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>Medical Myths

>There are many books out now condemning medical blunders. One I’ve been reading is 100 Most Common Medical Blunders …and How to Avoid them All! published by Boardroom, Inc. in 2008.

The source is Paul Barach, MD. He tells about a blunder he made while a third-year med student when an attending physician told him to insert a central intravenous line (IV) into a 75-year-old patient suffering from emphysema. Dr. Barach had never performed the procedure before. Alone and unguided, he wound up puncturing the air sac surrounding the lung, and the patient later died of related complications.

Though Dr. Barach went on to become a noted physician, this incident plagued him for years. He studied blunders like these with a desire to find out how errors can be prevented.

Here, we offer his list of mistakes and ways to avoid them. For starters, we should be absolutely sure that an operation is necessary before having a part excised. For example, experts tell us that one-fourth of all appendectomies
are unnecessary because of incorrect diagnosis and the appendix is not diseased.

This blog will not be all inclusive of the common errors Dr. Barauch gives, however on subsequent blogs we will pick up on some more:

1) Medication errors. This includes oral as well as those given through the veins (IV drugs) for serious conditions such as heart attack and stroke. Also included are subcutaneous injections (below the skin) such as a diabetic’s insulin shot. The Institute of Medicine estimates that between 3% and 5% of all medication is administered incorrectly. That is probably a far too-conservative estimate.

These errors can happen in doctors’ clinics, hospitals, offices, home, and pharmacies. For example, a drug might not be given at the right time, in the right dose, or with the right frequency. In most instances, this type of error is minor and has no lasting consequences.

However, IV drugs act much more quickly than oral medications and these errors are usually irreversible and of lasting or severe consequence. With chemotherapy, dosing is complicated and requires different combinations and amounts of toxic drugs.

Are certain people at increased risk for certain drugs?
Psychiatric and older patients are at high risk. Older people are more likely to be on multiple drugs and less likely to to pay close attention when drugs are being administered. Psychiatric patients usually don’t ask questions when given medications.

What can patients do to make sure their drugs are being administered properly?
Get very clear and detailed explanations from your provider beforehand and in writing. Find out what you are going to be taking, for how long, and what side affects might accompany these drugs.