Kaiser San Jose Covid Outbreak

Hospital officials initially reported an outbreak of 44 infections traced back to the apparently impromptu Christmas celebration, but this would be the first fatality associated with the informal Dec. 25 visit. All 44, including the employee who died, had been working in the emergency department that day, according to NBC Bay Area, which also described the outbreak’s first victim as a woman who worked as a registration clerk in the department.

Coronavirus: 1 employee dead after outbreak infects dozens at Kaiser San Jose — https://www.mercurynews.com/2021/01/04/coronavirus-1-employee-dead-after-outbreak-infects-dozens-at-kaiser-san-jose/

COVID-19 in the Elderly (case study and literature review)

Summary

Age is a risk factor for increased morbidity and mortality in COVID-19 infections.

Elderly men have increased mortality compared to elderly women.

Elderly patients can present differently. Delirium can be the primary symptom of COVID-19 infection, as can persistent hypoxia.

Consider COVID-19 in the setting of altered mental status and geriatric falls.

Elderly patients in the ED who live in nursing homes should undergo COVID-19 testing.

Elderly individuals with COVID-19 tend to have increased lesions and lobar involvement on chest CT.

Laboratory diagnostics may differ based on age, and the geriatric population may have lymphopenia, higher CRP values, and increased D-dimer on testing.

COVID-19 in the Elderly — http://www.emdocs.net/covid-19-in-the-elderly/?utm_source=feedly&utm_medium=rss&utm_campaign=covid-19-in-the-elderly

The full article takes some time to read but it’s well worth it if you are into the clinical stuff.

Mugged at Thanksgiving!

A mug every four years to commemorate milestones in a physician’s career.

Just another Saturday morning except this day starts the second half of a long four day Thanksgiving holiday break. We have given our thanks for the things we are grateful for. Today I’m asking all who read this post to give thanks for all of our front line healthcare workers for whom there is no break from work. We have many dedicated people who are spending the holiday away from their families while most of us are spending time with our families. These brave souls are putting their own health and safety on the line for the rest of us.

  • Thanksgiving – 3:00-11:00 PM
  • Friday Nov. 27 – 1:00-9:00 PM
  • Saturday Nov. 28 – 1:00-9:00 PM
  • Sunday Nov. 29 – 6:00 AM-2:00 PM
  • Is it too hard to wear a mask?

I’m getting better at writing effective click-bait blog post titles.

Anorexia Nervosa – More Dangerous Than You Think

This article is written by an Emergency Medicine doctor for other Emergency Medicine doctors as a quick primer on recognizing and diagnosing anorexia.  While those of us in the life insurance business are not diagnosticians  you will definitely benefit from this short ten minute article on the next case you encounter where Momma Bear is applying for $2,000,000 on her skinny 15 year old daughter who can’t seem to gain weight no matter how much the kid eats.

AN is a common, severe psychiatric illness. It is often present with co-morbid psychiatric illnesses. There is a high mortality rate, 5.6% per decade. It is notoriously difficult to treat with psychotherapy and pharmacotherapy.

Anorexia Nervosa – More Dangerous Than You Think

Coronavirus made simple by your friendly neighborhood emergency physician

When should I go to my doctor? The simple answer is when you can’t breathe or can’t hold down fluids. If you are having mild symptoms (fever, body aches, dry cough), stay home, and self-isolate. By going to the doctor, you risk spreading the virus to others, including us. If you go to the ER, we will see you but, if you are only having mild symptoms, you will likely be sent home with no COVID-19 test, no treatment, and a hospital bill.

Lastly, a personal plea. Many people are stuck at home with nothing to do. While alcohol is a disinfectant of sorts, it is not going to treat COVID-19! If you are drinking, have fun, but please wear a helmet and shoulder pads so that when you fall and hit your head, you do not have to come in and see me in the ER. We already see too many alcohol-associated visits in the emergency department. In a related note, drugs will make you feel strange. If you choose to use edibles or try new things because you are idle, please don’t do drugs and come in because you feel weird. I can’t fix that. As I told a patient this week, “You are high. If you don’t like this feeling, then don’t do drugs.”

Coronavirus made simple by your friendly neighborhood emergency physician

Amen.  Entire article is at the link above.

Hot New Model

Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study

Participants’ mean age was 81.5 years, 44.4% were women, and 10.5% were nonwhite. There were 266 deaths (8.8%) within 6 months. The final risk model included 15 variables, 4 of which were not included in prior risk models: hearing impairment, mobility impairment, weight loss, and lower patient-reported health status