Corporate Composting

As part of our Social Responsibility company value – we have recently partnered with Growing City in an attempt to reduce our carbon footprint and waste. 

Corporate Composting - growing city

The benefits of implementing a corporate composting plan

New to our lunch room is a “silver garbage receptacle.” Listed on top of this receptacle are all of the items which our office staff can compost. 

What to compost - Corporate Composting

The Plan

We currently have a 50L composting bin to start with and we will monitor the load capacity to see if we need to speak with Growing City and upgrade to a larger size.

We have also gone and switched our garbage bags to compostable bags and put them in each of our washrooms for paper towel use only.  They will be emptied into the compost bin in the kitchen at the end of each day.

We have also placed additional small bins in our coffee areas upstairs throughout the office to gather compostable waste to be transferred to the compost bin in our lunch room at the end of each day.

We look forward to working together with Growing City and their community oriented projects around the city.

Protecting Olympic Hearts

With the 2012 Summer Olympics beginning tomorrow, there is no doubt the spotlight will be on London. Spectators will be following their favorite sporting events, from cycling to swimming to rowing; from around the world they will be cheering for their athletes to bring home the gold.

I sure know the team here at Iridia will be cheering on Team Canada.

london 2012 - Olympic Hearts

Olympic Hearts – Cardiac Prevention

For Dr. Sanjay Sharma, bringing home the gold is one thing, but doing everything possible to protect olympic hearts and prevent a major cardiac event is his priority. A place where thousands of athletes gather and push their body to the limits can be a place that soon turns deadly.

As head of the cardiology team for the 2012 Olympics Dr. Sharma is taking no risks. His team is looking to prevent sudden cardiac arrest from grabbing the headlines.

As part of the prevention strategy Dr. Sharma and his team have screened the entire UK Olympic squad for possible underlying cardiac conditions.

cardiac screening - Olympic Hearts

“We had to screen 32 different squads from various sporting disciplines ranging from athletics to rowing, many of which contained individuals not necessarily going to make the final team. The aim was to identify conditions that could potentially cause sudden cardiac death in an individual,” said Sharma.

Recommendations & Guidelines

Currently the International Olympic Committees stance is one that recommends 12-lead ECG screening of athletes, but does not mandate it.

Similarly, the Heart and Stroke Foundation and the American Heart Association have no screening recommendations for olympic hearts. Although the Canadian Academy of Sport and Exercise Medicine are in the process of developing a position paper on best practices for athlete screening and care.

For Dr. Robert McCormack, the medical director for the Canadian Olympic team, the addition of the 12-lead ECG makes sense as is the standard of care for professional athletes in soccer leagues in Europe and North America.

12-lead ecg - Olympic Hearts

A 12-lead ECG

“Nothing has been decided yet, but I think there is a feeling that we need to develop some guidelines for better cardiac screening than simply taking a family history along with a physical exam,” said McCormack. “It’s too imprecise. It would miss a vast majority of individuals at risk for sudden cardiac death.”

Dr. Sharma understands the limitations of traditional guidelines; it’s why he’s focused on intensive screening efforts for the 2012 Games.

“Our own experience of screening high-level athletes is that about one in 100 has a condition that is congenital and could potentially cause problems later in midlife—such as heart failure or the heart becoming hypertrophied. And one in 300 harbors a condition that could potentially kill instantly. Sadly, only 20% of athletes with these conditions manifest any symptoms whatsoever. Sudden death is often the first presentation,” says Sharma.

2010 Winter Games

Dr Jack Taunton was chief medical officer for the 2010 Winter Olympic Games in Vancouver, so he knows how much effort and planning is needed to take care of the athletes, coaches, officials, support staff, media, and volunteers.

