Test Your ER IQ

As many of our regular readers know, I spend most of my spare time working as a volunteer EMT. The long hours and sacrificed sleep are a small price to pay for the camaraderie, sense of community service and the knowledge that you’re helping people during their worst moments.

Not to mention it satisfies the needs of my inner adrenaline-junkie!

Not knowing what the next call is going to be is both exciting and challenging. Not knowing who or what you’re going to find when you arrive on scene keeps things interesting.  From minor toothache to major trauma, you just never know.

It’s not always high drama. Many calls are probably unnecessary and leave us thinking “You called 911 for that?!?”  Sometimes we may even toss in the odd silent expletive or two!

But we never say it out loud. We’re trained to accept that it’s an emergency to the patient / family even if we don’t regard it as such.  And we accept that sometimes people just don’t know better.

New parents especially, seem to find it difficult to decide whether to take their child to the emergency room in the middle of the night or to wait until morning to see their child’s doctor, or even to recognize that something like crying, in a newborn, is perfectly normal.

Not surprising then that children under 4 account for about 10% of the 115 million emergency room visits a year.  Which is why we welcome a recent initiative by ProMedica Toledo Children’s Hospital.

Through a series of interactive videos, doctors and nurses guide parents through several common medical scenarios including ear pain, asthma attack, ankle pain, allergic reaction,  laceration, sore throat, abdominal pain  and mosquito bites.

In each video, you make the decision to go or not to go to the ER. The expert then explains which choice makes the most sense .  Click on the links above to see if you would make the right decisions.

Should this be mandatory viewing for all parents?  Let us know what you think.

Improving Inhaler Instruction

Many of us have never been properly trained on how to do or use certain things we really should be good at. Putting on condoms and wearing seat belts are just two that come to mind.  And when we get them wrong, the health consequences can be serious.

The same goes for asthma inhaler use.  Do you shake the device first? Did you breathe in with sufficient force? Did you press the canister at the right time?

Improper use of inhalers is a serious and expensive problem. In the US, 3 patients are admitted to the emergency room with asthma every minute, that’s >5,000 people a day!  Worse still, according to the Asthma and Allergy Foundation of America, 11 people die from asthma every day.

One study estimated up to 94% of patients use their inhalers incorrectly.  The most common mistakes include failure to exhale before actuation, failure to breath-hold after inhalation, incorrect positioning of the inhaler, incorrect rotation sequence, and failure to execute a forceful and deep inhalation. Those of us in healthcare have even seen patients who fail to take the cap off the inhaler before use, and others who use it nasally rather than orally.

This is hardly surprising given that many patients never receive instructions on how to use their inhalers and even those that do, are not routinely followed.  And let’s face it, some of these devices could use training wheels.

Enter the T-Haler, a digital asthma inhaler training device  developed by researchers at Cambridge Consultants.

Patients with asthma can use the inhaler and, via interactive software linked to the wireless device, get real-time visual feedback on the areas that need improving.

Specifically, whether patients have shaken the device before breathing in; whether they use sufficient force when breathing in; and whether they press down the canister that releases the drug at the optimal time. Click here to see a video of the T-haler in action.

Although still a conceptual product, the company says it has been designed as a training device to be available at pharmacies, schools, and clinics for children and adults alike.

They performed a study on 50 people aged 18 – 60 who had no prior experience with either asthma or inhalers and were given no instruction on how to use an inhaler. When tested, about 80% of the participants used an inhaler incorrectly.

They were then given the T-Haler with no further instruction and told to begin. A three-minute on-screen tutorial guided them through the proper use of an inhaler, and the success rate tripled to more than 60%.

“Without any human direction beyond the word ‘go’, participants went from around a 20% success rate without training to a success rate of more than 60% after only three minutes with the T-Haler device,” said Kate Farrell, a senior design engineer, in a news release. “This is more than twice the compliance rate we have seen in other studies with trained participants. Interestingly, a week later, 55 percent were still correctly using the device-showing that they retained what they learned.”

Whether the T-Haler itself will ever make it to market remains to be seen, but the concept of a 3-minute training device seems a no-brainer when it comes to properly using a device that may very well save the lives of the estimated 235 million asthma sufferers worldwide.