Thursday, August 13, 2009
Propofol must be taken only if an anesthesiologist is present

By Dr. Anthony Policastro

There are many medical things that pop up in the media. Some of them are familiar, others are not. One of the less familiar things to appear over the last few weeks had to do with a drug called Propofol. There was a question raised about it being possibly related to what happened with Michael Jackson. The name Propofol was probably new to many non-medical people. People are used to going through complicated procedures under sedation. The best example of this is screening colonoscopy. The sedation used for these procedures is known as conscious sedation. This means that the patient is awake enough to follow commands during the procedure. However, the drugs cause amnesia for what goes on during the procedure. For that reason, the patient does not remember any discomfort afterward. It is like it never happened. For years the drug that was used the most was something called Versed. This was very good at doing exactly what was needed. It allowed the patient to be cooperative and caused the patient to not remember anything about the procedure. Thus it is a very good drug for the procedure itself. However, after the procedure the patients usually had to recover for a period of time so they could be sent home. Even then they were still somewhat groggy. Propofol does the same kind of thing as Versed. However, it has a much shorter recovery period which allows physicians to move more patients through the system in the same period of time. They can do more procedures. It would sound at first like Propofol is a good replacement for Versed. However, all drugs are different. Propofol has an important downside to it. With any drug that we use, there are two blood levels that we see of the drug. The first drug level is what is called the therapeutic level. This is the level that causes the action that we want to see. The second level is the toxic level. This is the level that causes significant side effects from the drug. Some drugs have a large difference between the therapeutic and toxic levels. Thus if you give a little too much of the drug it still will not get high enough to be toxic. Other drugs have only a small difference between the therapeutic and toxic levels. For these drugs even if you give a little too much, it can be a problem. Propofol is one of the drugs with a very limited difference between the therapeutic dose and the dose that is too high. If the levels get too high, they put the patient into a general anesthesia state. At that point, the patient needs to have assistance with breathing. For that reason, Propofol should only be used when there is an anesthesia person present. That person needs to be responsible for monitoring breathing. If the patient goes too deep because the level moves to the high side, the anesthesia person can take over breathing. That is the same thing that happens in the operating room. The bottom line is that if someone wants to give you Propofol for a procedure, make sure there is someone there to monitor your respirations and breathe for you if that becomes necessary. If Michael Jackson took Propofol at home, it is unlikely that anyone was monitoring him to see if the level of anesthesia got too deep. We are in a position to ensure that the proper precautions are in place if we ever receive Propofol for a procedure.

Stroke and Osteoporosis Screening Residents living in and around the Blades community can be screened to reduce their risk of having a stroke or bone fracture. The Blades Town Hall-Hardin Hall will host Life Line Screening on Aug. 31. The site is located at 20 W. Fourth St. in Blades Appointments will begin at 9 a.m. Four key points every person needs to know: Stroke is the third leading cause of death and a leading cause of permanent disability. 80 percent of stroke victims had no apparent warning signs prior to their stroke. Preventive ultrasound screenings can help you avoid a stroke. Screenings are fast, non-invasive, painless, affordable and convenient. Screenings identify potential cardiovascular conditions such as blocked arteries and irregular heart rhythm, abdominal aortic aneurysms, and hardening of the arteries in the legs, which is a strong predictor of heart disease. A bone density screening to assess osteoporosis risk is also offered and is appropriate for both men and women. Packages start at $139. All five screenings take 60-90 minutes to complete. For more information regarding the screenings or to schedule an appointment, call 1-877-237-1287 or visit our website at Pre-registration is required. Life Line Screening was established in 1993, and has since become the nation's leading provider of preventive screenings.

Get fit at Delaware Tech Get in shape this fall with programs offered at Delaware Technical & Community College, Owens Campus. Release tension and stress through a series of meditation, breathing, and stretching exercises in yoga on Monday evenings beginning Sept. 21 or Wednesday evenings beginning Sept. 23. Want to exercise at your own pace? Become a member of the Delaware Tech Fitness Center by signing up for the monthly or 16-week program. Training sessions with Jim Edgerton, certified personal trainer, are also available for individual help reaching fitness goals. The state-of-the-art gymnasium complex is open five nights per week until 7 p.m. and includes a basketball court, fitness center complete with a cardio/weight training room, exercise room, and locker rooms for men and women. Special discounts are available for seniors. For more information or to sign up for a program, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

duPont Hospital holds raffle Nemours/Alfred I. duPont Hospital for Children is holding a raffle for a Harley-Davidson motorcycle. The motorcycle, a Soft-Tail Fat Boy in Black Denim that includes a riding gear safety package, was donated by Concordville Nissan-Subaru. Tickets are $25 each or five for $100 and proceeds benefit the hospital. The drawing will take place in the hospital lobby on Sept. 11 at 2 p.m. For ticket information, contact Kate Handling at 302-651-4383 or

