Paramedics take photos of 38 unconscious patients as part of ‘selfie war’

From the Herald:

Two paramedics reportedly challenged each other to a “selfie war.”

But instead of weird faces or exotic locations, the subjects of this selfie war were patients in ambulances, nearly all of them unconscious.

The challenge was between Kayla Renee Dubois, 24, and Christopher Wimmer, 33, in Okaloosa, Florida. The two would take videos and photos of themselves with patients who were “intubated, sedated, or otherwise unconscious at the time,” according to the Okaloosa County Sheriff’s Office.

A total of 41 patients were identified in the selfies, but three were with consenting patients. Two of the 38 unconscious patients have died.

CMS reveals new cardiac, stroke innovation model

From Becker’s:

The new program — dubbed the Million Hearts Cardiovascular Disease Risk Reduction Model — is a five-year, randomized controlled trial. The program’s 516 awardees, which include nearly 20,000 providers and more than 3.3 million Medicare fee-for-service beneficiaries, will be testing a two-step program that firstly assesses individual patients’ risk for heart attack or stroke, and secondly provides the necessary prevention interventions for at-risk patients.

The ‘Lolla Lift’ in the ER: Doctors prepare for onslaught of underage drinkers

From WGN:

Shocking statistics from Lollapalooza weekend last year have doctors scrambling to prepare to care for teens this year.

The music and the heat mix with long stretches standing and in many cases drinking alcohol not rehydrating water. The effect is frightening.

“There’s a lot of vomiting, a lot of emotional outbursts and some behavioral aggression problems,” says Dr Karen Mangold of Lurie Children’s Emergency Medicine. “There are some kids who get so sick they have altered mental status even to the point of being unconscious. … They can have some respiratory depression as well so they can end up not breathing which is quite dangerous.”

Also factored in are 100,000 people a day over four days this year and it’s a recipe for a packed emergency room.

Preteen robbers throw CPR manikin through window

From Boing Boing:

On Monday, five kids, around the age of 10, reportedly used a CPR dummy to bash in the window of a convenience store in Peoria, Illinois. They were foiled by bars that prevented them from entering. From the Peoria Journal Star:

According to Peoria police reports, the children, three girls and two boys, all about the age of 10, were at the Jackpot Supermarket, 200 N. MacArthur Highway, about 11:30 p.m. When officers arrived, the children weren’t there but the CPR dummy was.

Enhanced Risk Prediction Model for Emergency Department Use and Hospitalizations in Patients in a Primary Care Medical Home

From AJMC:

Objectives: With the advent of healthcare payment reform, identifying high-risk populations has become more important to providers. Existing risk-prediction models often focus on chronic conditions. This study sought to better understand other factors to improve identification of the highest risk population.

Study Design: A retrospective cohort study of a paneled primary care population utilizing 2010 data to calibrate a risk prediction model of hospital and emergency department (ED) use in 2011.

Methods: Data were randomly split into development and validation data sets. We compared the enhanced model containing the additional risk predictors with the Minnesota medical tiering model. The study was conducted in the primary care practice of an integrated delivery system at an academic medical center in Rochester, Minnesota. The study focus was primary care medical home patients in 2010 and 2011 (n = 84,752), with the primary outcome of subsequent hospitalization or ED visit. A total of 42,384 individuals derived the enhanced risk-prediction model and 42,368 individuals validated the model. Predictors included Adjusted Clinical Groups–based Minnesota medical tiering, patient demographics, insurance status, and prior year healthcare utilization. Additional variables included specific mental and medical conditions, use of high-risk medications, and body mass index.

Results: The area under the curve in the enhanced model was 0.705 (95% CI, 0.698-0.712) compared with 0.662 (95% CI, 0.656-0.669) in the Minnesota medical tiering-only model. New high-risk patients in the enhanced model were more likely to have lack of health insurance, presence of Medicaid, diagnosed depression, and prior ED utilization.

Conclusions: An enhanced model including additional healthcare-related factors improved the prediction of risk of hospitalization or ED visit.

– See more at: http://www.ajmc.com/journals/issue/2016/2016-vol22-n7/enhanced-risk-prediction-model-for-emergency-department-use-and-hospitalizations-in-patients-in-a-pcmh#sthash.DRpPRcBy.dpuf

 

Are freestanding emergency rooms following the money?

From Reuters:

When researchers took a look at the three states with the greatest number of these freestanding EDs – Texas, Ohio and Colorado – they found the facilities located in areas with population growth, higher incomes, a higher proportion of people with private health insurance and a lower proportion of residents with Medicaid, the U.S. health insurance program for the poor.

“Freestanding EDs have the potential to increase access in several ways: they can be located in areas without emergency care, like a rural area, or they can open in an area without adequate emergency care, for example, where hospital EDs have chronic long waiting times,” said lead study author Dr. Jeremiah Schuur of Brigham and Women’s Hospital and Harvard Medical School in Boston.

“Overall, in the three states we examined in this study, freestanding EDs are not primarily locating to address the regional access to care – rather they are more likely locating in areas where the population has good payment sources, which are also more likely to have more sites of health care like doctors’ offices and hospital EDs,” Schuur added by email.

‘Microhospitals’ Fill Some Emergency Room Needs

From Managed Care:

With an eye on fast-growing urban and suburban markets, some health care systems are opening tiny, full-service hospitals with comprehensive emergency services but often with fewer than a dozen inpatient beds, according to a report from Kaiser Health News.

These “microhospitals” provide local residents with quicker access to emergency care, and they may also offer outpatient surgery, primary care, and other services. They are generally affiliated with larger health care systems, which can use the smaller facilities to expand in an area without incurring the cost of a full-scale hospital. So far, microhospitals are being developed in only a few states—Texas, Colorado, Nevada, and Arizona.

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