Tuesday, January 31, 2006

More on Helicopters

From JEMS:

NTSB urges steps to prevent air ambulance crashes

The National Transportation Safety Board issued stringent safety recommendations for air ambulances Wednesday, after investigating 55 crashes that killed 54 people and seriously injured 19 others between 2002 and 2005.

Included in the NTSB's inquiry, which focused on the crashes of 41 helicopters and 14-fixed wing aircraft, was the fatal flight of a Colorado air ambulance company in which a crew of three died in early 2005.

The number of crashes, fatalities and injuries "clued us in that there were safety issues" and led to the recommendations, said Lauren Peduzzi, spokeswoman for the NTSB.

The recommendations, made to the Federal Aviation Administration which is the rule-making agency, include:

* Impose the same safety rules for flights going to pick up patients as those with patients on aboard.

The NTSB said that 35 of the 55 accidents reviewed involved flights with no patients on board, including the Steamboat Springs-based Yampa Valley Air Ambulance crash near Rawlins, Wyo., on Jan. 11, 2005.

* Require that air ambulance operators have risk-evaluation procedures that assess weather, geography, aircraft safety and pilot fatigue before every flight.

The NTSB said the formal risk procedures might have prevented 13 of the 55 accidents, including the Yampa Valley Air Ambulance crash.

* Require flight-dispatch rules for operators that include updated weather information for pilots, aircraft tracking and arrival notification.

Those dispatch rules might have prevented 11 of the 55 accidents, including the Rawlins flight, which ran into heavy snows and crashed into a ridge 2 1/2 miles from the runway's end.

* Require that helicopter air ambulances have Terrain Awareness and Warning Systems. The NTSB said that the warning systems could have prevented 17 of the 55 accidents.

The FAA already requires the warning systems on turbine-powered airplanes with six passengers.

The National Transportation Safety Board recommends that the Federal Aviation Administration require air ambulance operators to:

* Impose the same safety regulations for flights with patients and those without patients.

* Create and follow a flight-risk evaluation program.

* Implement dispatch operations that include up-to-date weather for pilots and flight tracking.

* Install Terrain Awareness and Warning Systems on all aircraft and train personnel to use the equipment.

More on Helicopter Crashes

From Ascribe.org:

BALTIMORE — Post-crash fires, darkness or bad weather greatly decrease the likelihood of surviving an emergency medical service (EMS) helicopter crash, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health's Center for Injury Research and Policy and Johns Hopkins School of Medicine. Improving crashworthiness of helicopters and reducing trips during hazardous conditions can decrease EMS helicopter fatality rates. The study was recently published online by Annals of Emergency Medicine.

"Crashes of EMS helicopters have increased in recent years, raising concern for patients, as well as pilots, paramedics and flight nurses," said Susan P. Baker, MPH, a professor in the Bloomberg School of Public Health's Department of Health Policy and Management and Center for Injury Research and Policy. "Our study found that darkness more than triples the risk of fatalities when EMS helicopters crash and that bad weather increases the risk eight-fold. Helicopter EMS programs should recognize these risky conditions and transport patients by air only when the benefit clearly exceeds the risk of the flight."

The study authors examined National Transportation Safety Board records of EMS helicopter crashes between January 1, 1983, and April 30, 2005. During the 22-year study period, 184 occupants died in 182 EMS helicopter crashes. A majority (77 percent) of crashes occurred when weather conditions required pilots to fly primarily by referencing their instruments rather than using outside visual cues. In darkness, 56 percent of crashes were fatal, as compared with 24 percent of crashes not in darkness. One in four EMS helicopters is likely to crash during 15 years of service. The death rate for EMS flight crew members is 20 times the rate of all U.S. workers.

Former Va. EMT pleads no contest in prank death of colleague

From JEMS:

LEBANON, Va. — A judge convicted a former rescue squad worker of involuntary manslaughter for zapping a co-worker with defibrillator paddles in what turned out to be a deadly prank.

Joshua Philip Martin, 25, faces up to 10 years in prison when he is sentenced in March. Circuit Court Judge Michael Lee Moore, who found him guilty after Martin entered a no contest plea, said Monday he likely will order prison time.

Martin had been on the job four days when he carried out the deadly prank on June 1.

Courtney Hilton Rhoton told Martin not to touch her with the paddles, but moments later, he placed the device on her chest and shoulder and activated it, prosecutors said.

