 Some studies are fascinating and disconcerting at the same time... but at least they’re good for a smile!
In this paper by Ghareeb et al. the authors addressed the question whether a handshake or a fist bump is more effective in preventing or reducing pathogen transmission in the setting of a hospital, where most of us work of course. Unsurprisingly they found that using the fist bump instead of handshakes made skin contact 2.7 times shorter and this reduced spread of bacteria. They concluded that the fist bump is an effective alternative to the handshake in the hospital setting and that bumping might lead to decreased transmission of bacteria and improved health and safety of patients and health care workers alike. So shall we all start bumping around the hospital? We performed an observational study in our medium sized ICU in Galway (without approval of any committee and of course without any statistical evidence to be presented, actually just out of interest and for fun). We might also mention beforehand that working atmosphere in our unit is very good and nurses and doctors work very closely together. Interestingly, neither nursing staff nor doctors shake hands when they meet and greet each other in the ICU. The only occasions handshakes were observed are when relatives are met for a discussion or a representative of some company comes in for a visit. In regards of the study mentioned above I have some serious concerns: I wonder how many health care professionals out there would welcome a family fist bumping that has come in to discuss an end-of-life issue for instance. Also when representing the unit towards someone outside of hospital a fist bump carries some substantial risk of giving a very unprofessional impression... at least in Europe! And in very few occasions also a warm hug will be irreplaceable by some awkward bump. Social behavior is also a way on communicating... and anyhow, who pays for such studies? Ghareeb PA et al. J Hosp Infect. 2013 Dec;85(4):321-3 Picture displayed above is taken from the New York Times  Hypothermia is back in the focus of discussions and was not only used for treatment after cardiac arrest. If hypothermia would protect after cerebral ischemia after an arrest it might be also useful after other impacts like stroke or meningitis.
To answer this question a french multi-center study was started involving 49 intensive care units. Patients with communitiy acquired bacterial meningitis and a GCS of less than 8 for less than 12 hours were enroled. The hypothermia group was cooled to 32-34°C for 48 hours and then passively rewarmed. Primary outcome was GCS at three months. After including 98 patients the study had to be stopped on the request of the data ans safety monitoring board due to concerns over excess mortality in the hypothermia group. Analysis showed no improve of outcome but might actually be harmful to patients. Hypothermia doesn’t seem to be the magic bullet here either. Mourvillier B, et al. JAMA. 2013 Nov;310(20):2174-83 |
Search
|
RSS Feed
