Bees escape from fatal wreck, hinder rescuers

From CNN:

Swarms of bees hampered rescue efforts at the scene of a fatal wreck in Minnesota on Monday after they escaped from the damaged tractor-trailer that was hauling them, state highway patrol said.

Rural patients need patience

From the Lancaster Eagle Gazette:

In 2014, newly insured Ohioans might learn what those living in rural areas already know: Having health coverage doesn’t guarantee easy and quick access to a family doctor.

In less than four years, more than 1 million additional Ohioans will have health insurance and will be encouraged to use it for routine check-ups. These new patients, who before might have turned to the emergency room instead of a doctor’s office, could worsen a shortage of primary-care doctors — practitioners of family medicine, general medicine, internal medicine, pediatrics and obstetrics and gynecology — in underserved communities.

Realistic expectations for public access defibrillation programs

From Current Opinion in Critical Care:

Purpose of review: Public access defibrillation programs have increased dramatically over the past 15 years. This review will focus on their effectiveness and operational characteristics and discuss the characteristics of successful programs, which can improve outcomes.

Recent findings: Automated external defibrillators increase survival from cardiac arrest when used by a bystander. Recent studies show that the best outcomes are achieved when devices are placed in areas with a high frequency of cardiac arrest and there is ongoing supervision with emergency plans and cardiopulmonary resuscitation training. Programs are cost-effective under these circumstances, but become very inefficient when placed in areas of low risk. There are few adverse events related to the public access defibrillation programs and volunteers are not harmed. Unguided placement results in devices not being used and a decline in organizational structure of the program. As most cardiac arrests occur in the home, the impact on overall survival remains low.

Summary: Automated external defibrillators are highly effective at reducing death from ventricular fibrillation and easy access in public areas is most effective. Placement must be prioritized based on public health impact and characteristics of the community.