Wikipedia:Reference desk/Archives/Miscellaneous/2016 February 2

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February 2[edit]

100,000 preventable deaths from hospital infections in the US[edit]

"Every year, nearly 100,000 people die in America alone from preventable infections acquired in hospitals." http://www.economist.com/blogs/babbage/2013/07/hospital-hygiene

I see this kind of statistic often enough but how accurate is it? Would preventable mean maintaining an unreachable level of hygiene or simple stuff like everyone washing their hands would prevent thousands of deaths from unnecessary infection? Muzzleflash (talk) —Preceding undated comment added 19:13, 2 February 2016 (UTC)[reply]

Here is an article in JAMA]which states that " Nosocomial bloodstream infections occur at a rate of 1.3 to 14.5 per 1000 hospital admissions and are believed to lead directly to 62 500 deaths per year in the United States." that was in 1995. So, in peer reviewed, non-sensationalistic journals like the highly respected Journal of the American Medical Association, we have a number which is well within range for your 100,000 deaths in 2013. --Jayron32 19:40, 2 February 2016 (UTC)[reply]
Thanks for citing a peer reviewed article but I wonder if this just refers to infections from hospital admissions that lead to death not infections from below standard hospital care that leads to death. Muzzleflash (talk) 19:58, 2 February 2016 (UTC)[reply]
Dying from a preventable infection that is caught at a hospital is below any standard I would care to set, for my own life... --Jayron32 23:47, 2 February 2016 (UTC)[reply]
There is more to it than that. Excessive use of antibiotics is a big contributor - it causes hospitals to become a breeding ground for antibiotic-resistant strains of bacteria that can then infect the people who are most vulnerable to them. Long waits in shared waiting areas (eg in the emergency room) causes sick people to infect other sick people. There are multiple causes. SteveBaker (talk) 19:43, 2 February 2016 (UTC)[reply]
My Dad died of a hospital infection, and I found the hygiene practices to be unacceptable. They had an intravenous line inserted at his crotch, and they also used a feeding tube, despite him being in a coma and therefore unable to relieve himself in a normal way. They had something called a "flexicath" which was supposed to collect feces, but instead it seemed to just prevent defecation, so they just removed it, let him defecate in the bed, then cleaned it up. This resulting in his central line becoming infected from fecal material, blood poisoning, and his subsequent death. I had requested that they feed him intravenously, but they said that that would pose even more of a risk. Putting that IV line somewhere that can be kept clean would be another option. StuRat (talk) 23:50, 2 February 2016 (UTC)[reply]
I'd like to add here that "preventable" isn't confined to the standard of care at any given hospital. If the US Department of Agriculture and the Food and Drug Administration had stood tough and told livestock producers to keep their livestock clean, rather than relying on antibiotics as feed additives to fight infections and increase the weight of the livestock they fatten in crowded, unsanitary pens, it's entirely possible that antibiotic resistance would be much less a problem here in the United States, and the nosocomial infection rate in hospitals would be lower. Animal disease bacteria, even when they don't cause clinical disease in humans, do multiply in humans and transfer resistance to antibiotics to human-virulent bacteria by resistance plasmid transfer.
So, when we started letting livestock producers use antibiotics developed specifically to overcome antibiotic resistance in human pathogens, like ciprofloxacin, in animal feed, it was predictable that ciprofloxacin resistance in human pathogens became a problem, just as resistance to sulfa drugs, penicillins and other antibiotics became problems before then.
Of course, overuse of antibiotics in humans is just as great an issue, perhaps more so, because the proliferation of antibiotic resistance plasmids from the bugs we carry that don't make us sick to the ones that do make us sick happens entirely within our bodies, and those of our families and neighbors. The old practice of prescribing antibiotics to people with viral diseases such as the common cold who have no evidence of bacterial infection contributed to this, but there's also the fact that people who feel terrible want their doctors to do something.loupgarous (talk) 01:19, 3 February 2016 (UTC)[reply]
  • Yes, without giving medical advice, I can attest that my best friend's father, my boyfriend, and my grandmother all died due to hospital negligence. The first two from iatrogenic infections, and my grandmother, who was left to feed herself, and choked to death since she was a stroke patient with profound right-side apoplexy. μηδείς (talk) 01:26, 3 February 2016 (UTC)[reply]
It has long been the "conventional wisdom" that hospitals are gathering places for all manner of diseases. There's more than a little truth to the old joke, "I'm not going to the hospital. There's nothing but sick people there." On the flip side, in the pioneer days, with no hospitals, if you got sick, you either recovered on your own, or you died. ←Baseball Bugs What's up, Doc? carrots→ 04:06, 3 February 2016 (UTC)[reply]
That's why, last year, when I knew I'd have to have surgery in December, I caught up on my immunizations, so that my chances of catching influenza during my stay were shorter. There's no shot to protect you from MRSA or the other big, bad nosocomial killer bugs, but being active (walking aroud just as soon as you can get out of bed) and cooperating with your respiratory and physical therapists shortens hospital stays (knocked about three days off mine, from what the doctor anticipated) and thus the chances of going a few rounds with an antibiotic-resistant bacterium. This isn't medical advice, just an anecdote. Y'all do what you want. loupgarous (talk) 04:50, 3 February 2016 (UTC)[reply]
off topic attack
The following discussion has been closed. Please do not modify it.
Good to see there are so many medical professionals here, who are able to accurately diagnose and determine causes of death.... </sarcasm> Since when is the plural of anecdote data? Only Jayron provided a useful reference answer. Fgf10 (talk) 08:39, 3 February 2016 (UTC)[reply]
And what did you provide here, aside from personal attacks? ←Baseball Bugs What's up, Doc? carrots→ 14:57, 3 February 2016 (UTC)[reply]
Stating that most of the replies are anecdotal and can be safely ignored. It's a large problem on the refdesk that needs pointing out. No personal attacks whatsoever. Fgf10 (talk) 18:19, 3 February 2016 (UTC)[reply]
Your opinion and attitude are of no value here. ←Baseball Bugs What's up, Doc? carrots→ 19:04, 3 February 2016 (UTC)[reply]
And presumably that most definite personal attack is just your opinion Bugs, or can you provide evidence that you speak for the Ref Desk community. Richard Avery (talk) 08:11, 4 February 2016 (UTC)[reply]
It has been said over and over on the ref desk talk page that attacking the OP and other editors, while contributing no facts to the discussion, is bad form. I can look for the quote that fgf complained about, if you like. ←Baseball Bugs What's up, Doc? carrots→ 18:08, 4 February 2016 (UTC)[reply]
Here's one example:[1]Baseball Bugs What's up, Doc? carrots→ 18:15, 4 February 2016 (UTC)[reply]
And herein is included a statement about the germ-laden nature of hospitals.[2] If anything, I understated the situation, and fgf's complaints were dead wrong. ←Baseball Bugs What's up, Doc? carrots→ 18:18, 4 February 2016 (UTC)[reply]
  • Pot, meet kettle. Oh well, shouldn't have expected anything else from you, BB. EDIT: Actually User:Baseball Bugs, I should really be referring you to ANI for that personal attack. But I'll set the right example by being mature and letting it slide. Make you should take an example here as well.... That and maybe only post when you have something useful to contribute. (That'll be the day....) Fgf10 (talk) 08:24, 4 February 2016 (UTC)[reply]

