News in brief - Nov. 21, 2011

Stockings ruled out in fight against deadly blood clots - Organizations respond to OSHA's decision not to oversee resident work hours

Stockings ruled out in fight against deadly blood clots

Physicians should steer clear of ordering compression stockings for hospitalized nonsurgical patients, because they do not cut the risk of pulmonary embolism and can damage patients' skin, according to American College of Physicians guidelines published in the Nov. 1 Annals of Internal Medicine (www.ncbi.nlm.nih.gov/pubmed/22041951/).

The college also recommends giving blood thinners to nonsurgical patients for whom the benefits outweigh the likely bleeding risks. The medicine helps prevent sometimes deadly pulmonary embolisms and deep vein thromboses, the internists organization said, but the drug can raise the risk of bleeding. Although the trend in hospitals has been toward taking anti-blood-clotting measures with all nonsurgical patients, not just those with stroke, the college advised against universal prevention efforts. Physicians should assess the thromboembolism and bleeding risks of each patient before giving blood thinners, the college said.

Organizations respond to OSHA's decision not to oversee resident work hours

The Occupational Safety and Health Administration's denial of a petition asking it to take over regulation of resident work hours from the Accreditation Council for Graduate Medical Education is garnering mixed responses.

The American Medical Association and ACGME praised the decision, saying they appreciate OSHA's affirmation of ACGME's authority. ACGME "is optimally suited to oversee resident and fellow physician duty hours on behalf of both the profession and the public," AMA President Peter W. Carmel, MD, said on Nov. 9.

But consumer advocacy group Public Citizen called the decision regrettable and asked OSHA in a Nov. 3 letter to limit resident work hours. "It is unacceptable that the Obama administration has opted out of its legal obligation to protect residents from excessive work hours," said Sidney Wolfe, MD, director of Public Citizen's Health Research Group.

Public Citizen and several groups and individuals submitted the petition on Sept. 2, 2010. OSHA responded with a denial more than a year later on Sept. 14. The agency rejected a similar petition in 2002.