2012 Olympics

Resources on hand:

  • Cardiac defibrillators, cardiac monitors, full cardiac medications, full intravenous, and full airway support at every competitive and non-competitive venue
  • A total of 225 automated external defibrillators (AEDs) and 72 LifePak 15 portable heart monitor/defibrillators
  • 10 000 cardiopulmonary resuscitation kits for first responders
  • Two 10 000-sq-ft polyclinics in Vancouver and Whistler
  • 1560 medical professionals
  • Two 54-ft tractor trailers, each with more than 1100 sq. ft. of space for two operating rooms, four trauma beds, and four intensive-care-unit beds

Treatment stats:

  • Health professionals treated 9200 people, many of them coaches, for ailments as minor as a cough or cold, but also for chest pain, shortness of breath, or arrhythmia
  • In Torino, they hospitalized 1198 people and in Salt Lake City they hospitalized 444 people. Compared to just 14 people hospitalized and another 43 patients treated with outpatient services in Vancouver

While the Vancouver Games clearly set a level of precedent for healthcare at the Olympics, we are confident Dr. Sharma is doing everything in his power to create a safe event for all athletes and attendees at the 2012 Games in London.

On behalf of the team here at Iridia we wish all Olympians the best and one final “Go Canada go!”

Polio – The Final One Percent

Eradicating an infectious disease of humans on a worldwide scale is no simple task. In fact, it is so difficult mankind has only achieved it once before – with smallpox.

Currently (with massive effort) we are on track to eradicate a few more diseases, such as polio, the measles and malaria. But even with all the effort we have made towards its eradication, the World Health Assembly voted to renew polio as a global emergency in May. This comes at a time when cases of the deadly virus are at an all-time low.

Eradication of Polio

How can polio be a global emergency when it’s been almost entirely eradicated?

First, there are only three countries (Pakistan, Afghanistan, and Nigeria) where polio is endemic (occurring without spreading from somewhere else). But in these countries the reported number of cases has actually gone up.

Second, the polio eradication effort has fallen short near $1-billion in funding due to tough economic times.

This can come as a shock as the efforts to eradicate this terrible disease have made huge leaps forward in recent years with help from the Bill & Melinda Gates Foundation, which has donated $1 billion to polio eradication since 2009.

With the Gates Foundation’s help, there were just 650 cases of polio in 2011, down from 1,352 in 2010, and just this year India was removed from the WHO list of polio-endemic countries.

Growth of Polio

But in Pakistan, Afghanistan, and Nigeria, the number of cases has risen in 2011. In Pakistan, the number of cases increased from 144 to 197; in Afghanistan from 25 to 80; in Nigeria from 21 to 62.

Click to see infographicpolio infographic

Although these infection rates are very low (especially for a disease that used to infect millions), the $9 billion eradication effort will only be successful once new polio cases cease to exist, ending the spread once and for all. This could lead to $50 billion in saved health costs.

Unfortunately, if we cannot continue to fight the disease at the same rapid pace, it’s likely the number of cases will continue to rise, until the disease affects hundreds of thousands of children again. Even one small outbreak can change the course of the eradication effort.

Future of Polio

Why can’t we continue on our current path of mass immunization? The answer is simple; the immunizations efforts so far are just not feasible on a regular basis. And even vaccines are available; it’s not always easy to vaccinate everyone, especially when some even prefer not to be vaccinated for various personal reasons.

polio vaccination

Child Receiving Polio Vaccination

The polio eradication shows us just how difficult it is to rid ourselves of any disease. We are so close, yet we still need to apply pressure. Amazing strides have been made so far in the fight against polio, but there is still much to do.

As experts in pandemic preparedness those of us at Iridia can relate the polio eradication effort to that of the recent H1N1 outbreak and the cropping up of the H5N1 avian flu.

These diseases are similarly difficult to eradicate and will remain with us until every single case has been stamped out. We believe we will get there one day, but until that time all we can do is be prepared.

Another Look at Chest Compressions

Chest Compressions

In 2010, international guidelines for cardiopulmonary resuscitation (CPR) recommended a change in compression depth. The minimum depth was raised from 38 to 50mm, although there was limited data to support the change from the 2005 guidelines.

Recently, the Resuscitation Outcomes Consortium (ROC) conducted a large scale study to examine patterns of CPR compression depth and associated survival rates.

The trial included 1,029 cases from 7 different sites across Canada and United States. The cases were typical of most cardiac events that take place out of a hospital; meaning 13 percent were in a public location and 40 percent were witnessed by a bystander.

The study was able to determine an average chest compression depth of 37.3mm, slightly less than recommended 2005 guidelines of 38mm and quite short of the new 50mm standard.

According to the study, half the patients received less than the 2005 guidelines and 90 percent received less than the 2010 guidelines; revealing a current trend of sub-optimal compression when delivering First Aid.

