Shout Outs

Updated 3/2017-- photos and all links removed as many are no longer active and it was easier than checking each one.

Amy, Diabetes Mine, is the host for this week’s Grand Rounds! You can read this week’s edition here.

The Ides of March is the first day of the Roman New Year. It also marks the first day of spring in the Roman calendar.

On this day in history, Julius Caesar was warned by soothsayers to “beware of the Ides of March”. Apparently, he did not heed the warning strongly enough as he was stabbed by Marcus Brutus on the Ides of March in 44 BC.

We must begin with last week’s betrayal by the forces of nature, as Dr. Paul Auerbach, of Stanford Emergency Medicine, voices our feelings at Heathline:

“Our thoughts and prayers go out to everyone in harm’s way related to the earthquake and tsunami that just struck Japan, as they did for persons in New Zealand, Haiti, and every other country recently affected by a natural disaster.”  ……

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A wonderful post by Michelle Au, the underwear drawer :  it gets better

The lowest point in my residency was in January of my intern year.  I was a Pediatrics resident back then, doing a month-long rotation on "Team 2," which is what we called the general inpatient pediatric team, with a focus on the patients on our liver transplant service.
It was a very long month.…………..

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Via both @movinmeat and @inwhiteink:  Satellite Photos - Japan Before and After Tsunami - Interactive Feature - NYTimes.com

and to @movinmeat:  @arclight this is an excellent, if long/wonky explanation of what happened at Fukushima Daichi nuclear plant Why I am not worried about Japan’s nuclear reactors

New York Times:  100 Photos of Japan Aftermath

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If you are looking for ways to help Japan, consider donating to the Red Cross:  Japan Earthquake and Pacific Tsunami Relief
or if you’d rather do so by texting:  Donate to @SalvationArmyUS by texting "JAPAN" to "80888" or text "REDCROSS" to "90999"
Other good sources for information can be found in Thomas Fiala, MD’s post:  OT:  Information on Japanese earthquake & tsunami relief efforts

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Two stories from NPR:

Radiation Fears Rise At Japanese Plant by NPR Staff and Wires

Dangerous levels of radiation are leaking from the earthquake-crippled Fukushima Daiichi nuclear power plant north of Tokyo and levels are rising, Japanese Chief Cabinet Secretary Yukio Edano said Tuesday.

Japanese Prime Minister Naoto Kan ordered everyone within 20 kilometers (about 12 miles) to evacuate. He told everyone within 30 kilometers (about 19 miles) to go inside. Japan's NHK television said most residents inside the 20-kilometer radius have already evacuated.  ………….

Why Iodine Tablets Come Out When Radiation Threatens by Scott Hensley

Just in case, Japan has distributed a whole bunch of potassium iodide to evacuation centers near the troubled Fukushima Daiichi and Fukushima Daini nuclear power plants.

The International Atomic Energy Agency said in a statement that 230,000 units (the stuff comes in tablets and as a liquid) are at the ready.

Why is that important? Well, one of the substances that can be released in a nuclear accident is radioactive iodine (I-131, if you're interested in the details). And some radioactive iodine has already been detected by Japanese authorities.  ……….

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H/T to @globalsurgeon: An interview in IPS News of @ReinouGroen from @SurgeonsSOS on #globalsurgery : Needing Surgery Shouldn't Be a Death Sentence 

Surgery saves the lives of millions of people around the world, but only a tiny percentage of them live in low- and middle-income countries (LMICs), where a shortage of skills, supplies and infrastructure can turn easily treatable accidents and illnesses into lifelong disabilities and even death.

The world's poorest receive only four percent of all major surgical operations worldwide, while 75 percent of surgeries benefit the richest third of the world, according to a 2010 Harvard University School of Public Health study.  …….

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Our medical blog friend, Dr Anonymous, has officially ended his old blog:  Goodbye @doctoranonymous.   He changed his twitter name last week: @drmikesevilla and has revealed his new website/blog:  Family Medicine Rocks. 

Best wishes to you, Dr. Sevilla!

