Emergency Room Workers Say Problems Are Rampant

From the Wall Street Journal Health Blog:

As if we needed more bad news about the dismal state of the nation’s ERs, doctors and nurses who work in them don’t have much confidence in their safety and worry about working conditions.

Those are some of the findings from a study funded by the federal Agency for Healthcare Research and Quality and just published online by the Annals of Emergency Medicine.

…the most surprising finding was how widespread the problems are–striking every type of hospital. “We found the same problems and issues in every region, in small and large ERs and in big academic medical centers and community hospitals,” Magid says. “I wasn’t too surprised that patients are being cared for in the hallways, but I was surprised that one-third said it happened consistently.”

The researchers surveyed 3,562 emergency medicine clinicians in 65 hospitals. The majority of those surveyed said their emergency departments consistently lack sufficient space to deliver patient care, with a third saying the number of patients consistently exceeds their capacity to provide safe care. On the staffing front, two-thirds reported that nursing staff is insufficient to handle patient loads during busy periods, and 40% said they don’t have enough doctors to handle patient loads when it gets busy.

Primary Care = PA, NP and IMG?

From Kevin MD:

Thomas Chappell writes about what is it like to be in Maryland (via Dr. Wes), where there are 16 percent fewer physicians per capita compared to the rest of the country.

Well, you get a situation where mid-level providers like NPs and PAs see an increasing number of patients.

Currently, 24 percent of mostly primary care training positions are filled with international medical graduates. That number will also likely rise.

Not that there’s anything wrong with NPs, PAs, and IMGs. The majority of them provide exceptional care.

Soon, specialists will uniformly be comprised of American medical graduates, while the majority of generalists will be composed of mid-levels and foreign-trained physicians.

It’s an interesting demographic glimpse of the future American medical workforce.

City-Wide Test of Therapeutic Hypothermia Post MI

From Medgadget:

New York City paramedics are initiating a policy of delivering many of their cardiac arrest patients only to hospitals equipped with therapeutic hypothermia capabilities. As many of our readers know, there is a growing evidence of data that shows that patients with neurological sequelae after a cardiac arrest retain more neuro function if treated with mild hypothermia, even if it was initiated as long as 6 hours after arrest.