Latest Entries

FDA Pulls Darvon & Darvocet Due to Cardiac Risk

The Food & Drug Administration (FDA) has issued an order to withdraw Darvon, Darvocet and generic versions of the drug propoxyphene due to risk of cardiac toxicity. 

The FDA has concluded that the safety risks of propoxyphene outweigh its benefits for pain relief at recommended doses.

Click here to read a press release from the FDA on this withdrawal, including background information and recommendations.  CNN.com also has additional information.

Lynn Eschenbacher is clinical manager of the WakeMed Pharmacy.

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WakeMed Recertified for Excellence in Stroke Care

WakeMed has received recertification from The Joint Commission as a Primary Stroke Center, and WakeMed Raleigh Campus, Cary Hospital, North Healthplex and Apex Healthplex remain the only certified Primary Stroke Center in Wake County.

Being a Primary Stroke Center is important because North Carolina is part of the nation’s “Stroke Belt” where death rates from stroke are significantly higher than the rest of the U.S. According to the North Carolina Stroke Association, someone in North Carolina is hospitalized every 20 minutes with a stroke and every two hours someone dies from a stroke. Two-thirds of these stroke survivors are moderately to severely disabled, and approximately 20 percent of stroke survivors require long-term care, and up to 30 percent are permanently disabled.

Being a Primary Stroke Center demonstrates WakeMed’s commitment to stroke prevention and care. We have dedicated hundreds of hours over the past four years educating our community about stroke prevention, warning signs and symptoms. Additionally, WakeMed has made a significant investment of time and resources to ensure patients with suspected stroke are identified early, their care is streamlined and coordinated across disciplines, and they have access to the most advanced treatments and technologies available.

Learn more about stroke warning signs and symptoms by clicking here.

Kimberly Elks, RN, is the WakeMed Stroke Program Coordinator.

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WakeMed First in North Carolina to Receive Heart Failure Accreditation

WakeMed Raleigh Campus and Cary Hospital are the first hospitals in North Carolina to receive full Heart Failure Accreditation from the Society of Chest Pain Centers.

To achieve SCPC Heart Failure Accreditation, WakeMed met or exceeded ten criteria, including quality measures that improve the process of care for heart failure patients, integration with emergency medical services, personnel competencies and training throughout the system, and much more.

“Being first in the state to earn Heart Failure accreditation demonstrates WakeMed’s continued commitment to ensuring cardiac patients receive gold-standard care based on demonstrated best practices,” commented Betsy Gaskins-McClaine, vice president Heart & Vascular Services.  “Providing this quality care requires a commitment across the health care continuum, starting from emergency medical services through the emergency department, Heart Center and continued care from a multi-disciplinary team during the patient’s hospital stay to follow-up care with cardiologists, primary care practitioners, home health, and outpatient therapy programs.

“For heart failure patients, this commitment from health providers is even more critical due to the need to continuously monitor and adjust medications, diet, and activity levels to prevent hospital re-admission and improve a patient’s quality of life.  National statistics show that one in five heart failure patients who is discharged from the hospital is readmitted within 30 days.”

Click here to read the entire press release.

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Treating a Bumped Head

As most parents know, minor head trauma is incredibly common in children.  Most active kids will at some point will either hit their head from a fall, run into an immovable object with their head, be struck in their head with some other object, fall off a bike or down the stairs, fall out of the grocery cart, have a sports related head collision, etc.  Fortunately, most of these injuries are very mild and require no treatment whatsoever.  The child’s brain is protected by a very rigid skull and, beneath which, is essentially cushioned by a water bath.

However, head trauma may – under rare circumstances – may result in more severe injury.  And, unlike a broken bone, it is often not obvious when such an injury may have occurred.  For this reason, head injury remains a very common reason parents bring their children for medical evaluation.  Over 600,000 emergency department visits annually in the U.S.A. are due to head trauma.  And, in the vast majority of cases the etiology of the head injury is relatively mild (as compared with, say, a high speed motor vehicle accident).

In the emergency department, about 50% of all head injuries are evaluated by a head CT scan.  A CT scan is a powerful x-ray of the brain that is very quick (about 3 minutes) and allows detection of most severe injuries to the brain that would require emergency treatment (such as a bleed inside the skull). 

