Virtual Reality Medical Simulator Being Adopted by Duke Medical School

From Medgadget:

Duke University School of Medicine is teaming up with Virtual Heroes, a software simulation company out of Raleigh, North Carolina, to utilize the firm’s HumanSim package as a tool for “healthcare team communication training; medical device and pharma product education; patient education; medical recertification; clinical trial education; CME courses; and healthcare quality assurance training.”

Mississippi looks to Iran for rural health care model

Ed. Love the headline…

From the AP (via Google):

Scratch-poor towns in the Mississippi Delta once shared more in common with rural Iran — scarce medical supplies, inaccessible health care and high infant mortality rates — than with most of the U.S.

Then things in Iran got better.

Since the 1980s, rural Iranians have been able to seek treatment at health houses, informal sites set up in small communities as the first stop for medical care, rather than an emergency room. They’re staffed by citizens, not doctors, and the focus is on preventive care.

Infant deaths have dropped from 200 per 1,000 births to 26. With the Delta’s rate 10 times worse than Iran’s, a group of volunteers is traveling to Iran this month to get a crash course in how health houses work.

Small Area Variations in Out-of-Hospital Cardiac Arrest: Does the Neighborhood Matter?

From the Annals of Internal Medicine:

Background: The incidence and outcomes of out-of-hospital cardiac arrest vary widely across cities. It is unknown whether similar differences exist at the neighborhood level.

Objective: To determine the extent to which neighborhoods have persistently high rates of cardiac arrest but low rates of bystander cardiopulmonary resuscitation (CPR).

Design: Multilevel Poisson regression of 1108 cardiac arrests from 161 census tracts as captured by the Cardiac Arrest Registry to Enhance Survival (CARES).

Setting: Fulton County, Georgia, between 1 October 2005 to 30 November 2008.

Measurements: Incidence of cardiac arrest by census tract and year and by rates of bystander CPR.

Results: Adjusted rates of cardiac arrest varied across neighborhoods (interquartile range [IQR], 0.57 to 0.73 per 1000 persons; mean, 0.64 per 1000 persons [SD, 0.11]), but were stable from year to year, (intraclass correlation, 0.36 [95% CI, 0.26 to 0.50]; P < 0.001). Adjusted bystander CPR rates also varied by census tract (IQR, 19% to 29%; mean, 25% [SD, 10%]).

Limitation: Analysis was based on data from a single city.

Conclusion: Surveillance data can identify neighborhoods with persistently high incidence of cardiac arrest and low rates of bystander CPR. These neighborhoods are promising targets for community-based interventions.

Hospital sees drop in emergency room patients after cracking down on pain medications

From the Star News (online):

Dosher Memorial Hospital’s crackdown on powerful pain killers for emergency department patients has led to a quieter ED.

“We have seen a bit of a decline in the emergency department in the number of patients that we’re seeing,” said Kirk Singer, spokesman for the Southport hospital. “We believe it’s a pretty direct result of the passage and publicizing of our policy.”

That policy, adopted in December of last year, stated emergency department physicians would no longer use or prescribe Schedule II, III or IV narcotics for patients who come in with ongoing, chronic conditions.

Rural Trauma Care Matters

From the Journal of Trauma:

First Echelon Hospital Care Before Trauma Center Transfer in a Rural Trauma System: Does It Affect Outcome?

Background: Rural trauma has been associated with higher mortality because of a number of geographic and demographic factors. Many victims, of necessity, are first cared for in nearby hospitals, many of which are not designated trauma centers (TCs), and then transferred to identified TCs. This first echelon care might adversely affect eventual outcome. We have sought to examine the fate of trauma patients transferred after first echelon hospital evaluation and treatment.

Conclusions: In this rural setting, care at first echelon hospitals, most (95%) of which were not designated TCs, seemed to augment, rather than detract from, favorable outcomes realized after definitive care at the TC.