Five drug companies are now increasing production of the vaccine for the H1N1 swine flu, and 10 million more doses are expected next week, Health and Human Services Secretary Kathleen Sebelius said on Saturday.
I have seen a lot of criticism of ERs lately. The new House Bill for healthcare reform introduces ways to reduce crowding and boarding in the ERs, and better prepare them for disasters like pandemics and Katrina-type travesties. But they also put the focus on reducing ER use, as if overuse of ERs is responsible for the exhorbitant waste and cost of Healthcare.
There is waste in healthcare, and some of the patients who come to ERs are inappropriately abusing the system. But those statistics state that 10% of patients are responsible for 90% of the visits. So the waste in the ERs is largely out of control of those who run them.
This site debunks some of the myths surrounding the ER and healthcare.
I go a step further, and challenge the criticisms that the ERs are unnecessarily over testing patients:
Ed. Posted for the bolded quote… follow the link and read the story for important context.
Paramedics would still respond to 911 calls and examine every patient, but would not automatically take everyone to the hospital.
“We’ll actually advise them, ‘Hey, you don’t need to go to the hospital. We’re not going to take you by ambulance to the hospital, because you don’t need to be in the emergency room,’” Zavadsky said.
Those who insist on going would still go, but not in an expensive ambulance.
“We’ll arrange for transportation for them either by taxi or sedan,” he said. “We’ll pay for that trip.”
It would be a one-way ride, not necessarily to an emergency room, but to an emergency clinic, where flu patients could be better separated from other patients to avoid spreading the disease.
A nurse at a Florida middle school was found passed out inside the school with a bottle of prescription painkillers. Some parents at school say they’re concerned that this incident could mean kids at the school had access to the drugs.
The nurse has not been charged with any crime and documents show that the painkillers came from a hospital where she also served as an Emergency Room nurse.
“Bennett was terminated from our facility. It was a serious breach of professional ethics,” said Dennis Markos, the hospital’s CEO.
Although many provisions in the new House health care reform bill are supportive of the nation’s emergency patients, the American College of Emergency Physicians (ACEP) today said the bill contains language about reducing unnecessary ER use, perpetuating a pervasive myth that even federal data show are inaccurate.
“The new House bill contains many excellent provisions that will strengthen the nation’s emergency department, including pilot programs to improve emergency care and a focus on crowding and the practice of ‘boarding’ emergency patients in hallways,” said Angela Gardner, MD, president of ACEP. “The authorization of an Emergency Care Coordination Center to coordinate emergency medical preparedness and response to disasters is also a critical step in focusing a national spotlight on the issues facing emergency patients. The role of emergency medicine in responding to epidemics and disasters has never been more clear as growing numbers of people have become infected with the H1N1 virus.”
Amusing post to the Student Doctor Network:
Attention Please! Attention Please! Code Friday!
Emergency Medicine – Saving the world from seeing its primary care doctor.
From PRNewswire (tip from the Wall Street Journal Health Blog):
MinuteClinic, the retail health care division of CVS Caremark (NYSE: CVS), and Allina Hospitals & Clinics of Minnesota and western Wisconsin have formed a partnership to pursue collaborative activities that will focus on enhancing high-quality health care services in the communities they serve. MinuteClinic is the pioneer and largest provider of retail health care in the United States, with about 500 locations nationally and 24 locations in the Twin Cities area, most within CVS/pharmacy stores.
Under the agreement, Allina and MinuteClinic will collaborate on aligning their clinical care operations, including medical oversight and informing patients of each parties’ services. In addition, as part of the collaboration, Allina and MinuteClinic will develop interfaces between their electronic medical records (EMR) systems to streamline communication around all aspects of a patient’s care. Allina and MinuteClinic will also explore the development of new services in the market.
To determine the percentage of Emergency Medicine patients using Complementary Therapies (CTs), to investigate what types of CTs are used most commonly, and to gauge the acceptability of studies of CT effectiveness in a hospital setting.
Prospective cross sectional survey using a convenience sample of adult patients, presenting to the Emergency Care Centre at North Shore Hospital in Auckland, New Zealand between December 2004 and March 2006.
The survey questionnaire collected demographic data, information on CT usage and attitudes to studies of CTs. Descriptive statistics with 95% confidence intervals are reported. Comparisons of proportions were made using Chi-Square or Fisher exact.
56.1% of participants had used a CT. Vitamins and minerals (21.2%), massage (13.4%), acupuncture (10.6%) were the most commonly used CTs. 53.3% of those using herbs or complementary medicines had not told their doctor. When compared to those who had not used CTs, respondents who had previously used CTs were both more likely to follow their doctor’s advice to use a CT (71.7% vs. 55.3%, p = 0.0035), and to participate in a study of CT effectiveness (65.0% vs. 45.4%, p = 0.0007).
More than half the patients surveyed had used CT in the past and more than half had not told their doctor. The majority of Emergency Medicine patients would follow the advice of their doctor if a CT was advised, and would agree to participate in a study of CT effectiveness, suggesting that such studies are practical in a hospital setting.
Opinion statement: Intravenous thrombolysis has been shown to improve outcome in patients with ischemic stroke if given within the first 3 hours. This benefit extends into a 4.5-hour time window when applied in a more selected patient population. Strokes from large-vessel intracranial occlusion carry high morbidity and respond poorly to intravenously administered thrombolytics. Endovascular therapy should therefore be considered in patients who fail or have contraindications for intravenous thrombolysis, or who present within a time window of 4.5 to 8 hours, and perhaps up to 12 to 24 hours for basilar occlusions.