The 23-year-old mother of two small children went into cardiac arrest. Her body first stiffened and then went limp. Rhoton, who had been an emergency medical technician for one year, never regained consciousness and died three days later.

Friday, January 27, 2006

FOUR Score instead of the GCS?

From BrightSurf:

Mayo Clinic neurologists have created the first new, reliable and easy-to-use clinical tool in 30 years for measuring coma depth, a proposed replacement for the Glasgow Coma Scale. The new scoring system, called the FOUR (Full Outline of UnResponsiveness) Score, will be described in the October issue of Annals of Neurology, to be published online Friday, Sept. 9.

When using the FOUR Score, evaluators assign a score of zero to four in each of four categories, including eye, motor, brain stem and respiratory function. A score of four represents normal functioning in each category, while a score of zero indicates nonfunctioning.

A coma scoring system is used by physicians to initially assess a comatose patient to determine the severity of the brain injury, to monitor the patient’s ongoing progress, and to determine the best treatment during a coma. Scores also help physicians determine whether a patient is likely to live, and if so, how disabled the patient might be upon recovery.

Eelco Wijdicks, M.D., Mayo Clinic neurologist specializing in treating patients in intensive care and inventor of the FOUR Score, says a new scoring system is imperative due to limitations of the system used most commonly, the Glasgow Coma Scale.

ED Telemedicine in Mississippi

Information about the "TelEmergency" program at the University of Mississippi Medical Center:

In response to a lack of emergency care and physicians in many rural areas of Mississippi, the University of Mississippi Medical Center has developed and directs the operation of a rural health telemedicine initiative called TelEmergency.

Providing qualified emergency care in rural hospitals with low patient volumes can be cost prohibitive. Additionally, it is difficult to recruit and retain physicians to these areas. Utilizing a nurse practitioner as the healthcare provider, the Emergency Department of the University of Mississippi Medical Center effectively provides emergency coverage in participating hospitals through the TelEmergency system.

The nurse practitioner works under the protocol of the University Emergency Department, as approved by the Mississippi Board of Nursing and the Mississippi State Board of Medical Licensure. The nurse practitioner is specially trained by UMC to function in this unique model of healthcare.

Rural hospitals have contracted with the University of Mississippi Medical Center to allow the Emergency Medicine specialist backup for the nurse practitioners who completed the program and were hired by the local facility. When these nurse practitioners staff the rural ED, they communicate with Emergency Medicine physicians at UMC via T-1 lines and a sophisticated telemedicine setup.

Air Medical Safety

From the NY Times, via Symtym:

Air ambulance crashes killed 54 people, most of them pilots, paramedics and nurses, in a three-year period ending in early 2005, according to a special study by the National Transportation Safety Board.

The report, which was approved by the board on Wednesday, concluded that pilots were not good at analyzing risks and that the rules are too lax for flights that are not carrying a patient or a donated organ.

Helicopters and planes used as ambulances fly under airline-type rules when carrying a patient or organs. But if they are on their way to a pickup, they fly under rules that apply to private planes, which do not limit how many hours a pilot can work and allow flights in worse weather. Three-quarters of the accidents occurred under those rules.

"It seems like a ridiculous paper loophole that needs to be closed," said one member of the board, Debbie Hersman. "You've got one, two or three medical personnel on board, and they have organs in their bodies. They're just as important cargo as an organ for transplant."

Investigators also supported a formal program of "flight risk evaluation," in which the pilot and possibly a second expert would dispassionately score each mission, based on weather conditions, time of day and other factors. Of the 55 accidents, 13 might not have occurred if such evaluations had been done, they said.

While the number of crashes is up, including nine more crashes killing eight people since the end of the study, the rate of accidents is uncertain because of difficulties in determining the number of flights. According to the Federal Aviation Administration, there are about 650 emergency medical service helicopters; an industry group estimates there are more than 750.

Thursday, January 26, 2006

Cigarettes and Oxygen Don't Mix

Posted on Medlaw.com:

A resident died at an Escondico, CA, nursing home after his oxygen tank burst into flames, according to the San Jose Mercury News. The 67-year-old man was reportedly sitting outside at Palomar Heights Care Center and smoking a cigarette while his oxygen was turned on.

SNF employees sprayed him with a fire extinguisher after the tank exploded, but the man later died of burns and inhalation at a nearby hospital.

