Tag: safety

Don’t tase me, bro!

These words were first uttered by Andrew Meyer, a 21-year-old fourth-year undergraduate telecommunications student on September 17, 2007 in a University of Florida lecture hall when he was forcibly escorted from the hall by the security officers because he would not stop questioning U.S. Senator John Kerry. He was pinned down on the floor and was about to be tasered when he spoke these words. Since then these words have become part of our lexicon.

In November, 2007 Robert Dziekanski, a Polish immigrant to Canada was tasered at the Vancouver airport and subsequently died. About two weeks ago, a 17-year old was tasered in Winnipeg and subsequently died. Death after being tasered has been reported many a times. “In fact, media reports to date have documented over 300 such deaths, 20 in Canada. Critics charge that tasers are too dangerous, that independent studies evaluating their safety are urgently needed and that a moratorium should be placed on their use,” says an article in the Canadian Medical Association Journal (CMAJ).

But Taser International (makers of Taser) has always maintained that taser is not directly responsible for any deaths. It has never been proven in a court of law that taser has directly killed anybody. The company says that taser cannot stop the heart. United Nations has classified the taser as a form of torture.

A news item in the July 15, 2008 issue of the CMAJ says, “Taser International Inc. suffered its first product liability suit loss in roughly 70 instances after a California district court ruled that it was 15 per cent responsible in the death of a 40-year-old drug suspect who died after receiving simultaneous shots from 3 tasers used by police officers. The jury awarded US$1.02 million in compensatory damages, as well as US$5.2 million in punitive damages, for Taser International’s failure to inform police that extended exposure to electric shock from the device could lead to cardiac arrest. The company said it plans to appeal the decision.”

Taser International and law enforcing agencies consider Taser as a valuable tool for subduing criminals and safeguarding the lives of law enforcement personnel. Others consider this as a potentially lethal weapon. What does medical science think?

In the May 20, 2008 issue of the CMAJ, taser is described as “an emerging and increasingly popular medical device.” The review article in the CMAJ says that Taser has potentially lethal effects in animals and humans. But Taser International says that Taser is safe and has sponsored research to prove this point. Has any independent medical research institution sponsored research to prove this point?

Taser International says that taser does not kill but a medical condition; “excited delirium” kills the person after being zapped by a taser. Excited delirium is not a recognized clinical condition. But it is being suggested by certain people that taser should be used to treat excited delirium. Does that mean taser now be considered a medical device? Can taser satisfy rigorous scientific standards through clinical trials before it is accepted as a medical device?

CMAJ article says, “New and independent research, both epidemiologic and biological, into whether tasers can kill is essential to settle this issue. Also, law enforcement agencies could be made to open up their databases on taser use for independent analysis, on the principle that the assertion that tasers have saved lives of police and suspects alike, while plausible, should be proven, not merely asserted as fact.”

I wonder when will this happen. In the meantime, don’t tase me, bro!

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How safe do you feel as a patient?

Some years ago, experts estimated that in U.S. up to 98,000 people die each year from medical errors that could have been avoided. Many others may have been less seriously injured. In Canada and other developed countries the figures are proportionally no different.

There is no doubt that health care professionals work hard to provide safe and high quality medical care. But errors occur and there are many reasons for that. We cannot cover them all here but we can discuss few in terms of how you, as a patient, can stay safe.

Your safety, first of all, depends on your identification. Make sure your name and current address is correctly spelled and written, your date of birth is correct and your health insurance plan number on the card is correctly copied.

If you Google your name on the Internet you will find there are many people in the world who bear the same name as yours. In our office we have several patients with identical names. We have to be very careful that we do not mix their reports or give them wrong treatment. We feel checking the name, address, date of birth and health care insurance card number is very important. In the hospital, make sure your wrist band has correct information.

One thing which bothers me a lot is how dates are written by various people, organizations, departments, hospitals and doctors’ offices. The way I like to write is month in alphabets followed by day and year in numerical (June 10/08). This creates no confusion. Can you imagine people writing the same date in various different ways: 6/10/08 or 10/6/08 or 08/10/6? I think it is ridiculous and dangerous that we allow so many different ways to write dates.

Medication errors are not uncommon. There are many medications which have similar sounding names. You should always carry in your purse or wallet a list of medications you take. When you visit a doctor (who is not your regular doctor) you should take all your medications with you. Each year, during your annual physical, take with you all your pills and review with your doctor the necessity of continuing to take them. Also make sure your allergies are recorded properly.

You run the risk of picking up infection in every health care setting. To minimize the risk take necessary precautions. Wash your hands before and after your visit to a health facility. Just like washing your hands before and after you eat. Shower and wear clean clothes before your visit. With snow and rain, we tend to carry lot of dirt on our shoes. Most health care facilities request patients to remove wet and dirty shoes before they go in the examination rooms. Some facilities provide shoe covers. There is no guaranteed way to prevent infection. But each person, including health care providers, has responsibility to minimize the risk of infection.

What about complications from surgical procedures and invasive investigations? All procedures carry risks. Risks vary from minor to major like death. Before going through a procedure, you should discuss with your health care provider your expectation of the outcome. In return, the health care provider will explain to you the procedure and its likely complications. Make sure the site of surgery is marked with indelible ink so you do not end up getting a wrong foot amputated or a wrong side hernia repaired or a healthy knee replaced. In your follow-up visit make sure you get the results of all your tests and procedures.

