One can predict acute lung injury

Health Care, Medicine, Social Health Community 977 Comments

The lung injury prediction score (LIPS) should be used to predict patients who are unlikely to develop ALI/ARDS.

  • LIPS >4 predicts ALI with a sensitivity and specificity of 69 and 78 %, respectively.
  • LIPS <4 has a negative predictive value of 97%.

Score: Sum up the assigned points

  1. Shock (2 points)
  2. Aspiration (2 points)
  3. Sepsis (1 point)
  4. Pneumonia (1.5 points)
  5. Orthopedic spine surgery (1.5 points)
  6. Acute abdominal surgery (2 points)
  7. Cardiac surgery (2.5 points)
  8. Aortic vascular surgery (3.5 points)
  9. Traumatic brain injury (2 points)

10. Smoke inhalation (2 points)

11. Near drowning (2 points)

12. Lung contusion (1.5 points)

13. Multiple fractures (1.5 points)

14. Alcohol abuse (1 point)

15. Obesity (BMI >30, 1 point)

16. Hypoalbuminemia (1 point)

17. Chemotherapy (1 point)

18. Fraction of inspired oxygen >0.35 or >4 L/min (2 points)

19. Tachypnea >30 breaths/min (1.5 points)

20. Oxyhemoglobin saturation <95 percent (1 point)

21. Acidosis (pH <7.35, 1.5 points)

22. Diabetes mellitus (-1 point)

(Ref : Gajic O, Dabbagh O, Park PK, et al. Early identification of patients at risk of acute lung injury: evaluation of lung injury prediction score in a multicenter cohort study. Am J Respir Crit Care Med 2011;183:462).

FDA Warning: Test kidney function before prescribing Zoledronic acid

Health Care, Medicine 230 Comments

FDA  has updated a warning regarding kidney failure and use of zoledronic acid. Kidney failure is a rare but serious condition associated with its use in patients with a history of or risk factors for kidney impairment.

Doctors are being warned to check patient kidney function before prescribing zoledronic acid and to check those who are already taking the drug.

The new warning indicates that patients with creatinine clearance of less than 35 mL/min or evidence of acute renal impairment should not be given zoledronic acid for osteoporosis.

The warning also lists risk factors including advanced age, concurrent treatment with other nephrotoxic drugs, and dehydration secondary to fever, sepsis, gastrointestinal losses, or diuretic therapy.

The Supreme Court of India ordered private Delhi hospitals to treat poor for free

Social Health Community 354 Comments

The Supreme Court of India today has ordered that Delhi private hospitals built on subsidized government land will have to provide free treatment to the poor. A bench of Hon’ble Mr Justice R. V. Raveendran and Hon’ble Mr Justice A.K. Pathak has ordered that these hospitals will have to reserve 25% of their OPD and 10% of their indoor patients for free treatment of the poor. The bench has said that poor patients are not to be charged. There are 37 hospitals which are built on government land at concessional rates out of which 27 have been providing free treatment to the poor patients.

The counsel appearing for the hospitals had pleaded that it was not practical for them to provide free treatment to the poor in all the cases. The bench did not buy that argument.

The hospital pleaded that treatments for diseases like cancer, neuro surgery and plastic surgery are costly and hence hospitals cannot provide free treatment for these conditions. The Supreme Court also did not buy that statement. The Court said that poor patients will have to be provided free admission, bed, drugs, treatment, surgery facility, nursing facility, consumables and non-consumables. The hospitals charging any money from such patients shall be liable to be proceeded against in accordance with the law. Besides, this act will be treated as a contempt of court.

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