Chest Compressions

To lend credence to the “ sub-optimal trend,” the study has found a strong connection between survival and the increase in chest compression depth from 38 to 50mm.

Although compression depth continues to play an important role in CPR, the most effective depth is still unknown. The ROC found no evidence to prove or disprove the new recommendations at depths greater than 50mm.

During the study, the ROC also found an increased rate of chest compressions negated the positive effects of an increased depth. The recommend rate is 100 compressions per minute. Researchers suggest rescuers be cautious not to exceed a compression rate of 120.

The bottom line is that we don’t push hard enough on the chest. In order to increase survival rates, we need to deliver high-quality CPR. High-quality CPR must consist of proper compressions in both depth and rate; constraints rescuers need to be aware of.

 

 

Shins and Needles – Intra-Osseous Placement

Intra-Osseous Placement

I came across this discussion point while perusing the medical blog world. The discussion revolves around the difficulties with pediatric Intra-Osseous needle placement and more so, keeping the needle in the bone.

Most of my experience with IO insertion and care has been on adults and rarely, actually never, have I witnessed an IO cannula dislodge or come out of an adult limb without the application of brute force. I understand this is not the case for children.

Intraosseous

Intraosseous pediatric trainer

See this link for discussion about how best to secure an IO in pediatric patients. 
http://emcrit.org/misc/how-to-secure-an-io-in-a-peds-patient/

Take home message; if you need to insert an IO, you need to make sure it stays in.

FYI: “cannula” is Latin for little reed

Intra-Osseous in action:

[youtube=http://www.youtube.com/watch?v=PL3DMY1Zln0]

Innovation Corner – Flipboard

What’s the Innovation Corner?

Every month, the Iridia team gets together for staff meeting. During the meeting, we discuss a variety of topics from our diverse organization. One object on the agenda is “The Innovation Corner”.

Innovation is one of our eight core values at Iridia, values we strive to live every day. It’s one thing to say “innovation is a corporate value of ours,” but it’s another to live it.

We are always keeping our sharp eyes on the lookout; finding creative ways to fit pieces together. In order to “fit pieces together,” we need to do things more efficiently and, if possible, with the use of new tools.

The Innovation Corner is a brief (5 min.) section of the agenda dedicated to the introduction of a story, a tool, a concept, or anything else that might spur on innovation within our team.  Anyone can lay claim to the Innovation Corner in upcoming meetings, and thereby use it to share an innovative find they have come across.

“This effort has already brought forward tools that have been put to immediate use in our business operations.  In seeing how these insights have made a difference for us, we’ve decided to take time out and share them with a broader audience.” – Iridia Vice President

Flipboard

During our June staff meeting we profiled an app called Flipboard.

In a nutshell, Flipboard is a mobile app (works on iOS and Android devices) that allows you to create your own “social magazine” from various sources.

Start by downloading the app for iOS or Android. Then start putting together your customized social magazine.

You can add your own social media feeds or search for endless content from other websites and blogs (including this one!).

flipboard

Screenshot of Iridia’s “Flipboard Homescreen.”


If you would like your social media accounts and your news all in one place, then this app is for you. 

Currently we have set up an “Iridia” Flipboard account. We have added some of our social networks such as Facebook and Twitter as well as a few magazine we subscribe too. Now our staff can access all this material in one easy to read format.

To learn more have a look at the Prezi we created to show the app to our staff: http://prezi.com/yjeu7t1ywu7i/flipboard/

Stay tuned for future updates from the Innovative Corner!

H1N1 More Deadly Than Previously Thought

H1N1 Emerges

In 2009 the world was taken by surprise. A new global flu pandemic swooped into our lives, creating media frenzy.

As pandemic and emergency preparedness specialists, we at Iridia Medical were prepared to fight the outbreak and did just that.

But by August 2012, little over a year after the H1N1 virus became breaking news, the Director-General of the World Health Organization declared an end to the pandemic and left everyone wondering, “did the WHO exaggerated the danger,” spreading fear and confusion.

Influenza Virus - H1N1

Influenza Virus

When the H1N1 virus spread around the world three years ago, there was little over 18,500 deaths reported; a number much lower than the global media attention would have one believe.

