Congestive Heart Failure: Bring on the Leeches?

Wikimedia photo.

The April edition of Right on Prime covers everything you need to know about congestive heart failure from the definition to palliative care, including advice on therapeutic phlebotomy. No matter where you practice you will find breath-taking take home points. Take a listen or read: The Generalist: Acute and End Stage CHF in the ED by Vanessa Cardy MD, Mel Herbert MD, and Heidi James MD in the April edition of Right on Prime available to all CMES participants using either the CMES thumb drive or Pi.

Leech application tubes and blood letting tool, probably from 1800s. Photo from Wikimedia.

Who Knew? Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, now called therapeutic phlebotomy, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily fluids were regarded as “humours” that had to remain in proper balance to maintain health. It is claimed to have been the most common medical practice performed by surgeons from antiquity until the late 19th century, a span of almost 2,000 years. (article content from Wikipedia)

Don’t Let Pediatric Tachycardia Get Your Heart Racing

Early ECG machine. Photo from Wikipedia.

According to Medscape, an online medical information site: “a heart rate of more than 160 beats per minute in infants and a respiratory rate of more than 60 per minute are associated with an increased mortality risk and often signal the development of septic shock.”

The May EM:RAP Pediatric Pearls podcast by Dr. Ilene Claudius, Dr. Sol Behar, Dr. James Salway and Dr. Liza Kearl offers prudent advice on differentiating respiratory from cardiac sources of pediatric tachycardia. Or pull up the PDF and have a fast read of the bullet points to keep your rate in check and your knowledge bounding.

Who Knew? Willem Einthoven, working in Leiden, the Netherlands, used the string galvanometer (the first practical electrocardiograph) he invented in 1901 which was more sensitive than previous 1870s inventions. He assigned the letters P, Q, R, S, and T to the waveform deflections. (Wikipedia)

HEART Pathway

Valentines card (photo Wikimedia Commons)

Valentines Day is this week on February 14th. What better time to review the HEART Pathway for your patients with chest pain.

(Photo PubMed Commons)

Check out the podcast or pdf on how one community hospital incorporated it into their electronic medical record (EMR) in the February EMRAP podcast: HEART in EMR; by Rob Orman MD and Peter Smulowitz MD. Don’t use EMR at your facility…leave a comment and tell your colleagues how you would use it in your practice or at your facility.

Who knew? In 1835, 60,000 Valentine cards were sent by post in Britain, despite postage being expensive. (Wikipedia)