Influenza parotitis: a case from the 2004 to 2005 vaccine shortage.

We report a case of acute parotitis due to influenza A in which, unlike other published cases, the diagnosis was confirmed by demonstration of subtyped influenza A, serological evidence of mumps immunity, and full recovery without antibiotic treatment. In the United States, acute infectious parotitis was historically caused primarily by symptomatic paramyxovirus (mumps) infections, but because of the near-universal administration of the measles, mumps and rubella vaccine, other infectious and noninfectious etiologies now predominate. We discuss the differential diagnosis and therapeutic and public health considerations of parotitis and influenza. Due to time-sensitive pharmacologic management and possibly far-reaching public health issues, providers should be aware of atypical influenza presentations, such as parotitis.

Audibility of patient clinical alarms to hospital nursing personnel.

The audibility of patient clinical alarms to nursing personnel was tested during the first shift on a medical/surgical in-patient ward at William Beaumont Army Medical Center. This study was conducted during normal hospital operations, and we tested the Joint Commission on Accreditation of Healthcare Organizations 2004 National Patient Safety Goal, Section 6b to determine whether patient alarms could sufficiently compete against environmental background noises. Patient clinical alarms were audible at distances of > or = 95 feet with room doors open but were not sufficiently audible to hospital staff members when room doors were closed or during floor-buffing activities. This study suggests that, under these circumstances, hospitals may not meet Joint Commission on Accreditation of Healthcare Organizations 2004 National Patient Safety Goal, Section 6b. Because the audibility of patient clinical alarms directly affects patient safety, satisfaction, and quality of care, we provide recommendations for engineering controls and modifications to work routines.