Thursday, August 7, 2014

Charlotte's Presbyterian hospital now treatment choice for trauma

Since Aug. 1, Carolinas Medical Center is no longer Mecklenburg County’s only trauma center.

Paramedics can now transport victims of gunshot wounds and other serious accidents to Novant Health Presbyterian Medical Center.

The Hawthorne Lane hospital received approval in June as a “practicing Level II trauma center” from the North Carolina Office of Emergency Medical Services. To qualify for the full designation, Presbyterian must care for 1,200 trauma patients in the next year. During that time, the state agency will evaluate Presbyterian’s physician response times and patient outcomes.

Carolinas Medical Center remains the county’s only Level I, or highest level, trauma center where Medic, the county’s emergency medical service, takes the most serious trauma victims. CMC has had that designation since 1990.

Three other area hospitals – CMC-NorthEast in Concord, Cleveland Regional Medical Center in Shelby, and CaroMont Regional Medical Center in Gastonia – are Level III trauma centers, which can treat less seriously injured patients.

Before 2013, Presbyterian had been treating some trauma patients transported by Medic, said Phil Angelo, Novant’s regional trauma program manager. But a change in state regulations that year prohibited Medic from taking trauma patients to any hospital without an official trauma center designation.

Now, when Medic staff ask patients where they want to be transported, patients can choose between CMC and Presbyterian. If the patient makes no choice, Medic will transport patients to the nearest center.

“We’ve shown that we can take care of those patients,” Angelo said. “This (designation) allows our patients who want to come to our facility to come here.”


Medic will continue to transport some patients to CMC automatically because of the seriousness of their injuries. They include patients with head injuries, extreme burns or amputations. CMC will also receive any pediatric trauma patients.

Thursday, July 31, 2014

Teens ban on tanning goes nowhere

In the same week the U.S. Surgeon General called for immediate action to reduce the rate of skin cancer, the North Carolina General Assembly failed to act on a bill that would have banned the use of tanning beds by teens.

The Youth Skin Cancer Protection was OK'd by the North Carolina House of Representative last year by a vote of 94-22, and dermatologists across the state had hoped the Senate would follow suit.

"It's a sad irony that we received the news about North Carolina tanning bed bill the same week as the U.S. Surgeon General issued a national call to action on skin cancer," said Dr. Brent Mizelle, president of the North Carolina Dermatology Association. "We are disappointed that North Carolina teens will not be among those who enjoy this protection."

Eleven states have prohibited minors from using tanning beds.

Similar legislation has been opposed by the American Suntanning Association, a group of tanning salon owners whose website says they are "dedicated to taking immediate action to correct misconceptions about sunbed salons in the press, the medical community and in state and federal government bodies." 

Earlier this week, acting Surgeon General Dr. Boris Lushniak said no previous surgeon general has ever said "UV radiation is bad for you; protect your skin."

"We have to change the social norms about tanning," he said. "Tanned skin is damaged skin, and we need to shatter the myth that tanned skin is a sign of health."

The report was released just two months after the Food and Drug Administration said it would require manufacturers to put warnings on tanning beds, cautioning against their use by anyone under the age of 18. 


Skin cancer is on the rise, according to the American Cancer Society, with more cases diagnosed annually than breast, prostate, lung and colon cancer cases combined.

Nearly 5 million people are diagnosed and treated for skin cancer each year. From 1973 to 2011, the rate of melanoma, the deadliest form of skin cancer, increased more than 200 percent, according to the Department of Health and Human Services.



Monday, July 28, 2014

Will fist bumps replace handshakes in the hospital?


In June, the well-respected Journal of the American Medical Association published an article that proposed "Banning the Handshake From the Health Care Setting."

Given the problem with hand hygiene and transmission of infections in hospitals, this isn't as far-fetched as it sounds.

But I bet the authors of the JAMA article didn't realize that another study, to be published in August in the American Journal of Infection Control, would take their proposal to the next level.

The newer piece concludes that “fist bumping” -- the gesture made popular by President Barack Obama and First Lady Michelle Obama during the 2012 election campaign -- transmits significantly fewer bacteria than a handshake or a high-five.

Researchers from the Institute of Biological, Environmental, and Rural Sciences at Aberystwyth University in Wales found nearly twice as many bacteria were transferred during a handshake compared to a high-five, and significantly fewer bacteria were transferred during a fist bump than a high-five.

“Adoption of the fist bump as a greeting could substantially reduce the transmission of infectious diseases between individuals,” said author David Whitworth. “It is unlikely that a no-contact greeting could supplant the handshake; however, for the sake of improving public health we encourage further adoption of the fist bump as a simple, free, and more hygienic alternative to the handshake.”

I won't hold my breath until this change of habit takes place. But any reminder that we should be more careful about transmitting germs in the hospital is welcome.

The hands of health-care providers frequently spread potentially harmful germs to patients, leading to "health-care associated infections," among the leading causes of preventable harm and death in the United States. 

Monday, June 23, 2014

Charlotte doctor offers alternative to PediaSure

Charlotte pediatrician Sheila Kilbane has a keen interest in good nutrition and helping children who have developed allergies or aversions to particular foods.

Kilbane
As an integrative medicine practitioner, trained by Dr. Andrew Weil at the Univesity of Arizona, Kilbane was asked by "100 Days of Real Food" to write a recipe for a natural alternative to PediaSure, advertised as a "nutritional drink for children."

