Heart Association: Hands-only CPR works

From CNN.com

In a major change, the American Heart Association said Monday that hands-only CPR — rapid, deep presses on the victim’s chest until help arrives — works just as well as standard CPR for sudden cardiac arrest in adults.

Experts hope bystanders will now be more willing to jump in and help if they see someone suddenly collapse. Hands-only CPR is simpler and easier to remember and removes a big barrier for people skittish about the mouth-to-mouth breathing.

“You only have to do two things. Call 911 and push hard and fast on the middle of the person’s chest,” said Dr. Michael Sayre, an emergency medicine professor at Ohio State University who headed the committee that made the recommendation.

Hands-only CPR calls for uninterrupted chest presses — 100 a minute — until paramedics take over or an automated external defibrillator is available to restore a normal heart rhythm.

Part-Time Practice Trends Intensify Physician Shortage

From Cejka:

The imbalance in the supply and demand for physicians will continue to intensify as the U.S. population continues to grow faster than the physician workforce. Added pressure will come with the increasing number of physicians practicing medicine on a part-time basis, as reported the 2007 Retention Survey from the American Medical Group Association (AMGA) and Cejka Search, a nationally recognized physician and healthcare executive search organization.

In the recently released AMGA/Cejka Search survey, responding groups reported an increase in the percentage of physicians practicing part-time from 13 percent in 2005 to 19 percent in 2007.

A loan-forgiveness program isn’t always enough to attract doctors to rural areas

From the Times Union:

Former Gov. Eliot Spitzer proposed a new loan-forgiveness program that would entice new doctors to rural communities like Cobleskill, and his newly sworn-in successor, Gov. David Paterson, has expressed support for the initiative.

But many in the medical community say it isn’t enough.

The program, they say, doesn’t address the overarching problems: exorbitant malpractice insurance premiums, flat Medicare reimbursement rates, a lagging rural economy.

More than one-quarter of New Yorkers live in areas designated “underserved,” which is classified as more than 3,500 people per primary-care doctor, according to the state Department of Health. The Mohawk Valley, the Finger Lakes and the North Country are among the regions struggling to attract doctors. The Health Department estimates more than 300 primary-care physicians are needed to alleviate the shortage. Speciality doctors are hard to find, too.

Avera Health Forms Avera Medical Group

From Modern Physician:

Avera Health, Sioux Falls, S.D., announced it has formed Avera Medical Group, a network of 325 physicians and 187 health professionals in communities across Minnesota, Iowa, Nebraska and the Dakotas. The 75 practices in the medical group will share branding, business operations, managed-care contracting, recruitment and retention, coding and reimbursement, information technology, property insurance and other services.

 “Avera is very sensitive to the fact that each physician and practice is unique,” David Flicek, senior vice president of Avera Medical Group, said in a news release. “Avera Medical Group brings us together around a shared infrastructure, standards and brand identity, and gets us all on the same page for such vital initiatives as the electronic medical record.” 

Sponsored by the Sisters of St. Benedict of Sacred Heart Monastery of Yankton, S.D., and the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, S.D., Avera is a regional partnership of health professionals who share support services at more than 231 locations in eastern South Dakota and the surrounding states

City Tries to Cut Down on Unnecessary Ambulance Calls

From the Washington Post:

The ambulances come screaming down city streets, rushing on calls to burst boils, clip hangnails and check on smelly body parts. At the cost of $700 a visit.

Meanwhile, the District’s ambulances are unavailable to help in real 911 emergencies, a problem the city’s Fire and Emergency Medical Services Department is trying to fix with a new program it rolled out this week called Street Calls.

Thirty people accounted for 2,400 emergency transports last year, said Michael D. Williams, the department’s chief medical officer. That’s a good chunk of the 78,000 ambulance trips his teams made in that same period, he said.

The program to try to change the lopsided statistic was announced by Mayor Adrian M. Fenty (D) in his State of the District speech this month and was introduced this week.

Medical workers will get into vans and visit the top 20 offenders who habitually call 911 in instances of “misuse” and try to work with them to gently curb the inappropriate calls that send ambulances racing around town, department spokesman Alan Etter said.

Study Finds Many Patients Dissatisfied With Hospitals

Here’s the NY Times Health Blog’s Take:

Many hospital patients are dissatisfied with some aspects of their care and might not recommend their hospitals to friends and relatives, the federal government said Friday as it issued ratings for most of the nation’s hospitals, based on the first uniform national survey of patients.

The survey was meant to provide a constructive way for patients to complain about arrogant doctors, crabby nurses and dirty or noisy hospital rooms. Medical experts said that some of the complaints bore directly on the quality of care.

Many patients reported that they had not been treated with courtesy and respect by doctors and nurses; that they had not received adequate pain medication after surgery; and that they did not understand the instructions they received when discharged from the hospital.

