Browse Primary Care/Hospitalist Articles by Topic

The New Guidelines Put C. difficile on the Run

SYNOPSIS: Patients have decreased disease recurrence and mortality when physicians follow the IDSA/Society for Healthcare Epidemiology of America guidelines for the treatment of C difficile infection.

Nasal High-Flow Oxygen Lowers Reintubation Rate

SYNOPSIS: Use of nasal high-flow oxygen was associated with better comfort, fewer desaturations and interface displacements, and a lower reintubation rate.

Can We Reduce Unnecessary Head CT Scans in Patients with Delirium?

This study was a retrospective review of medical records of hospitalized general medicine patients with head CT imaging performed for the evaluation of delirium.

Health Care Utilization in the Aftermath of Severe Sepsis

SYNOPSIS: This observational cohort study of survivors of severe sepsis found that the post-discharge needs of this population are substantial. Severe sepsis survivors spent more days admitted to facilities after their acute hospitalization than prior and had greater mortality, a steeper decline in days at home, and a greater increase in proportion of days alive in a facility compared to survivors of non-sepsis hospitalizations.

Peri-procedural Management of New Oral Anticoagulants

Due to the short half-life and rapid onset of action of the new oral anticoagulants (NOACs), peri-procedural anticoagulant free time intervals should be shorter than with warfarin. Thus, there is uncertainty about the use of heparin bridging. These investigators from Germany analyzed the Dresden NOAC registry data to assess peri-procedural NOAC management and safety until 30 days post-procedure.

End-of-Life and Futile Medical Care in the Emergency Department

The purpose of this article is to review the complicated issues of end-of-life and futile medical care as applicable to the emergency department (ED). It will address sources of conflict and confusion, and will conclude with a practical discussion of how emergency physicians can best navigate these complex waters by practical case review.

Lack of pediatric care makes bad situation worse

When Katie Westbrook was 14 years old, she and her mother, Beth Westbrook, made a monumental decision together. Katie, who had been battling osteosarcoma since she was 12, had already endured several rounds of chemotherapy, surgery to remove a tumor in her lower back, a leg amputation, and an inoperable tumor in her neck. She decided she was ready for hospice.

Lawsuits over withholding support are called myths

Health care providers are understandably concerned about the legal climate in which they live, observes Marshall B. Kapp, JD, MPH, professor in the department of community health at Wright State University School of Medicine in Dayton, OH.

Report card gives states low grades in providing end-of-life care

A state-by-state report card on hospice services shows most states are doing a poor job of caring for the dying. According to the report, patients are spending less time in hospice care than they did in the early 1980s when the movement first started in the United States.

How some states fared: Lousy to above average

Even states that ranked high in hospice use earned low grades overall on a national report card prepared by the Last Acts organization in Washington, DC.