Sandra is the Founder, Lead Legal Nurse Consultant, and Coordinator of Krug Consulting, a Legal Nurse Consulting firm. She is a Certified Registered Nurse Anesthetist (CRNA), Advanced Practice Registered Nurse (APRN), and Registered Respiratory Therapist (RRT). She has over 12 years of college ...
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Issues with Surgical Bone Cement
By Sandra Krug
Please enjoy my article Issues with Surgical Bone Cement, published in the Spring 2020 edition of the Journal of Legal Nurse Consulting.
Issues with Surgical Bone Cement – AALNCJLNCSpring2020 (1)
If you find this information useful, please share with colleagues and send them to our website: www.LNCKRUG.com.
A novel coronavirus is what happens when a new strain occurs
By Sandra Krug
A novel coronavirus is a new coronavirus that has not been previously identified.
There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses. The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold.
COVID-19 is a new disease, caused by a novel (or new) coronavirus that has not previously been seen in humans. The name of this disease was selected following the World Health Organization (WHO) best practice for the naming of new human infectious diseases.
On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for the disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”.
Coronaviruses are a large family of viruses. Some cause illness in people, and others, such as canine and feline coronaviruses, only infect animals.
Rarely, animal coronaviruses that infect animals have emerged to infect people and can spread between people. Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) are two examples of coronaviruses that originated from animals and then spread to people. This is suspected to have occurred for the virus that causes COVID-19.
This virus was first detected in Wuhan City, Hubei Province, China. The first infections were linked to a live animal market, but the virus is now spreading from person-to-person. It is important to note that person-to-person spread can happen on a continuum. Some viruses are highly contagious (like measles), while other viruses are less so.
The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.
The virus that causes COVID-19 is spreading from person-to-person. Someone who is actively sick with COVID-19 can spread the illness to others. That is why the CDC recommends that these patients be isolated either in the hospital or at home (depending on how sick they are) until they are better and no longer pose a risk of infecting others.
Quarantine means separating a person or group of people who have been exposed to a contagious disease but have not developed illness (symptoms) from others who have not been exposed, in order to prevent the possible spread of that disease.
Quarantine is usually established for the incubation period of the communicable disease, which is the span of time during which people have developed the illness after exposure. For COVID-19, the period of quarantine is 14 days from the last date of exposure, because 14 days is the longest incubation period seen for similar coronaviruses. Someone who has been released from COVID-19 quarantine is not considered a risk for spreading the virus to others because they have not developed illness during the incubation period.
How long someone is actively sick can vary so the decision on when to release someone from isolation is made on a case-by-case basis in consultation with doctors, infection prevention and control experts, and public health officials and involves considering specifics of each situation including disease severity, illness signs and symptoms, and results of laboratory testing for that patient.
Current CDC guidance for when it is OK to release someone from isolation is made on a case by case basis and includes meeting all of the following requirements:
• The patient is free from fever without the use of fever-reducing medications.
• The patient is no longer showing symptoms, including cough.
• The patient has tested negative on at least two consecutive respiratory specimens collected at least 24 hours apart.
Someone who has been released from isolation is not considered to pose a risk of infection to others.
Coronaviruses are generally thought to be spread from person-to-person through respiratory droplets. Currently, there is no evidence to support the transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash your hands with soap and water for 20 seconds for general food safety.
Throughout the day wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that is shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.
It is not yet known whether weather and temperature impact the spread of COVID-19. Some other viruses, like the common cold and flu, spread more during cold weather months but that does not mean it is impossible to become sick with these viruses during other months. At this time, it is not known whether the spread of COVID-19 will decrease when the weather becomes warmer.
There is much more to learn about the transmissibility, severity, and other features associated with COVID-19 and investigations are ongoing.
Are You Sick and Tired of the Flu?
By Sandra Krug
Avoid Getting Sick by Keeping Your Distance
There are quite a few things you can do to avoid coming down with the flu or catching one of those nasty colds this year. Yes, you can and probably should get a flu shot. Get plenty of sleep, eat a healthy diet, and exercise regularly. The healthier your body, the stronger your immune system. Another important preventative measure is washing your hands. But don’t stop there.
As much as possible, keep your distance from people who are coughing and sneezing.
Turns out that the average cold or flu virus only travels about six feet through the air. That means if you can keep a little bit of distance between yourself and anyone that looks like they are sick, you improve your chances of staying healthy.
Take a different route when you see someone with glassy eyes or someone who is showing any kind of symptoms that indicate they may have a cold or the flu.
Of course, that is easier said than done. Sometimes we end up stuck in meetings with sick coworkers who did not stay home. Or we must brave public transportation. Or worst of all, we have to wait in a doctor’s waiting room or hospital. Wearing a mask and washing your hands will help. You should also do your best to keep that six feet distance I mentioned earlier. Move a few seats if you can.
Teach your loved ones with the flu or colds to do the same.
If they get sick, you will be surrounded by people who spent most of their day within close proximity of you, needing your help and physical attention. Eat a healthy diet and go out and exercise as a family. Boost your vitamin C intake during the winter months when cold and flu are most rampant. When they do get sick – it happens – do your best to protect yourself. Wash your hands and try to avoid getting coughed or sneezed on. I know, easier said than done, but do what you can.
Last but not least, use your influence to encourage others to stay home when they have the flu.
Lead by example. Stay home from the office and avoid heading out to the store when you are sick. If you have to venture out, keep your distance and wear a mask. Do not sneeze or cough into your hands. Use hand sanitizer before touching common use items like the keypad at the grocery store and the likes. Keep your kids home from school. Spread the message of the importance of staying home when sick to get others to do the same.
For more information, please visit the CDC flu website page.