California’s Department of Health Services is investigating, the Mercury News reported.

Smart Cards

From Information Week, via Medgadget:

Mount Sinai Medical Center, along with eight affiliated hospitals, next spring plans to begin deploying more than 100,000 smart cards to its patients. In total, there will be more than 45 related and affiliated health facilities in the region involved with the smart card initiative.

The project, which will be rolled out in phases and might eventually provide the facilities' 500,000 patients with smart cards, could also serve as a model for a regional health information network effort in New York City overall, which has a population of about 8 million, says Mount Sinai VP of IT Paul Contino.

The cards, which will also feature a photo of the patient, are embedded with a "secure microchip" that will contain demographic information—like patient name and address—and also medical history, drug prescription and allergy, recent lab results, and other key data, says Contino. The information can be updated whenever a patient receives new health services or has a change in health status. The cards, which are read by devices that can attach to PCs, require that patients enter a PIN before the chip's data can be accessed. If cards are lost or stolen, information cannot be accessed without the PIN, Contino says.

Tuesday, January 24, 2006

Boone, Iowa - Dr. Kenneth Friday

From Boone Today:

Making the transition from working at a family practice to becoming Boone County Hospital's Emergency Room (ER) director is a drastic change but it's a transition that Dr. Ken Friday has achieved successfully. Friday's experience in the medical field has allowed him to handle the increased patient load seen recently at the ER.
He has worked at the ER occasionally since 1991 and joined the full-time staff in 2002. In 2004, he was promoted to ER director.

For 30 years, Friday worked at a family practice in Jefferson. He currently still calls Jefferson home. Asked why he left the practice, Friday said he wanted a career change and enjoys working in the ER.

"This way I could stay active in the medical field," he added.

The shift to ER medicine has served him well.

"I really enjoy this aspect," he said.

It is a plus that he loves his job so much due to the amount of patients the ER has seen in the last two months.

The ER saw 477 patients during the first two weeks of January compared to 400 patients in that time in 2005. December also saw an increase of 50 patients compared to the year before.

Iowa Board of Medical Examiners: Privacy

From the Des Moines Register:

A judge has ordered the Iowa Board of Medical Examiners to quit disclosing publicly the reasons behind charges it brings against the doctors it regulates. The meat of the allegations must remain secret until the charges are resolved, the judge ruled. That can take a year or more.

The medical licensing board has appealed to the Iowa Supreme Court and has asked the Legislature to change the law. But in the meantime, it will release only doctors' names and the title of the charges against them. The change will take effect as soon as next week, when the board is expected to release a batch of new charges.

Sunday, January 22, 2006

Video language-interpretation service

From the Stockton (CA) Record:

A first-of-its-kind video language-interpretation service in place at San Joaquin General Hospital since October is on the verge of being rolled out to two other public hospitals in Northern California.

The Health Care Interpreter Network's ultimate goal is to establish a nationwide standard for providing cost-efficient, accurate and immediate translation between the patient and health-care provider - wherever they might be.

The difference between the new network launched at San Joaquin General and videoconferencing and telephone-based translation services in other hospitals is its regional scope, ease of use and the technology pulling it all together.

It also costs less than commercial services now available, according to project officials.

"It's a pretty new type of solution," said Cisco Systems' Jacqueline Pigliucci, whose company's unique software is at the heart of the network.

The call center at the county's public hospital is connected to the participating hospitals by a secure high-speed data line dedicated to video and voice interpretation services.

Interpreters employed by San Joaquin General speak Spanish, Cambodian, Lao and Hmong. When a non-English-speaking patient comes into one of the hospital's units, such as the emergency department or one of several medical clinics, the doctor, nurse or even the admitting clerk attending to that patient turns on the video unit and in 15 seconds connects with a live interpreter.

"Smoker torches emergency room"

From the Salt Lake City Tribune:

A patient who decided to light up ignited a fire at Salt Lake Regional Medical Center, burning himself and closing the emergency room on Saturday.

The fire occurred at about 5:45 p.m. in the hospital's emergency room when an intoxicated patient receiving oxygen lit a cigarette, said Brian Dunn, the hospital's chief executive officer. The patient caught fire, as did his oxygen tube and the wall to which it was connected.

Dunn said hospital staff extinguished the flames on the patient before firefighters arrived.

"I can't praise enough the emergency room physicians and the emergency room staff that acted and put the fire out," Dunn said.

