When the novel coronavirus began sweeping around the world earlier this year, it left doctors, hospitals and public health experts scrambling for answers. How should diagnoses of COVID-19 cases be made? What are the symptoms that need the most careful monitoring? What are the right treatment options for each stage of the disease? And what happens if patients have other conditions, such as being pregnant? The answers were—and continue to be—evolving so rapidly that it has been hard for overworked physicians, nurses and other healthcare providers to keep up.
But there isone place they can turn quickly for the latest information—a free online training module from a medical education company called CaseNetwork. First released on March 17, this program also illustrates the growing potential of virtual, case-based medical education even long after the pandemic has subsided.
For the 30 million Americans living with some form of kidney disease, the current COVID-19 pandemic brings a host of additional challenges not faced by the general population—like a greater risk of developing serious complications if they contract the virus. And for the 500,000 Americans with kidney failure who rely on dialysis treatments to stay alive, these challenges only multiply. Do they follow “stay-at-home” orders and skip their dialysis treatments, or do they risk exposure by going to a dialysis clinic where social distancing is difficult, if not impossible, to enforce? Either decision could have life-threatening consequences.
And what about the procedures to create and maintain the necessary access to their bloodstream that makes dialysis possible? In mid-March, the CMS deemed these procedures “non-essential,” leading to a host of cancelled appointments and operations. Even when CMS reversed its decision days later, the confusion that resulted from the chaos left many physicians, hospitals and patients unsure of which path to follow.
In the United States alone, nearly half a million people currently suffer from end-stage kidney disease and must undergo hemodialysis several times a week. For these patients, the vascular access site is quite literally their lifeline, as it provides direct access to their bloodstream for the life-saving treatments.
Yet due to the current COVID-19 outbreak, procedures to establish these vascular access sites have been deemed “non-essential” elective procedures by CMS and HHS, and nephrologists and vascular surgeons are finding themselves unable to secure operating room time.
Though we must all work together during this crisis to reduce the intense strain on our healthcare system, this decision could have devastating implications for patients with end-stage kidney disease — a group that is already highly vulnerable to potential complications of COVID-19. Limiting access to these procedures will increase reliance on riskier vascular access options that significantly increase patients’ chances of infection, hospitalization and even death. This will only add to the strain on resources as hospitals continue to deal with the outbreak.
Multiple myeloma is the most common hematological malignancy. It forms in plasma cells, white blood cells found mainly in the bone marrow that protect the body from infection by producing antibodies. When these cells become malignant, abnormal plasma cells accumulate in the bone marrow, producing abnormal antibodies and crowding out normal blood-forming cells. Some of these abnormal cells, known as circulating multiple myeloma cells (CMMC), escape from the primary tumor space and travel through the bloodstream.
Current approaches for diagnosing patients with multiple myeloma require bone marrow aspiration and biopsy. These are invasive procedures that use a hollow needle inserted into the hipbone or breastbone to remove bone marrow, blood, and a small piece of bone. While generally safe, bone marrow exams can result in excessive bleeding, infection, and long-lasting discomfort.
This basic fact makes IV therapy a pressing healthcare issue affecting nearly every specialty, according to Lee Steere, RN, CRNI, VA-BC, Manager of IV Therapy Services at Hartford Hospital – especially when you consider that nearly 90 percent of hospitalized patients will require a peripheral IV (PIV) catheter at some point during their stay.
In the United States, PIV failure rates average around 53%, meaning one out of every two catheters fail to last until the end of treatment. This could be the reason that needle sticks are among the top ten patient fears, according to a national survey of hospitalized patients.