Finally, carry a copy of your health history. It should contain your personal and medical information as discussed earlier including your family history. Being safe is being healthy.

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Out of this nettle, danger, we pluck this flower, safety, says William Shakespeare in Henry IV.

To parents with young children, the Safety City Society is that beautiful flower which teaches our children about safety from age 3 to grade 6. This is wonderful because what happens to our children in the first 6 years of their lives largely determines how well they are able to learn in school, how they can cope as adults, and often, how healthy they will be as adults.

Last week, the Safety City Society of Medicine Hat had their annual general meeting. Here is what I learnt.

In Alberta, average life expectancy is 81 years for women and 76 years for men. According to Alberta Health and Wellness, we can make it to this age if we don’t smoke and are able to avoid injury.

How can we do this? First, let us see what is killing Albertans. The top 5 causes of death are: heart disease, cancer, lung diseases, stroke and injuries. The first 4 causes are directly or indirectly related to smoking. The 5th cause is due to falls, motor vehicle accidents, poisoning, suicide, work place and farm injuries. And injuries kill 4 people daily. Just like losing a family of 4 everyday! This has not changed in the last 5 years.

Why injuries are hurting us? Thirty six percent of fatalities are related to drinking and driving. Four out of 5 collisions occur in cities. Rural Alberta sees 72 percent of fatal collisions. Afternoon rush hour accounts for 30 percent of all collisions. Friday sees the most collisions and Sunday has the most fatalities. So, where and when can we take our family out?

Should we blame the government? No. It is us…. the drivers!

Drinking and driving takes its own toll. Driver errors account for 89 percent of collisions. And we make the same mistakes over and over again: following too closely, running off the road (rural areas), turning left across the oncoming traffic, running red light, and changing lanes without shoulder check.

We know seat belt save lives and reduce the injury rate. But recent study, released by the RCMP shows only 60 per cent of rural drivers in the Palliser health district use seat belts and that only 57 per cent of rural passengers buckle up. We are the third worst ranking health district of the 17 surveyed. That is not good!

But the impressive work is done by the people at the Safety City with the help of dedicated workers and donors. They teach our children about helmet awareness, seatbelt safety, train safety, winter safety, traffic safety, bicycle safety, pedestrian safety, bus safety, Halloween safety, home safety, and organize car seat clinics. All this on a shoestring budget!

The Board Chair, Dorothy Patry says: At Safety City we envision that very soon this community, will no longer accept “accidents” as inevitable, instead many “predictable and preventable” injuries will be significantly reduced.

This can only be done if we learn to be patient and careful at home, at work and on the roads. Let us slow down and enjoy the drive!

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“Ninety percent of injuries suffered by Canadians are predictable and preventable,” says Dr Barry McLellan, chair of the National Trauma Registry Advisory Committee.

Why are they predictable and preventable?

They are predictable because we know the circumstances under which most accidents occur. They are preventable because, most of the time, the events leading to accidents can be modified.

Injuries can be intentional (suicides, homicides) or unintentional (motor vehicle accidents, falls, poisoning, fires, drowning).

With the weather getting better there are more people on the roads. They are walking, jogging, biking, or driving. Can we do something for them so they can safely enjoy what they are doing?

Yes, the following ten principles of injury prevention are developed from the information contained in the Alberta Motor Association Collision Facts and the New England Journal of Medicine:

1. Do not drink and drive. Why? Because 23 percent of drivers involved in fatal collisions had consumed alcohol prior to the crash. Males between 18 and 21 years old make up the group most likely to have been drinking prior to an accident.

2. Drive carefully on weekends and holidays. Why? The collisions fatality rate usually doubles on long weekends. In 1997, the highest number of fatal collisions happened in August, with Friday being the most collision-prone day of the week.

3. Use your seatbelt. Why? People who do not buckle up are more than twice as likely to be injured as those who wear a seat belt. The current three-point lap-shoulder restraints are thought to reduce the risk of death or serious injury by 45 percent.

4. Avoid common driving mistakes. Why? Running off the road, following too closely and left turns across the path of oncoming vehicles were the most common mistakes contributing to casualty collisions.

5. Be careful if you are young and restless. Why? Traffic collisions cause 7 out of 10 unintentional fatal injuries to people between 15 to 24 years of age. Injuries are the most common cause of death among people 1 to 34 years of age.

6. Be careful on all types of road conditions. Why? Because 60 percent of fatal collisions happen on dry roads. And 70 percent of fatal collisions occur on highways in rural areas.

7. Use children’s safety seat correctly. Why? About 50 percent of car seats are used incorrectly. Air bags can cause deaths of infants in rear-facing car seats. Car seats for children reduce the risk of death or serious injury by approximately 70 percent.

8. Use bicycle and motorcycle helmets. Why? Helmets decrease the risk of head and brain injury by 85 percent.

9. Cross streets at pedestrian crossings only. Why? Injuries to pedestrians are the second largest category of motor vehicle deaths. School aged children are at greatest risk.

10. Do not drive when tired or sleepy. Why? Because fatal car accidents increase by 7 percent in Canada on the Monday after the spring time change. When the Canadians move their clocks back an hour in the fall, collisions drop by 7 per cent. Even an hour of sleep can make a difference!

It was in 1899, U.S. reported the first death related to motor vehicle accident. Are we proud of our record in the last hundred years?

Enjoy the good weather. Be safe!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!