EMTs not “Licensed Healthcare Profesionals”

Jeff Bezo, president and CEO of Amazon, was sent a letter by the U.S. Department of Labor a couple of weeks ago warning him to stop using AMCARE, their in-plant medical unit which is staffed with EMTs to provide medical care. EMTs are only supposed to provide first aid, nothing more.

In the letter the DOL states “After reviewing relevant facts pertaining to this case, it has been determined the AMCARE is providing medical care beyond first aid.” The letter goes on to specify that EMTs are not licensed to practice medical care independently as per the state laws. “AMCARE personnel were providing medical care beyond what is allowed by their licensing and certification without the supervision of a board certified qualified medical professional licensed to practice independently.”

Bottom line is that EMTs are only allowed to provide first aid as well as provide referrals to an outside health care provider when necessary.

You can read the entire warning letter here.

FDA Warns that Powdered Caffeine can Kill

I recently watched an episode of the “Brew Dogs” (if you haven’t watch “Brew Dogs” catch it on youtube). They were in Seattle and they were trying to make the most caffeinated beer in the world. To do this, coffee wasn’t going to be enough so they went to a lab and we got to watch as they extracted caffeine and made it into a powder.

Turns out brews dogs aren’t the only ones doing this and powdered caffeine is now available on the internet. The problem is that this pure caffeine in even small doses can be fatal.

At least one teen has died from an overdose already and rumors are going around that teenagers are starting to snort it. If that’s the case, more deaths will follow.

The FDA is warning people to stay away from it as standard measuring equipment like measuring spoons are accurate enough; even a teaspoons can kill.

Because caffeine is in a lot of food and drinks as a natural by-product of tea, coffee and other substances, it isn’t regulated by the FDA, something that the FDA plans on changing in the near future.

Right now, caffeine is sold as a dietary supplement and widely available.

The FDA is warning people to just stay away from it and make sure that your children and teenagers know that it isn’t something to mess with.


World Health Organization Speaks out about Antibiotic Resistance

The World Health Organization announced in a 256 page report on Antibiotic Resistance that if something isn’t done about the issue, then we are facing a “problem so serious that it threatens the achievements of modern medicine.”

They go on to state that “Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. ”

The key findings, according to the document, are:

• Very high rates of resistance have been observed in bacteria that cause common health-care associated and community-acquired infections (e.g. urinary tract infection, pneumonia) in all WHO regions.

• There are significant gaps in surveillance, and a lack of standards for methodology, data sharing and coordination.

Key findings from AMR surveillance in disease-specific programmes are as follows:

• Although multidrug-resistant TB is a growing concern, it is largely under-reported, compromising control efforts.

• Foci of artemisinin resistance in malaria have been identified in a few countries. Further spread, or emergence in other regions, of artemisinin-

resistant strains could jeopardize important recent gains in malaria control.

• Increasing levels of transmitted anti-HIV drug resistance have been detected among patients starting antiretroviral treatment.

Download or read the full document here.

MERS Virus Warning


Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a Coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. More than 30% of these people died.This virus has spread from ill people to others through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spreading in community settings. As of Friday, 538 cases of MERS have been confirmed in 17 countries, including the United States, according to the World Health Organization. Of those, 145 people have died.

MERS is in the same family of viruses as SARS (severe acute respiratory syndrome — coronavirus) as well as the common cold. However, unlike SARS, which sickened more than 8,000 people in 2003 and killed 773 worldwide, MERS does not spread easily between humans — at least not yet. On May 2, 2014, the first U.S. case of MERS was confirmed in a traveler from Saudi Arabia to the U.S. The traveler is considered to be fully recovered and has been released from the hospital. Public health officials have contacted healthcare workers, family members, and travelers who had close contact with the patient. At this time, none of these contacts has had evidence of being infected with MERS-CoV.

On May 11, 2014, a second U.S. imported case of MERS was confirmed in a traveler who also came to the U.S. from Saudi Arabia. This patient is currently hospitalized and doing well. People who had close contact with this patient are being contacted. The two U.S. cases are not linked. CDC and other public health partners continue to investigate and respond to the changing situation to prevent the spread of MERS-CoV in the U.S. These two cases of MERS imported to the U.S. represent a very low risk to the general public in this country.

