10 Common First-Aid Mistakes

1. Myth: Cut a snakebite
“The safest thing to do for snakebite is just splint the limb and go to the hospital,” says Christopher P. Holstege, M.D., an emergency medicine doctor and toxicology expert. “Cutting the bite wound could sever tendons, nerves or arteries or increase the risk of infection, and tourniquets are risky,” Dr. Holstege explains.

Dr. Holstege recommends the right approaches for the following first-aid myths.

2. Myth: Put butter on a burn.
Reality: If you apply butter or another substance to a serious burn, you could make it difficult for a doctor to treat the burn later and increase risk of infection.

The right approach: “It’s usually OK to cool the burn with cool water, but burns with significant blistering need to be seen at a health-care facility,” says Dr. Holstege. Keep the burn clean and loosely covered. Don’t pop the blisters.

3. Myth: Keep syrup of ipecac on hand in case of an accidental poisoning.
Reality: The American Academy of Pediatrics (AAP) and other experts no longer recommend using syrup of ipecac. The AAP says there’s no evidence that vomiting helps children who have swallowed something poisonous. Most emergency medical facilities have switched to activated charcoal, which binds with the poison in the stomach and prevents it from entering the bloodstream.

The right approach: Throw out any syrup of ipecac that you have at home. If an accidental poisoning occurs, immediately call your doctor or a poison-control center for advice.

4. Myth: Apply a tourniquet to a bleeding extremity.
Reality: When severe bleeding occurs, some people mistakenly tie a belt or shoestring around the limb above the wound to slow the flow of blood. But doing so can cause permanent tissue damage.

The right approach: Pad the wound with layers of sterile gauze or cloth, apply direct pressure, and wrap the wound securely. Seek medical help if the bleeding doesn’t stop or if the wound is gaping, dirty, or caused by an animal bite.

5. Myth: Apply heat to a sprain, strain, or fracture.
Reality: Heat gives the opposite of the desired effect—it promotes swelling and can keep the injury from healing as quickly as it could.

The right approach: Apply ice wrapped in a cloth or something else to keep it from having direct contact with the skin, alternating 10 minutes on, 10 minutes off for the first 24 to 48 hours.

6. Myth: You should move someone injured in a car accident.
Reality: A person with a spinal-cord injury won’t necessarily appear badly injured, but pulling him or her out of a vehicle—even removing the helmet from an injured motorcyclist—could lead to paralysis or death.

The right approach: If the vehicle isn’t threatened by fire or another serious hazard, it’s best to leave the person in place until paramedics arrive.

7. Myth: Rub your eye when you get a foreign substance in it.
Reality: Doing so could cause a serious tear or abrasion.

The right approach: Rinse the eye with tap water.

8. Myth: Use hot water to thaw a cold extremity. Hands and feet go numb when they get too cold, in which case many people try to warm them up by putting them under hot water.
Reality: Hot water can cause further damage.

The right approach: Use lukewarm water only, or use dry heat.

9. Myth: Sponge on rubbing alcohol to reduce a fever.
Reality: In children, the alcohol vapor is absorbed from the lungs. Children are sensitive to very small amounts of alcohol.

The right approach: “Take acetaminophen or ibuprofen,” says Dr. Holstege. “If a fever is very high, have it checked by a physician or treated in a hospital emergency room.”

10. Myth: It’s OK to treat at home an allergic response to a bee sting.
Reality: Delaying professional treatment could be fatal.

The right approach: For symptoms such as breathing problems, tight throat, or swollen tongue, call for an ambulance immediately.

Read more: http://www.care2.com/greenliving/10-common-first-aid-mistakes.html#ixzz1i1ZkQ1eE

Small Patients, Big Consequences in Medical Errors

WHEN 6-year-old Chance Pendleton came out of surgery for a wandering eye, it was obvious that something was not right. “He was crying hysterically, vomiting and kept saying, ‘I wish I was dead,’ ” his mother, Grace Alexander, of Paris, Tex., recalled.