Samantha Fox rescues the most urgent of the cat cases
By Sandra Krug
Fox Foster Kittens inc is a no-kill 501c3 rescue in Sarasota, Florida, dedicated to saving those that no one else wants. Samantha Fox and her team take the tiniest most critical and injured kittens. No matter what they need, Samantha is committed to providing them the best care possible and getting them to their forever homes. Whether it costs $100 or $10,000, Samantha believes they are ALL worth saving. Here are just a few of the beautiful babies currently in her care.
Genevieve
Genevieve is a 9-month-old kitten who came to Samantha from animal services where she was signed off to be euthanized and given 2 hours to find a rescue because someone shot her in the spine, which broke it and paralyzed her.
Genevieve has had a very long recovery and it is not over yet. That one injury has led to so many issues. Her broken spine healed, but removing the bullet left her paralyzed. She could not go to the bathroom by herself either. So, twice a day the Fox Foster Care Kittens team had to express her bladder and bowel. With time some nerve feeling came back and Genevieve was able to defecate on her own. But, she still requires someone to express her bladder. Genevieve learned how to do something called spinal walking. She has no feeling in her back end but she has reflexes and had learned to walk. It was a true miracle!
Her orthopedic surgeon finally cleared her to get spayed. After that, she did not walk for a while and some of her muscles atrophied. Enough to show more damage. She had a luxating patella.
She just recently had surgery for this and is now in the process of learning to spinal walk again and will be looking for a special home in a few weeks.
Glen Coco
Glen Coco is another very special boy. He also came from the same high kill shelter and was given until closing of business to find a rescue. Samantha was not made aware of the extent of his injuries. The shelter only told her that he had a broken maxilla. However, he had blood coming from his eyes, nose, and mouth.
This rescue turned into much much more. His CT scan revealed his skull had actually been crushed. His maxilla, mandible, frontal bone, sinuses, and other pieces of his skull were all fractured. One of the fractures left a bone shard in his eye causing it to rupture, necessitating its removal.
The fractures in his sinuses were allowing air into his head surrounding his brain making him a high risk for infection. There was no surgical option because these fractures were just in millions of little shards. They had to fuse on their own. He had a feeding tube placed in his esophagus that ran directly to his stomach and had an IV catheter. Glen Coco had these for two months to provide him with fluids and nutrition until he was able to eat and drink on his own. He was also on a dozen medications.
Glen Coco almost did not survive and gave Samantha”s team many scares. He is still battling a sinus infection but has made incredible strides and someday soon will be available for adoption!
Bethany
Bethany came to Fox Foster Kittens as a newborn kitten. At the time, Samantha did not know anything was wrong with her until she grabbed her out of the carrier. Immediately she knew something was wrong. Her chest was caved in. She has a condition called pectus excavatum which is a congenital deformity of the breast bone causing her chest to cave in compromising her lungs and heart. She needs surgery to correct this. Without it, she is prone to many issues, including pneumonia, which she has already battled a severe case of once.
She is now big enough to undergo surgery and that will be happening next week. They will put a plate on her chest and suture the sternum to the plate to pull it into the correct position so it will heal in the proper place and her chest will no longer be concave. Bethany will be a happy, healthy kitten and looking for her home.
Samantha also has some regular kitties like Cupcake and her newborns who were born at Samantha’s rescue last week!
And, their newest intake mama to be, Nova.
Pictures are two of Their adoptable kitties, Olivia and Walt!
Kitten season is here, and it is going to be a crazy one. Any donations towards Their foster care are so greatly appreciated. They also have an amazon wishlist and PayPal.
Thank you for reading!
Check out Samantha’s wish list on Amazon
wishlist
Donate directly for the cats to Samantha Fox on PayPal
Paypal
Healthy – is what happens when diet and exercise are improved!
By Sandra Krug
Stay Healthy Through Good Diet and Exercise
One of the most important things you can do to avoid getting sick – and not just from cold and flu, but anything else out there that is contagious – is keep your body as strong and healthy as possible. One of the best ways to do that is to eat a healthy diet and get some sort of daily exercise.
Here is what that may look like.
Tips for Eating Healthy
Improving your diet to eat healthier can seem like a challenge. There is a lot you can do. The key is to start and make small improvements as you go along. A great place to start is by cutting out sugar and processed foods. Replace them with whole food options where you can. Have an apple instead of a candy bar when you need a snack. Fix some scrambled eggs instead of pouring a bowl of sugary cereal in the morning. Skip the fast-food burger and fix a salad to take to lunch. You get the idea.
From there, I would encourage you to add more fresh fruits and vegetables. Try something new. A new piece of produce, a new healthy recipe, a new way to cook your favorite foods in a healthier way. Experiment and do not be surprised if your tastes change over time. A baked sweet potato will start to taste better while soggy burgers will start to lose their appeal.
Simple Ways to Sneak More Exercise into Your Day
The key to regular exercise is to create a few habits. An easy way to start is to incorporate a brisk daily walk. Something as simple as a stroll after dinner or first thing in the morning can contribute to a healthy body. Another option many find helpful is to wear a pedometer or fitness tracker. Monitor your daily step count for a few days and then start to increase it until you get to the recommended 10,000 steps – or challenge yourself to do even more.
Keep your bones strong and improve your overall fitness by adding some simple weightlifting routines. You do not need any fancy equipment. Use your body weight for resistance and grab some cans to use as weights. Of course, if you are feeling motivated, you may also choose to join a gym or hire a personal trainer to help you get into a good workout routine.
Between the healthy food you are eating and the exercise you are getting, you will start to feel better, get stronger, and become healthier. As a result, your immune system will be in a better position to protect you from whatever cold and flu season sends your way.
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