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Nurse Arrested After Protecting Patient From Blood Draw

http://www.medscape.com/viewarticle/885157

Video images released Thursday show a Utah nurse screaming while being arrested for refusing to allow an officer to draw blood from an unconscious patient.

According to the Salt Lake Tribune in Salt Lake City, the images came from officers’ body cameras and University Hospital burn unit footage and were released in a news conference.

The video shows that after the nurse, Alex Wubbels, explained to Salt Lake Police Detective Jeff Payne that, according to the hospital’s policy, the police needed a warrant or consent from the patient or had to put the patient under arrest before she could allow a blood draw, she was handcuffed and shoved into a patrol car while she screamed, “Help! Help! Somebody help me! Stop! Stop! I did nothing wrong!” She was not charged, but several news reports indicated she was in the patrol car about 20 minutes.

In the video, Payne acknowledges that none of those three conditions had been met but says he still has the authority to take the blood.

According to the Tribune, Payne wrote in a report that he was carrying out a request from Logan police to draw the sample to check whether it showed the patient had illicit substances in his blood at the time of the crash.

In a videotaped statement after the incident, Wubbels said, “The only job I have as a nurse is to keep my patients safe. A blood draw just gets thrown around like it’s some simple thing. But blood is your blood, that’s your property.”

The Washington Post reports, “Wubbels was right. The U.S. Supreme Court has explicitly ruled that blood can only be drawn from drivers for probable cause, with a warrant.”

Today the American Nurses Association (ANA) released a statement expressing outrage and is “calling for the Salt Lake City Police Department to conduct a full investigation, make amends to the nurse, and take action to prevent future abuses.”

“It is outrageous and unacceptable that a nurse should be treated in this way for following her professional duty to advocate on behalf of the patient as well as following the policies of her employer and the law,” said ANA President Pam Cipriano, PhD, RN.  

The encounter is now the subject of an internal investigation by the police department, the Tribune reported.

According to the Washington Post, Salt Lake police spokesman Sgt. Brandon Shearer told local media that Payne was suspended from the department’s blood draw unit but is still on active duty.

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CVS Accused Of Revealing HIV Status Of 4,000

Ohio Customershttps://consumerist.com/2017/08/31/cvs-accused-of-revealing-hiv-status-of-4000-ohio-customers/

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Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
Juan E. Méndez

Summary The present report focuses on certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. It identifies the policies that promote these practices and existing protection gaps. By illustrating some of these abusive practices in health-care settings, the report sheds light on often undetected forms of abusive practices that occur under the auspices of health-care policies, and emphasizes how certain treatments run afoul of the prohibition on torture and ill-treatment. It identifies the scope of State‟s obligations to regulate, control and supervise health-care practices with a view to preventing mistreatment under any pretext. The Special Rapporteur examines a number of the abusive practices commonly reported in health-care settings and describes how the torture and ill-treatment framework applies in this context. The examples of torture and ill-treatment in health settings discussed likely represent a small fraction of this global problem.

Full report -23 pages

 

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Fentanyl, carfentanil and cocaine overdose deaths surge in 2016

https://www.10tv.com/article/fentanyl-carfentanil-and-cocaine-overdose-deaths-surge-2016

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Kasich hopes pain-pill limits will reduce opioid addiction

http://www.timesreporter.com/news/20170830/kasich-hopes-pain-pill-limits-will-reduce-opioid-addiction

Ohioans and their medical-care providers face stricter limits on pain-pill prescriptions beginning Thursday as the state seeks to choke off abuse leading to opioid addiction.

Likening opioid pain prescriptions to a “loaded gun,” Gov. John Kasich said the restrictions hold the promise of preventing abuse and keeping excess pain pills off Ohio’s streets.

The new requirements prohibit doctors, dentists and others from prescribing more than seven days of opioids — five days for minors — for treatment of pain.

Refills can be prescribed only if physicians and others document the need for extending pain-relief medication.

Medical-licensing and pharmacy boards are monitoring the prescribing of opioids with an eye toward cracking down on medical professionals who prescribe opioids without medical justification.

“You violate these guidelines and the medical board will come after you,” Kasich said of physicians who could face the loss of their licenses.