Nationwide, in the average hospital, 67 percent of patients said they would definitely recommend the institution where they had been treated to friends and relatives. Sixty-three percent gave their hospitals a score of 9 or 10 on a scale of 0 to 10.

and the Wall Street Journal’s Health Blog entry on the same topic:

Quick: Which of your local hospitals treats patients best? And how does it compare with facilities in the next town?

You’d have been out of luck getting much of an answer in most parts of the country until now. But this afternoon, Mike Leavitt, secretary of Health and Human Services, unveiled the addition of patient satisfaction data to Medicare’s three-year-old Hospital Compare Web site. The changes are part of a continuing effort by HHS to improve the measurement of health quality and, in the process, to spur better care.

“We’re not very good at this, but we’re making a lot of progress,” Leavitt conceded to a room packed with reporters and editors attending the annual meeting of the Association of Health Care Journalists outside Washington. In a video game analogy, Leavitt added, “We are just leaving the Pong era when it comes to measuring quality.”

The 10 new data points– including how clean and quiet patients found the joint, whether medical staff listened and communicated well, and how well the facility treated patients’ pain — join some 26 quality measures already on the site. HHS is also moving some data on Medicare’s cost to treat a number of conditions, and the volume of procedures done, here from elsewhere on its site. All of it will be hospital-specific, with local, state and national comparisons.

3 dead in hospital shooting in Georgia

From MSNBC:

COLUMBUS, Ga. – A retired teacher bearing a grudge over his mother’s treatment at the hospital where she died fatally shot one of her nurses, another employee and a man outside Thursday before police shot him, authorities said.

Charles Johnston, 63, is being charged with murder and will be turned over to police after an overnight stay in another hospital, where he was treated for a shoulder wound, Police Chief Ricky Boren said.

The chief said the gunman arrived at Doctors Hospital with three pistols, including a 9mm automatic and a .38-caliber revolver, and went to the fifth-floor intensive care unit where his mother had been in 2004.

“Give Me 5” Raises Awareness of Stroke Symptoms

From the American College of Emergency Physicians (ACEP):

ACEP and The Stroke Collaborative have kicked-off a nationwide public relations campaign to encourage Americans to recognize stroke symptoms, call 9-1-1, and get to the emergency department. The campaign, “Give Me 5,” features ACEP member and stroke survivor Diana Fite, MD.

The “Give Me 5” Site: http://www.giveme5forstroke.org/ 

Safety features can impede car crash rescues

From Kansas.com

Capt. Clint Roberts makes his living cutting accident victims out of hideously mangled vehicles, but even he could hardly believe it when two people in a 2007 midsize car survived a head-on crash with a full-size pickup last year.

The Ford Fusion’s reinforced steel construction probably saved the lives of the 18-year-old driver and his 16-year-old passenger. But Roberts said it gave his Hillsborough County Fire Rescue crew fits as they tried to free them last November.

Because hydraulic cutters couldn’t shear the roof posts, rescue workers had to turn to heavy-duty electric saws, replacing blade after blade as they dulled on the rugged material.

“It was just beating the snot out of the tools,” adding minutes and delaying medical treatment, Roberts said.

There is no question that today’s cars save lives by cocooning motorists in reinforced alloys, impact-absorbing crumple zones and as many as a dozen air bags.

But in interviews with the Associated Press, rescue officials and experts from around the United States said the new technology is also hindering extrication of injured people, increasingly forcing crews to work deeper into the critical “golden hour” between accident and treatment by emergency room doctors. On many 2005 and later cars, an extrication that once took 10 or 15 minutes can now take twice that or longer.

Emergency Contraception Case Lands in Illinois Supreme Court

From the Wall Street Journal Health Blog:

Pharmacists shouldn’t be forced to dispense the “morning-after pill,” a form of emergency contraception known as Plan B, lawyers argued yesterday in the Illinois Supreme Court, the Associated Press reports.

Plan B, sold by Barr Labs, is simply a high dose version of the same hormones used in birth control pills; it reduces the risk of pregnancy if taken in the first 72 hours after unprotected sex. But some pharmacists, arguing that the pills in some cases may prevent a fertilized egg from implanting in the uterus, have objected to an Illinois rule that requires pharmacies to dispense the drug. They say the requirement violates a state law that prohibits making health care decisions over moral objections.

The rule was implemented in 2005, and there’s been a fair bit of legal wrangling over it already, with an effort to work out a compromise solution. Under a settlement of another suit reached last year, individual pharmacists in Illinois who believe dispensing the pills would violate their religious beliefs don’t have to be the ones to process the order. But owners of the pharmacies are obligated to find a way to fulfill each woman’s prescription.

A similar law in Washington state is also working its way through the courts. And last year, the Pope last year said Catholics shouldn’t dispense emergency contraception.