Dennis McKone, a spokesman for the Salt Lake City Fire Department, said firefighters arrived to find some flames still on the wall where the oxygen was connected.

The patient had minor burns to his face and was transferred to University Hospital, Dunn said. A male acquaintance of the patient suffered smoke inhalation and was transported to another hospital.

"No Wait" ER's

From the NY Times:

It had all the markings of a typical emergency department waiting room: magazines scattered on end tables; a wall-mounted television; more than two dozen institutional chairs lining the walls.

Only the people were missing. On a recent weekday afternoon, the waiting room at the Hudson Valley Hospital Center here was empty. The hospital has adopted a no-wait emergency room procedure. A recent $1 million renovation eliminated the registration desk. A greeter now sends patients to one of three triage rooms. Insurance information is taken at bedside. The department is split into two zones: fast track, for minor injuries and illnesses treatable by nurse practitioners, and critical care.

"Nobody wants to wait for anything anymore," said Dr. Raymond Iannaccone, director of the emergency department. "We have to focus on clinical care, but no-wait is also good medical care."

Friday, January 20, 2006

Ouchless (Pediatric) ER

From the Washington University (St. Louis) Record:

At one time, pediatric emergency medicine physician Robert M. "Bo" Kennedy, M.D., could guess, without even looking, how many patients were waiting for treatment in the St. Louis Children's Hospital Emergency Department. The loud cries of these frightened children, many of them in pain, always tipped him off.

With his trademark intensity, Kennedy decided they could do better. So in his research projects, he began to focus on alleviating children's anxiety and suffering from the moment they enter the hospital. Thanks to a range of regimens that he has developed in collaboration with colleagues in anesthesiology and psychiatry, the noise level in his department has noticeably tapered off.

"I really think that we have worked hard to become the 'ouchless emergency department,'" says Kennedy, who is also an associate professor of pediatrics. Along the way, some of his innovations have changed emergency room treatment worldwide.

"Bo Kennedy is simply one of the finest pediatric emergency physicians in practice today," says David M. Jaffe, M.D., head of the division of pediatric emergency medicine. "He is passionate about alleviating the pain and anxiety of children in the emergency department and has become a leader in clinical investigation in this area. Bo was here before our division existed, and we are fortunate to have benefited from his many contributions over the past 20 years."

Among the treatments that Kennedy has pioneered is the use of buffered lidocaine — injected with tiny, 30-gauge needles — to blunt the pain of starting an intravenous line. Even sleeping babies only stir a little but don't awaken when he hooks them up.

Another is the combination of two drugs, ketamine and midazolam, which he tested in children with forearm fractures who needed a painful bone realignment. The results were clear: ketamine worked better and caused fewer breathing complications than earlier drug combinations. Over time, the staff began using IV-administered ketamine for a variety of serious procedures, such as treating burns.

"But there were more minor procedures, such as suturing lacerations, where we really only needed a local anesthetic and lighter sedation," he says. "Using ketamine seemed like using a sledgehammer when a tack hammer would do."

Working with colleague Janet D. Luhmann, M.D., assistant professor of pediatrics, Kennedy began to take a fresh look at nitrous oxide or "laughing gas," often used in dental procedures. In small children with facial lacerations, was it as effective as midazolam or did the two work best together? The nitrous oxide had joyous results.

Thursday, January 19, 2006

Hospitals Say Meth Cases Are Rising, and Hurt Care

From the NY Times

A sharp increase in the number of people arriving in emergency rooms with methamphetamine-related problems is straining local hospital budgets and treatment facilities across the country, particularly in the Midwest, according to two surveys to be released in Washington today.

The studies, conducted late last year by the National Association of Counties, are another indicator of the toll the drug has taken on local communities, particularly in rural areas where social service networks are ill-equipped to deal with the consequences. In July, the association reported that an overwhelming number of sheriffs polled nationwide declared methamphetamine their No. 1 law enforcement problem.

In the most recent survey, conducted late last year, 73 percent of the 200 county and regional hospitals polled said they had seen an increase in the number of people visiting emergency rooms for methamphetamine-related problems over the last five years; 68 percent reported a continued increase in the last three years, and 45 percent in the last year.

The problem was particularly intense in the middle of the country: 70 percent of hospitals in the Midwest and 80 percent in the Upper Midwest said methamphetamine accounted for 10 percent of their patients. Nationwide, 14 percent of the hospitals said such cases made up 20 percent of their emergency room visits.

