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Biomedical subjects

M R Cohen

Publications and source records attributed to M R Cohen.

At least 109 records · Page 6Linked to original sources
PubMed1992

Free flow associated with electronic infusion devices: an underestimated danger.

Accidental, uncontrolled free flow after removal of administration sets from electronic infusion devices (EIDs) has only occasionally been reported. Recent evidence indicates that this problem is far more widespread and serious than previously understood. Well-documented cases of accidental death and serious injury have now come to light and are a particular cause for concern. Many of the EIDs commonly used in hospitals incorporate sets that offer no protection if someone removes the set from the device without first closing the set's flow control clamp. Because the problem has infrequently been reported and the risk is not well appreciated, only minimal warnings are issued about the problem by manufacturers. Standard intravenous tubing sets and other nonprotected EID sets are less expensive than protected sets and some hospitals have acquired EIDs that use unprotected sets without an adequate understanding of the risks of free flow (i.e., fluid overload and drug toxicity). Therefore critically ill patients receiving certain types of intravenous fluids or critical care drugs may be at great risk of injury when an overinfusion occurs. This article provides a better understanding of the extent of the problem and offers suggestions for minimizing or eliminating the problem.

Critical Care↗
PubMed1992

Look-alike and sound-alike drug names: the problem and the solution.

This list of 645 pairs of look-alike and sound-alike drug names (1,290 names are shown; they are listed both ways), has been complied to graphically emphasize the importance for the pharmaceutical industry, the United States Adopted Name (USAN) Council, and Food and Drug Administration (FDA) to select new names with great care. It also stresses to health professionals the necessity of writing legibly, writing complete orders, speaking slowly and clearly when giving verbal orders, carefully reading prescription orders, knowing what is wrong with patients, maintaining records of previous drugs patients have received, and learning about new drug products. It also indicates that patients must be educated about the medications they are taking. Your cooperation in alerting the authors of names they may have overlooked or of new problems would be greatly appreciated. When a sufficient number of additions are received, an updated list will be published.

Drug Information Services↗
PubMed1992

What should a pharmacy manager do when a serious medication error occurs? A panel discussion.

Questions related to medication errors were discussed by a panel of hospital department managers. When a serious medication error occurs, the manager has a responsibility to help the employee, the patient, and the patient's family cope with its effects, as well as a responsibility to prevent such errors from recurring. The difficulty of dealing with medication errors may be compounded when the legal system and the news media get involved. Therefore, a system for handling a serious error should be in place before that error occurs. It is also necessary to decide whether to use medication error reports in the employee evaluation process; this could make employees reluctant to report their errors. Ultimately, pharmacy managers are responsible for medication errors that occur, and repercussions have varied from nothing to reprimands to termination. Past errors, if they are reported, can be used to improve the system in which they occurred and to educate other health-care professionals. Therefore, pharmacists need to cooperate with other health-care professionals in documenting medication error reports. A national reporting system is needed so that medication error information can be shared on a large scale without placing the people involved in legal jeopardy. Sharing information about medication errors is necessary to prevent future occurrences; mechanisms are needed to facilitate such sharing.

Legislation, Medical↗
PubMed1991

Astrocytes: a possible primary site for colchicine-mediated neurotoxicity in the rat striatum.

Ultrastructural changes in rat astrocytes including endfoot swelling and rupture of plasma membranes were seen as early as 1 h after injection of 6.0 micrograms colchicine (CO) into the striatum. Significant change in neuronal morphology was not seen by 24 h. Astrocytes may therefore be primary targets for CO-mediated damage, which then may have secondary neurotoxic consequences.

Animals↗
PubMed1991

Effectiveness of technical assistance in the development of psychiatric rehabilitation programs.

Most mental health programs need technical assistance to develop effective psychiatric rehabilitation programs. This article discusses how psychiatric rehabilitation was introduced into three community mental health programs and describes the elements of a psychiatric rehabilitation program and the phases of a technical assistance process. A case study illustrates how technical assistance consultants can be trained to develop psychiatric rehabilitation programs. Barriers and facilitators to the technical assistance are discussed in the context of several other technical assistance studies.

Community Mental Health Services↗
PubMed1991

Double laparoscopy: an alternative two-stage procedure to minimize bowel and blood vessel surgery.

We present double laparoscopy as an alternative technique especially useful with the scarred abdomen postlaparotomy or when open laparoscopy has failed. This is a two-stage abdominal endoscopic procedure. Stage 1. This is the establishment of a pneumoperitoneum with insertion of a Verres needle through the left upper quadrant of the abdominal wall lateral to the rectus muscle, two fingers beneath the inferior costal margin. A sharp 5 mm trocar and sleeve is inserted through a small skin incision at the needle puncture site, and a small endoscope is then inserted. The hysteroscope or a 5 mm OD diagnostic laparoscope is an excellent instrument for upper abdominal laparoscopy in the adult and for general laparoscopy in infants and children. The abdominal cavity is surveyed, especially viewing the periumbilical area. Stage 2. When an adhesion-free and bowel-free area is identified, a standard 10 mm sharp trocar and sleeve is inserted under direct vision, and a standard laparoscope is introduced. We present a small sampling (24 cases) of our combined experience of 5000 laparoscopies, where this technique proved useful. Although we have used this technique over the years without any complications, the procedure has never been published.

Blood Vessels↗
PubMed1991

The high cost of customization: compounding drugs.

Physicians wishing to make a special compound for an inpatient for the first time, should contact the pharmacy well in advance of its need. Physicians should consider that the cost of compounding is very expensive. Furthermore, it is often less accurate in its dose than manufactured products. This is particularly important to remember with regards to mg/kg dosing. Provided certain conditions are met, the pharmacy will specially compound a product for an inpatient, if it has the ability to do so. Currently, the pharmacy cannot compound or dispense products for outpatients, or provide special compounding services to the BUSM, labs, departments, or clinics. If there are any questions about what can or cannot be done in the way of special formulations, contact the Pharmacy.

Cost-Benefit Analysis↗