Shedding New Light

Criticism and finger pointing are inevitably part of an outbreak cycle. During the H1N1 outbreak some even went as far to call it a “false pandemic.” Contrary to this belief, a new study suggests the outbreak was more severe than originally thought.

Now that the dust has settled, the actual number of deaths from the 2009 H1N1 pandemic has been pegged at more than 15 times higher than earlier estimates.

Based on a study published online in The Lancet Infectious Diseases, researchers estimate 284,400 people actually died in the first year alone.

According to the study authors, the actual number of deaths linked to the H1N1 flu virus could range anywhere from 151,700 to 575,400.

H1N1 Map

H1N1 reported cases from 2009

H1N1 – A Numbers Game

The sudden change in statistics is due to a number of reasons:

• Health officials did not take into account laboratory-confirmed flu deaths can considerably underestimate of the actual number of deaths from the flu.
• During the 2009 pandemic, many countries, particularly in Africa and Southeast Asia, lacked the ability to perform routine laboratory tests and therefore had difficulty identifying H1N1-related deaths.
• The WHO data suggests less than 12% of the confirmed deaths were in Africa and Southeast Asia, this new study estimates 51% of the deaths may have been from those two regions alone.

Lessons Learned

Dawood, a medical epidemiologist (also known as a disease detective) at the Centers for Disease Control and Prevention, says she hopes this research will help “limit the loss of human life in future pandemics.”

Studies like this are important as they can provide us with solid evidence of disease spread, infection rates and the impact of pandemics in various geographical regions; leading to future prevention efforts.

Canadians Still Struggling to Find a Family Doctor

ministry of health - Family Doctor

The Plan for Family Doctor’s

In 2010 the BC Ministry of Health set out to provide every British Columbian who wants a family doctor with one by 2015.

Aside from extending access to family doctors; this plan aims to provide better care for patients with chronic diseases, seniors and those with complex health needs.

“Ensuring that British Columbians have access to their own family doctor – a health professional who is familiar with their medical history – can drastically improve health outcomes for patients and in doing so, can help ensure the sustainability of our health system. This shift will change the patient’s journey through the health system and streamline care so patients receive consistent and appropriate care through their family doctor over a lifetime” – Kevin Falcon, Health Services Minister.

Read the original 2010 news release.

Where Are We Now?

Fast-forward two years and it looks as though the BC Ministry of Health is still struggling to connect citizens to family doctors.

A recent Statistics Canada report shows little to no change in the accessibility of a regular family doctor since 2010. In fact, access to a family doctor is at the lowest point in almost a decade.

access to family doctor

With only three years left to achieve their goal, the Ministry of Health must continue to push integrated primary health systems throughout British Columbia.

Where’s The Change?

B.C.’s move to a more integrated primary and community health care system began in stages with some communities and regions across the province in 2010-11.

With this approach changes will happen slowly as the plan is fully rolled-out to communities around the province.

By March 2011, integration had begun in 40 communities and regions of the province and, by 2015, the program will be available in more than 160 B.C. communities, covering the entire province.

doctor patient - Family Doctor

Where Are We Going?

Shifting to primary health-care is part of the innovation and change agenda to improve patient care while managing growing health care costs and ensuring long-term sustainability.

At Iridia, we have seen this shift first hand and the Ministry of Health plan in action.

Our involvement at the Jim Pattison Outpatient Care and Surgery Centre has shown us one such program, the Primary Care Clinic.

The Primary Care Clinic helps patients who are discharged from Surrey Memorial but don’t have a family doctor to get follow-up care.

So far, more than 3,300 patients have been connected with a primary care provider; a staggering number for a program/facility that opened its doors in 2011.

Bottom line – as the Ministry of Health plan expands, we can expect to see more individuals throughout the province connected with family doctors.

Healthy Lifestyles – BC Leads, Canada Follows

Iridia Medical is an advocate for healthy living. We believe positive choices can be made to enhance physical and mental health. As such, we encourage all of our employees to implement a healthy living plan that works to fit their unique lifestyles.

No surprise, (to me anyway) it looks like Iridia is not alone. According to a 2011 Stats Canada Community Health Survey, British Columbia families are leading the way in healthy living.

The Community Health report card ranks BC at or near the top on most indicators measured.

