Even though Hispanics are at higher risk for stroke than whites, they are significantly less likely to call 911 when they’re experiencing such an event. Researchers from the University of California, San Diego, looked at 192 Hispanic and 925 non-Hispanics who were seen at five San Diego hospitals for strokes. About 73 percent of Hispanic stroke victims arrived by ambulance, compared to 83 percent of whites.
Researchers say the disparity could be one reason why Hispanics tend to do more poorly after an ischemic stroke than whites. Three months after their stroke, 29 percent of Hispanics had favorable outcomes, compared with 40 percent of whites. The study was presented at the American Stroke Association meeting in New Orleans in February.
A second study also presented at the meeting found that men experiencing stroke symptoms call for emergency help more quickly than women do, especially if the men are married.
Researchers reviewed the records of 91 stroke patients brought by EMS to the Mayo Clinic Hospital in Phoenix. Married men called 911 an average of 26 minutes after the onset of symptoms, while married women waited 72 minutes. Single men called 911 faster than single women, but the difference was not significant.
Needlestick Injuries Drop Since Safety Law Enacted
The number of needlestick/sharps-related skin puncture injuries suffered by workers at U.S. hospitals fell 38 percent since a federal law took effect in 2001, according to a letter to the editor published in the Feb. 16 issue of the New England Journal of Medicine.
The Needlestick Safety and Prevention Act (NSPA) requires employers to provide safety-engineered devices to employees who are at risk for exposure to bloodborne pathogens, to let frontline workers have a say in selecting these devices, to review their exposure-control plans at least once a year to ensure they keep pace with advances in sharps-safety technology, and to maintain sharps-injury logs that contain details about injuries. The Act also directs the U.S. Occupational Safety and Health Administration to incorporate the new requirements into its standard for the handling of bloodborne pathogens.
Researchers from the University of Virginia, Charlottesville, examined data on nearly 24,000 needlestick/sharps-related puncture wounds that occurred in 85 hospitals in 10 states between 1995 and 2005. They found there was a trend toward increasing rates of these injuries before the NSPA took effect in 2001, then a 38 percent drop. Injury rates through 2005 remained well below pre-NSPA rates.
Autoinjector Delivery of Midazolam Best in Prehospital Setting
Prehospital administration of midazolam using an autoinjector is a fast and effective way to stop life-threatening seizures, a randomized controlled clinical trial finds.
Status epilepticus is a prolonged, life-threatening seizure that causes 55,000 deaths nationwide each year. The study, led by researchers at the University of Michigan, Ann Arbor, found that intramuscular midazolam given by EMS halted seizures in 73 percent of patients by the time they arrived at the hospital, compared with 63 percent of those treated with IV lorazepam. Even though the numbers show that midazolam performed slightly better, researchers say the real importance of the findings is that midazolam, which is much easier to administer, works at least as well. “Since intramuscular treatments can be given more quickly and reliably than intravenous treatments and have noninferior efficacy, our data support the use of the former route of administration by EMS … personnel,” the researchers write in the Feb. 16 issue of the New England Journal of Medicine.
The findings are from the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART), which involved more than 4,300 paramedics from 33 EMS agencies and 79 hospitals across the United States. Patients, who included both children and adults, were having convulsions for more than five minutes and were still convulsing when paramedics arrived. They were randomly assigned to receive midazolam given via an investigational intramuscular autoinjector or IV lorazepam given via a prefilled syringe.
WTC Responders Have Double the Asthma
First responders at the World Trade Center attack suffer asthma at more than double the rate of the general U.S. population, according to a study published online Dec. 8, 2011, in the American Journal of Industrial Medicine. The cause, researchers say, is the toxic dust created when the towers collapsed. “This epidemic of asthma among WTC responders started right after the 9/11 disaster, and we are still observing elevated rates of asthma in this population,” lead study author Hyun Kim, M.D., an epidemiologist and assistant professor of population health, said in a news release from North Shore-LIJ Health System and the Hofstra North Shore-LIJ School of Medicine. “It is critical to keep monitoring responders’ health and provide proper treatment.”
The study, which includes information on nearly 21,000 responders, found that 6.3 percent reported asthma symptoms or attacks, compared to just 3.7 percent of the general U.S. population. Although rates of asthma were stable for the general population, there was a surge in 12-month asthma rates among WTC responders from 2000 to 2005. And when researchers also included the year before the WTC attacks, 12-month asthma rates were 40 times higher among first responders.
Latex Gloves = Lax Hand Hygiene?
Health care workers who wear gloves while treating patients often don’t wash their hands before and after patient contact, according to a study in the December 2011 issue of Infection Control and Hospital Epidemiology.
World Health Organization guidelines call for health care workers to wear latex gloves when they anticipate coming into contact with body fluids, and to clean their hands immediately before and after wearing latex gloves to prevent the spread of germs. While latex gloves reduce contact with infectious agents, “Gloves are not a substitute for effective hand hygiene: they do not eliminate contamination of hands, and they are themselves potential vectors of transmission between patients if not changed between contacts,” according to the study. When taking off gloves, hands can be contaminated by “back spray.”
After secretly observing more than 7,000 patient contacts in 15 United Kingdom hospitals, researchers found that when wearing gloves, workers complied with hand-washing recommendations only about 41 percent of the time. When workers didn’t have on latex gloves, they washed or disinfected their hands using an alcohol rub before and after patient contact 50 percent of the time. Researchers also found that health care workers often used gloves during “low-risk” patient contacts, when the gloves weren’t necessarily needed, and failed to wear them during “high-risk” encounters, when they should have had the gloves on.
“The rate of compliance with hand hygiene was significantly worse when gloves were worn. This finding has possible important clinical implications for the control of organisms such as methicillin-resistant Staphylococcus aureus (MRSA),” according to the study, titled, “The Dirty Hand in the Latex Glove.”