Monday, January 16, 2006

Lessons in Hospital Courtesy

From the Boston Globe:

Boston teaching hospitals -- known for their world-class medical care, but sometimes brusque treatment of patients -- are responding to increased competition among themselves by trying to make patients feel more like valued customers.

Mass. General brought in a consultant from Ritz-Carlton, the global hotel chain known for its luxury service, to stress what may seem obvious: the importance of a warm smile and addressing patients by name.

Getting customer service right is a higher priority because patients are becoming more discerning and are more likely to shop around for care, said hospital officials. Also, starting in 2007 the federal Medicare program plans to post the results of standardized patient-satisfaction surveys. That will allow the public to view how patients ranked their hospital experience.

Saturday, January 14, 2006

Rubber bullets end standoff

From the Herald (Everett, WA) :

Everett Providence Medical Center, Colby campus, is reopened after a four-hour standoff with an suicidal man in the parking lot ended when police knocked him down by firing rubber bullets.

The hospital was shut down about 4:20 a.m. this morning after police located a Snohomish man just outside the south entrance. The man was armed with a handgun and threatened to kill himself, police said. He had gone to the hospital after he reportedly assaulted his estranged wife at her house in the 6600 block of 133rd Place SE, Snohomish, Everett Sgt. Boyd Bryant said.

The woman fled to a relative's house and was later taken to the hospital for treatment.

Police learned that the man was parked just outside the emergency room entrance at the hospital. Police blocked off the roads and the hospital was locked down. Only critical-care employees were allowed into the building. Ambulances were rerouted to the Pacific campus, a hospital spokeswoman said.

Negotiators spoke with the man off and on, but he refused to surrender. About 8 a.m., police fired off a flash-grenade to distract the man and then shot him twice with rubber bullets. The bullets, about three-inches long, struck the man in the hip and thigh. Officers rushed him and were able to handcuff him. He is being treated at the hospital for injuries that are not believed to be life-threatening, Bryant said.

Friday, January 13, 2006

Vehicle crashes into hospital lobby

From the Daily Light (TX):

Baylor Medical Center at Waxahachie public safety officer Ronnie Vineyard had just locked up and walked to the back of the outpatient waiting area when a vehicle drove through the doorway at about 9:10 p.m. Wednesday.

“I was helping housekeeping with some equipment and had my back to the door when I heard the loudest noise I have ever heard,” Vineyard said, saying his initial reaction was to look to the windows at his left to see what might have happened outside.

But it wasn’t outside, and as Vineyard turned back to look at what was unfolding in the waiting area, the housekeeping employee said, “Golly, he just drove in.”

And there it was, a 1998 maroon-colored Chevrolet Suburban that had burst through the revolving door and one of its two side doors, shattering glass everywhere before slamming into a wall by the receptionist’s desk.

Vineyard told police he had seen the vehicle circle the hospital a couple of times and that the driver had gotten out and checked the doors before getting back into his vehicle, Waxahachie police Lt. Billie Pendleton said.
emergency help after the male driver drove into the lobby. He said he assisted the man from his vehicle and sat him in a chair.

“The fire department, the police department and the nurses got here real quick,” Vineyard said, noting the nurses running to the area put the man into a wheelchair and immediately took him to the emergency room.

The man’s statements had indicated it was an intentional act, Vineyard said. “The guy said, ‘I made sure no one was in the way.’ He said, ‘I wanted to see the doctor.’ ”

Wednesday, January 11, 2006

Decision making after awakening from sleep

From the Financial Express:

Professionals like doctors and pilots, who are suddenly woken up from deep sleep, need to take some time before taking major decisions, a new study has concluded.

Researchers have found that people are as woozy when they wake up as they are after drinking several beers, 'nature' magazine said. Sleep researchers have long been interested in the symptoms of sluggishness and disorientation that people experience after awakening, which they call sleep inertia.

Now they have measured exactly how hopeless early-morning brains are at carrying out everyday tasks.

Kenneth Wright at the University of Colorado, and his co-workers looked at the mental handicap caused by sleep inertia, and compared it with the detriment of having stayed up all night.

They allowed nine volunteers to enjoy roughly eight hours' nightly slumber for four weeks, the final week taking place in the lab.

