Health, Medicine & Nutrition
Anesthesia Professionals Question Safety of Non-experts Giving Propofo to Patients via New Sedasys™ Machine PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Christopher Bettin   
Friday, 10 May 2013 12:37
PARK RIDGE, Illinois – Responding to a decision by the Food and Drug Administration (FDA) to approve a new machine that allows healthcare providers who are not anesthesia experts to give the powerful drug propofol to patients undergoing colonoscopies and other gastrointestinal procedures, the American Association of Nurse Anesthetists (AANA) stated that the safest option for any patient receiving propofol is still the hands-on care provided by Certified Registered Nurse Anesthetists (CRNAs) and  physician anesthesiologists.

The pre-market approval of Johnson & Johnson’s Sedasys™ machine for administering propofol (Diprivan™) was announced on May 6 after three years of denial by the agency.

“Propofol is an effective anesthetic drug for colonoscopies and endoscopies because it is short acting and patients typically wake up quickly and feeling alert,” said Janice Izlar, CRNA, DNAP, president of the 45,000 member AANA. “However, propofol is also a very powerful drug in that any patient receiving it can slip from a mildly sedated state into a state of general anesthesia requiring assistance with breathing. That’s why it is always best for propofol to be administered by a qualified anesthesia professional. Since a machine is not able to prevent or manage loss of consciousness, we have serious concerns.”

A 2004 joint position statement of the AANA and the American Society of Anesthesiologists (ASA) concurs, saying, “Whenever propofol is used for sedation/anesthesia, it should be administered only by persons trained in the administration of general anesthesia, who are not simultaneously involved in these surgical or diagnostic procedures.”

Even the FDA-approved labeling on propofol warns that the drug should only be provided by persons qualified in general anesthesia, because the drug’s effects cannot be reversed.

According to Johnson & Johnson, facilities where the Sedasys is used should have an anesthesia professional immediately available for assistance or consultation, a vague requirement that generally limits the machine’s utility and cost-effectiveness. Johnson & Johnson also stresses the need for the propofol provider to be trained in dealing with the drug’s cardiorespiratory effects—abilities that CRNAs and anesthesiologists master during years of advanced education and clinical training.

“CRNAs are master’s prepared anesthesia experts educated and trained in the administration of general anesthesia and pain management,” said Izlar. “Numerous studies have demonstrated the cost effectiveness and high quality of CRNA care when personally provided to an individual patient.  Substituting a machine for a dedicated anesthesia expert involves unknown costs and risks.”

Johnson & Johnson plans to conduct two studies to monitor use of the Sedasys machine in actual clinical practice after a limited rollout in 2014.

About the American Association of Nurse Anesthetists
Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization representing more than 45,000 Certified Registered Nurse Anesthetists (CRNAs) and student registered nurse anesthetists.  As advanced practice registered nurses, CRNAs administer approximately 33 million anesthetics to patients in the United States each year and are the primary providers of anesthesia care in rural America. In some states, CRNAs are the sole anesthesia professionals in nearly 100 percent of rural hospitals. For more information, visit www.aana.com.

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discount prescription drug program oversight continues PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Thursday, 09 May 2013 14:36
Wednesday, May 8, 2013

Sen. Chuck Grassley of Iowa is looking into how hospitals are using a discount prescription drug program, known as 340B.  Certain hospitals appear to be making sizeable profits from the program at the expense of Medicare, Medicaid and private health insurance.  Grassley asked the federal agency in the charge of the program, the Health Resources and Services Administration, about its oversight of the program.  HRSA’s response is available here.  Grassley’s letter to HRSA is available here.  Grassley made the following comment on the response.

“The law requires HRSA to increase its guidance to participants in areas such as the definition of a patient. I intend to follow up with HRSA on the progress of those updates. Congress needs to know the extent to which the agency believes it lacks the statutory authority to ensure that hospitals use the 340B program to help the uninsured receive affordable prescription drugs.  Medicare and private insurance are paying much more for some drugs than the hospitals paid because of the program discount.  Congress needs a full picture of how hospitals are using the program and how their uses affect other programs in the health care system.”