However, the dose of radiation a patient receives during a head CT is about 200 times that of a chest x-ray.  Over the past 5 to 10 years the medical profession has had an increasing appreciation of the risks that may be associated with this degree of radiation exposure.  Some now estimate that as many as 1 in 1000 to 5000 head CTs result in a cancer that would otherwise not have occurred. 

Therefore, no patient should undergo a CT scan unless the benefit outweighs the risk.  The problem is that the risk is almost never crystal clear, and many physician’s and parents want to err on the side of caution fearing they would miss even one child who might have a serious injury.  Fortunately, recent studies help guide physicians and parents as to who may be at extremely low risk for having a serious problem after a head injury.

For example in the case of a child under 2 years of age, if the child meets the following criteria after injury, their risk of having a serious brain injury is almost zero:

  • If they have normal mental alertness
  • If they have no bruise or swelling on their head other than their forehead
  • If they have not lost consciousness for more than 5 seconds (yes, very brief loss of consciousness does not seem to predict a serious problem if everything else is OK)
  • If the mechanism of the head injury is not severe (not a high speed collision)
  • No obvious skull fracture
  • And the child is behaving normally in the view of the parents

In the case of children over 2 the criteria are slightly different, but similar:

  • The child has normal mental alertness
  • There was no loss of consciousness
  • The child is not vomiting
  • The mechanism of the injury is not severe
  • There is no bruising under the eyes
  • And the child does not have a severe headache

As with any clinical guidelines based on results from even the best studies, predictive criteria will never be right in every single case; therefore, parents should always seek medical attention if they have concerns.  However, the above guidelines can be used to reassure parents that if their child meets all the criteria listed above after a minor head injury that their child risk of a life-threatening outcome is extremely remote.  Additionally, even if medical care is sought, the parents and physicians should both consider the risks vs benefits of a head CT before obtaining that study.

Mike Cinoman is a pediatric intensivist in the WakeMed Children’s Hospital.

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Children’s v/s Closest Emergency Department

I am often asked by parents whether children should be taken to the closest emergency department or possibly take a little more time in the car and come directly to the Children’s Emergency Department on WakeMed Raleigh Campus.  I expect as we open more freestanding emergency departments like North Healthplex and Apex Healthplex, that this question will only become more frequent.

The answer is actually pretty simple, and in less acute cases, may prevent a trip to the emergency department in the first place. 

1.       If your child is acutely ill or injured, and you believe it could be life-threatening call 9-1-1.  The paramedics can often stabilize your child onsite and can quickly determine which facility best suits your child’s needs. 

2.       If your child’s illness or injury is not life-threatening and you have some time to figure out which facility would be best, then it is my recommendation to call your pediatrician.  Pediatrician’s offices, including the health departments and WakeMed clinics, have someone taking call 24 hours a day 7 days a week. The advice nurse or physician can help you assess the best place to take your child should an ED visit seem necessary.  So, if an illness or injury is not life-threatening and you are trying to decide where to go, the best first move is to pick up the phone.

The reality is, most of the emergency physicians that staff WakeMed emergency departments rotate through all facilities, so you will be getting the same top-quality medical care regardless of the emergency department your pediatrician recommends.  The main difference is that the Children’s Emergency Department is designed exclusively for children and children are only admitted to the WakeMed main campus Children’s Hospital.

Courtney Mann, MD, is the medical director for WakeMed Children’s Emergency Department.

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WakeMed Honors Veterans

Tomorrow, the WakeMed Diversity & Inclusion Council will honor the men and women who have served our country in the armed forces.  And, we would like to cordially invite Veterans to join us.

We has identified more than 320 WakeMed employees, physicians and volunteer veterans who have served or are currently serving in the United States Armed Service.  Our program on Raleigh Campus will include remarks by WakeMed President and CEO Dr. Bill Atkinson and Colonel Elizabeth D. Austin, the highest ranking female officer in the North Carolina Army National Guard.  Additionally, the WakeMed Honor Guard (Campus Police & Public Safety staff) will be participating, along with the WakeMed Chorus.