After a final pleasant night's sleep, they woke each person and immediately, without even a cup of coffee, asked them to calculate a string of sums. Then they scored how many problems each one totted up correctly over two minutes.

The test was then repeated after 20 minutes and again at regular intervals until the subjects had gone a full 26 hours without sleep.

Brain power was worse in the first few minutes after awakening than it was after a whole night's sleep deprivation, the report in the 'journal of the American Medical Association' said.

Tuesday, January 10, 2006

Blood Substitute Trial in KS

From LJWorld.com (Lawrence, KS):

An experimental blood substitute has been delivered to Douglas County ambulances and is ready to be pumped into emergency patients, but a similar trial in California has sparked criticism and legal battles.

“If this really works, this will revolutionize the treatment of patients with hemorrhagic blood loss due to trauma,” said Jim Murray, support services division chief with Lawrence-Douglas County Fire & Medical.

PolyHeme has been placed on six area ambulances — five in Lawrence and one in Baldwin. It will be administered to qualifying, critically-injured trauma patients. The blood substitute also will be used in Leavenworth and Wyandotte counties.

PolyHeme, developed by Northfield Laboratories Inc. and used in several study sites across the country, has seen its share of problems and controversy. In California, the weekly San Diego Reader is battling the company over the publishing of details about the project. Northfield representatives say the paper is trying to publish “trade secrets” contained in public documents.

ACEP Grades States' Emergency Medicine System

From the American College of Emergency Physicians (ACEP), a new website: The National Report Card on the State of Emergency Medicine. Here's a selection from the report on Iowa:

Iowa Compared with the Nation: Iowa earned a C+ overall for its support of an emergency care system to meet the needs of its residents. Although it achieved excellent ratings for Quality and Patient Safety and above-average ratings in Access to Emergency Care, it received a mediocre score in the Public Health and Injury Prevention category and a near-failing grade for its Medical Liability Environment.

DC OTC Cough Remedies?

From USA Today:

If your biggest decision about how to treat a cough is whether to take cherry- or grape-flavored syrup, you might find this a little hard to swallow: The American College of Chest Physicians is advising people who have colds not to waste their money on over-the-counter (OTC) cough syrups or drops, either for themselves or for their children.

Of the estimated 829 million visits to doctors' offices each year in the USA, nearly 30 million are for coughs, the doctors' group says.
The new advice, part of the most comprehensive guidelines yet on diagnosing and treating coughs, appears in this month's issue of the journal Chest. The chest doctors, who reviewed scores of studies dating back decades, conclude that there is no scientific evidence that suppressants, such as dextromethorphan, or expectorants, drugs such as guaifenesin that thin out mucus, relieve coughs that are the result of colds.

"Cough is so common, and there are medicines that actually work," says guidelines committee chair Richard Irwin, professor of medicine at the University of Massachusetts Medical School. If you feel you need to take something, he says, "take something that has been shown to be helpful."

Monday, January 09, 2006

Report: Half of ER visits preventable

From MSNBC.com

About half of Tri-State emergency room visits, and 15 percent of inpatient stays, could have been prevented with timely treatment by a primary care doctor, a health group has found.

And despite popular perception, the uninsured did not make up the bulk of preventable ER visits in the 20-county area studied, according to a report released by the Health Foundation of Greater Cincinnati, which awards grants to nonprofit and governmental organizations for improving community health.

The figures were based on 741,000 ER and 293,000 inpatient discharges in 2004. Data for individual hospitals were not available.

Examples of preventable hospital use include severe asthma episodes and dental infections, both of which can be life-threatening but can generally be avoided with early care, said Pat O'Connor, program vice president for the Health Foundation. Preventable status was determined by the diagnosis at discharge.

Humiliation in the ER

From the Herald Tribune (FL):

When William Deloge was lying in the emergency room with a tube in his throat, a man charged with his care made a crude game of his vulnerable state.

"I felt helpless, totally humiliated," said Deloge, 49. "I could hear people laughing at what was going on. I couldn't protect myself."

The Port Charlotte man said that a hospital employee at Peace River Regional Medical Center purposely exposed Deloge's genitals to the emergency room staff at least four times in the July incident.

Deloge said that the employee repeatedly lifted his hospital gown, saying "Peek-a-boo" each time. Others laughed.

About two weeks after the incident, Deloge received a letter from the hospital, acknowledging the truth of his complaint and informing him that disciplinary action had been taken.

