Cardiac arrest in hospital can be prevented: report
A third of cardiac arrests and resuscitation attempts in hospital could be prevented if doctors assessed patients better, a report has found.
An audit of more than 500 patients whose heart stopped while in hospital found that in many cases this could have been prevented with better care.
The report by the National Confidential Enquiry into Patient Outcome and Death found that warning signs that the patient was deteriorating were not recognised in a third of cases.
In ten per cent of cases CPR was attempted even though the patient or their doctors had already decided it should not take place, which the authors said was ‘poor’ and should not happen.
It means patients were needlessly subjected to ‘undignified and unjustified’ CPR when they should have been allowed to die peacefully.
The report recommended that all patients admitted as an emergency be assessed by doctors and a decision taken over whether to attempt CPR should their condition deteriorate.
Report author and NCEPOD Lead Clinical Coordinator Dr George Findlay said there are times when patients should not undergo CPR.
He said: “In our study we found that there were cases when it was recognised that the patient was deteriorating but it should have been recognised that it was part of the dying process and it was inevitable that the patient was going to die.
“Within this study it was felt that there was quite a lot of these patients but unfortunately they had CPR. Part of good care is recognising that this patient should not have CPR, it is not dignified and it is not effective.”
He said good doctors should be able to tell the patients who are otherwise quite well and stand a good chance of recovery and who CPR is appropriate from those who are very sick with lots of complicated problems and who are not going to recover.
Dr Findlay, who is an intensive care doctor, said patients should be involved in these discussions where possible so their wishes can be recorded and everyone involved knows whether CPR should be attempted or not.
Free pre-school education for poorest toddlers ‘to give them fair crack of whip’, British Liberal leader says
That such schemes have never worked either in Britain or the USA is a lesson that “sound-good” liberals are incapable of learning
Free pre-school education is being extended to two-year-old children in the poorest areas of the country to boost their chances in life.
Nick Clegg, the deputy Prime Minister, will also say today that parents of children on free places can drop their children earlier and collect them later. Mr Clegg said the changes were designed to help children from the poorest backgrounds get the best start in life.
More than 800,000 three and four year olds nationally are currently eligible for 15 hours per week of free early education.
The plan had been to extend this to 150,000 two year olds from the poorest families from September 2013, rising to around 260,000 in the following year. However, Mr Clegg said that a £3million trial – affecting around 1,000 children – will now start in September in 10 trial areas.
The time when parents can pick up and drop children is also being increased from 8am to 7am, and from 6pm to 7pm, to suit better parents work commitments.
Parents will also be able to spread their free nursery places over two, rather than three, days, which will allow them to leave their children for longer on individual days.
Mr Clegg said: “Every child should have a fair crack at the whip from the start and be able to go on to fulfil their potential. “By getting things right from the off we’re making sure our youngsters are ready to learn when they start school so that they get the most out of their education.”
The news came as a Government review is expected to say that people from poorer backgrounds from the North are least likely to get ahead in their careers in Britain.
Some professions – such as politics and the law – were becoming more elitist, and were virtually shut off to people from working class backgrounds.
Green Party nonsense: nuclear power and the problem of the precautionary principle
Since I’ve already ruined my chances of ever leading the warriors of the Green Party in glorious revolution, what with saying that the vandalism of publicly funded scientific research is pretty much not cool, I’ve decided to throw caution to the wind.
From the Greens’ energy policy, I read this:
“The Green Party is fundamentally opposed to nuclear energy, which we consider to be expensive and dangerous. The technology is not carbon neutral, and being reliant on uranium it is not renewable. We consider its use, moreover, to be elitist and undemocratic. There is so far no safe way of disposing of nuclear waste. To a degree unequalled by even the worst of other dangerous industries, the costs and dangers of nuclear energy and its waste will be passed on to future generations long after any benefits have been exhausted.”