This is entirely unhelpful. I saw my grandmother's and my boyfriend's death certificates, and my best friend, whose father died of Pneumonia, has a PhD from Columbia. So what is the point of these attacks? What was admitted was openly anecdotal, and I will out myself to provide the documented facts, in which case the OP can email me. μηδείς (talk) 02:10, 7 February 2016 (UTC)[reply]

Putting it another way, has any journal article tried a methodology like this, estimating the number of hospital acquired infection deaths that would be prevented if all US hospitals could in the future perform in hygiene standards as well as the top 10% of US hospitals now do? Muzzleflash (talk) 17:26, 3 February 2016 (UTC)[reply]

This is a short review of the subject, and the simple answer is that no one can agree. It's generally agreed that about half of post-surgery infections are preventable, but estimates for all iatrogenic infections range from 10-70% being preventable. Even looking at the rates of iatrogenic infections from hospital to hospital may not be totally enlightening, since infection rates vary wildly with patient population (both age and what types of treatment are needed). Someguy1221 (talk) 03:07, 4 February 2016 (UTC)[reply]

Birdsong[edit]

How do I identify a bird from its birdsong? Are there any tools on the internet for this? KägeTorä - () (もしもし!) 22:14, 2 February 2016 (UTC)[reply]

Do any of these options help? --Jayron32 23:46, 2 February 2016 (UTC)[reply]
If you're in Europe there's Collins Field Guide: Bird Songs and Calls of Britain and Northern Europe, which contains 2 CDs and a description of scores of both calls and songs (and explains the difference) ISBN 0-00-220037-6. There was a newer version with 3 CDs, but it's not so easily available.--Shantavira|feed me 10:16, 3 February 2016 (UTC)[reply]
If you're in North America, the Cornell Lab of Ornithology has this nice smartphone app [3]. Their general website [4] has lots of ID tools and samples of birdsongs. Their audio/video library [5] claims to cover about 75% of the world's bird taxa, so if it's a bird you've heard, it's probably in there. In general, easy bird ID starting from recorded sound is not available to the public (yet, though there are some research projects that are focused on this [6] ). What you usually have to do is listen to a bunch of songs and then pick the one that matches best. SemanticMantis (talk) 19:00, 3 February 2016 (UTC)[reply]
Oops, correction: I see that Warblr [7] [8] and other similar products are now available to the public, and they claim to ID a bird from an audio sample. I haven't yet heard any reports of its effectiveness, and the number of species is a paltry 88... SemanticMantis (talk)
The Guardian reviewed Warblr and a rival, Chirpomatic, and found that Warblr seemed to do better. Smurrayinchester 09:24, 5 February 2016 (UTC)[reply]
Thanks. I got Warblr, but the last few days it has been raining, so the birds are not chirping. I will have to wait until better weather. KägeTorä - () (もしもし!) 02:09, 7 February 2016 (UTC)[reply]