The boy had been through surgery before and had never reacted this way. “The nurse was quite peeved and wanted me to calm him before he disturbed anyone,” said Ms. Alexander, who said Chance was denied more pain and anti-nausea medication. “She thought he was just throwing a tantrum.”
After about 20 minutes, another nurse walked by, and Ms. Alexander beckoned her for help. The nurse checked the intravenous line in Chance’s ankle and saw that it wasn’t inserted correctly. He wasn’t receiving any medication. She immediately fixed it, bringing relief to Chance in a matter of seconds.
Medical mistakes, though also common in adults, can have more serious consequences in children, doctors say. The actor Dennis Quaid’s newborn twins nearly died last year after receiving 1,000 times the prescribed dose of a blood thinner. Other infants have died from the same error. A study in the journal Pediatrics in April found that problems due to medications occurred in 11 percent of children who were in the hospital, and that 22 percent of them were preventable.
An Institute of Medicine report nearly a decade ago highlighted the prevalence of medical errors, and they are still a major problem. “There’s been slow progress in the decline of these errors,” said Dr. Peter B. Angood, chief patient safety officer of the Joint Commission, the independent hospital accreditation agency. The agency recently called onhospitals to further reduce medication errors in children.
Children are also the victims of diagnostic errors, incorrect procedures or tests, infections and injuries.
Medical errors pose a greater threat to children than to adults for a number of reasons. They are physically small, and their kidneys, liver and immune system are still developing. Even a tiny increase in the dose of medication can have serious effects — especially in babies born prematurely. And if children take a turn for the worse, they can deteriorate more rapidly than adults. Children also are less able to communicate what they are feeling, making it difficult to diagnose their problem or know when a symptom or complication develops.
Adult medications are prepackaged and have standardized doses, but pediatric medications vary, based on the child’s weight and sometimes height, requiring doctors to make calculations. It is easy to misplace a decimal point, a tenfold error.
Typically, an adult formulation is diluted for children, and sometimes “the amount of medication being diluted is smaller than an air bubble in a syringe,” said Dr. Rainu Kaushal, director of quality and patient safety at the Komansky Center for Children’s Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
“A pharmacist can get orders for 55 milligrams, 65 milligrams, 70 milligrams of the same medication,” said Michael R. Cohen, president of the Institute for Safe Medication Practices, a nonprofit health care education organization. And medications for children come in different formulations, from drops to liquids to chewables. These variables increase the chance of human error, Dr. Kaushal said.
The Joint Commission reported that about 32 percent of medication errors in children in the operating room involved the wrong dose, compared with 14 percent in adults.
But not all errors happen in hospitals. Karen Rhodes was giving her 2-year-old daughter, Lanie, the prescription medication Zyrtec for allergies three times a day, as the label indicated. But Lanie began to suffer tremors, her breathing grew shallow, and she became “zoned out,” her mother said. It turned out she was getting three times the recommended dose; the drug should have been taken once a day. It was the pharmacist’s error, said Mrs. Rhodes, of Spartanburg, S.C.
At the American Academy of Pediatrics annual meeting in 2006, Dr. Kaushal reported that potentially harmful medication errors affected 26 percent of children in outpatient care.
“There needs to be more medications specifically manufactured for the pediatric population, more standardized dosing regimens and very accurate and clear labeling and packaging of medications,” said Dr. Angood of the Joint Commission. A labeling issue caused the mix-up that led to the overdose of the Quaid twins. The label for a 10-unit dose of the blood thinner heparin, which is used to flush intravenous lines, looked similar to the label of the 10,000-unit dose that the twins were given.
TECHNOLOGY has helped to reduce medication errors. Two methods are favored by experts: an electronic prescribing system known as computerized physician order entry, and a system in which a bar code assigned to a patient is swiped against the bar code of the drug he is about to receive.
But these technologies are expensive and require training. Only about 10 percent of hospitals in the United States use computerized prescribing, and 20 percent use bar coding, said Dr. Cohen. One technology, adopted by about half of the hospitals in the United States, is the smart pump, a programmable intravenous device that regulates the amount and timing of drug delivery. Infections, which are considered errors because they are preventable, are also common among children being treated in hospitals. Studies of neonatal and pediatric intensive care units found that infections topped the list of medical errors, followed by medication errors and injuries from catheters (many are left in too long), said Dr. Paul J. Sharek, chief clinical patient safety officer of the Lucile Packard Children’s Hospital at Stanford in Palo Alto, Calif.
Misdiagnosis is also common and can lead to serious complications or death. A study of malpractice lawsuits involving children visiting emergency departments found thatmeningitis, appendicitis and broken arms were the most common misdiagnosed conditions.
Hospitals can take simple measures to reduce mistakes. For example, when members of a surgical team take a time-out a moment before operating to check that they have the right patient, the right procedure and the correct location, errors are reduced.
Parents need to be the eyes, ears and advocates for their children. “Parents have to pay attention and speak up,” said Dr. Steve Selbst, professor of pediatrics at Jefferson Medical College in Philadelphia, who conducted the study on malpractice suits. “You know your child, and if you feel something’s wrong, go up the chain of command.”
Chance Pendleton’s mother said she was not aggressive enough. “I wish I had been more confrontational sooner,” she said. “That was the worst 20 minutes of my life.”
Here are some tips from experts for parents to lower the chance their child will be harmed by his or her treatment.
ID BRACELETS If your child is in the hospital, make sure the identification bracelet is worn at all times.
HYGIENE Ask all health care providers to wash their hands before approaching your child.
INFORMATION Before a procedure, ask the surgery team’s members if they know exactly what the procedure is.
KNOWLEDGE Schedule a time every day to review with the physician and nurses the medications your child is taking and any other information about his care.
AWARENESS Keep an eye on catheters and incisions, looking for redness and swelling.
ASK QUESTIONS If your child is very sick, make sure a pediatric specialist is involved, and ask whether your child should be moved to a children’s hospital.
TALK ABOUT IT Express your concerns about a missed diagnosis.
BE PREPARED Carry a list of the medications your child is taking and remind doctors about any allergies your child has.
DOUBLE-CHECK Understand why medications are being ordered, and don’t be afraid to ask the doctor to double-check that he used your child’s correct weight and height in calculating the dose.
MEDICINES Familiarize yourself with the medications so that you can recognize if your child is given the wrong pill or liquid. Ask about potential complications and whom to contact if your child has a reaction.
VIGILANCE Be especially watchful if your child is taking multiple medications or is on high-risk medications like chemotherapy drugs, insulin or heparin, or if your child has a compromised immune or organ function.
THANKS  http://www.nytimes.com/2008/09/15/health

