Critical Care Medicine
- Sepsis is common and it is one of the top killers in U.S. hospitals and worldwide.
- Since the definitions of sepsis and septic shock were last revised in 2001, considerable insights have been made into the pathobiology, management, and epidemiology of the syndromes.
- These important advances created sufficient need for reexamination of all related guidelines.
- The new paradigm excludes the of tachycardia, tachypnea, hyperthermia or hypothermia, and elevated white blood count sepsis diagnosis.
- Kits to be sold without prescription at all pharmacies in Ohio.
- Ohio-based CVS pharmacies join those in Arkansas, California, Massachusetts, Minnesota, Mississippi, Montana, New Jersey, North Dakota, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, and Wisconsin in dispensing naloxone kits without a prescription.
- Rates of opioid-related overdose deaths increased 14% from 2013 to 2014, according to the Centers for Disease Control and Prevention (CDC) statistics.
- During 2014, 47,055 drug overdose deaths occurred in the United States, representing an increase of 6.5% over the previous year, according to CDC statistics.
- A wide variety of non-pharmacologic programs have been shown effective for controlling hospital acquired infections.
- Infections are typically spread to and from hospital personnel, patients, and visitors.
- Nosocomial infections kill between 90,000 and 100,000 patients per year.
- Cost of each case infection has been estimated at between $15,000 and $25,000.
- Handwashing remains the most effective way to reduce incidence of nosocomial infections.
- Urinary-catheter associated infections remain the single most common type of nosocomial infection.
- Transmission occurs by direct contact, via common vehicles (examination tables, instruments, etc.), and by airborne, droplet, and vector-borne mechanisms.
- At around $70 per kit, this may be the most cost-effective life-saving intervention available to physicians.
- The opioid epidemic is arguably the most significant current public health emergency in the U.S.
- Depending on geography, the cost of an overdose survival is ~$10,000.
- The average cost of an overdose-related death at the MetroHealth System in Cleveland, Ohio, is approximately $3000.
- Naloxone kit distribution programs can be run at a cost of <$1000/life saved.
- About 25% to 30% of ischemic strokes occur during sleep.
- Tissue-plasminogen activator is the only specific stroke treatment proven effective in large randomized trials.
- Without knowledge of exact time of symptom onset, this large group of patients is excluded from treatment with tissue-plasminogen activator.
- Clinical and imaging studies suggest that many wake-up strokes occur close to awakening and these patients might be within the approved time-window for thrombolysis upon arrival at the ED.