CDC continues to closely monitor the MERS situation globally and work with partners to better understand the risks of this virus, including the source, how it spreads, and how infections might be prevented. The virus acts like a cold and attacks the respiratory system, the Centers for Disease Control and Prevention has said. But symptoms, which include fever and a cough, are severe and can lead to pneumonia and kidney failure. Gastrointestinal symptoms such as diarrhea have also been seen,CDC recognizes the potential for MERS-CoV to spread further and cause more cases globally and in the U.S. We have provided information for travelers and are working with health departments, hospitals, and other partners to prepare for this.

There are no treatments and no vaccine

As of now, doctors can treat symptoms of MERS, such as fever or breathing difficulties. However, there is no vaccine and no specific medicine, such as an antiviral drug, that targets MERS.

New Mexico Department of Health is asking that healthcare providers, infection preventionists and laboratorians be alert for and evaluate patients who meet the following:

  • Developed severe acute lower respiratory illness within 14 days after traveling from countries in or near the Arabian peninsula (e.g., Saudia Arabia, United Arab Emirates (UAE), Qatar, Oman, Jordan, Kuwait); OR
  • Close contacts of a recent traveler from this area who has fever and acute respiratory illness; OR
  • Close contacts of a confirmed case

Clusters of patients with severe acute respiratory illness (e.g., fever and pneumonia requiring hospitalization), without recognized connections to patients with MERS-CoV or to travelers from the Arabian Peninsula and surrounding areas, should be evaluated for common respiratory pathogens.


Additional information can be found in the MERS-CoV Risk Assessment document provided by the World Health Organization (WHO).

Information from the CDC, World Health Organization and NMDOH


Today’s post comes to us courtesy of Ken Oswald, Safety and Security Manager for Plateau


Sodium Phosphate FDA Warning

It’s used primarily to treat constipation and available over-the-counter but if the dosage isn’t probably adhered to it can be extremely dangerous, even fatal. Sodium Phosphate is the drug that we are talking about and the usual dosage is to be taken no more than once in 24 hours. The problem is that in our “instant relief” world people take it more often than that.

The results can damage organs like the liver, the kidneys and the heart. The problem is seen most often in those who are really young or older as well as anyone who combines the Sodium Phosphate with other medications that may increase the dehydration. Even simple anti-inflammatory drugs such as aspirin and ibuprofen can be a problem.

You can read more about the FDA warning on their website.

OSHA/NIOSH Hazard Alert on 1-bromopropane (1-BP)

OSHA and NIOSH have released a “joint” warning concerning a chemical that “has increased in workplaces over the last 20 years“, namely 1-bromopropane (1-BP).

According to the 7 page pdf warningExposure to 1-BP has been associated with damage to the nervous system among workers, and it has been shown to cause reproductive harm in animal studies. The chemical is used in degreasing operations, furniture manufacturing, and dry cleaning.

At this time OSHA has not set a PEL (permissible exposure level) but the warning refers to the level of 5 PPM that California has adopted.

Employers are required, by law, to make sure that all employees are aware of the dangers of 1-bromopropane which is ingested primarily through inhalation.

Learn more about how to protect from the hazards of 1-BP by downloading the OSHA/NIOSH warning.

“Latex Free” misleading according to the FDA

A “Draft Guidance for Industry and Food and Drug Administration Staff” released by the FDA (Food and Drug Administration) released today (March 11, 2013), outlines the problem with claims of “Latex Free” or “does not contain latex”. According to the FDA the problem is that “it is not possible to reliably assure that there is an absence of the allergens associated with hypersensitivity reactions to natural rubber latex” and “may give users allergic to natural rubber latex a false sense of security”

While the draft and recommendations only apply to FDA regulated medical products, the implication is clear for pretty much anything else, especially for products that are made in an area where latex is processed or used.

At this time there are no regulations requiring a company to state that natural rubber latex was not used as a material in the manufacture” of a specific product, because of the increasing awareness and widespread scope of latex allergies, many manufacturers are starting to write “Latex-Free” or “Does not contain latex” (or sometimes “natural rubber”) on the packaging of products that are made with silicone, nitrile or other non-latex items.

