EZ-IO Enhancement

From Medgadget:

A press release for Vidacare Corporation states that the company has equipped its intraosseous vascular access system EZ-IO® with lithium-powered driver to replace the alkaline battery-powered drivers used previously.

The new EZ-IO Power Driver addresses the single biggest concern associated with using a battery-operated device in an emergency situation: the condition and reliability of the batteries. By using a lithium ion power supply, emergency personnel can complete 500 to 750 EZ-IO insertions–more than 10 times the insertions they could make using alkaline batteries. Additional attributes of the lithium battery upgrade include an increased shelf life to 15 years, a 10 percent increase in torque over alkaline batteries, decreased battery weight and elimination of the linear decline in battery performance associated with alkaline batteries. Vidacare anticipates that the user should not have to change the lithium batteries over the life of the product, thereby making it a hassle-free battery-powered device.

Australian EMS Technology

From ARNnet:

Victoria’s Metropolitan Ambulance Service has issued its paramedic teams with fully ruggedized Panasonic CF-18 Toughbook laptops for use across its entire fleet of 160 ambulances.

The Toughbooks will be used primarily in tablet PC form and will run a software program called Vacis (Victorian Ambulance Clinical Information System), which the ambulance service designed and developed to assist paramedics by simplifying the process of capturing patient data for further analysis and reporting.

The Toughbooks will also hold information to help paramedics whilst they work including clinical practice guidelines, animated work instructions, training materials and the eMIMS electronic drug database.

Now, paramedics using Vacis provide the hospital with a paper copy of the patient care record, which is printed in the ambulance or at the hospital using the 802.11 wireless and Bluetooth features of the Toughbook. A future enhancement to Vacis will enable the patient care information to be wirelessly transferred direct to the hospital emergency department’s information system.

Hospitals Train Staff with iPods

From the BBC:

Two hospitals in Glasgow are using iPod music players to train staff.
The gadgets give new recruits an “audio induction” to the workplace, which is followed by a computer-based test.

Hopital managers at NHS Greater Glasgow say the iPod tours can be used to train staff on issues like superbugs, moving patients and coping with violence.

The iPods are being used in operating theatres at Glasgow Royal Infirmary and in the labour ward and neonatal unit at the Princess Royal Maternity Hospital.

They are also being introduced at the Western Infirmary’s Accident and Emergency department.

Most ER Patients Are Insured, Study Says

From the LA Times, referencing a study by ACEP:

Challenging a common notion that uninsured patients are clogging hospital emergency rooms, a new study has found that the vast majority of adults who turn up there frequently have health insurance and regular doctors.

The finding suggests that expanding health coverage will not by itself significantly help emergency rooms cope with demands that include patients seeking care for routine problems such as colds or sinus infections, experts said.

The uninsured account for just 15% of emergency-room visits, according to the study to be published today by the American College of Emergency Physicians. The nonprofit organization advocates for the interests of emergency-room doctors and supports medical research.

Emergency rooms are crowded because they fill up with patients who cannot get in to see their own doctor or are waiting for regular hospital beds, experts said.

“We’ve cut hospital budgets so much, the only way they can be efficient is by operating as close to capacity as possible, like airlines,” said Sandra Schneider, head of the emergency medicine department at the University of Rochester in New York.

The study confirms earlier findings that have begun to change scholarly thinking about the cause of emergency room crowding.

Healthcare providers assumed until recently that uninsured patients were the primary cause of crowding, said Diane Jacobsen, a director at the Institute for Healthcare Improvement in Cambridge, Mass., who did not participate in the study. Most doctors are free to turn away patients who cannot pay, but emergency-room doctors must see everyone.

Over the years, however, research has indicated that the problem is broader and more complex. “We often focus on the ER as the problem, when the ER is a symptom of the problem,” Jacobsen said.

Course Educates Docs on Malpractice Issues

From the Seattle Post-Intelligencer via Symtym

Except for a crop of gray hair, the enrollees in Sean Byrne’s malpractice course at the University of Richmond Law School look like normal students. They sip Starbucks coffee and tap out notes on their laptop keyboards. And with lumpy hair and bleary eyes, a few looked like they rolled out of bed after a few hours of sleep.

But instead of suffering the effects of late-night study, some of them might have come off a long night at a hospital. That is because more than half the students are physicians, many of them in obstetrics or other specialties at high risk for malpractice lawsuits. Some have been sued; others say it’s only a matter of time.

