Prehospital 12-Leads in Oklahoma

From JEMS:

Oklahoma City and Tulsa have experienced one of the highest cardiac arrest survival rates in the country, but Oklahoma’s EMS leaders aren’t resting on their laurels. Instead, they’re planning a statewide ST-elevation myocardial infarction (STEMI) referral network in order to boost survival rates across Oklahoma’s urban and rural areas.

The plan involves implementing new statewide protocols, making 12-lead ECGs universal among EMS units, and having paramedics and EMTs transmit ECG data to hospitals in order to ascertain the best receiving facility.

“One Week”

An excellent poem about what I presume is a new attending, from The Central Line.

It’s been one week with my new ID;

the kind that says “OK, you can now sue me”

One week since I got the key

to a sleep room that I will probably never see

Four days since my last day off

How long is it that you’ve had that cough?

Yesterday since you had no pee?

And your primary said you had to come to see me.

“Poplarville ER woking well”… woking?

From the Picayune Item:

The Pearl River Co. Hospital’s emergency room, in existence only for about three weeks, might have already saved a life.

Lori Stanford, who lives here, said that a severe allergic reaction to food she had eaten completely shut off her windpipe, or trachea, and she could not breath (sic).

The incident happened on Saturday night, and she said she had only minutes to reach a hospital.

Incidence and types of non-ideal care events in an emergency department

From Quality and Safety in Healthcare:

Aim To identify and characterise hazardous conditions in an Emergency Department (ED) using active surveillance.

Methods This study was conducted in an urban, academic, tertiary care medical centre ED with over 45 000 annual adult visits. Trained research assistants interviewed care givers at the discharge of a systematically sampled group of patient visits across all shifts and days of the week. Care givers were asked to describe any part of the patient’s care that they considered to be ‘not ideal.’ Reports were categorised by the segment of emergency care in which the event occurred and by a broad event category and specific event type. The occurrence of harm was also determined.

Results Surveillance was conducted for 656 h with 487 visits sampled, representing 15% of total visits. A total of 1180 care giver interviews were completed (29 declines), generating 210 non-duplicative event reports for 153 visits. Thirty-two per cent of the visits had at least one non-ideal care event. Segments of care with the highest percentage of events were: Diagnostic Testing (29%), Disposition (21%), Evaluation (18%) and Treatment (14%). Process-related delays were the most frequently reported events within the categories of medication delivery (53%), laboratory testing (88%) and radiology testing (79%). Fourteen (7%) of the reported events were associated with patient harm.

Conclusions A significant number of non-ideal care events occurred during ED visits and involved failures in medication delivery, radiology testing and laboratory testing processes, and resulted in delays and patient harm.

Heading to the ER? Check your smartphone first

From Boston.com:

“Utilizing a mobile app also allows patients to obtain other useful information – not just ER wait times,” said Sandra Fancher, vice president at MedTouch. The app will also contain hospital maps, pre-registration, and other features.

Money Magazine’s “Best Jobs”: ED Physician #25

From CNNMoney:

PA is #2

CRNA is #13

DON is #27

Hospital Administrator is #36