Well, the American Academy of Pediatrics, the professional organization that speaks publicly on behalf of the pediatricians in this country, thinks that choking on hot dogs is unacceptable, and that hot dog makers are not helping the problem.  The AAP wants to change the design of the hot dog and revamp packaging to warn of the risk of choking.

ABC News has a great video, complete with an animation of the choking mechanism. Take a look…

More of the article can be read on abcnews.com

Although a child dies every five minutes from choking, and despite hot dogs being the number one choking hazard, hot dog manufacturers are reluctant to change the design or even the package labels for their product.  The claim that placing an ominous label on their product will hurt sales.  They also claim that grapes and peanuts are just as harmful, but since they are naturally-occurring, they are not subject to regulation or scrutiny.

Now, I’m not sure how changing the shape of the hot dog can solve the problem.  It’s not like a square hot dog would be much better.  And I’m sure that whatever shape it will be, it will have to be cut up to serve to children.  But I could definitely say that if I owned a hot dog factory – I’d be the first one to change the shape — sounds at least like a good business plan!

First, a little about the news topic. Toyota has been dealing with recalls for several models of their 2009 and 2010 line of vehicles. We first heard of this issue several months ago. We have seen and heard stories of families being devastated when loved ones are killed by their own cars. At first, Toyota had claimed that the floor mats were the problem – that they got in the way of the gas pedal.  The problem; however,  lies in the computer mechanism of the vehicle, causing it to accelerate out of control. Drivers then get into accidents, some of which have horrific outcomes. Toyota’s most recent recall announcement came just this past week. Here’s the information directly from Toyota’s Press Room.

Take a look at this interesting video from Consumer Reports on how to stop your out-of-control Toyota.

So what happens when your car is accelerating out of control and you hit another object?
Your body is stationary within the vehicle before impact, and then accelerates once the vehicle comes to an abrupt stop, but your body lags behind a little bit compared to the vehicle.  The structures within your body also go through the same acceleration-deceleration motion, but they too lag behind the framework of your body, thus causing a shearing force that disrupts various tissues.  Two of the most susceptible structures are the brain and cervical spine.  The Johns Hopkins web site has a brief overview of whiplash, one of the commonest injuries after acceleration-deceleration, which involves the cervical spine.  There is also a great narration of what happens to the brain during a car accident on You Tube.  This is called diffuse axonal injury – similar to what happens in shaken baby syndrome.

So I was on call for the operating room this weekend at my hospital in NYC, where I did a crush injury case – coincidence!  The patient was an 18-year-old who got his hand crushed in a piece of machinery at his job.  He had a complicated pinky finger fracture as well as nerve and blood vessel rupture to that finger.   A special orthopedic hand specialist was called in to perform the surgery to reconstruct the finger, including repairing the nerves, arteries, and veins in order for the patient to keep his pinky finger.  It was about a 3 hour case in a sophisticated operating room, with an infinitely expensive microscope used to repair the tiny nerves and vessels in the finger.

Compare and contrast that to the videos I watched of the surgeries taking place in Haiti.   Watch this piece below.

Pretty amazing to see that patients in Haiti are being anesthetized without the use of modern monitors. The surgeries are being performed on modular tables, open to the dust and debris carried in the air, with only ambient light – no high-intensity OR lighting to be found.  They are using garden hoses for tourniquets and Black-and-Decker drills intended for home use to perform the procedures, much less a 100K-dollar microscope.  And the goal is not to repair the limb, but to stabilize the patient to prevent further health risk, such as infection.

Just some food for thought…..

Hopefully the surgeons will come back to the US a little humbled by the experience, and maybe a little easier to get along with!!

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And what about pain control for these people? What is the cheapest and strongest drug? If you are thinking morphine, you are right. People must be screaming in the background. But the news stories are not full of screams. I wonder why the post amputation screams are not on TV.