Can data in electronic medical records be trusted?

If the subject is respiratory rates, the answer is “No” according to a recent study. The authors reviewed the records of 28,500 patients over 220,000 hospital days and found recorded maximum respiratory rates “were not normally distributed but were right skewed with values clustered at 18 to 20 breaths per minute.”

The figure below shows maximum respiratory rates compared to heart rates which were normally distributed.

Reminder: Most sources say the normal respiratory rate of an adult ranges from 12 to 20 breaths per minute.

More negative data about the nonoperative management of simple appendicitis

If you think I am the only one urging restraint in the adoption of nonoperative management of patients with uncomplicated appendicitis, you are wrong. A pediatric surgeon and a research fellow from Harvard and Massachusetts General Hospital have recently published their thoughts on the matter online in Annals of Surgery.

They call their opinion piece “Ulysses Syndrome” because they liken the fate of those undergoing nonoperative management to the “10-year ordeal filled with unexpected peril and ample misfortune” that befell Ulysses while attempting to go home.

Here are a few highlights.

How the public is misinformed about the outcomes of CPR

A survey of 1000 volunteer adults found 71% regularly watched medical television dramas, but only 12% said the shows “were a reliable source of health information.”

The participants were given some brief vignettes describing scenarios where CPR was administered—a 54-year-old who suffered a heart attack at home and received CPR by paramedics, an 80-year-old with a postoperative cardiac arrest in the hospital after surgery, and a post-traumatic arrest in an 8-year-old.

Those surveyed estimated CPR success rates at 57% to 72% and rates of long-term survival with neurologic recovery at 53% to 64%.