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 The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997.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.
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.
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.
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.
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 [...]
Like millions of Americans, I plan to fire up the grill today for a Fourth of July cookout. But I’ll be adding an extra step to my routine: checking the grate for bristles that may have fallen off my cleaning brush. An article in this week’s Morbidity and Mortality Weekly Report describes six people injured by consuming grill-cleaning bristles hidden in grilled meat. Three had abdominal pain from wire bristles poking through the small intestine or colon. Three others had bristles stuck in the neck. All of the wire bristles were safely removed with open surgery or laparoscopy (“keyhole” surgery). The same team had published a report of six other cases earlier this year in the American Journal of Roentgenology. Twelve cases from one medical center over a three-year period does not an epidemic make. But it’s enough to suggest that ingesting wire bristles happens wherever home grilling is going on. Keep your grill bristle free by using a brush that’s in good shape. After you use a brush to clean your grill rack, use a towel or wadded up bunch of paper towels to wipe it down.