Her report, including a recipe for Dr. Kilbane's Liquid Vitality, starts by describing her own experience with Pediasure. On a road trip years ago, she stopped at a gas station and bought a bottle of PediaSure instead of indulging in chips or candy bars. She began drinking as she finished pumping my gas, and she described what happened next as a "scene from a Jim Carrey movie."

She gagged and nearly spit the contents all over her car. THEN she read the ingredient list. After water and sugar, the list was rife with items such as short-chain fructooligosaccharides, carrageenan, calcium pantothenate, phylloquinone and cyanocobalamin.

She realized she should have followed the advice she has given parents for years: “If you can’t pronounce the product ingredients, put it back on the shelf.”



Friday, June 13, 2014

Chikungunya virus strikes North Carolina resident

North Carolina’s first case of chikungunya, a viral infection that can be transmitted to humans by infected mosquitos, was confirmed in a resident who recently traveled to the Caribbean.

The virus has been spreading rapidly through the Caribbean, but for now, no cases of the disease are known to have been acquired in North Carolina or in the continental United States.

Still, state health officials say the Asian Tiger mosquito that is commonly found in North Carolina could effectively transmit this virus.

Prior to its introduction in the Caribbean, chikungunya was established in East Africa, India, the Indian Ocean and the Western Pacific regions. It was introduced in the Caribbean in 2013 through travelers returning from affected areas. As of June 6, chikungunya has caused illness in over 130,000 persons in the Caribbean, state health officials said.

Symptoms of chikungunya usually begin three to seven days after being bitten by an infected mosquito. They typically include sudden onset of fever and severe, often disabling, joint pains in the hands and feet. Many patients feel better within a week, but joint pain may persist for months in some people. Newborns exposed during delivery, adults over 65 years and people with chronic medical conditions have a greater risk for a severe form of the disease.

State health officials advise people traveling to countries where chikungunya transmission is occurring to take precautions to prevent mosquito bites and immediately consult a doctor if they develop fever in the two weeks after their return.

“With North Carolina residents traveling to and from the Caribbean and other affected areas, we have been monitoring for possible imported cases,” said Dr. Megan Davies, state epidemiologist for the Department of Health and Human Services. “Travelers who visit countries where chikungunya is widespread should take extra precaution against mosquito bites.”

Precautions include wearing light-colored long pants and long-sleeved shirts, reducing time outdoors during early morning and early evening hours when mosquitoes are most active, and applying mosquito repellents such as DEET, picardin, oil of lemon eucalyptus or IR3535 to exposed skin areas.

Also, residents should take steps to decrease possible breeding grounds for the Asian Tiger mosquito. That means removing containers that hold water, changing water in bird baths and pet bowls, keeping gutters in good repair, using screens for doors and windows.





Tuesday, April 29, 2014

See how Charlotte hospitals rated in safety survey

Charlotte's two major hospitals did not make the "A" list Tuesday when the nonprofit Leapfrog Group issued its annual safety scores.

The scores are developed from a survey based on 28 safety measures such as hand hygiene, antibiotic selection and catheter removal.

Carolinas Medical Center got a B, and Novant Health Presbyterian Medical Center got a C.

Charlotte-area hospitals that received "A" grades were: Carolinas Medical Center-University and CMC-Mercy in Charlotte, CMC-Pineville, CMC-Union in Monroe, Cleveland Regional Medical Center in Shelby, Kings Mountain Hospital, Stanly Regional Medical Center in Albemarle. Both Piedmont Medical Center in Rock Hill, and Springs Memorial Hospital in Lancaster also got A grades.

Other "B" grades went to: CMC-NorthEast in Concord, CaroMont Regional Medical Center in Gastonia, Iredell Memorial Hospital in Statesville, Novant Health Huntersville Medical Center, Novant Health Matthews Medical Center, Novant Health Rowan Medical Center in Salisbury.

Other "C" grades went to: CMC-Lincoln in Lincolnton, and Lake Norman Regional Medical Center in Mooresville.

The Leapfrog group's survey is intended to address the more than 180,000 deaths and accidents from hospital errors and injuries that occur each year. Scores are based on federal data from the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services as well as an annual survey by the American Hospital Association.

Nationwide, 32 percent of hospitals got A grades, 26 percent got B’s and 35 percent got C’s. Six percent got Ds and less than 1 percent got an F.

Tom Zweng takes over as Novant Health's chief medical officer



Dr. Tom Zweng, a longtime Charlotte surgeon, has assumed the role of chief medical officer for Novant Health, replacing Dr. Stephen Wallenhaupt, who moved to a part-time role after seven years as chief medical officer and more than 20 years with Novant.

Zweng

Wallenhaupt

Zweng, 58, served as senior vice president of medical affairs for Novant Health’s Greater Charlotte market for the past seven years. A graduate of the University of California at Davis and UCLA medical school, did his surgery residency at the University of Michigan.

From 1990 to 1995, he was assistant professor of surgery at University of Kentucky Medical School where he developed the laparoscopic program for general surgery. He then moved to Charlotte, where he practiced with Surgical Specialists of Charlotte for 11 years and also served as chief of general surgery for Novant Health Presbyterian Medical Center.

Wallenhaupt, 62, will focus his efforts on roll-out of electronic medical records across the hospital system.

Winston-Salem-based Novant operates four hospitals in Mecklenburg County -- Presbyterian Medical Center, Charlotte Orthopaedic Hospital,  Huntersville Medical Center and Matthews Medical Center.