The limits do not apply to opioids prescribed for cancer, palliative care, end-of-life care and medication-assisted treatment for addiction.

The heads of the medical, nursing and pharmacy boards all joined Kasich in saying the new limits will help Ohio rein in an out-of-control opioid crisis that kills thousands each year.

“There is some light shining through right now,” Kasich said. Voluntary prescribing guidelines have cut the number of overdose deaths from opioid prescriptions from 667 in 2015 to 564 in 2016, he said.

State officials say 74 percent of those who died from drug overdoses in 2015 previously had received legally prescribed opioids.

Kasich said the number of deaths from heroin also are leveling off, but cautioned, “We’re not out of the woods.” Fentanyl, a powerful man-made opioid, increasingly is killing more Ohioans as it is laced into cocaine and other drugs, the governor said.

A federal grant will help pay for a campaign called “Take Charge Ohio” that will begin in October and seek to educate medical professionals and patients about alternatives to pills to treating pain.

More than 4,100 Ohioans died from accidental drug overdoses, largely from opioids, last year, according to a Dispatch survey of county coroners. That number represented a 36-percent increase in OD deaths from 2015, when Ohio led the nation with 3,050 deaths.

The Kasich administration says Ohio spends $1 billion a year to fight opioids, with about two-thirds of that coming from Medicaid coverage of drug-addiction treatment for poor Ohioans. The legislature added nearly $180 million of additional funding in the new two-year budget.

Kasich continues to defend his expansion of Medicaid to more than 700,000 additional Ohioans to help combat drug addiction.

“Think about where Ohio would be … if we hadn’t expanded Medicaid. To kind of keep debating this and wringing our hands because we got some right wingers somewhere who want to kill this program … if we cut this money off, if you take this money away, you will not have the resources needed.”

A 20% drop in prescribed opiates resulting in 103 fewer OD deaths … but .. OD’s from illegal opiates up 1050..  Anyone wonder how many people committed suicide in 2015 and 2016.. No one wants to talk about that ?

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How Ibuprofen May Affect Your Heart

https://www.attn.com/stories/15721/how-ibuprofen-may-affect-your-heart?utm_source=facebooklife&utm_medium=fbpost&utm_campaign=internal

Ibuprofen and other non-steroidal anti-inflammatory (NSAID) drugs might be more dangerous than most people think, according to a new study that links these over-the-counter painkillers to heart problems.

Though drugs containing ibuprofen such as Advil are widely sold without a prescription in gas stations and grocery stores around the world — giving consumers the impression that they’re relatively safe — researchers at Copenhagen University Hospital determined that these drugs raise the risk of cardiac arrest by about 31 percent on average.

The researchers are calling for stricter regulation of NSAIDs, such as requiring a prescription to obtain these products, in order to ensure that patients are better informed about the health risks. The risk is greatest for individuals suffering from heart conditions like cardiovascular disease, they found.

Stocksy/Margaret Vincent – stocksy.com

“Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe,” Gunnar Gislason, a professor of cardiology who co-authored the study, said in a press release. “The findings are a stark reminder that NSAIDs are not harmless.”

Though past studies have arrived at similar conclusions about the cardiac risks of ibuprofen, this new research only looked at NSAID use among patients who were prescribed the drug. The ingredients are the same, but as one UK trade group representing over-the-counter drug makers told The Guardian, “[p]rescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

For the study, which was published in the European Heart Journal on Wednesday, researchers looked at about 29,000 patients in Denmark who experienced heart attacks from 2001 and 2010. About 3,300 of those patients had taken an NSAID in the 30 days before the cardiac event, and the study compared that finding to each patient’s medical records from the preceding 30 days to evaluate the risk. Here’s what they found, according to the press release:

“Use of any NSAID was associated with a 31 percent increased risk of cardiac arrest. Diclofenac and ibuprofen were associated with a 50 percent and 31 percent increased risk, respectively. Naproxen, celecoxib and rofecoxib were not associated with the occurrence of cardiac arrest, probably due to a low number of events.”

Wikimedia – wikimedia.org

NSAIDs appear to raise the risk of cardiac arrest by causing platelets to build up, which can lead to blood clots. The study also indicated that these drugs make arteries constrict and increase blood pressure.