 
AARP Says Iowans Deserve Better Healthcare Plan PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by AARP Iowa   
Tuesday, 07 May 2013 15:28

“IOWANS DESERVE BETTER”

Iowa groups will urge lawmakers to stand against shifting healthcare costs onto Iowa residents, and to stand for more local provider access.

What: AARP Iowa, the Iowa State Association of Counties, and Iowa’s American Cancer Society Cancer Action Network join with other Iowa groups to urge fellow Iowans to speak out against shifting higher costs onto Iowa taxpayers to pay for a system that offers less local health care access.

Who: Anthony Carroll, Associate State Director for Advocacy, AARP Iowa

Linda Hinton, Government Relations Manager, Iowa State Association of Counties

Dr. Richard Deming, Iowa Board Member, American Cancer Society Cancer Action Network

When: 8:30 a.m., Wednesday, May 8

Where: Room 116, Iowa State Capitol, 1007 East Grand Avenue. Des Moines.

Why: Providing healthcare for the poor is the right thing to do. Both the Iowa Senate and Iowa House have re-affirmed that with their majority votes for plans to cover low income Iowans. However, the two plans before the state legislature differ greatly in multiple ways. They differ in both the cost to all Iowa taxpayers and local, preventative access offered to those low income Iowans who would receive coverage.

Iowa groups will provide visual illustrations of these major differences and announce their current effort to inform Iowans of these differences.

These groups believe that hard-working, low-income Iowans deserve a plan that provides healthcare from local providers, without shifting more costs to Iowa taxpayers.

 
Governor Quinn Announces State is Accepting Applications to Join ACA Outreach Effort PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Ryan C. Woods   
Monday, 06 May 2013 14:46
Health Insurance Marketplace Seeks Community Groups’ Assistance in Educating the Public and Creating a Culture of Coverage Across the State

CHICAGO – Ramping up efforts to educate the public about the Affordable Care Act (ACA), Governor Pat Quinn today announced that the state is accepting applications from community-based organizations to assist with outreach and consumer education efforts that are now underway. The announcement is part of Governor Quinn's agenda to ensure all people have access to quality healthcare and improve the health and well-being of the people of Illinois.

“We’ve got a big job to do making sure that people across Illinois are aware of the affordable and high-quality health care coverage options that will soon be available through the Affordable Care Act,” Governor Quinn said. “That’s why we are partnering with trusted organizations that have proven records of success and roots in communities across Illinois to ensure that no one is left out.”

The Illinois Department of Public Health, in coordination with the Health Insurance Marketplace will be accepting applications until May 30th, from community groups and other qualified organizations who want to participate in the In-Person Counselor (IPC) Program. The state has received approximately $28 million in federal funds for grants to participating groups.

Submissions will be competitively scored based upon quality of application, organizational capacity, and proposed scope of work. Special consideration will be given to ensure proper statewide distribution of funding based on population, regional and cultural needs. Organizations that are selected through the online application process will participate in outreach training this summer.

“We know that far too many people, especially those who lack health care coverage, are simply not aware of the coming opportunity to acquire coverage as a result of the Affordable Care Act,” Marketplace Director Jennifer Koehler said. “We estimate that more than half of the Marketplace’s customers will require help sifting through the options and enrolling in a health plan that meets their needs. We’re looking for partners who are trusted in their communities to help us carry out our goal of creating a ‘culture of coverage’ in every corner of the state.”

Enrollment in the Illinois Health Insurance Marketplace will begin on Oct. 1, with coverage to start Jan. 1, 2014. The Marketplace will be accessed through a robust, user-friendly website where individuals, families and small businesses will be able to compare health care policies and premiums and purchase comprehensive health coverage.

For more information about the state’s implementation of the ACA, go to: www.HealthCareReform.illinois.gov.  For more information about the application process for the Illinois In-Person Counselor (IPC) Grant Program, go to: http://www2.illinois.gov/gov/healthcarereform/Pages/IPC.aspx.

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3 Tips to Lower Your Veterinary Bill PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Ginny Grimsley   
Monday, 06 May 2013 08:21
New Tax Adds to Already Growing Costs

Pet owners’ vet bills are growing, which may explain why fewer are taking their dogs and cats to the animal doctor although more Americans than ever have pets.

