Bacteria

In the US, 23 million households rely on private wells for their drinking water, yet these wells are unregulated and unmonitored, and thus vulnerable to contamination. These exposures may lead to significant health consequences, including both acute manifestations and chronic disease. Primary care physicians often serve as the first point of contact for screening for environmental exposures and for patients with concerns about water safety. This article equips family physicians with practical guidance on the reasons and methods of testing private wells for microbiologic and chemical contaminants such as “bacteria, nitrates, arsenic, and lead”. Patient testing and relevant matrices are also reviewed. Recommendations are provided for when and how to test, interpretation of laboratory results, and how to counsel patients on mitigation strategies. Focus is placed on rural and disadvantaged communities commonly affected by contaminated well water. By integrating well water safety into routine preventive care, clinicians can play a crucial role in protecting patients from waterborne illnesses and exposures.

Author/s:

Dominika A. Jegen, Matthew E. Bernard, Paul J. Jannetto

Persistent Value of the Stethoscope in the Age of COVID-19

Brian Desmarais — Mon, 22 Jun 2020 15:09:57 +0000

Date Added:

June 22, 2020

Journal/Publication:

The American Journal of Medicine

Publication Date:

June 19, 2020

URL:

Persistent Value of the Stethoscope in the Age of COVID-19

Type:

Best Local Practices

Format:

Article

DOI (1):

https://doi.org/10.1016/j.amjmed.2020.05.018

Keywords

MeSH

Physician-Patient Relations

severe acute respiratory syndrome coronavirus 2

An interesting review of the history and future of the stethoscope including tips for disinfecting one. James W. Mold, MD, MPH

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Abstract

The stethoscope has long been at the center of patient care as well as a symbol of the physician-patient relationship. While advancements in other diagnostic modalities have allowed for more efficient and accurate diagnosis, the stethoscope has evolved in parallel to address the needs of the modern era of medicine. These advancements include sound visualization, ambient noise reduction/cancellation, Bluetooth™ transmission, and computer algorithm diagnostic support. However, despite these advancements, the ever-changing climate of infection prevention, especially in the wake of the COVID-19 pandemic, has led many to question the stethoscope as a vector for infectious diseases. Stethoscopes have been reported to harbor bacteria with contamination levels comparable to a physician's hand. Although disinfection is recommended, stethoscope hygiene compliance remains low. In addition, disinfectants may not be completely effective in eliminating microorganisms. Despite these risks, the growing technological integration with the stethoscope continues to make it a highly valuable tool. Rather than casting our valuable tool and symbol of medicine aside, we must create and implement an effective method of stethoscope hygiene to keep patients safe.

•Stethoscopes are clinically valuable and integral to the doctor-patient connection

•Technological advancement will augment the utility of the stethoscope

•The stethoscope has high utility for assessment of COVID-19 patients

•Pathogen contamination in light of COVID-19 is a concern for the stethoscope

•Innovations in stethoscope hygiene will allow safe auscultation

Author/s:

Vasudevan, R.S., Horiuchi, Y., Torianni, F.J., Cotter, B., Maisel, S.M., Dadwal, S.S., Gaynes, R., Maisel, A.S.