Health care info sessions

Looking for opportunities with a great starting salary in the expanding health care field? Attend a free information session on Monday, Aug. 17 from 6 to 8 p.m. at Delaware Technical & Community College, Owens Campus. Discuss new and existing health career certificate programs at Delaware Tech including certified nursing assistant, polysomnography technician, medical coding and billing, medical transcriptionist, health information coding specialist, and health information clerk. For more information or to sign up for this info session, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

Occupational Health moving On Monday, Aug. 17, Nanticoke Memorial Hospital's Occupational Health Services will be moving to a new location at 543 N. Shipley St., Suite F in Seaford. The new location is dedicated to only Occupational Health clients. From treatment for work-related injuries and illnesses, DOT screenings, post incident testing, pre-employment physical examinations, to drug testing, Nanticoke's Occupational Health Services has been operating for more than 20 years. For more information, contact Occupational Health Services at 629-6875.

Stroke Support group Nanticoke Memorial Hospital's next Stroke Support Group meeting is Thursday, Aug. 20 at 1:30 p.m. at Nanticoke Memorial's 2nd Floor Cancer Care Center Conference Room. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Certificate programs offered Enroll in one of the new health career certificate programs offered by Delaware Technical & Community College, Owens Campus. New certificate programs include medical coding and billing, health information clerk, health information coding specialist and medical transcriptionist. "Medical terminology" is a prerequisite course for all of the health career certificate programs. Students will learn basic terminology in this 16-hour online course; the first session is Monday, Aug. 24 from 6 to 8 p.m. at the Owens Campus. In "Medical Coding and Billing" students will utilize basic medical terminology to understand the medical insurance claims process and reimbursement procedures; learn to identify and use special terms, marks, abbreviations and symbols used in the ICD-9 coding system. The course begins Tuesday, Sept. 22 at 6 p.m. "Health Information Clerk" prepares students for technical positions in health information management departments, physician's offices, long-term, home health and other health care settings. The course begins Monday, Nov. 2 at 6 p.m. In "Health Information Coding Specialist" students are trained to analyze patient health records in order to abstract information necessary to assign accurate ICD-9 and CPT codes. Course prerequisites are medical terminology and medical coding and billing; the health information coding specialist portion of the course begins Monday, Nov. 2 at 6 p.m. Prepare to be a medical transcriptionist by obtaining basic knowledge, understanding and skills required to transcribe medical dictation with accuracy, clarity and timeliness including medical terminology, human anatomy and physiology. The course begins Monday, Nov. 2 at 6 p.m. For more information or to sign up for courses, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

Depression Support Group There will be a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call Life Matters Counseling and Consulting at 302-465-6612.

Pharmacy Tech information session Enter the rapidly expanding field of health care with the pharmacy technician certificate training program at Delaware Technical & Community College, Owens Campus. Pharmacy technicians help pharmacists package or mix prescriptions, maintain client records, refer clients to the pharmacist for counseling, assist with inventory control and purchasing, as well as payment collection and billing coordination. A free information session about the program will be held on Thursday, Aug. 20 from 6 to 8 p.m. The 189-hour classroom course will be held at Delaware Tech on Monday and Wednesday evenings, 6 to 9 p.m., from Sept. 21 to April 19. A 120-hour externship is also necessary to complete the program. Graduates will receive a certificate of completion and be prepared to take the Pharmacy Technician Certification Board (PTCB) exam to become a nationally certified pharmacy technician. Funding through the Department of Labor and a payment plan through Delaware Tech's Corporate and Community Programs are available for this course. For more information, contact Corporate & Community Programs at 302-854-6966.