“I’m shocked at what is part of my life that nobody ever taught me about,” said Dr. Shannon Weatherford, an obstetrician in Richmond who is taking the Saturdays-only class. “Four years of medical school and four years of residency, and there’s nothing about the business of medicine and the legal aspects. This is just a single, terrific opportunity to get educated on something I should know about.”

Much of the interest in the course was sparked by soaring premiums and growing insurance losses from malpractice claims that have led to calls for tort reform (though some critics have accused insurers of overstating these losses).

Fewer physicians offer free care

From CNN:

The percentage of physicians who provide free care to the poor has dropped over the past decade, signaling a growing problem for the uninsured, a survey suggests.

About three-quarters of physicians provided charity care in the mid-1990s, compared with about two-thirds now, according to a study released Thursday by the Center for Studying Health System Change.

The numbers have declined across all major specialties. The highest rate of free care, 78.8 percent, comes from surgeons, perhaps because many of these doctors treat uninsured patients in emergency rooms.

Just over 60 percent of pediatricians provided free care, the lowest rate among the specialties. That could be because children are more likely than adults to have insurance coverage.

“With fewer physicians providing charity care, it’s going to drive more uninsured people to seek care in hospitals emergency rooms,” Cunningham said. “Care in emergency rooms is more costly, it’s less efficient.”

Detonator on the Cot…

From 14WFIE (Evansville, IN) , emphasis added:

Three employees of the Crane Naval Surface Warfare Center were hurt Tuesday when detonators they were unpacking detonated prematurely.

Base officials said the employees were treated initially at Crane’s medical facility and were reported to be in stable condition. Local news reports said at least two employees were transferred to a Bloomington hospital. The injured workers’ names and conditions were not immediately available.

When a fragment of a detonator was discovered on a cot used to transport one of the injured workers into the hospital, it prompted a partial evacuation of the emergency room out of fear it could lead to further injury. Crane is about 30 miles southwest of Bloomington.

Waist packs track ER patients

From Boston.com, via Symtym:

Emergency room doctors and nurses at Brigham and Women’s Hospital are getting some high-tech help watching vital signs and rapidly locating patients in the waiting room.

Under a trial funded by a $3.1 million grant from the National Institutes of Health, the hospital will today begin distributing 10 waist packs to patients that contain sensors, transmitters, and tracking gear. The packs will allow medical staff to constantly monitor patients’ heart rates and blood-oxygen levels while they await treatment.

If a patient needs immediate attention — or collapses in the vicinity of the emergency room — an ultrasound tracking beacon will instantly give caregivers the patient’s exact location. If successful, the units could be commercialized to be used to help handle large numbers of patients in major disasters.

”We wanted some way to monitor patients and track where they were,” said Dr. Thomas Stair, a Brigham and Women’s emergency physician coordinating the project.

Patients’ vital signs will be picked up by a three-lead electrocardiogram and a finger sensor and fed into a personal digital assistant (PDA), then transmitted to a server that will display the information for nurses to monitor.

An ultrasound transmitter will send location information to receivers in the walls of the emergency room, halls, and restrooms. Ultrasound receivers transmit the signals to a computer that stores information about a patient’s movements, according to a program written by MIT scientists.

”This system will tell us heart rhythm, oxygen saturation, and where they are so we can respond better to codes,” Stair said.

Fire Marshal Cites WakeMed For Overcrowding

From NBC17.com (Raleigh, NC)

The Raleigh fire marshal issued WakeMed on New Bern Avenue a citation last week because hospital beds were crowding the hallways in the emergency room.

Over the last two weeks, the hospital has been operating at 120 percent capacity.

“At one point last week, we got to the point where we were going to have to early discharge the moms of newborns and let them stay in a hotel,” said Debbie Laughery, a WakeMed spokeswoman.

At another point, the hospital’s emergency room became so overcrowded that patients were placed on beds and put in the hallway. Someone called the fire marshal, who came down and hit the hospital with a citation.

“We were doing everything in our power to provide the absolute best care possible under really, really busy, busy times,” Laughery said.

Doctors are fallible, just like the rest of us

From the Concord (NH) Monitor:

My mother-in-law died 11 years ago. But the recent death of John Arsenault brought it back to me again. The hospital staff sent Arsenault by cab from the emergency room to a local homeless shelter. Six hours later, the shelter staff, concerned by his inability to sit or stand, called an ambulance to take him back to the hospital, where he died.

I can imagine the shock and anger of his family on learning of his death. I still remember the look on my husband’s face when at last he arrived home from the hospital that long ago Sunday. He was pale with grief and misery. But beneath his sadness lay a quiet fury aimed at the emergency room doctor.