Funtabulously Frivolous Friday Five 089

Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the Funtabulously Frivolous Friday Five 089

Question 1

What new law was introduced in Spain in 2011, and is expected to save the Spanish health service over 2 billion euros a year?

Reveal the funtabulous answer

Doctors were required to prescribe generic drugs whenever possible.

According to GaBI:

“The new law means that Spanish doctors will now have to complete prescriptions giving only the details of the active ingredients of the medicine, along with the dose and format. The pharmacist is then obliged to provide the cheapest available medicine, which will often be a generic drug rather than the more well-known brand-named version.”

Worth thinking about next time you write a prescription…

Question 2

According to the CDC, each year in the United States over 10 million courses of antibiotics are prescribed for what condition?

Reveal the funtabulous answer

Upper respiratory tract infection (such as the common cold) caused by viruses

It goes without saying that these prescriptions are a waste of time for viral illnesses, which do not respond to antibiotics. But there is also the unnecessary cost, growing antibiotic resistance among bioflora and the exposure of patients to potentially life-threatening adverse effects.

This statistic was even worse before the CDC’s Get Smart campaign.

Question 3

What is ego bias?

Reveal the funtabulous answer

Ego bias is defined as systematic overestimation of the prognosis of one’s own patients compared with the expected outcome of a population of similar patients.

More senior physicians tend to be less optimistic and more reliable about patient’s prognosis, possibly reflecting reverse ego bias.

  • Poses RM, McClish DK, Bekes C, Scott WE, Morley JN. Ego bias, reverse egobias, and physicians’ prognostic. Crit Care Med. 1991 Dec;19(12):1533-9. PubMed PMID: 1959374.

Question 4

In 1903, which Dutch doctor-physiologist developed a string galvanometer to graphically record the changes in electrical potential during contractions of the heart?

Reveal the funtabulous answer

Willem Einthoven (1860–1927)

Einthoven coined the term electrokardiogram (EKG) for his invention, which won him the Nobel Prize in 1924. His assignment of the letters P, Q, R, S and T to the various deflections is still used.

He is also known for these eponyms:

  • Einthoven’s law – In the ECG at any given instant the potential of any wave in lead 2 is equal to the sum of the potentials in lead I and III.
  • Einthoven’s triangle – an imaginary equilateral triangle with the heart at its centre, its equal sided representing the three standard limb leads of the electrocardiogram.

“We should first endeavour to better understand the working of the heart in all its details, and the cause of a large variety of abnormalities. This will enable us, in a possibly still-distant future and based upon a clear insight and improved knowledge, to give relief to the suffering of our patients.”

Question 5

What is a micromort?

Reveal the funtabulous answer

A micromort is the risk out of a million of dying from a particular event.

As discussed in a great post on ScanCrit, they’re a useful way of quatifying the risk of different activities.

For instance:

Risk of a 50 year old dying from external cuases in normal daily living = 1 micromort
Scuba diving = 8 micromorts
100km motorcycle ride = 10 micromorts
Skydiving = 10 micromorts
Risk of of death from anesthesia during emergency surgery = 10 micromorts
Base jumping from Kjerag outside Stavanger in Norway = 430 micromorts
Climbing Everest = 12,000 micromorts per climb!

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Funtabulously Frivolous Friday Five

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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