. annually. HPV vaccination can prevent more than 90% of these cancers.
2015: FDA approves an oral treatment for hepatitis C, which cures 90% of cases with few side effects.
- In 2018, the CDC estimated 50,300 people contracted hepatitis C, with 15,713 deaths.
2019-2021: COVID-19, caused by SARS-CoV-2, declared a pandemic. As of December 18, of 51 vaccine candidates in development globally, FDA approved two for emergency use in U.S.
Containing Contagion
“Countries that have contained COVID-19 have deployed multiple tools: vigilant and pervasive testing, contact tracing, isolating those who are sick, quarantining those who have been exposed, physically distancing, wearing masks, increasing hygiene practices such as handwashing and covering coughs and sneezes, avoiding crowded areas—especially indoors—and improving indoor ventilation.
None of these protections is foolproof on its own. But scientific evidence repeatedly shows combining these interventions can be remarkably effective at containing the spread of highly contagious respiratory diseases such as COVID-19.
Scientists call this the “Swiss-cheese model,” where each safeguard is like a slice of Swiss cheese, where the holes represent a weakness in the intervention. When used together consistently, the weaknesses in any single layer of protection can be offset by the strengths of other layers of intervention. And the more interventions are combined, the more successfully contagion can be contained.”
Antibiotic Resistance Is Now Rife across the Globe
Dangerous antibiotic-resistant bacteria and other pathogens have now emerged in every part of the world and threaten to roll back a century of medical advances. That’s the message from the World Health Organization in its first global report on this growing problem, which draws on drug-resistance data in 114 countries.
“A post antibiotic-era—in which common infections and minor injuries can kill—far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century,” wrote Keiji Fukuda, WHO’s assistant director general for Health Security, in an introduction to the report. The crisis is the fruit of several decades of overreliance on the drugs and careless prescribing practices as well as routine use of the medicines in the rearing of livestock, the report noted.
Antibiotic resistance is putting patients in peril in both developing and developed countries, as bacteria responsible for an array of dangerous infections evolve resistance to the drugs that once vanquished them.
Gonorrhea, once well treated by antibiotics, is once again a major public health threat due to the emergence of new, resistant strains. Drugs that were once a last resort treatment for the sexually transmitted disease—which can lead to infertility, blindness and increased odds of HIV transmission if left untreated—are now the first-line treatment and are sometimes ineffective among patients in countries such as the U.K., Canada, Australia, France, Japan, Norway, South Africa, Slovenia and Sweden.
Drugs to treat Klebsiella pneumoniae—a common intestinal bacteria that can cause life-threatening infections in intensive care unit patients and newborns—no longer work in more than half of patients in some countries. And fluoroquinolones, drugs used to treat urinary tract infections, are also ineffective in more than half of sufferers in many parts of the world. Efforts to limit the spread of multidrug-resistant tuberculosis, malaria and HIV are also all under threat due to increasing bacterial resistance.
Although the development of resistance is to be expected over time, overuse of the drugs has accelerated the process by supplying additional selective pressure, noted the report, which was authored by an extensive team of researchers with WHO. And there are few drugs to replace the ones that are now ineffective: The last entirely new class of antibacterial drugs was discovered 27 years ago, according to the report.Read more via scientificamerican.com
Infographic by who.int
Model of vesicle adhesion, rupture and island dynamics during the formation of a supported lipid bilayer (from work by Atzberger et al) featured on the cover of the journal Soft Matter (I love their rubric: “Where physics meets chemistry meets biology for fundamental soft matter research.”)
Photo Credit: Peter Allen
Source: At the Interface of Math and Science (The UCSB Current)
You can never escape that phospholipid bilayer!
