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MunoRN

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  1. MunoRN's post in Do you need certification for the Modified NIHSS? was marked as the answer   
    I think first it helps to put the clinical usefulness of the NIHSS into context in order to consider the importance of ensuring clinicians are doing it correctly.
    The NIHSS was designed solely for research, to help compare different stroke interventions.  As a way of guiding clinical care of stroke patients, it has little to no usefulness.
    Someone 'officially certified' in the NIHSS needs to perform one NIHSS assessment in the first 12 hours of admission as a requirement of a JC accredited Stroke Center, but it doesn't serve much actual purpose and additional NIHSS assessments during their stay aren't useful, yet for some reason hospitals have gone a little overboard with the use of the NIHSS.
    The modified NIHSS is intended to have less interrater variability, which is the main reason for the extensive training to be certified for the full NIHSS, so should be more "accurate" when used by those with no specific mNIHSS training.
  2. MunoRN's post in Septic Shower was marked as the answer   
    As far as medical terminology goes, "Septic" is not particularly well defined, although based on the generally agreed upon definitions the doctor explaining it to you was not correct.
    "Septic shower" usually refers to a release of either pathogens themselves (bacterial/fungal vegetations, etc) or their byproducts where they follow bloodflow to another part of the body, these individual particulates that are released are usually referred to "septic emboli". By definition, these emboli must be the pathogens or the products of pathogens to be called "septic", that's what the word means. There must be an infectious pathogen for there to be sepsis, otherwise it's SIRS. Sepsis is SIRS plus a causative infection.
  3. MunoRN's post in Do I have a right to a copy of my employee health file? was marked as the answer   
    You are legally entitled access to employee records containing your medical information.
    The relevant law is: OSHA - Access to Employee Exposure and Medical Records [Title 29 of the Code of Federal Regulations (CFR) Part 1910.1020].
    From the law:
    As an employee, what types of records can I access?
    You may access any employee exposure records ...
    You also may access any employee medical records concerning your health status that were created or maintained by a physician, nurse, health care professional, or technician. Employee medical records include the following:
    Medical and employment questionnaires or histories. Results of medical examinations and laboratory tests. Medical opinions, diagnoses, progress notes, and recommendations. First-aid records. Descriptions of treatments and prescriptions. Employee medical complaints. https://www.osha.gov/sites/default/files/publications/osha3110.pdf

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