Tele-Ambulance, Part 2

I blogged about this previously, but here’s a bit more detail (remote controlled cameras on the exterior!) from the Arizona Daily Star:

The days of doctors making house calls are long gone.

Virtual visits in ambulances, however, are the wave of the future, city officials said of a new system that could be operational in about six months.

Beginning next summer, video cameras mounted on top of and installed inside of Tucson Fire Department ambulances will allow University Medical Center emergency-room doctors to see live images of accident scenes and patients before they are taken to the hospital, officials said.

The set-up will be similar to a video conference call, Leyva said. Emergency room doctors will have control of the cameras with the ability to zoom in on the patient’s injuries. They will also be able to speak directly to the paramedics.

In addition, UMC will be better prepared for incoming patients because doctors will have a better idea of what resources will be needed to give the best treatment possible, Capt. McDonough said.

New Rewarming Technology

From the San Jose / Silicon Valley Buiness Journal, based on a post at Medgadget:

The new chief executive and president of Fremont’s Dynatherm Medical Inc. is making the rounds on Sand Hill Road to pitch the idea of a high tech mitt that warms hypothermic patients through a combination of heat and air. He’s seeking to launch the mitt as the company’s first product and tap a $1 billion-plus market.

Based on a patent developed at Stanford University, VitalHeat is deceptively simple and extremely effective, he says. A patient’s hand, placed in a sealed mitt, is subjected to heat and vacuum pressure. This rapidly channels blood to a patient’s vital organs, or core, spiking the body temperature by several degrees within minutes.

Mr. Christensen, a medical device veteran who was appointed in May, says the product, cleared by the FDA in the fourth quarter of 2004, is needed in frosty environs like operating rooms because the threat of hypothermia in patients undergoing anesthesia or suffering from trauma is a constant challenge for health care providers. It is not unusual for a patient’s core temperature to drop several degrees during surgery, medical experts say, raising the risk of longer recovery times and other complications. Treatments to counteract the effects of hypothermia can cost hospitals up to $7,000 per patient, according to Dynatherm.

Conventional thermal technologies, meanwhile, fail to heat up patients as quickly and easily, Mr. Christensen says. Blankets made by competitors like Arizant Inc. of Eden Prairie, Minn., for instance, which blow hot air over a patient’s supine body, take up to two hours and are obtrusive for doctors, he says, while treatments that involve warming patient fluids via catheters are invasive and more risky.

For Dr. Jim Watkins, forced air blankets have been the treatment of choice for combating hypothermia. But the Fresno anesthesiologist says there are certain cases, such as heart surgeries or vein harvests, where a bulky blanket isn’t practical.

When Dynatherm showed Dr. Watkins its product to see if he would test it for the company, “I laughed at it,” he says. “It was hard to convince me that warming a small area of the body — 2 to 3 percent of a body’ total surface — would work.”

His skepticism disappeared after a dozen trial runs. “It worked beautifully,” he says. “I’ve chatted with several people at the hospital about [buying] the system.”

Adding hospitality to the hospital stay

From the Kansas City Star:

When you go to the hospital, you probably don’t expect to enjoy the hospitality.

But AVP Inc., an Overland Park company, is working to change that notion by bringing upscale customer attention — valet parking, concierge service, room service and bell staff — to hospitals and other health-care facilities.

“The health-care institutions are fighting for the baby boom generation. We’re providing services that help them compete,” said Jeff Perry, part owner and a division president of AVP.

The company serves more than 100 hospitals in 34 states. In the Kansas City area, facilities include Lee’s Summit Hospita l, Menorah Medical Center, Overland Park Regional Medical Center, Research Medical Center and Shawnee Mission Medical Center.

It’s Perry’s contention that patients want to be treated better during hospital visits.

“We want to improve the hospital stay,” Perry said. “We’re trying to dress up the front end and when they (patients) depart the hospital.”

Iraqi Suicide Bombing; Hospital / ED

From the London News-Telegraph:

A suicide car bomber killed dozens of people in an Iraqi town yesterday when he rammed his vehicle into American and Iraqi soldiers as they handed out toys and sweets to children outside a hospital.

But instead of inflicting mass casualties among the soldiers, the bomber’s victims were mostly children, medics and patients, killed when the brunt of the blast was taken by the hospital’s emergency room, which was wrecked by the explosion.

The attack in Mahmoudiyah, south of Baghdad, claimed at least 30 lives and was followed by a second blast last night in a shopping district in Hilla, also south of the Iraqi capital, where up to 11 people were reported to have died

Prehospital Stroke Care Initiative in Illinois

From the (Champaign-Urbana) News-Gazette:

All too often, precious time is lost because people don’t recognize the signs of a stroke and don’t go to the hospital, according to Dr. James Ellis, medical director of the emergency department at Provena Covenant Medical Center, Urbana.

That’s why Covenant and its sister hospital in Danville, Provena United Samaritans Medical Center, have launched a new stroke assessment and treatment program that starts at the first possible moment, right in the ambulance.

Now, Provena officials say, when an ambulance is called for a possible stroke victim, emergency medical crews serving those two hospitals begin an assessment in the ambulance to determine if the patient is suffering an ischemic stroke and meets the strict criteria for a controversial, clot-busting drug treatment best-known by its acronym, tPA.

The ambulance crew also now starts the patient’s IV, gets blood for lab tests and begins documenting findings on a treatment form that is continued by nurses upon arrival at the hospital.

And, to save time, the patient is taken directly to a CT scan at the hospital to confirm that an ischemic stroke has occurred, instead of being taken first to the emergency room, Ellis said.

The two Provena hospitals have set a goal of administering tPA, or tissue plasminogen activator, to patients who meet the criteria for the drug treatment within 30 minutes of arriving at the hospital.

Cigarette Tax in California: Pay for ER Care?

From the San Mateo County Times:

The battle over next year’s ballot initiatives is already beginning, with health-care groups feuding over two different measures that would impose new taxes on tobacco.

On one side, the California Hospital Association is now seeking voter signatures to put an initiative on the June primary ballot that would impose a $1.50 tax on cigarettes to offset hospitals’ costs for providing emergency-room care.

On the other side are anti-smoking groups such as the American Lung Association and the American Cancer Society, which are hoping to put their own $1.50 tobacco-tax measure on the November ballot. Their initiative, also supported by children’s advocates and the California Nurses Association — the hospitals’ frequent nemesis — would use the money to provide health insurance for all uninsured children in California and pay for tobacco-control programs.

Doctor tips off cabbie to illness

From the Pioneer Press

Dr. Victor Tschida had an unusual tip for a cabdriver at the end of his ride Sunday night: Get to the emergency room; your heart is failing.

The St. Paul cardiologist was riding from the airport to United Hospital and noticed the driver was breathing rapidly and coughing. The cabbie, Mamo Assefa, 47, dismissed his ailment, but Tschida grew more concerned during the eight-mile drive as he asked Assefa about his health.

“I offered to drive the cab, but he chose not to let me do that,” Tschida said. He asked Assefa to stay off the interstate, then persuaded him to pull up to the United emergency room.

The Columbia Heights man was diagnosed with pulmonary edema, a severe form of heart failure. He was treated with medication and is recovering at United.

Turned out Assefa had forgotten medication he takes for high blood pressure during a recent trip to visit relatives. Tschida said the lack of medication for a week probably contributed to the man’s heart failure.