This statement is problematic on a number of levels. I don’t like the idea of being “fundamentally opposed” to one of the most obvious available options for keeping our lights on. If it is shown to be safe and economic, then we should use it. It’s not a moral issue; it’s just one more tool, which we can use well or badly, safely or unsafely. Also: how can an energy technology be “elitist”? I literally don’t know what that means. Is it elitist because it’s hi-tech and third-world countries can’t easily make their own? Well, so are iPads, then, and Toyota Priuses. Or does the word “elitist” just mean “bad” in Green-land, in the same way that “natural” means “good”? [Edit: I can’t believe I didn’t pick up on “undemocratic” as well. Since when are power stations democratic institutions?]
As for it not being renewable: well, neither is sunlight or the wind, if you’re taking a sufficiently long view. Eventually the Sun will consume the last of its hydrogen and expand into a red giant, probably blasting the Earth to its constituent atoms as it does so. But that’s quite a long way off, so we don’t worry about that. In the shorter but still decently long term, even if no more uranium deposits are found (although they will be) and no more efficient ways of using it developed (although they will be), “total identified resources are sufficient for over 100 years of supply”, according to the IAEA. That ain’t nothing.
“Carbon neutral” is a bit of a red herring as well in this case. It’s true, nuclear power is not carbon neutral. But it’s much less carbon positive, if that makes sense, than fossil fuels. The perfect is the enemy of the good, as the saying goes: just because something isn’t the best possible, doesn’t mean you should ignore it if it’s an improvement over what is available. Furthermore, there is potential to improve the carbon emissions of nuclear; if it is made economically attractive to do so, companies will do it themselves. Targeted carbon taxes, or an auction of carbon credits, would work; certainly the latter did for industrial sulphur dioxide emissions.
But this is all a side issue, isn’t it? It’s about safety. Nuclear power is unsafe. Look at Chernobyl, look at Three Mile Island, look at Fukushima. It’s dangerous, as the Greens say, and its cost, dangers and waste will be “passed on to future generations”.
But as Prof Paddy Regan says in our paper today, that’s false. Chernobyl killed about 50 people (28 people in the immediate weeks after; an estimated 19, according to the WHO, died of radiation-induced cancers in the following 20 years). Three Mile Island killed, and indeed harmed, precisely nobody. And Fukushima was the most ridiculous of all: as a vast earthquake and tsunami killed 15,000 people, the world’s attention was focused on a meltdown in a 40-year-old reactor which, again, killed no one at all. As Prof Regan points out, it led to absurdities:
“The Italian foreign ministry, for example, recommended that its citizens flew out of Tokyo to avoid potential radiation exposure in the first couple of weeks following the Fukushima leak. While the radiation levels in the Japanese capital rose significantly above normal, they remained lower than the typical average background radiation levels in Rome, leading to the bizarre situation of individuals being relocated to places with higher radiation levels than those they were leaving.”
He also points out that the waste from the “natural reactor” at Oklo in Gabon, which underwent a spontaneous nuclear reaction in its uranium-rich deposits two billion years ago, has moved less than 10 metres from where it was formed. “If this is what happens in nature’s random geological disposal site, a carefully chosen, geologically stable deep storage facility for vitrified nuclear fuel waste would seem safe to me,” says Prof Regan.
Meanwhile, in the last 40 years, tens of thousands of people have been killed by failures at hydroelectric dams; hundreds more have died in coal mines, and of course thousands every year in the US alone from respiratory problems caused by fossil fuels. But the fear of “radiation”, evident in the nonsense scares about “electrosmog”, trump the very real dangers of other energy sources. (There’s another interesting piece to write some day about our evolved fear of “contamination”; since the 1940s or so “radiation” has been mentally filed under “poisons”, and therefore any at all is bad. But this piece is long enough already.)
The “precautionary principle”, the idea that a new technology or policy should not be employed until we can be sure it is safe, sounds very reasonable. But as always, it’s more complicated than that. Everything we do entails not doing something else; in this case, not using nuclear, in the short term at least, means more coal, more shale gas, more fracking, to maintain energy demands (and cutting energy use would cause its own problems, of course). Is that safer? Nuclear power has risks, of course it does. But so does everything, and nuclear power has clear potential benefits. The trick is to calmly and sensibly assess those risks and benefits, not pull up the drawbridge out of misguided fear.