Adult Abuse Registry online As of Monday, Aug. 3, Delawareans seeking to hire someone to help care for their elderly loved one and employers can go online and check the job applicant's name against the Adult Abuse Registry. The listing of a person's name on the registry is based on a civil finding of abuse, neglect, mistreatment, financial exploitation, or a combination of those findings. It is not a criminal finding. Individuals are placed on the Registry for a fixed period of time. When that time runs, the sanction is over and the name is removed. A listing of "Substantiated Pending Appeal" means that the person listed either has filed an appeal to challenge the listing, or still has time in which to do so. Otherwise the listing is "Substantiated," meaning that the listing has been finalized after an appeal, or that no appeal was requested within the time permitted. Delaware's aging population is growing faster than in most states. By 2030, the US population over 65 is expected to double while Delaware's is expected to grow by almost 134 percent. To report abuse in the community or in a long term care facility, call the Elder Abuse and Neglect Hotline at 800-392-0210 24 hours a day.

'Go Fish' to benefit Autism Delaware "Go Fish," a bass fishing tournament to benefit Autism Delaware's southern location, will be held on Saturday, Sept. 19 at eight ponds throughout southern Delaware, and will be followed by a celebration at Milford's Bicentennial Park. "This is the first big public event we've had down here and the money we're raising will help us expand our services and move us closer to the goal of a permanent office here," said Autism Delaware's Southern Delaware Coordinator Dafne Carnright. Anglers of all ages are welcome. Each team of two can register for $40 and will receive an information and fundraising packet. Prizes, including a grand prize of $500, will be awarded at the celebration. The general public is welcome to come to the celebration which will feature music, food, kids' fishing demonstrations, a visit from Texas Roadhouse's Andy the Armadillo, and other fun at Milford's Bicentennial Park. Nominal fees will be charged to those not participating in the morning tournament. In addition to the tournament, benefit nights are scheduled at the Seaford (Sept. 16), Bear (Sept. 17), and Camden (Sept. 18) locations of top Go Fish sponsor Texas Roadhouse. Pro bass fisherman Mike DelVisco will appear at each event as well from 4 p.m. to 6 p.m., and will fish in the tournament Saturday. There are only 160 slots for fishing, so register today by visiting or calling 302-422-2255.

NMH holds diabetes classes Nanticoke Memorial Hospital, Seaford, will hold a four-session diabetes educational program beginning Sept. 9 and continuing Sept. 16, 23, and 30 from 5 to 7 p.m. at the hospital. Registration for this class is required. The cost of the four-session program may be reimbursable by insurance. This four-session program includes weekly education sessions and individualized meal planning for diabetes self-management. Our goal is to give you the self-management skills to control your diabetes. Family members/significant others are welcome to attend the weekly sessions. To register and obtain additional information regarding the course, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.

White promoted to unit director Nanticoke Health Services has promoted Ms. Michele E. White, RN, BSN to the position of Surgical Specialty Unit director where she will be accountable for the delivery of medical surgical care in collaboration with physicians and other health care providers. White has a bachelor's degree from Salisbury University. For the past six years, she has worked at Nanticoke Memorial Hospital as a nurse and an administrative nursing supervisor. She has more than 10 years of health care experience.

Dr. Dasika joins NMH Nanticoke Memorial Hospital welcomes Samyutka Dasika, MD to its active medical staff. Dr. Dasika joins Nanticoke Health Services as a specialist in pediatric inpatient hospital care and will also practice pediatrics from Nanticoke Health Services' new pediatric practice opening this fall in Seaford. Dr. Dasika completed her residency in pediatrics at Newark Beth Israel Medical Center in Newark, N.J. She completed her medical degree at Trichur Medical College in India.

Three join Delaware Hospice Delaware Hospice welcomes the following area staff members: Martin Baker, C.N.A., of Bridgeville, certified nursing assistant; Jo-Allynn Bloomfield, C.N.A., of Seaford, certified nursing assistant; and Kristina Sechrest, RN, of Delmar, as a registered nurse. Bloomfield has been in the medical field for 10 years, including the Kent Campus of Bayhealth Medical Center. Sechrest has been a medical-oncology nurse for Peninsula Regional Medical Center and a staff nurse for Maxim Healthcare Services.

A Spaghetti Dinner on Aug. 22 An all-you-can-eat Spaghetti Dinner will be held Saturday, Aug. 22, from 4 to 7 p.m. for $8 (includes salad, garlic bread, dessert and beverage.) Children under age 8 are free. The dinner will be held at Fraternal Order of Eagles, 107 Alexander Ave., Salisbury, to benefit 11 year old Kara Adams of Delmar in her battle with cancer. Donations may be made at any Farmers Bank of Bank of Willards to the "Kara Adams Fund." For more information contact: Carole Kauffman at 443-783-5112.