WakeMed Raleigh Campus

Andrews Conference Center

12:30 – 1:30 pm

 

WakeMed Cary Hospital

Conference Room B

9 – 9:30 am

Anthony Newkirk is manager of employee relations and diversity.

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WakeMed Honored for Commitment to Wake Tech

WakeMed has been helping Wake Technical Community College provide high-quality training for the region’s nurses and health professionals for more than 50 years. Now, that commitment was recognized with a national philanthropy award. The Council for Resource Development (CRD), based in Washington D.C. bestowed the Community College Benefactors Award on WakeMed.

WakeMed’s long-standing partnership with Wake Tech strengthened in recent years, as a result of a critical nursing shortage in the area. Under Dr. Atkinson’s leadership, WakeMed began to allow staff nurses to teach at Wake Tech while remaining on the hospital’s payroll. The arrangement gives students access to the very latest techniques and technologies – and to the expertise of successful professionals working in the field – while helping the college turn out more qualified nurses to meet community demand. WakeMed also established an emergency fund to help promising nursing students overcome financial obstacles and succeed. In all, WakeMed’s cash and in-kind contributions to the program and its students total more than $1.7 million.

Dr. Atkinson’s believes that as the largest private employer and the primary provider of health care in Wake County, it is both WakeMed’s honor and responsibility to support our educational system.  As such, WakeMed has formed strong partnerships with Wake County Public Schools and Wake Tech and frequently collaborate to provide opportunities that enrich students’ experiences and help them on the path to becoming productive, contributing members of our community.  

Additionally, WakeMed has a vested interest in ensuring our educational system has the tools and resources it needs, because whether students choose a career in health care, culinary arts, or information technology there is a place for them at WakeMed.

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Sesame Street Takes On Emergency Preparedness

Sesame Street is making a real impact these days with viral videos and PSAs that communicate simple, but very important messages to young and old alike. Remember last year when Elmo taught us how to stay healthy by sneezing into our elbow?

Now, Grover and Rosita star in a PSA teaching us all about the importance of creating an emergency preparedness kit.  And, Sesame Street has an entire section of their web site dedicated to emergency preparedness.   Take some time to visit the site with your child, watch the videos and talk through the information.  In the event of an emergency, you’ll be thankful you did.

Barb Bisset is the executive director of the WakeMed Emergency Services Institute.

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Helping Kids Fall Back Smoothly

It’s that time of year again when our clocks tell us one thing and our bodies tells us another.  Yes, the end of daylight savings time is Saturday, November 7. 

For young children who are early birds, avoid crankiness by helping them adjust their sleep schedules to the change gradually.  Try to move bed and nap times back by 15 minutes at a time for four days in a row.  This should help ensure a smooth sleep transition so you can actually enjoy the extra hour of play time.

I believe that most older children can benefit from and may enjoy having a little more sleep.  For these children, it may make more sense to keep bedtime where it is.  This decision may mean they stay up a little later the next night, but that is OK because you know they have had plenty of rest for the day.

Also, remember that the biannual time change is always a good time to change your smoke detector batteries.

Melissa Johnson is a Clinical Psychologist with WakeMed Children’s.

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5 Indoor Workout Resources You Didn’t Even Know You Had

The weather is getting colder and for many this means an excuse not to exercise. But the weather in your living room or at the gym is always ideal for a no-excuses workout. 

You may also have access to fitness tools you didn’t even know you had.  Here are just a few suggestions to help keep you moving even in colder weather. 

1.       Wondering what to do with the exercise ball other than crunches?  Try these   (free)

2.       Podrunner has great mixes that are a steady beats per minute (good for treadmill). (free)

3.       ExerciseTV Online workout videos.  (free) FitTV (Time Warner 153, Direct TV 261) also has a great workout variety airing 24/7.

4.       Dance around the house to Pandora Dance Music stations (free)

5.       Netflix has lots of fitness videos on demand.  They vary in intensity, length and type of work out, but there is something there for everyone.

Chrissie Staton is a fitness specialist with Healthworks, WakeMed’s on-site medically directed fitness facility.

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