Report: Half of ER visits preventable


About half of Tri-State emergency room visits, and 15 percent of inpatient stays, could have been prevented with timely treatment by a primary care doctor, a health group has found.

And despite popular perception, the uninsured did not make up the bulk of preventable ER visits in the 20-county area studied, according to a report released by the Health Foundation of Greater Cincinnati, which awards grants to nonprofit and governmental organizations for improving community health.

The figures were based on 741,000 ER and 293,000 inpatient discharges in 2004. Data for individual hospitals were not available.

Examples of preventable hospital use include severe asthma episodes and dental infections, both of which can be life-threatening but can generally be avoided with early care, said Pat O’Connor, program vice president for the Health Foundation. Preventable status was determined by the diagnosis at discharge.

Humiliation in the ER

From the Herald Tribune (FL):

When William Deloge was lying in the emergency room with a tube in his throat, a man charged with his care made a crude game of his vulnerable state.

“I felt helpless, totally humiliated,” said Deloge, 49. “I could hear people laughing at what was going on. I couldn’t protect myself.”

The Port Charlotte man said that a hospital employee at Peace River Regional Medical Center purposely exposed Deloge’s genitals to the emergency room staff at least four times in the July incident.

Deloge said that the employee repeatedly lifted his hospital gown, saying “Peek-a-boo” each time. Others laughed.

About two weeks after the incident, Deloge received a letter from the hospital, acknowledging the truth of his complaint and informing him that disciplinary action had been taken.

Post Arrest Hypothermia

From Medical Equipment Designer (courtesy of Medgadget):

The induction of mild hypothermia (lowering a patient’s temperature from 37°C to between 32° and 35°C) after cardiac arrest was proposed in the 1950s in an effort to protect the brain against global ischemia, which Webster’s defines as: “the localized tissue anemia due to obstruction of the inflow of arterial blood.” However, the idea wallowed in obscurity until recently because of the many uncertainties involved in deliberately inducing hypothermia in a resuscitated patient. Since then, various medical journals — The New England Journal of Medicine (NEJM) and Resuscitation, among them — have included numerous studies on animals and humans demonstrating the usefulness of this technique. The February 21, 2002 issue of NEJM features two studies that suggest therapeutic hypothermia is beneficial to the neurological outcome of the patient when he has been resuscitated after cardiac arrest due to ventricular fibrillation. These studies and their favorable results have led to an endorsement of mild hypothermia therapy by the American Heart Association as well as to the development of a sophisticated system that is designed to perform the entire task simply and accurately.