Drive-through medical experiment conducted at Stanford Hospital & Clinics

From the Mercury News:

The cars, minivans and sport-utility vehicles began lining up and slowly moving forward, just as they would at a busy fast-food drive-through. But there weren’t any burgers or fries on the menu. Instead, drivers and passengers were examined by a team of Stanford doctors and nurses, all without getting out of their cars.

In what is believed to be the first training exercise in the country, a team of health care professionals at Stanford Hospital & Clinics turned the first floor of a parking garage into a drive-through emergency room Friday morning in hopes of creating a more efficient way to treat a large number of patients during an influenza pandemic or other emergency.

Dr. Eric Weiss, medical director for disaster planning at Stanford Hospital and Clinics and Lucile Packard Children’s Hospital, believes the drive-through triage can serve as a blueprint for hospitals nationwide and across the globe.

“Everywhere throughout the country, during flu season, emergency rooms are absolutely overwhelmed and bursting at the seams,” Weiss said. “With limited health care insurance and people not having primary care physicians, they use emergency departments as their primary care physician. And it’s our safety net. We have to have a new mechanism to take care of large numbers of patients during a pandemic, and I think that this is going to be it.”

Dr. Greg Gilbert, a Stanford clinical professor and medical director for San Mateo County, came up with the idea of a drive-through triage a few years ago while doing pandemic flu planning with Weiss. At first he thought of creating a tent outside the ER, but scrapped that idea because it would require people standing outdoors during winter.The drive-through idea came to him while resting in bed. He thought “everyone has cars, why not keep them in cars,” which would keep people from infecting others.

Weiss said, “We thought this would be a great way to use the automobile as a self-contained contamination.”

Become a Virtual Activist for Emergency Medicine

From the American College of Emergency Physicians (ACEP):

Health care reform has taken center stage and the Obama Administration has promised to move quickly, leaving no time to waste in making sure emergency medicine is part of what promises to be the largest overhaul our nation’s health care system has ever seen. ACEP is on Capitol Hill fighting for you and your patients, but the voice of each emergency physician is vital as we seek to gain ground.

ACEP’s quick and easy online form allows you to send a letter to your federal legislators demanding that emergency medicine is a part of overall health care reform. This online advocacy tool also allows you to personalize your letter, quickly identifies your district leaders and fills in the e-mail address. All you have to do is hit send.

And if your ED’s overcrowded waiting room isn’t evidence enough that something must be done, then consider the latest report released by the United States Government Accountability Office (GAO) that finds emergency patients who need to be seen in 1 to 14 minutes are being seen in twice that timeframe (37 minutes).

Even more alarming is that the nation’s emergency departments already treat 120 million people annually and that number is expected to rise each passing year as Baby Boomers age. People age 65 and older represent the fastest growing segment of the population and the group whose visits to the emergency department are increasing the fastest. They are also the patients who require the most acute care and are admitted to the hospital from the emergency department most often. This could lead to catastrophic crowding in just a few years.

News reports and the views of some policymakers that enactment of universal health care coverage will ease the stress on our nation’s emergency departments are not borne out by the data. The Centers for Disease Control and Prevention reports that 83 percent of emergency patients have some type of insurance and a 2008 study reported that the percentage of uninsured patients in the emergency department has dropped while the percentage of insured emergency patients has risen. Yet wait times continue to grow.

Health care reform will require systemic changes, and emergency medical care is a critical part of that system. Have a voice in that change – in the future of emergency medicine – by contacting Congress today. Your patients are depending on you.

ICD Saves Soccer Player – With Video

From Dr. Wes (an electophysiologist):

…in the video (click on the link above, as it’s embedded in the post), Van Loo is seen walking from the field and then collapsing at 7 seconds, his legs are seen twitching at 15 seconds as his automatic defibrillator fires to restore his heart rhythm to normal, and then by 21 seconds after the event he regains consciousness and sits up. According to some reports, Van Loo was not allowed to return to soccer unless he had an ICD implanted due to his known cardiac disorder.

Despite all of the press out there, this is NOT a heart attack, but rather the result of a life-threatenting heart rhythm disorder like ventricular fibrillation or ventricular tachycardia. In young people, the cause of these life-threatening arrhythmias include right ventricular dysplasia, catecholamine-induced ventricular tachycardia, idiopathic cardiomyopathy, and long QT syndrome (to name just a few). At maximum output, a defibrillator can deliver about 830 volts in a tenth of a second to restore the heart rhythm back to normal.