Healthy Lifestyle Highlights:

  • British Columbian adults have the lowest rates of self-reported obesity or overweight in the country, at 46.6 per cent. 
  • Physical activity rates for those 12 and older are the highest among the provinces, at 59.6 per cent.
  • Smoking rates are the lowest in the country, at 15.8 per cent.
  • British Columbian families rank third among all Canadian jurisdictions in fruit and vegetable consumption, with 40.7 per cent of those 12 and older consuming fruit or vegetables five or more times per day. 
  • British Columbia continues to increase its ranking of self-perceived health for those over 12 years of age, moving from fourth to second in the country (along with Newfoundland and Labrador) with 60.9 per cent of respondents reporting very good to excellent overall health.
Fruit - Healthy Lifestyles

Minister of Health Michael de Jong

“Once again, British Columbians have shown that they are among the healthiest in the country – something each of us can be proud of. However, prevention is the best medicine, and if we want to continue to reduce the burden of chronic disease and illness on our health system and our lives, we are going to need to keep striving for improvement.”

“Through initiatives like Healthy Families BC, our comprehensive smoking cessation program and our formal partnership with ParticipACTION to promote physical activity, we are committed to helping British Columbians get and stay healthy.”

Healthy Lifestyles – Quick Facts:

  • B.C. is the first province in Canada to partner with ParticipACTION 
  • Evidence shows that individuals, who are physically active, achieve and maintain a healthy body weight, enjoy a healthy diet and refrain from smoking, can reduce their risk factors for most chronic diseases by up to 80 per cent. 
  • Obesity rates in children have almost tripled in the last 25 years. 
  • In British Columbia, 51,000 children (seven per cent) aged 2-17 years were classified as obese About 2,000 British Columbians die prematurely every year due to obesity-related illnesses, such as heart disease, high blood pressure and diabetes.
    • 138,500 (20 per cent) as overweight.

Healthy Living Activities at Iridia

Kayaking - Healthy Lifestyles

Michael ready to take on the Capilano River as part of the Red Bull Divide and Conquer race.

To embrace healthy lifestyle choices, staff at Iridia participate in a variety of healthy activities. One such activity was our 90-day fitness challenge led by Innovative Fitness. Read more on the challenge here: IF Challenge.

Members of our staff also recently participated in the Walk to Fight Arthritis.

Many of our staff are also are avid bikers and brave temperamental Vancouver weather on two wheels. But it’s not just biking. You may even see Iridia staff members kayaking down rivers, surfing the ocean, playing squash, skiing, snowboarding, running, rock climbing, …the list could go on, but you get the idea.

With the help of Iridia, each of us in our own way has embraced a work/life balance that allows us to shine in all that we do.

For resources to support healthy eating, healthy lifestyles and healthy communities, visit: www.healthyfamiliesbc.ca

All About Supraglottic Airway… pt. 2

This week I am highlighting two airway discussion points which have recently come to my attention: cuffed vs. non-cuffed endotracheal tubes (ETTs) in pediatric patients and the possible, negative side effects of supraglottic airways.

See my first post on cuffed vs. non-cuffed endotracheal tubes: Part 1

Supraglottic Airways: Help or Harm?

Health Care Providers (HCPs), working in multi-disciplinary, team oriented environments, are able to achieve rapid and early airway management without interrupting resuscitation efforts. However, the role of ETTs has been de-emphasized during cardiac arrest management and HCPs are encouraged to use alternate airway devices, such as supraglottic airways.

Supraglottic airways minimize interruptions in compressions and as a result, maximal blood flow to the brain. Or, so we thought…

A recent swine study shows evidence supraglottic devices may decrease cerebral blood flow in low output states. See the article below.

http://emcrit.org/wee/extraglottic-airways-harmful-cardiac-arrest/

 Supraglottic Airway

In the ACLS courses I instruct at Iridia, I have been strongly encouraging the use of supraglottic airway devices.  Mainly because King Tubes or laryngeal mask airways can be inserted without stopping chest compressions and this allows for more blood to the brain. But, if these airway devices impede blood flow to the brain, should we be using them at all?

What is the future of airway management during cardiac arrests? Will newer, high-tech devices make it to market or will airway management go back to a head-tilt, chin-lift with oxygen from a simple mask?

I’d love to hear your thoughts and opinions. Let me know what you think about these discussion points.