The FDA’s suggestion is that manufacturers change the statement to “Not made with natural rubber latex” in order not to lull users with latex allergies into a false sense of security which may adversely effect their health when even minute particles of latex protein shows up in a supposedly “latex-free” item.

Bottom line is that, if you have a latex allergy or suspect that you may have one, you need to be proactive about making sure that even items labelled as “latex-free” don’t give you a reaction.

February Healthy Heart Awareness Month

February is Healthy Heart Awareness month

Heart Attack, Stroke and Cardiac Arrest Warning Signs

Every 39 seconds, an adult dies from a cardiovascular disease such as a heart attack or stroke. Cardiovascular disease claims the lives of more than 800,000 adults each year, 150,000 of whom are under the age of 65. Learn what you can do to reduce your risk

Act in Time
As February begins, it also kicks off American Healthy Heart Month. The American Heart Association have launched a new “Act in Time” campaign to increase people’s awareness of heart attack and the importance of calling 9-1-1 immediately at the onset of heart attack symptoms.

Dial 9-1-1 Fast
Heart attack and stroke are life-and-death emergencies every second counts. If you see or have any of the listed symptoms, immediately call 9-1-1. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast! Today heart attack and stroke victims can benefit from new medications and treatments unavailable to patients in years past. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. But to be effective, these drugs must be given relatively quickly after heart attack or stroke symptoms first appear. So again, don’t delay get help right away!

Coronary heart disease is America’s No. 1 killer. Stroke is No. 3 and a leading cause of serious disability. That’s why it’s so important to reduce your risk factors, know the warning signs, and know how to respond quickly and properly if warning signs occur.

Heart Attack (Damage is occurring to the heart muscle) Warning Signs

Some heart attacks are sudden and intense the “movie heart attack,” where no one doubts what’s happening. But in reality most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are some signs that can mean a heart attack is happening:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes (3-5 min), or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, indigestion or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. The sharp pain shooting down your left arm or in your neck.
  • Shortness of breath with or without chest discomfort.
  • Other signs may include breaking out in a cold sweat, nausea or lightheadedness
  • No symptoms: some people will never experience any of the above symptoms while having a heart attack; the best prevention of a heart attack is maintaining a healthy diet and lifestyle.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the warning signs, but remember this: Even if you’re not sure it’s a heart attack, have it checked out. Minutes matter! Fast action can save lives maybe your own. Dont wait more than five minutes to call 9-1-1.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

If you can’t access the emergency medical services (EMS), have someone drive you to the hospital right away. If you’re the one having symptoms, don’t drive yourself, unless you have absolutely no other option. Lastly, if you do not have stomach problems take an ASPERIN (Not Tylenol or Ibuprofen), two 81 mg baby aspirin or one 325 adult. This can also help thin your blood and possibly save your life.

Stroke Warning Signs
The American Red Cross says these are some of the warning signs of a stroke:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

Remember FAST (Face. Arms, Speech and Time) these simple steps can help determine if the person is experiencing a stroke:

A. Face- Have the person smile and check for signs of weakness on one side of the face

B. Arms-Have the person raise both arms at the same time and check for weakness or numbness in one or both the limbs

C. Speech-Ask the person to say a simple sentence(i.e. Lunch is ready), check for any slurred speech or trouble speaking

D. Time- Call 911 or your local emergency number immediately and note the time the stroke signals started.

If you or someone with you has one or more of these signs, don’t delay! If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common types of stroke.

Stay with the person they may feel fearful or anxious. Most often they do not understand what has happened to them. Offer comfort and reassurance, but never give them food or water and wait till Emergency Medical Service arrives.

Cardiac arrest (Heart has stopped beating) strikes immediately and without warning. Here are the signs:

  • Sudden loss of responsiveness (no response to tapping on shoulders).
  • No normal breathing (the victim does not take a normal breath when you tilt the head up and check for at least five seconds).
  • No pulse when checked at your pulse points(Wrist, Neck and Upper Arm)

If these signs of cardiac arrest are present, tell someone to call 9-1-1 and get an AED (Automated External Defibrillator) (if one is available) and begin CPR immediately. Remember it only takes 6 minutes of blood loss to the human brain for brain damage to occur. After 10 min, it begins irreparable damage.