To avoid adverse cardiac effects of NSAID use, the researchers recommend taking no more than 1,200 milligrams of ibuprofen per day, and to limit use in general.

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If you or someone you know will need infusion therapy in the coming weeks, this Infusion Center locator resource can help identify an alternative site of care in a nearby community: https://locator.infusioncenter.org

About Rx Open

Open Pharmacies Map

This map is used to provide pharmacy status in a region when Healthcare Ready activates for a response (or is requested to activate the map by a local government). When active, you can search or zoom to find open pharmacies or Red Cross shelters in your area.

This map reflects the pharmacies enrolled in Rx Open. If you would like to enroll your pharmacy, please email Admin@healthcareready.org.

To make sure a pharmacy has your medication call before you visit.

County Overview

The overview map displays a high level view of how each county within an affected region’s pharmacies are impacted by an emergency. Click on a county to see a pharmacy status summary.

Click here for a downloadable Excel file which lists all of the pharmacies in the affected area, their address, and their operational status. (Choose download from the file menu on the page)

Is the status of your pharmacy incorrect? Please click here to send feedback, and include your NCPDP or NPI number.

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Antidepressant Use Among Persons Aged 12 and Over: United States, 2011–2014

https://www.cdc.gov/nchs/products/databriefs/db283.htm

Key findings

Data from the National Health and Nutrition Examination Survey

• During 2011–2014, 12.7% of persons aged 12 and over, 8.6% of males, and 16.5% of females took antidepressant medication in the past month.
• For both males and females, non-Hispanic white persons were more likely to take antidepressant medication compared with those of other race and Hispanic-origin groups.
• One-fourth of persons who took antidepressant medication had done so for 10 years or more.
• Antidepressant use increased from 1999 to 2014.

Antidepressants are one of the three most commonly used therapeutic drug classes in the United States (1). While the majority of antidepressants are taken to treat depression, antidepressants can also be taken to treat other conditions, like anxiety disorders. This Data Brief provides the most recent estimates of antidepressant use in the U.S. noninstitutionalized population, including prevalence of use by age, sex, race and Hispanic origin, and length of use. This report also describes trends in the prevalence of antidepressant use from 1999–2002 to 2011–2014.

 

Keywords: depression medication, prescription drugs, NHANES

 

In 2011–2014, 12.7% of persons aged 12 and over reported antidepressant medication use in the past month.

• Overall and in each age group, females were about twice as likely as males to take antidepressant medication (Figure 1).
• Overall, antidepressant use increased with age, from 3.4% among persons aged 12–19 to 19.1% among persons aged 60 and over. Increased use with age occurred among both males and females.

 

Figure 1. Percentage of persons aged 12 and over who took antidepressant medication in the past month, by age and sex: United States, 2011–2014

¹Statistically significant trend by age.
²Significantly lower than females in all age groups.
³Significantly lower than the older age groups.
⁴Each age group is significantly different from all other age groups.
NOTE: Access data table for Figure 1.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2014.

 

During 2011–2014, non-Hispanic white persons were more likely to take antidepressant medication in the past month compared with other race and Hispanic groups.

• Among persons aged 12 and over, non-Hispanic white persons were five times more likely than non-Hispanic Asian persons to have taken antidepressant medication in the past month (16.5% compared with 3.3%) and three times more likely than Hispanic (5.0%) and non-Hispanic black (5.6%) persons (Figure 2).
• Females in every race and Hispanic-origin group were significantly more likely than males of the same race and Hispanic-origin group to have taken antidepressant medication.
• More non-Hispanic white females took antidepressants than females of any other race and Hispanic-origin group.

 

Figure 2. Percentage of persons aged 12 and over who took antidepressant medication in the past month, by sex and race and Hispanic origin: United States, 2011–2014

¹Significantly lower than all other race and Hispanic-origin groups.
²Significantly higher than all other race and Hispanic-origin groups.
³Significantly lower than females in each race and Hispanic-origin group.
⁴Significantly higher than non-Hispanic Asian females.
NOTE: Access data table for Figure 2.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2014.

One-fourth of persons who took antidepressant medication in the past month had been doing so for 10 years or more.

