CAUTION: Hypoglycemia Risk

At the recent Annual Convention of the American Osteopathic College of Anesthesiologists I reviewed the last decade worth of literature surrounding the peri-operative management of diabetes.  One danger is intra-operative hypoglycemia with our current "point of care" (POC) measuring devices.  

Factors that may interfere with POC Measurements:

1.  Normal variation by POC can be as much as 15% for glucose levels < 100 (National committee for    clinical laboratory standards recommendations) 

2.  POC Meters are Less accurate:

         a.  Hypo-perfused patients  (Septic)

         b.  Hemo-dynamically unstable patients

         c.  Anemic Patients

3.  Inaccurate sampling:  Too large a sample may result in a spuriously high measurement

4.  Some medications may result in inaccurate readings.  See case study below

       

MY RECOMMENDATION:

If you ever question a POC's measurement obtain a central lab glucose level and if indicated empirically treat the patient until you have the results back.  On a system level, collaborate with the lab and pharmacy to develop a process that clearly identifies things (medications etc)  that may invalidate your POC measurements.

Go Save Lives

DN

Graduation 2011/Dr. Ma Tribute

Congratulations to our 2011 Anesthesia Graduating Class:

Fellowships:

                            Dr.  Hiral Patel--Pediatric Anesthesia at Children's Hospital Los Angeles

                            Dr.  Jennifer Rhoads--Pediatric Anesthesia at Children's Hospital Los Angeles

                            Dr.  Aaron Huang---Cardiac Anesthesia at Cedars Sinai

                            Dr.  Nitesh Mody---Cardiac Anesthesia at Cedars Sinai

Dr. Ma Tribute:

It is fitting to begin our first blog by recognizing Dr. Ma as the founder of our program.

About This Blog

Each year I coach a hand full of alumni on how to prepare for board exams, negotiate with governing bodies, survive group/hospital politics, cope with lawsuits, optimize the business aspects of medicine, etc.  Recently it occurred to me, that my RCRMC family and friends have reached a critical mass as our network of graduates hold many key positions throughout the country.

The time has come to pool our collective resources.  Taken together we have a tremendous asset in terms of knowledge, experience, and networking.  This blog is the beginning of a very personal campaign to strengthen the ties that bind us in an effort to foster our community and elevate each of us to heights that we could not attain as disparate individuals.

DN