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On a lighter note, this story comes from @KnittingNephron  ---Knitted breasts created by 91-year-old pensioner

You might expect your granny to knit you a woolly jumper, but one pensioner has been defying expectations by using her needles to craft amazing knitted BREASTS.

Coral Charles-Dunne, 91, from Birmingham, has knitted dozens of the unusual educational tools as part of a project to inform expectant and new mums about breastfeeding.

She says spends about two hours creating each of the woolly boobs and makes them in a range of sizes, knitting for up to six hours per day. …………

ACS’s Surgical Case Log for Haiti Workers

Updated 3/2017 -- links removed as many no longer active.

H/T to Dr. Val, Better Health and her post  The American College Of Surgeons Creates Case Log For Surgeries Performed In Haiti.  I’d like to help her get the word out on this web-based tool the ACS has created to help medical workers in Haiti keep track of surgical procedures.

The ACS has a case log system in place already for College members which they have expanded and opened to non-College members as well.

Non-ACS members can register here.  The system will automatically add Haiti as a location, and surgeons can start adding cases right away.

ACS members who have used the case log system before can log in here.  ACS members who have not registered to use the case log system can register at here.  Once ACS members are logged in, they can add “Haiti” as a location for cases associated with relief activities.

The system currently works with both Palm and Pocket PC phones.  The iPhone and Blackberry editions will be released in the next 1-2 weeks.

Disaster Medicine and Public Health Preparedness

Updated 3/2017-- photos and all links removed as many no longer active as it was easier than checking each one.

As the floods continue to be an issue here in Arkansas and with the explosion of a meat packing plant in Booneville which required an evacuation due to an ammonia leak into the air, it seems like a good time to review some sources for information for both medical and non-medical folk. Gallery of flood pictures.

• Don't drive through rising water. It only takes 2 feet of water to carry away most cars and sport utility vehicles. The majority of drowning deaths from flash floods are related to being trapped in the motor vehicle.
• Flash flooding causes most of the fatalities due to natural disasters in the United States.
• Clean up mold and germs from the flood water. Fix any leaking pipes and other water problems and then dry things, or the mold will grow again.
• It is best to wear a respirator mask over your mouth and nose when you clean, so that you do not breathe in a lot of mold. A respirator that protects against mold is called an N-95 respirator.
• Wash your hands often and be careful of cuts and scratches. The water you wade through may be contaminated by sewage overflow or backup.

Check out these sources for more information. Be safe.

MedLine Plus -- Disaster Preparedness and Recovery. A lot of good information for citizens. The main page has many links to other agencies and articles, but these two are a good place to start.

Are You Ready? An In-Depth Guide to Citizen Preparedness(Federal Emergency Management Agency) - Links to PDF
Picking up the Pieces After a Disaster(American Red Cross)
Arkansas Department of Health--Food and Water Safety Following a Flood - opens as a PDF

CDC Emergency Preparedness and Response -- website has sections on Bioterrorism Emergencies, Chemical Emergencies, Radiation Emergencies, Mass Casualties, Natural Disasters and Severe Weather, and Recent Outbreaks and Incidents. Full of information and worth checking out.

FEMA Emergency Management Institute Independent Study Program -- The Emergency Management Institute (EMI) offers self-paced courses designed for people who have emergency management responsibilities and the general public. All are offered free-of-charge to those who qualify for enrollment. To get a complete listing of courses, click here.

Nurses on the Front Line: Preparing for and Responding to Emergencies and Disasters - hosted by The National Nurse Emergency Preparedness Initiative (NNEPI), developed by The George Washington University Department of Nursing Education and funded by The U.S. Department of Homeland Security.

Johns Hopkins Center for Public Health Preparedness Online Training Modules -- training modules on the following emergency preparedness and response topics: Agriculture, Food and Water; Chemical, Biological, Radiological, Nuclear Terror; Infectious Disease and Vaccines; Legal Issues; Mental Health Preparedness; and General Public Health Preparedness

WISER is a system designed to assist first responders in hazardous material incidents. WISER provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression advice. Free download available as a stand-alone application on Windows Mobile devices, Palm OS PDAs, and Microsoft Windows PCs.