University of Iowa ED Physician Trying to Get Back to Haiti

From the Press-Citizen:

The University of Iowa Hospitals and Clinics Emergency Room doctor just got back from Haiti on Saturday and now he’s trying to get back.

“We’re hoping to get back in the next couple days,” Buresh said.

In the past seven years, Buresh has made eight or nine trips to the now-ravaged country to do medical work. Working in teams of 10-14 people, Buresh worked closely with the Children’s Nutrition Program of Haiti. Based out of Leogane, Haiti, Buresh’s group worked out of a hospital and in villages, treating meningitis, tuberculosis, malaria, typhoid fever and other maladies.

“We can do a lot of things,” he said.

Buresh said he received a page about the 7.0 magnitude earthquake on Tuesday, but wasn’t sure if he could immediately return.

“It’s dangerous and counterproductive to go down there without a plan,” he said.

But, ultimately, Buresh said he had to go back, despite the strain it places on his family.

“I don’t think I could not go and sleep well at night,” Buresh said.

Buresh said he has a “rough plan” of what’s going to happen when he gets down there, but admits there will be a “fair bit of winging it.” First, he has to get there, however. Buresh said all commercial fights to Haiti have been booked up, but he’s hoping to piggyback on a private flight taken by the Minnesota governor.

Would you like fries with that diagnosis?

Ed. I blogged about this previously. Interesting to see it resurface. BTW. Is that Tiger Woods in the picture?

From the LA Times.

As we all know, Californians are car-crazy. So perhaps it was only a matter of time before an enterprising group of ER docs set up an experimental drive-through flu clinic in a parking garage near Stanford University Hospital in Palo Alto.

To test this awesome idea, the doctors got actors to play 38 actual patients who came to the hospital’s emergency room in April, when the H1N1 outbreak was just getting started. The “patients” remained in their cars while they went through the usual steps of registration, triage, screening and discharge, according to the report in Annals of Emergency Medicine.

Receiving hospital characteristics associated with survival after out-of-hospital cardiac arrest

From Resuscitation:

Survival after out-of-hospital cardiac arrest (OOHCA) varies between regions, but the contribution of different factors to this variability is unknown. This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases.
Material and methods

Prospective observational database of non-traumatic OOHCA assessed by emergency medical services was created in 8 US and 2 Canadian sites from December 1, 2005 to July 1, 2007. Subjects received hospital care after OOHCA, defined as either (1) arriving at hospital with pulses, or (2) arriving at hospital without pulses, but discharged or died ≥1 day later.

A total of 4087 OOHCA subjects were treated at 254 hospitals, and 32% survived to hospital discharge. A majority of subjects (68%) were treated at 116 (46%) hospitals capable of cardiac catheterization. Unadjusted survival to discharge was greater in hospitals performing cardiac catheterization (34% vs. 27%, p=0.001), and in hospitals that received ≥40 patients/year compared to those that received <40 (37% vs. 30%, p=0.01). Survival was not associated with hospital bed number, teaching status or trauma center designation. Length of stay (LOS) for surviving subjects was shorter at hospitals performing cardiac catheterization (p<0.01). After adjusting for all variables, there were no independent associations between survival or LOS and hospital characteristics.

Some subsets of hospitals displayed higher survival and shorter LOS for OOHCA subjects but there was no independent association between hospital characteristics and outcome.

Thinking Outside the Box: Value-Based Emergency Care

From Emergency Medicine News:

A plan by the college’s recently convened think tank, the Task Force for Value-Based Emergency Care, spells out a strategy for becoming part of the health care reform now inching toward becoming federal law.