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.

Drunk ASU Student Left at ED with Post-it

From Fox News:

An Arizona State University student who passed out from drinking tequila was left in wheelchair in a hospital lobby with a Post-it note to tell doctors that he took part in a drinking competition.

Trend spotting: Yet another ruckus in the ED

From CBC News:

Hospital ruckus lands young man in lockup

A man was taken into custody early Tuesday morning after police were called to a hospital emergency room in St. John’s.

The Royal Newfoundland Constabulary was called to the Health Sciences Centre around 12:30 a.m. after staff reported that “an intoxicated male [had been] causing trouble” at the ER.

Hospital Not Liable For Emergency Physician Fees, Calif. Appeals Court Says

 From Law360, via EDPMA 

The following article reports that a California appeals court dismissed an action against a hospital for failure to prevent independently-contracted ED doctors from charging excessive fees when balance billing patients:

A California appeals court on Thursday affirmed the dismissal of a putative class action over Watsonville Hospital Corp.’s alleged failure to prevent emergency room doctors at the hospital charging excessive fees, ruling it is not responsible for the independently contracted doctors’ rates.

Nurses Without Jobs: A Sign of the Times

From Georgia Health News via Kaiser Health News:

It’s true that the need for nurses will never disappear, and the U.S. Bureau of Labor Statistics has projected that 711,900 new nursing jobs will be created by 2020.

But in the current economy, the job prospects for a nurse are surprisingly uncertain.

For years, the profession suffered from labor shortages, and a nursing degree was considered a sure ticket to a job. Now many new graduates struggle to find work.

More than one-third of newly licensed RNs graduating in 2011 had not found employment four months after graduation, according to a September 2011 survey of more than 3,700 new RN grads by the National Student Nurses Association.

Arrested Texas Paramedic Vocal after Fertilizer Plant Explosion

From JEMS: 

Three days after a massive explosion at a Texas fertilizer plant, Bryce Reed climbed onto a coffee table at a local hotel where displaced families picked over donated sweatshirts and pizza. Wearing a navy blue shirt emblazoned with “West EMS,” he gathered the crowd close.
“You’re safe where you’re at,” Reed said, describing an anhydrous ammonia leak inside the rubble at the West Fertilizer Co. plant. “If you’re not, I’d be dragging you out of here myself.”
That day in the West hotel lobby, applause erupted when Reed stepped down. Yet no one had asked Reed to come, and in a town swarming with federal and state investigators — who had handled all the official briefings and tightly controlled updates — a local volunteer paramedic relaying such information was a stark contrast.

In fact, Reed had been “let go” by West EMS as of April 19, the day before the speech, according to an email obtained by The Associated Press sent by a regional EMS organization, the Heart of Texas Regional Advisory Council, to the state health officials.

An Emergency Physician did an AMA (ask me anything) on Reddit last night

From Reddit:

I have worked as a Emergency Room Physician since 1991. I have traveled all over US; and have worked in 11 states. I have calculated a guesstimate that I have treated about 100,000 patients. That is based on hours worked times average patients seen per hour. (Since people are calling BS….2.5 patients per hour x 165 hours per month x 12 months in a year x 22 years = 108,900 patients. That doesn’t include residencies, I often see more patients per hour and work more hours than used in the math.)

I have seen a lot in my career as I have worked in small towns to large cities, affluent areas to more impoverished ones, and special events such as the ’96 Olympics. I currently travel to 5 different states to work in contracted emergency rooms.

I have quite interesting stories, experiences, opinions, etc to share. Ask me anything except why it burns when you pee.

Hospital Locked Down Based on ED Patient’s Threat

From Patch:

Northfield Hospital was placed on lockdown early Sunday afternoon after a threat was called to the Emergency Department.

The Pioneer Press says the hospital was locked down from about 12:30 p.m. until 2:20, when a 24-year-old man from Biwabik, MN, was arrested at a relative’s home in Farmington.