Posts by Danielle Scheurer

Risk of methemoglobinemia with topical anesthetic

This large retrospective cohort found the overall risk of methemoglobinemia associated with topical anesthetic was low (0.035%) and was most common in hospitalized patients with benzocaine-based anesthetics. Hospitalists should be aware of this risk in hospitalized patients undergoing procedures (abstract).

Failure of advanced care planning

This multicenter study from Canada interviewed hospitalized elderly patients (and their families) at the end of life, about their end of life wishes; they found ~75% had thought about end of life care, ~50% had completed an advanced care plan, and ~75% had named a surrogate for decision making. Only ~30% of patients had concordance between their stated wishes and what was documented in the medical record. There is ongoing lack of communication of wishes between end of life patients and their care providers (abstract)

Steroids may increase VTE risk

This large population based cohort found current use of steroids increased the risk of VTE by a factor of 2-3, depending on the timing and dosage. Steroids should be factored in when determining VTE risk (abstract).

Mortality rates higher at critical access hospitals

The large retrospective cohort of Medicare patients admitted with AMI, CHF, or PNA found those admitted to critical access hospitals (CAHs) had similar mortality to non-critical access hospitals in 2002, but from 2002 to 2010, mortality rates increased by 0.1% per year at CAHs and decreased by 0.2% per year at non-critical access hospitals (abstract).

Evaluation tool for handoffs

This multicenter study tested an evaluation tool for handoffs, which consisted of 6 subdomains and an overall assessment. There was good internal validity, but peers consistently rated the handoff higher than did external evaluators. This handoff evaluation tool can best be used by external evaluators to rate the quality of handoffs (abstract).