Tuesday, April 15, 2008; HE02

Adapted from blog.washingtonpost.com/checkup

Vaccines: The Debate Continues

Do news reports about vaccination risks -- and particularly the MMR's supposed link to autism -- give you pause?

Last month, the federal government agreed to pay an Atlanta family whose daughter developed autism after receiving vaccines against five diseases (including measles, mumps and rubella) at one time.

But in February, the Archives of Disease in Childhood, the journal of the Royal College of Paediatrics and Child Health, published results of a good-sized study that showed, as have several studies before, that there's no connection between the MMR vaccine and autism.

I don't remember actually making a decision to vaccinate my own kids. But nowadays, some parents -- often clusters of like-minded ones -- are opting out.

Before the measles vaccine was introduced in 1963, half a million Americans a year got measles; 500 died from the illness each year. In an odd way, wiping out that disease has made room for us to worry about other ones.

I know it's hard to keep the interests of society at large in mind when you're worrying about that precious babe in your arms. But aren't parents who opt not to vaccinate banking on others' willingness to vaccinate their kids? It isn't fair for only some of us to shoulder that risk -- even if it's just a perceived risk.

-- Jennifer Huget

milwmom wrote:

If, God forbid it, your child were suddenly struck with a mysterious illness with little treatment and no cure, you would be searching high and low for answers and looking for accountability in the medical community, too.

albert wrote:

The key to understanding autism is genetics and an analysis of how the changing methods of diagnosis and epidemiology have yielded higher rates.

Does Your Family Defibrillate?

Automated external defibrillators -- easy-to-use devices that correct abnormal heart rhythms -- have been shown to save lives when they've been installed in public settings. A study published online April 1 in the New England Journal of Medicine suggests that home AEDs can do a decent job of keeping heart-attack victims alive till they could get professional help.

But the same study showed that good old low-tech CPR did an equally good job.

A home-model AED costs between $1,200 and $2,000. CPR training (which usually includes guidance on how to use an AED) for the whole family costs a few hundred dollars, tops. Once you're trained, you carry that training everywhere you go.

New "hands-only" CPR guidelines this month from the American Heart Association make CPR a lot easier to learn and execute: Call 911. Then start pressing hard and fast on the center of the chest. No more mouth-to-mouth breathing.

-- Jennifer Huget

Witness to aed wrote:

Just 2 weeks ago I was at the gym when a mid-40-year-old male fell over in obvious distress. Less than 3 minutes later, his heart stopped beating. The gym staff and others were very tentative at starting CPR but did eventually. However, it was the AED that we got out that saved his life. It worked exactly as intended, and I stood there in awe as the flat line on the monitor began to show a pulse again.

What Happened to the ER

Since George Clooney?

We've been watching "ER" on TV since 1994. But since George Clooney first appeared in scrubs, a lot more has changed than just the cast of the prime-time drama. For one thing, emergency rooms have gotten a lot more crowded.

Sandra Schneider of the University of Rochester School of Medicine and her colleagues studied patients who came through the Strong Memorial Hospital ER last August. The researchers focused on 277 patients over retirement age.

Those who had to wait more than six hours to get admitted were more than four times as likely to end up in nursing homes after being discharged. The study didn't examine why. But the researchers suspect the difference lies in the physical and emotional stress of the wait. Lying for long periods in a noisy, crowded ER could be enough to push a frail elderly person over the edge into no longer being able to care for himself.

-- Rob Stein

Dr No wrote:

The sad truth is that the ER has become the doctor of choice for the uninsured and underinsured.

Former ER employee wrote:

Deep lacerations, concussions, strokes, heart attacks, broken limbs, serious asthma attacks, extremely high fevers, dehydration -- all of those things and many more are what an ER is for. It is not about drop-in care for your convenience.