Top Ten Mistakes in Education

Obviously, I believe that the school system is making a great many mistakes. Here are my ten favorites, favorite not because I like them but because eradicating them would go so far towards helping kids learn:

Mistake #1: Schools act as if learning can be disassociated from doing.

There really is no learning without doing. There is the appearance of learning without doing when we ask children to memorize stuff. But adults know that they learn best on the job, from experience, by trying things out. Children learn best that way, too. If there is nothing to actually do in a subject area we want to teach children it may be the case that there really isn't anything that children ought to learn in that subject area.

Mistake #2: Schools believe they have the job of assessment as part of their natural role.

Assessment is not the job of the schools. Products ought to be assessed by the buyer of those products, not the producer of those products. Let the schools do the best job they can and then let the buyer beware. Schools must concentrate on learning and teaching, not testing and comparing.

Mistake #3: Schools believe they have an obligation to create standard curricula.

Why should everyone know the same stuff? What a dull world it would be if everyone knew only the same material. Let children choose where they want to go, and with proper guidance they will choose well and create an alive and diverse society.

Mistake #4: Teachers believe they ought to tell students what they think it is important to know.

There isn't all that much that it is important to know. There is a lot that it is important to know how to do, however. Teachers should help students figure out how to do stuff the students actually want to do.

Mistake #5: Schools believe instruction can be independent of motivation for actual use.

We really have to get over the idea that some stuff is just worth knowing even if you never do anything with it. Human memories happily erase stuff that has no purpose, so why try to fill up children's heads with such stuff? Concentrate on figuring out why someone would ever want to know something before you teach it, and teach the reason, in a way that can be believed, at the same time.

Mistake #6: Schools believe studying is an important part of learning.

Practice is an important part of learning, not studying. Studying is a complete waste of time. No one ever remembers the stuff they cram into their heads the night before the exam, so why do it? Practice, on the other hand, makes perfect. But, you have to be practicing a skill that you actually want to know how to perform.

Mistake #7: Schools believe that grading according to age group is an intrinsic part of the organization of a school.

This is just a historical accident and it's a terrible idea. Age-grouped grades are one of the principal sources of terror for children in school, because they are always feeling they are not as good as someone else or better than someone else, and so on. Such comparisons and other social problems caused by age-similar grades cause many a child to have terrible confidence problems. Allowing students to help those who are younger, on the other hand, works well for both parties.

Mistake #8: Schools believe children will accomplish things only by having grades to strive for.

Grades serve as motivation for some children, but not for all. Some children get very frustrated by the arbitrary use of power represented by grades and simply give up.

Mistake #9: Schools believe discipline is an inherent part of learning.

Old people especially believe this, probably because schools were seriously rigid and uptight in their day. The threat of a ruler across the head makes children anxious and quiet. It does not make them learn. It makes them afraid to fail, which is a different thing altogether.

Mistake #10: Schools believe students have a basic interest in learning whatever it is schools decide to teach to them.

What kid would choose learning mathematics over learning about animals, trucks, sports, or whatever? Is there one? Good. Then, teach him mathematics. Leave the other children alone.

This list does not detail all that is wrong with school, neither do the teaching architectures we propose fix all that is wrong with education. Nevertheless they give an idea of where to begin. And, I believe that high quality software could help make these changes possible.

   
Thanks:-   http://www.engines4ed.org/hyperbook/nodes/NODE-283-pg.html