If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is available) before you begin CPR.

ABCs of Preventing Heart Disease, Stroke and Heart Attack

Sounds simple doesnt it? So why is coronary heart disease and stroke the No. 1 and No. 3 killers of Americans? One reason is undeniably a lack of commitment to a heart-healthy lifestyle. Your lifestyle is not only your best defense against heart disease and stroke, its also your responsibility. By following these three simple steps you can reduce all of the modifiable risk factors for heart disease, heart attack and stroke including:

Stop smoking. If you smoke, look to quit. If someone in your household smokes, encourage them to quit. We know its tough. But its tougher to recover from a heart attack or stroke or to live with chronic heart disease. Commit to quit it will be better for your overall health.

Reduce blood cholesterol. Fat lodged in your arteries is a disaster waiting to happen. Sooner or later it could trigger a heart attack or stroke. Youve got to reduce your intake of saturated and trans fat and get moving. If diet and exercise alone dont get those numbers down, then medication is the key. Take it just like the doctor orders. Heres the lowdown on where those numbers need to be:

Total Cholesterol Less than 200 mg/dL
LDL (bad) Cholesterol LDL cholesterol goals vary by person.

  • Low risk for heart disease Less than 160 mg/dL
  • Intermediate risk for heart disease Less than 130 mg/dL
  • High risk for heart disease including those with heart disease or diabetes Less than 100mg/dL

HDL (good) Cholesterol 40 mg/dL or higher for men and 50 mg/dL or higher for women
Triglycerides Less than 150 mg/dL

Lower high blood pressure. Its the single largest risk factor for stroke. Stroke is the No. 3 killer and one of the leading causes of disability in the United States. Stroke recovery is difficult at best and you could be disabled for life. Shake that salt habit, take any medication the doctor recommends exactly as prescribed and get moving. Those numbers need to get down and stay down. American Heart Association recommended less than 120/80 mmHg.

Be physically active every day. Research has shown that getting 3060 minutes of physical activity on most days of the week can help lower blood pressure, lower cholesterol and keep your weight at a healthy level. But something IS better than nothing. If youre doing nothing now, start out slow. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with a low fitness level.

Aim for a healthy weight. Obesity is an epidemic in America, not only for adults but also for children. Fad diets and supplements are not the answer. Good nutrition and physical activity are the only way to maintain a healthy weight. Obesity places you at risk for high cholesterol, high blood pressure and insulin resistance, a precursor of type 2 diabetes the very factors that heighten your risk of cardiovascular disease. Your Body Mass Index (BMI) will tell you if your weight is healthy.

Manage diabetes. Cardiovascular disease is the leading cause of diabetes-related death. People with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors, including high blood pressure, high cholesterol, smoking, obesity and lack of physical activity.

Reduce stress. Some scientists have noted a relationship between coronary heart disease risk and stress in a person’s life that may affect the risk factors for heart disease and stroke. For example, people under stress may overeat, start smoking or smoke more than they otherwise would. Research has even shown that stress reaction in young adults predicts middle-age blood pressure risk.

Limit alcohol. Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, produce irregular heartbeats and affect cancer and other diseases. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. However, its not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.

Information provided by American Heart Association, CDC, Medic First Aid and American Red Cross

Erionite Warning for Western States

A “naturally occurring mineral” that you might not even know exists could be a potential hazard, especially if you live in the West.

NIOSH recently released a post on their science blog entitled “Erionite: An Emerging North American Hazard” comparing Erionite to asbestos with regards to the nature of the mineral and the similar health hazards that it poses. A natural fiber that is the result of volcanic ash that has been broken down over time by ground water and the weather, the mineral can become airborne and be inhaled. The body reacts to it in much the same way as it does asbestos.

First diagnosed in 1981 in a road worker who worked outdoors in an area rich in Erionite, the mineral has slowly grown in awareness.

You can read the complete blog post on the CDC/NIOSH blog.

Check out the map to find the highest Erionite occurrences.