In Other Journals

The right stuff

We’re all used to having bar codes of various types scanned at some point in our lives, from checking in our tickets at sporting grounds to checking out our groceries at the local supermarket. Now, bar-code verification technology is being used to check that patients are getting the right medicines at the right time in a 735-bed tertiary academic medical centre in the US — Boston’s Brigham and Women’s Hospital. Unit nurses are required to scan the bar codes on a patient’s wristband and on their medication before it is administered. If the dose does not correspond to a valid pharmacist-approved medication order, the application issues a warning. Previously, nurses manually verified the dose and the patient’s identity before medication was given. Over a 9-month period of observation, it was found that this bar-code technology significantly reduced, but did not eliminate, errors in medication administration. The bar-code medication-verification technology is embedded within a broader, integrated electronic medication-administration system.

Cats and small dogs are permitted to travel in the cabin of many Air Canada flights. Each animal needs to be small enough to fit and stay comfortably in a carrier-cage under the seat in front of the owner for the duration of the flight. This your-animals-are-welcome-to-fly-with-you policy has got the CMAJ editor’s and colleagues’ dander up, because they believe that the preferences of pet owners should not supersede the wellbeing of fellow passengers. In particular, they are concerned about passengers with allergies to animals, as pet dander has been shown to remain on seats long after the pet and its owner have gone. They say about one in 10 people have allergies to animals. Would you want to manage a patient having a severe allergic reaction on an aeroplane, at high altitude and isolated from emergency medical care?

If a patient’s loved one died in tragic circumstances, would you advise them to view or not to view the body? UK researchers interviewed 80 mainly white British people bereaved because of suicide or other traumatic modes of death, including by murder, fire, and bomb explosion. Most had seen the body of their deceased loved one. Although seeing a damaged body was distressing, it was rarely regretted. Those who had regretted or who had mixed feelings about seeing the body felt they had lacked either choice about it or preparation, in that they had not been warned how different their loved one might look to them. The researchers said that clinicians should not assume that relatives will necessarily be harmed by seeing a bruised or damaged body; and that within a family there may be different attitudes and preferences that need to be taken into account.

Growth hormone supplementation can increase sprint capacity, according to Australian research. The researchers conducted a randomised controlled trial involving 63 men and 33 women, all of whom were healthy recreational athletes. After 8 weeks of treatment, a modest dose of growth hormone had no effect on the subjects’ aerobic capacity or on measures of their strength and power. However, there was an effect on sprint capacity; an effect that was nearly doubled in the men who had received testosterone as well as growth hormone supplementation. The researchers did state that the athletic significance of their finding was unknown; however, they did also speculate that the approximately 4% increase in sprint capacity could translate to an improvement of 0.4 seconds in a 10-second sprint over 100 metres or 1.2 seconds in a 50-metre swim.

The integration of new with traditional approaches to surveillance offers the greatest promise for future surveillance of influenza and other emerging diseases, say the authors of a special report in the New England Journal of Medicine. Brownstein and colleagues highlighted HealthMap (http://healthmap.org), a new effort in transparent, global, public health surveillance. The HealthMap system combines automated 24/7 data collection from diverse sources, including online news media, blogs, Twitter and Facebook, with expert review and analysis to provide not only comprehensive but also contemporaneous reports by type of disease and geographic location.

N Engl J Med 2010; 362: 1731-1735