Why Scots die young
There’s a lot of beating about the bush in the report below so perhaps it falls to me to tell the real story.
Scots in Scotland today are a very socialist lot. Add to that a tradition of fighting and you have a very “Bolshie” lot, not to put too fine a point on it.
The hard-working and enterprising Scots have long ago emigrated elsewhere — if only to England but also notably to North America and Australasia.
So having to work makes Scots resentful and in the postwar era they gradually destroyed most of their traditional industries (shipbuilding, floorcoverings etc.) by constantly going on strike — leaving them very welfare dependant. In many Scottish households now no-one has worked for generations.
And with nothing to do and no hope for the future, the chief entertainment for their young men became sticking shivs into one another on Saturday night. Glasgow (where about half of all Scots live) is one of the world’s most violent cities. And a shiv (home-made stabbing knife) in your ribs is not good for your health or your survival
Scotland’s shorter life expectancy is not just due to higher rates of smoking and drinking and a poor diet but is also the result of decades of bad political decisions, according to researchers.
The country’s mortality rate is markedly higher than in other European countries, including the rest of the UK.
This has been caused by a range of factors influenced by the political direction of the last 60 years, and in particular since 1980, a study by NHS Health Scotland claims.
Scientists identified and tested a range of reasons for why those living in Scotland die at a younger age; they found no single cause.
These included migration, genetics, individual values, substance abuse, climate, inequalities, deindustrialisation and ‘political attack’.
The researchers found that between 1950 and 1980 life expectancy in Scotland started to diverge from elsewhere in Europe.
They believe this was linked to higher deprivation due to industrial employment patterns, housing and urban environments, community and family dynamics, and negative health behaviour cultures.
From 1980, they attribute the country’s higher mortality to the political direction taken by the governments of the day, and the consequent hopelessness and community disruption that was experienced as a result.
The study said: ‘For over half a century, Scotland has suffered from higher mortality than comparably wealthy countries, and for the last 30 years has suffered from a new and troubling mortality pattern.
‘It is unlikely that any single cause is entirely responsible, and there is uncertainty around why Scotland started to diverge from elsewhere in Europe around 1950.
‘It is clearer that the health and social patterns that emerged from the 1980s are more closely linked to negative health behaviours (eg alcohol consumption), but these behaviours are, in turn, heavily influenced and shaped by the social, cultural and economic disruption which occurred as the political and economic policies of the UK changed from the late 1970s.’
Other factors, such as alcohol, smoking, unemployment, housing and inequality are all important, the scientists said, but require an explanation as to why Scotland was disproportionately affected.
Lead researcher Dr Gerry McCartney said: ‘It is increasingly recognised that it is insufficient to try to explain health trends by simply looking at the proximal causes such as smoking or alcohol.
‘Income inequality, welfare policy and unemployment do not occur by accident, but as a product of the politics pursued by the government of the day.
‘In this study we looked at the “causes of the causes” of Scotland’s health problems.’
The study is published in the journal Public Health.
British woman jailed for saying what many think
“A DRUNK passenger who hurled racist abuse at fellow travellers on a London underground train in a tirade that became an internet sensation has been jailed for 21 weeks.
Jacqueline Woodhouse, 42, launched an expletive-laden rant at passengers on the Central line, telling those seated near her: “I used to live in England and now I live in the United Nations.”
In the video of her latest foul-mouthed outburst, filmed by businessman Galbant Juttla, Woodhouse can be heard shouting in a thick Essex accent: “All f***ing foreign f***ing s***heads.”
Prosecutor Claire Campbell said Woodhouse, who has since lost her job and is now claiming benefits, began her stream of abuse after a retirement party when she was feeling a little “worse for wear”. She had drunk an unknown quantity of champagne.