Hospitalists Reduce Diversion and ED’s Boarding Burden

From Emergency Physicians Monthly:

A team of hospitalists dedicated to the emergency department can improve patient flow and timeliness of care, significantly reducing the ED’s time on diversion while also improving quality of care for boarded patients and opening lines of communication between the two departments.

Body found at impound lot after going unnoticed at accident scene

From JEMS:

An autopsy shows the body of a Clayton woman found inside her car after it was towed to an impound lot had a blood-alcohol level of 0.18 percent, and suggests she may not have lived long after the crash.

Watkins was reported missing three days after her car was discovered in a ditch near Smithfield on March 29. At the time, a state Highway Patrol trooper wrote in a report that there was no driver at the scene of the collision.

Fire Department to take part in flash mob for CPR awareness

From Yelm Online:

The purpose of the flash mob is to let people know how easy CPR is to do. Hambly said the participants will come out of a crowd at the mall, have a collection point to pick up their manikins, and then walk around for awhile.

At 1 p.m. “Stayin’ Alive” will start, “which is the correct beat for how fast you do the chest compressions,” Hambly said. “Then somebody from the crowd will put down a manikin and start doing CPR, and pretty soon you’ll have maybe like 45 manikins with people doing CPR, so it should be pretty fun.”

The performance will last about 4 minutes, 30 seconds — i.e. the length of the song. This is the first time Thurston County’s fire departments have joined forces to do a flash mob for CPR awareness.

ER docs sending more patients to the ICU

From Fierce Healthcare:

Emergency physicians are sending more patients to intensive care units than ever before, according to a study released by George Washington University School of Public Health and Health Services (SPHHS) and published in the journal Academic Emergency Medicine.

The study examined admissions to the ICU at hospitals across the nation and found that nearly 50 percent came from emergency departments.

“The increase might be the result of an older, sicker population that needs more care,” SPHHS researcher and lead author Peter Mullins said yesterday in a statement. 

The Promise And Limitations Of Telemedicine

From NPR (hat tip: Dr. Menadue)

Telemedicine is nothing new, but advancements in technology have made it even more widely available. Neurologists can now treat Parkinson’s patients from miles away, therapists can reach service members overseas, and general practitioners can work in rural areas without actually going there at all.

WHO reports first patient-to-nurse spread of new SARS-like virus

From Reuters:

Two health workers in Saudi Arabia have become infected with a potentially fatal new SARS-like virus after catching it from patients in their care – the first evidence of such transmission within a hospital, the World Health Organization said.

The new virus, known as novel coronavirus, or nCoV, is from the same family of viruses as those that cause common colds and the one that caused the deadly outbreak of Severe Acute Respiratory Syndrome (SARS) that emerged in Asia in 2003.

“This is the first time health care workers have been diagnosed with (novel coronavirus) infection after exposure to patients,” the Geneva-based U.N. health agency said in a disease outbreak update late on Wednesday

Fewer CTs, More Ultrasounds in Children

From Emergency Medicine Literature of Note:

Their protocol is generally simple – if it’s clinical appendicitis, consult surgery.  If it’s uncertain, do ultrasound first – if ultrasound equivocal, do CT.  If the patient appears unwell, skip ultrasound and do CT to evaluate for perforation.  Their institution started out with 82% of patients undergoing appendectomy having received CT, with this percentage dropping to 20% following implementation of the protocol.  Their negative appendectomy rate was stable at 5% after implementation, as well.  They also note the cost of a pediatric CT is $6500 compared with ultrasound at $1100.

Should families be allowed to witness CPR?

From Kevin MD:

This is a topic that comes up from time to time for often spirited discussion. The most recent example comes in a a couple of articles in the New England Journal of Medicine. One was a research paper; the other was a pro and con discussion.

The research paper studied cardiac arrests that happened outside the hospital. The authors tested the premise that allowing families to watch the efforts of the medical team reduce their psychic distress later. One group of patients received usual care, which meant keeping the families away from what was going on. Families of patients in the other group were asked if they would like to observe the resuscitation up close: 79% chose to watch. A medical team member was assigned to be with them and explain everything that was going on. The researchers then followed up with the families 90 days later to determine how many had symptoms of anxiety, depression, or actual post-traumatic stress disorder. 

The investigators found a significant reduction in psychological symptoms among family members who had watched the CPR. Also important is that there was no problem with family members interfering with the medical team.

Clot Busters May Not Be Best for Major Stroke

From MedPage Today:

Endovascular interventions appear to be superior to intravenous clot-busting drugs for treating a specific type of ischemic stroke in the emergency setting, a study has found.

Among 203 patients with intracranial large-vessel occlusions (ILVOs), those with NIH Stroke Scale (NIHSS) scores of 14 or higher at presentation and occlusions located in the more proximal segment of the middle cerebral artery had significantly better outcomes — as measured by final infarct volumes — when treated with endovascular therapy, also known as intra-artery therapy, according to Rishi Gupta, MD, of Emory University in Atlanta, and colleagues.

Man shoots himself at Ariz. hospital emergency room following shooting of another man at store

From The Republic:

Phoenix police say a man shot himself in a hospital emergency room where he’d gone after allegedly being involved in an apparent domestic dispute that left another man wounded.

Police say the man who shot himself at John C. Lincoln Hospital Monday night had earlier walked into a juice store and gotten into a fight with a worker.