End-of-Life Wishes: Lack of Communication Persists

Steven For Medscape    Although many elderly patients and their families discuss advance care planning (ACP) with their physicians, those wishes often fail to be added to patients' medical records, according to findings from a study carried out in Canada and published online April 1 in JAMA Internal Medicine.    "To our knowledge, there has been no rigorous audit or evaluation of ACP from the patient or family perspective using validated questionnaires that assess the frequency of engagement in key ACP activities," write Daren...

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ADHD: Why Do the Numbers Keep Growing?

Thomas J. Power, PhD from Medscape    A recent New York Times analysis of data from the most recent National Survey of Children's Health concluded that almost 1 in 5 teenage boys and 11% of all school-aged children have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Medscape asked Dr. Thomas Power, from the Children's Hospital of Philadelphia (CHOP), to discuss some theories to explain this increase.    My name is Tom Power. I'm a psychologist and Director of the Center for Management of ADHD at CHOP....

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Best Practices of Paracentesis

http://reference.medscape.com/      Ascites (shown) is the accumulation of fluid within the abdominal cavity. For patients with ascites, peritoneal paracentesis is performed to aspirate and analyze the ascitic fluid. It is one of the oldest medical procedures, dating back to approximately 20 BC. The collected fluid can be used to help determine the etiology of ascites, as well as to evaluate for infection or the presence of cancer. Causes of ascites include hepatic cirrhosis,...

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ACLS and BLS Recommendations You Must Know

http://reference.medscape.com/     The 2010 American Heart Association (AHA) guidelines for basic life support (BLS) and advanced cardiac life support (ACLS) represent a departure from how most clinicians were trained. Image courtesy of Wikimedia Commons.    Do you follow current, best practice for BLS and ACLS? Some of the significant recommendations include: • Chest compressions as the first step in BLS -- a "C-A-B" (circulation, airway, breathing) approach, instead...

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Best Practices of Emergency Airway Management

Anticipating and recognizing respiratory decompensation is only the first step in emergency airway management. Practitioners must be familiar with the indications and techniques for airway intervention and how to anticipate a difficult airway. The basic approach includes assuring airway patency, protection from aspiration, and providing adequate oxygenation and ventilation. This image shows the use of a GlideScope® (Verathon Inc.; Bothell, Washington) video laryngoscope to intubate the trachea...

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