Emergency Department Closed After Swine Flu Outbreak

From Biosurveillance:

April 22 (excerpt):

The Instituto Mexicano del Seguro Social (IMSS), a national health entity, had now joined the SSO in responding to the cases; reports did not indicate the Mexican National Ministry of Health had joined in the response efforts. The IMSS extended the sanitary cordon surrounding the hospital. Patients exhibiting flu-like symptoms would be sent to the hospital’s epidemiology department for further study. IMSS instructed physicians to hospitalize respiratory disease patients immediately if they meet certain standards for severity of symptoms. Lastly, the hospital’s emergency room would remain closed for an additional 15 days so that cleaning and preventive disinfection could be carried out.

Emergency Departments’ Role in Swine Flu Response

From PlanetAlbany:

DOH (Ed. Department of Health) will work with CDC on developing guidance appropriate for the public and providers of New York State. The nationwide situation is rapidly evolving and guidance is subject to change. In addition, DOH is monitoring respiratory illness throughout the State by tracking emergency department visits for respiratory illnesses, as well as monitoring the volume of Medicaid prescriptions for Tamiflu and Relenza, which are used for treatment of flu.

U.S. declares public health emergency as swine flu spreads

From CNN:

The United States government declared a public health emergency Sunday as the number of identified cases of swine flu in the nation rose to 20.

The declaration is part of a “standard operating procedure” that will make available additional government resources to combat the virus, Homeland Security Secretary Janet Napolitano said at the White House.

Additional cases of swine flu are expected to be reported in the coming days, added Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention.

Ed. Here’s a link to the CDC’s Swine Flu webpage

Boarded EM Physician Shortage

From ACEP:

The United States has nearly 40,000 clinically active emergency physicians, but these numbers are not adequate to treat the growing number of people who visit emergency departments each year.  New emergency physicians are not being trained fast enough, and shortages are expected to continue for several decades, particularly in rural areas and the central part of the country.  The workforce study results are being published online today in the Annals of Emergency Medicine (“National Study of the Emergency Physician Workforce, 2008”).

“The U.S. population is aging and moving into retirement, and that includes emergency physicians,” said lead author Adit Ginde, MD, MPH, of the Department of Emergency Medicine at the University of Colorado Denver School of Medicine.  “While U.S. medical schools graduate approximately 1,400 new emergency physicians every year, the shortage of emergency medicine trained and emergency medicine board certified physicians will continue for decades.  As older emergency physicians retire or die, the pronounced shortage in rural areas may even worsen.  Seniors are living longer with conditions that often require emergency care, and they need emergency physicians to treat them.”

The research team from University of Colorado Denver and the Emergency Medicine Network at Massachusetts General Hospital analyzed the 2008 American Medical Association Physician Masterfile, which contains data on all 940,000 U.S. physicians.  Of the 39,061 clinically active emergency physicians in the United States, 57 percent were board certified in emergency medicine; this percentage climbed to 69 percent when all emergency medicine trained physicians were added.  Nearly all (98 percent) of emergency physicians who graduated within the last five years were emergency medicine trained or emergency medicine board certified compared to only 44 percent who graduated 20 years ago or more.

“Although an increasing number of emergency physicians are now emergency medicine trained or board certified in emergency medicine, 31 percent of practicing emergency physicians were neither,” said Dr. Ginde.  “It is difficult to satisfy completely the current demand for emergency physicians with emergency medicine board certified physicians, especially in rural areas.  We need to improve access to high quality emergency care for all Americans.”

Of emergency physicians who graduated 20 years ago or more, 15 percent are practicing in a rural area.  By contrast, of emergency physicians who graduated within the past five years, only five percent are currently practicing in a rural area.

“The good news is that the increased public access to emergency medicine trained and emergency medicine board certified physicians demonstrates the growth of our specialty in a very short time, “said ACEP’s president, Dr. Nick Jouriles.  “But the news on continued shortages of emergency medicine specialists is sobering, particularly in rural areas.  The lack of access to emergency physicians in rural areas may increase in coming years.  Emergency care is a national priority. We need to train more emergency medicine specialists.  This is a critical as lawmakers and the nation take up health care reform.”

FAA Plan Would Require Alarms On Air Ambulances

From JEMS:

A proposal aimed at stemming crashes of air ambulances would require that the helicopters carry alarms that would warn pilots if they are close to hitting the ground, the Federal Aviation Administration announced Wednesday.

The alarm is part of a computerized device that can track every hill and radio tower in the world, warning pilots when they get too close to danger. The Terrain Awareness Warning System (TAWS), which is credited with preventing dozens of accidents on jets, would cost about $100,000 per helicopter.

Between December 2007 and October 2008, 13 air ambulance accidents killed 35 people.

The FAA has pressured air-ambulance operators to improve safety and add devices such as TAWS, but so far the effort has been voluntary. The National Transportation Safety Board, which investigates aviation accidents, had criticized the FAA for not moving more quickly.

“We recognize that relying on voluntary compliance alone is not enough to ensure safe flight operations,” John Allen, director of the FAA’s Flight Standards Service, said at a Congressional hearing on safety in the industry.

There are more than 800 air-ambulance helicopters in the U.S.

The industry is moving to equip the devices. More than 40% of operators have begun installing them on their fleets, the FAA estimates. Honeywell, the leading manufacturer of the devices, has sold 200 to air-ambulance companies, spokesman Bill Reavis said.

Allen said the agency expects the rule to go into effect in 2011.