To make matters worse, a 2.3 percent tax on medical devices that kicked in Jan. 1 includes equipment that’s used for animals as well as people. Items as basic as IV pumps and scalpels are now subject to the tax, which is to help fund the Affordable Care Act.

“Even before the tax, the latest survey showed spending for dog care alone rose 18.6 percent from 2006 to 2012. And even though cat vet visits dropped 4 percent in that time, cat owners paid 4 percent more,” says Dr. Rod Block, citing the 2012 U.S. Pet Ownership and Demographic Sourcebook, a survey of more than 50,000 households.

“Add to that the new excise tax and I’m sure we’re going to see even more people torn between paying the light bill and taking their pet to the vet,” says Block, a board-certified animal chiropractor and author of  “Like Chiropractic for Elephants,” (www.drrodblock.com). But there are simple ways to keep veterinary costs down, while still providing excellent care for your pet – whether it’s a dog, cat, horse or guinea pig, Block says.

“It’s important to always get appropriate care when your animal needs it, but you can easily prevent problems, or catch them early, by simply staying in tune with your pet’s physical, emotional and spiritual needs,” he says.

He offers these tips for accomplishing that, and distress signals to watch for:

• Is your pet in pain?: Before X-rays and MRIs, health practitioners relied on these physical indications of pain: heat, redness, lumps or swelling, tremors, obvious discomfort. To recognize the first four, a pat on the head is not enough. Get used to taking some quiet time to place your hands on your pet, and work on honing your perceptive abilities. Being in a rush or having your mind on what you need to do next will impede your ability to perceive changes – use the time to simply be with your animal. If a joint feels warm, it may be inflamed. Mild localized tremors can indicate a problem in the area beneath your hand. Lumps or an asymmetrical feel when you have your hands on either side of the pet may indicate growths. “Take your time and quiet your mind. Animals are keenly aware of intent, and they’ll work with you if feel your intent,” Block says.

• Watch how your pet plays: It’s important that a pet gets physical and psychological stimulation, but those needs vary with temperament, age, and even how energetic the pet owner is. “Pets tend to match their owners’ energy levels, for instance, very elderly owners will tend to have pets that like to nuzzle and curl up next to them,” Block says. Take note of how your pet plays so you’ll be aware of changes. Is he becoming more aggressive? He may be telling you something’s bothering him. Has she stopped hopping up on the couch? Is he favoring a paw (or hoof?) Beyond the physical, your pet’s play can also communicate emotional distress. For instance, if he becomes fearful or timid, consider any changes in the home, routines, etc., that may be affecting him.

• Have a thorough neuro-muscular-skeletal exam done. A veterinary chiropractor can examine a pet’s frame, muscles and nerves for areas that may be pre-disposed to injury, and suggest ways you can help protect them. In dogs, cats and horses, joint injuries are common, with muscle and tendon strains and tears. Problems with the spine can lead to compressed or herniated discs, and neck issues can lead to mobility problems and even seizures. If you know your pet’s vulnerabilities, you can take steps to prevent injuries.

“If you decide to take your pet to a chiropractor, make sure he or she is certified by the American Veterinary Chiropractic Association,” says Block, who’s been treating people for 43 years and animals for 16.

“Find one who is in tune with animals – a host of technical skills does not compensate if the practitioner is not in tune with his patients.”

About Dr. Rod Block

Dr. Rod Block serves as a chiropractic consultant to numerous veterinary practices in Southern California and is an international lecturer on animal chiropractic. He is board certified in animal chiropractic by the American Veterinary Chiropractic Association, is a member of the International Association of Elephant Managers and serves as an equine chiropractic consultant to Cal Poly Pomona. Dr. Block is the equine chiropractor for the Los Angeles Police Department’s Mounted Police Unit, a lecturer at Western State University College of Veterinary Medicine and a lecturer at University of California Irvine (Pre-Veterinary Program). He completed his undergraduate studies at UCLA and later received his Doctorate in Chiropractic.

 
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