Safety

Heidi Godman

Two tricks to make it easier to swallow pills

The expression that something is “a hard pill to swallow” isn’t just a metaphor. Swallowing pills can be difficult and downright unpleasant. It causes one in three people to gag, vomit, or choke. That may keep people from sticking to their medication routines, which can make them sicker. A new study by researchers from the University of Heidelberg in Germany may help people with pill swallowing difficulties. They suggest two techniques — the pop-bottle method and the lean-forward method — that can help people swallow pills more easily. Both methods were tested among people with self-professed difficulty swallowing medicine, and offered improvements of 60% to 90%.

Julie Corliss

Make smart seafood choices to minimize mercury intake

Fish and shellfish are great sources of lean protein, and many types are rich in heart-healthy omega-3 fatty acids. But there’s a catch: some species of fish contain worrisome amounts of methylmercury, a toxin that’s especially dangerous to developing brains. That’s why women who are or could become pregnant and young children shouldn’t eat high-mercury fish such as swordfish, shark, king mackerel, and tilefish. A new study hints that eating too much—or the wrong kind—of salmon and tuna can also boost mercury levels. But the study also offered reassurance: 95% of the nearly 11,000 people surveyed, including those who ate fish often, had blood mercury levels in the safe zone.

Lori Wiviott Tishler, M.D.

Drug-resistant bacteria a growing health problem

Antibiotic-resistant bacteria sicken more than two million Americans each year and account for at least 23,000 deaths. The main cause? Overuse of antibiotics. A new report from the Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States, 2013, details the health and financial costs of antibiotic resistance in the United States. In terms of health, antibiotic resistance should be in the CDC’s top 15 causes of death. It also adds as much as $20 billion in direct health-care costs. And the problem could get worse before it gets better. Antibiotic resistance is a problem because commonly used antibiotics will become less able to treat common infections. The CDC identified three types of bacteria as urgent hazards: Clostridium difficile, Enterobacteriaceae, and Neisseria gonorrhoeae. Decreasing the use of antibiotics and preventing infection in the first place are two key steps to halting the problem.

Patrick J. Skerrett

Falling TVs injure 17,000 kids a year

More than 17,000 American youths end up in emergency departments each year with injuries from a falling television set. Two-thirds of them are under age 5, according to a report published online today in the journal Pediatrics. From 1996 to 2011, nearly 400,000 children under 18 years old were treated in emergency departments for TV-related injuries. In 1996, most of the injuries occurred when kids ran into television sets. By 2011, injuries from falling TVs dominated. The rate of TVs falling from dressers, bureaus, chests of drawers, and armoires nearly quadrupled. The authors of the study suggest that adding TVs to the list of furniture types that come with anti-tip devices “would be an important step in decreasing the number of injuries resulting from falling TVs.”

Howard LeWine, M.D.

Medical crises don’t take vacations

The sudden hospitalization yesterday of Teresa Heinz Kerry, wife of U.S. Secretary of State John Kerry, while vacationing on Nantucket Island is high-profile testimony that illness can happen at any time—even during a vacation. Heinz Kerry was taken by ambulance on Sunday afternoon to Nantucket Cottage Hospital. She was accompanied by her husband. After being stabilized, she and the Secretary of State were flown to Massachusetts General Hospital in Boston. Neither the hospital nor Heinz Kerry’s family has commented on the nature of her illness. News reports say she is in critical but stable condition. Heinz Kerry’s situation highlights the value of electronic medical records, and the hazards of not having, or being able to access, medical information when you are travelling or on vacation.

Patrick J. Skerrett

New concussion guidelines say “When in doubt, sit it out”

New guidelines for recognizing and managing sports-related concussions could help protect the brains of millions of athletes at all levels of play, from professional football to youth soccer. The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997. The guidelines step away from trying to “grade” concussions or diagnose them on the field or sidelines. Instead, they focus on immediately removing from play athletes who are suspected of having a concussion until they can be evaluated. “When in doubt, sit it out.” The AAN estimates that concussions cause between 1.6 million and 3.8 million mild brain injuries each year. Many athletes don’t get medical attention for these injuries, often because they or their coaches don’t recognize the warning signs or take them seriously. The new guidelines should help better identify athletes who have suffered concussions and improve how concussions are managed and treated.

Patrick J. Skerrett

Distracted driving: We’re Number 1

Americans drive while talking on a cellphone or texting more than their counterparts in seven European countries. A report published yesterday showed that 69% of American drivers surveyed said they had talked on a cellphone while driving at least once in the previous month (31% said they did it “regularly or fairly often”), and 31% said they had read or sent text messages while driving. The least distracted drivers were in the United Kingdom. Not surprisingly, younger drivers were more likely to have reported talking on a cellphone or texting while driving. The statistics on distracted driving are chilling: In 2011 (the last year with complete statistics), 3,331 people were killed in motor vehicle crashes involving a distracted driver, and nearly 400,000 were injured. The National Highway Traffic Safety Administration estimates that distracted driving accounts for about one in five crashes in which someone was injured.

Patrick J. Skerrett

Panel cites top 10 strategies for improving patient safety

The toll taken by medical mistakes burst into public attention with a 1999 report called To Err Is Human from the U.S. Institute of Medicine. The report estimated that between 44,000 and 98,000 people die each year as a result of preventable medical errors. Such errors can be headline grabbers, like the death of Boston Globe columnist Betsy Lehman from an overdose during chemotherapy. The safety of hospital stays and encounters with health-care providers got a boost today with the publication of 22 evidence-based “patient safety strategies.” Although most focus on care that takes place in hospitals, they extend to almost all interactions between individuals and their doctors, nurses, and other care providers. Very few of the safety practices are expensive, high-tech interventions. Instead, they are almost old-fashioned efforts that aim to improve communication between health-care providers and their patients, and to improve the practice of medicine rather than the art of medicine. The theme of all of these interventions is to create systems that help caregivers follow every step that is known to improve patient care, and to avoid relying on fallible human memory. To err may be human, but it is also often preventable.

Patrick J. Skerrett

Many drivers asleep at the wheel

If you’ve ever nodded off while driving, you aren’t alone. In a new report from the Centers for Disease Control and Prevention, 4.2% of Americans admitted to falling asleep while driving at least once in the previous month. The just-published survey, conducted in 19 states and the District of Columbia, found the sleepiest drivers in Texas (6.1%) and Hawaii (5.7%), and the most alert ones in Oregon (2.5%) and the District of Columbia (2.6%). Individuals most likely to have fallen asleep while driving were those who said they unintentionally fell asleep during the daytime at least once during the preceding month, those who said they snore at night, and those who reported sleeping less than six hours a night. Keep in mind that these numbers reflect only the percentage of people who were aware they had fallen asleep. They don’t include those who fell asleep while driving without recognizing that had happened.

Heidi Godman

Medication errors a big problem after hospital discharge

After a hospitalization, being discharged is a key step on the road to recovery. But that road can take a dangerous turn—namely, a serious problem with one or more medications. It’s a common problem that many people experience within a few weeks of leaving the hospital. Researchers at Brigham and Women’s Hospital now report in […]