• During 2011–2014, 68.0% of persons aged 12 and over who took antidepressant medication had been taking antidepressants for 2 years or more (Figure 3).
• During 2011–2014, 21.4% of males and 27.2% of females had been taking antidepressant medication for 10 years or more.
• There were no statistically significant differences between males and females in the length of antidepressant use.

 

Figure 3. Length of antidepressant use among persons aged 12 and over, by sex: United States, 2011–2014

NOTE: Access data table for Figure 3.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2014.

 

Antidepressant use increased from 1999 to 2014.

• Antidepressant use in the past month increased overall, from 7.7% in 1999–2002 to 12.7% in 2011–2014 (Figure 4).
• The percentage increase in antidepressant use over time was similar among males and females.
• Females were approximately twice as likely as males to have taken antidepressant medication at all time points.

 

Figure 4. Trends in antidepressant use among persons aged 12 and over, by sex: United States, 1999–2014

¹Significant increasing trend.
²Significantly higher than males for all years.
NOTE: Access data table for Figure 4.
SOURCE: NCHS, National Health and Nutrition Examination Survey, 1999–2014.

 

Summary

During 2011–2014, about one in eight Americans aged 12 and over reported taking antidepressants in the previous month. Antidepressant use increased with age and was twice as common among females as males. Non-Hispanic white persons were more likely to take antidepressants than non-Hispanic black, Hispanic, and non-Hispanic Asian persons.

Long-term antidepressant use was common. One-fourth of all people who took antidepressants in the past month reported having taken them for 10 years or more.

Antidepressant use increased nearly 65% over a 15-year time frame, from 7.7% in 1999–2002 to 12.7% in 2011–2014. This increase was similar among males and females. At every time point, females were about twice as likely as males to report antidepressant use in the past month.

 

Definitions

Antidepressant medication: Prescription drugs were classified based on the three-level nested therapeutic classification scheme of Cerner Multum’s Lexicon (2). Antidepressants were identified using the second level of drug categorical codes, specifically code 249.

Length of use of antidepressants: Evaluated by asking participants how long they had been taking the medication. Among persons taking more than one antidepressant, the one they had taken the longest was included in the data shown in (Figure 3).

Prescription drug use: National Health and Nutrition Examination Survey (NHANES) participants were asked if they had taken any prescription drug in the past 30 days. Those who answered “yes” were asked to show the interviewer the medication containers of all prescription drugs. For each drug reported, the interviewer recorded the product’s complete name from the container.

 

Data source and methods

This report is based on the analysis of data from the 14,034 persons aged 12 and over who participated in the NHANES 2011–2014 household interview. Of these participants, 13,951 persons gave information on medication usage. Questions were administered in English and Spanish.

NHANES is a continuous survey conducted to assess the health and nutrition of the American people. The survey is designed to be nationally representative of the U.S. civilian noninstitutionalized population. Survey participants complete a household interview and visit a mobile examination center for a physical examination and private interview. The annual interview and examination sample includes approximately 5,000 persons of all ages.

For 2011–2012 and 2013–2014, non-Hispanic black, non-Hispanic Asian, and Hispanic persons were oversampled to obtain reliable estimates for these population subgroups. Specific race and Hispanic-origin estimates reflect persons reporting only one race. Those reporting “other” race or more than one race are included in all figures except (Figure 2), where they are not reported separately.

NHANES sample interview weights, which account for the differential probabilities of selection, nonresponse, and noncoverage were used for all analyses. Standard errors of the percentages were estimated using Taylor series linearization, a method that incorporates the sample design and weights.

Overall differences between groups were evaluated using the chi-square statistic. Where the chi-square test was significant, differences between subgroups were evaluated using the univariate t statistic. A test for linear trends was done to evaluate changes in the estimates by age in (Figure 1) and over time in (Figure 4). All significance tests were two-sided 0.05-level tests, with no adjustment for multiple comparisons. All comparisons reported are statistically significant at the 0.05 level unless otherwise indicated. Data analyses were performed using SAS version 9.4 (SAS Institute, Cary, N.C.) and SUDAAN version 11.0 (RTI International, Research Triangle Park, N.C.).

 

About the authors

Laura A. Pratt is with the National Center for Health Statistics (NCHS), Office of Analysis and Epidemiology. Debra J. Brody and Qiuping Gu are with the NCHS Division of Health and Nutrition Examination Surveys.

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