Post Arrest Hypothermia

From Medical Equipment Designer (courtesy of Medgadget):

The induction of mild hypothermia (lowering a patient’s temperature from 37°C to between 32° and 35°C) after cardiac arrest was proposed in the 1950s in an effort to protect the brain against global ischemia, which Webster’s defines as: “the localized tissue anemia due to obstruction of the inflow of arterial blood.” However, the idea wallowed in obscurity until recently because of the many uncertainties involved in deliberately inducing hypothermia in a resuscitated patient. Since then, various medical journals — The New England Journal of Medicine (NEJM) and Resuscitation, among them — have included numerous studies on animals and humans demonstrating the usefulness of this technique. The February 21, 2002 issue of NEJM features two studies that suggest therapeutic hypothermia is beneficial to the neurological outcome of the patient when he has been resuscitated after cardiac arrest due to ventricular fibrillation. These studies and their favorable results have led to an endorsement of mild hypothermia therapy by the American Heart Association as well as to the development of a sophisticated system that is designed to perform the entire task simply and accurately.

Saturday, January 07, 2006

Defibrillators donated to 28 county schools

From the Georgetown Times

A private donor has supplied the Georgetown County School District with 28 Automated External Defibrillators (AEDs).

About 7,000 children lose their lives every year due to sudden cardiac arrest, said Dick Wright, president of AED Headquarters. Student athletes are just one example of people susceptible to sudden cardiac arrest. If a ball hits a student in the right spot at the right time in the cardiac cycle, sudden cardiac arrest may follow. People with congenital heart defects are also at-risk.

However, the outcome of sudden cardiac arrest is not necessarily death. Automated External Defibrillators (AEDs) can restart the heart and save lives.
A training session for school personnel on the proper use of the defibrillators was held Wednesday at the J.B. Beck Administrative Building. The training included teams from each of the district’s schools.

Friday, January 06, 2006

Hospital's Profit Margins Hit 6 Year High in 2004

From USA Today:

The nation's hospitals, boosted by a slowdown in expense growth and continued ability to drive a hard bargain with insurers, posted profit margins that reached a six-year high in 2004 — and indications are that 2005 was just as good.
The hospital industry is in the midst of its biggest construction boom in 50 years, spending nearly $100 billion in inflation-adjusted dollars in the past five years for new and expanded facilities nationwide, often in rapidly growing suburban areas.

That spending comes as conditions have been good for both borrowing and spending. Hospitals reported an average 5.2% profit margin in 2004, the last full year of data available from the American Hospital Association.

In addition to strong bargaining power and slowing expenses, profits were also driven by investment income from an improving stock market, says the association's Rick Wade. Even so, Wade says the good times are not shared by all.

"About 25% of hospitals are in the red," Wade says, down from about a third in the past few years.

Hopsital Building Boom

From USA Today:

The USA is in the middle of the biggest hospital-construction boom in a half-century, a development expected to increase the use of high-tech medicine and add fuel to rising health care costs.

The hospital industry has spent nearly $100 billion in inflation-adjusted dollars in the past five years on new facilities, up 47% from the previous five years, according to the Census Bureau. Spending was likely to reach a record $23.7 billion in 2005.

"We are replacing a generation of hospitals that are obsolete," says Kirk Hamilton, a hospital architect who teaches at Texas A&M University.
New hospitals don't mean more beds: Capacity fell to 808,000 beds in 2004, down 18,000 from 2001.

The money is being spent on more luxurious buildings packed with advanced equipment. The hospitals focus on profitable treatments such as heart surgery and neonatal care that are reimbursed at higher rates by private insurance and Medicare

Thursday, January 05, 2006

Florida "ER Crisis"

From the Palm Beach Post:

A statewide health task force on Wednesday confirmed what people in Palm Beach County and Treasure Coast have known for several years: The wait in hospital emergency departments in Florida has grown excruciatingly long, and patients aren't always getting the care they need.

"Florida is facing a crisis in providing emergency care to the citizens in Florida," according to the 120-page report from the group of hospital executives, health insurance officials, state regulators, doctors and emergency medical services personnel.

At its core, the problem is a simple supply-and-demand issue: As the number of patients seeking care in hospital emergency departments has soared with the state's population growth, the number of doctors working in emergency rooms has shrunk. Florida doctors have fled the emergency room mostly because of their perceived increased risk of being sued and worries about not collecting payment from uninsured patients.

