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Side Bar Articles - November 26, 2005How Hospitals make people sick How hospitals make people sick“Latrogenic” illnesses are those inadvertently caused by medical care, such as an allergy to a medicine. The word is first found in 1920s psychiatric writings. In a six-nation survey released this month, Canadians reported the second-highest level of medical mistakes, just behind the U.S. The Commonwealth Fund study found 30 per cent of Canadians surveyed had, for example, received incorrect medications or doses, or were given test results that were in error or significantly late. In the U.S., hospital infections are the fourth-leading cause of death, killing as many people as AIDS, breast cancer and auto accidents combined. As many as half of hospital patients around the world become undernourished due to poor-quality food, lack of appetite and difficulty feeding themselves. Malnutrition lengthens hospital stays by 50 per cent and worsens patients’ outcomes and death rates. One solution: Across the U.S., 240 hospitals offer the At Your Request program, hotel-style room service, served all day, that lets patients eat whenever they’re hungry. A computer monitors the individual’s daily nutritional intake.
The body’s cutleryStruggling with the names and functions of surgical instruments is one of the frustrations of medical training. “You can’t say to the nurse, I need a thingamajiggy for the doohickey,” an instructor tells surgical residents, “because then you just blew half an hour of your OR time getting the right instruments.” A small sample of common operating tools: Scalpel: Knives in various sizes and blade styles, with longer handles for deeper work. Miller-Senn retractor: For drawing back small incisions in arms and other places where skin is thin. Dull rake retractor: For pulling soft tissue. Self-retaining retractor: For hands-free pulling back of superficial tissue. Ribbon retractor: For abdominal work. Double-armed Jackson retractor: For deep abdominal work. Harrington retractor (or Sweetheart retractor): For very deep work in the abdominal region. Double-armed Jackson retractor: For deep abdominal work. Harrington retractor (or Sweetheart retractor): For very deep work in the abdominal region. Balfour retractor with blade: A self-retaining device for abdominal work. Homann retractor: Used near a bone to retract muscle. Rib stripper: For scraping tissue off the ribs. Cobb elevator: Strips the “periosteum,” the membrane that envelops the bones. Forceps (various): Surgical pincers that grasp and hold. Mosquito forceps: Used on blood vessels to control bleeding or hemorrhage. Satinsky clamp: Forceps that clamps off a vessel. Rongeur: Takes small nibbles of bone, for access to deeper structures or to move bone chips. Kerrison rongeur: For deeper bone-nibbling during spinal operations. Tracheal spreader: Retracts neck tissue so a tracheostomy tube can be inserted.
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