Tuesday, January 03, 2006

MN Hospitals Chill Heart Attack Victims

From Yahoo News:

A handful of Minnesota hospitals are now chilling some heart attack patients in an effort partly to protect their brains, a therapy that has produced results one doctor called "breathtaking."

Take the case of Robert Kempenich, 52, of Little Falls. On Dec. 5, he collapsed at a SuperAmerica store and was rushed to a St. Cloud hospital where he was hooked up to a machine that lowered his body temperature to 92 degrees.

Under normal circumstances, only about 5 percent of patients who collapse after a sudden heart attack survive. Even if emergency workers get the heart started again, the brain damage is often permanent.

Yet two days after Kempenich collapsed he awoke from a coma and gave the "thumbs up" sign. His wife, Mary, was there. The sign meant, "He knows," she said. "He knows what he's doing."

Less than a week later, Kempenich went home from the hospital. He was back at work at the SuperAmerica last week. His doctors say there are no signs of lasting brain damage.

Dr. Scott Davis, head of the critical care unit, called the results "breathtaking."

SUV's no safer than cars for kids

From Forbes:

Despite the public perception that SUVs are safer than passenger cars for family driving, a new report shows the bigger vehicles are no better at preventing children's injuries in accidents.

"Many people just assume that the extra weight and size of an SUV makes them safer, but what we found was that the potential benefits were canceled by the SUVs' increased likelihood of rolling over," said study co-author Dr. Dennis Durbin, an emergency room doctor at Children's Hospital of Philadelphia.

"The message for parents is that SUVs are no safer, and that they should know the importance of ensuring that their children are properly restrained for their age on every trip in the car."

In their review of car crashes involving nearly 4,000 children from infancy to the age of 15, Durbin and his colleagues found that rollovers occurred twice as frequently in SUVs as passenger cars, and that children involved in rollover crashes were three times more likely to be injured than children in crashes not involving rollovers.

Further, the children who weren't appropriately restrained in SUVs in rollover accidents were at a 25-fold greater risk for injury compared to appropriately restrained children in the SUVs. And nearly half of these unrestrained children suffered serious injuries, compared to only 3 percent of the children who were properly restrained.

Cheerleading Injuries

From the Chicago Sun Times:

Cheerleaders catapult in the air, climb human pyramids and catch their tumbling teammates as they fall to the ground.

They also make lots of emergency room visits.

Research indicates cheerleading injuries more than doubled from 1990 through 2002, while participation grew just 18 percent over the same period.

''Cheerleading is not what it used to be. It's no longer standing on the sidelines looking cute in a skirt,'' said Erin Brooks, a former cheerleader who teaches a safety course in Mississippi. ''It's more body skills.''

A study published today in the journal Pediatrics estimates 208,800 young people ages 5 to 18 were treated at U.S. hospitals for cheerleading-related injures during the 13-year period.

Sunday, January 01, 2006

Rattlesnake Bob

From the Casper Tribune:

A pet rattlesnake bit its extremely drunk owner once on the finger while the man was playfully flicking its head, then bit him again on the lip and tongue after he attempted to kiss it on March 23, reported the Lander Journal.

According to Sgt. Gene Galitz's popular column "CopsCorner," the Lander man, identified as Rattlesnake Bob, was driven to the emergency room at the Lander Valley Medical Center by his girlfriend. When he saw a patrol car at the hospital, he refused to get out, saying he hadn't had much luck with cops

Congratulations, Canton!

From PJStar.com:

$6 million investment by Graham Hospital in the health of the Canton community will open next week.

The project was a large but rewarding undertaking for hospital officials, Graham Hospital President and CEO Ray Slaubaugh said.

"I've been here over 35 years and I think this is one of the greatest steps in improving care for the community that we have ever taken," he said.

Scheduled to open Jan. 11, the new emergency department is larger, offers more comfort and privacy for patients and families and gives hospital staff more room to treat patients.

The new emergency department was needed to accommodate the hospital's steadily rising stream of patients, Slaubaugh said.

"Over the last five years you can gradually see the numbers go up each year," he said.

Sara Kimble, Vice President of Patient Services for the hospital, said the numbers have almost doubled in that time. Emergency room staff used to see around 7,000 patients each year and now see closer to 13,000, she said.