“Medical Helicopters Need Better Safety Standards—Now”

From Popular Mechanics:

n a farmer’s field two miles east of Jackson, Tenn., there’s a helicopter rotor blade sticking straight out of the ground. Another medical helicopter has crashed. Another three people are dead.

It’s sad, but not surprising. The medical helicopter industry has more than tripled in size over the last two decades, expanding from 200 helicopters in 1988 to 668 in 2008. While the pilots and crew endeavor to save lives, they also put their own at risk: flying to the scenes of accidents in often remote, dark locations, landing not on pads but in fields and on streets. But though the industry is the most dangerous sector of commercial aviation, it operates with some of the least safety regulation.

Analgesic Prescribing for Patients Who Are Discharged from an Emergency Department

From Pain Medicine:

Objectives. Among patients who arrive at an emergency department (ED) with pain, over half remain in moderate or severe pain at ED discharge. Our objectives were to identify ED physicians’ prescribing patterns when discharging patients with common musculoskeletal conditions and to determine if disparities in opioid prescribing exist.

Design. Five-year retrospective investigation.

Setting. An urban, academic ED with approximately 100,000 annual visits, where physicians write discharge prescriptions, including over-the-counter medications, using a computerized order entry system.

Patients. Adult patients who were discharged home from an ED with fractures (clavicle or long bone fractures) or non-fracture musculoskeletal diagnoses (sprains, strains, sciatica, or back pain).

Outcome Measures. Patient demographics and pain medications prescribed for use at home.

Results. The study sample included 13,335 patients with a mean age of 39 years. Half were female; 52% were white; 39% were black; and 7% were Hispanic. Among fracture patients, 77% received an opioid prescription, 2% received a non-opioid prescription, and 21% received no analgesic prescription. The percentages for patients with non-fracture diagnoses were 65% (opioids), 18% (non-opioid analgesics), and 17% (no analgesic). Patients aged 80 years and older were significantly less likely to receive opioid prescriptions. Although prescribing by race for fractures was similar, significantly fewer black and Hispanic patients with non-fracture diagnoses received opioid prescriptions, compared with white patients.

Conclusions. Approximately one fifth of patients in the fracture and non-fracture groups did not receive an analgesic prescription. Age greater than 80 years and minority race/ethnic status were associated with lower rates of opioid prescribing.

Patient choice of provider type in the emergency department

From the Emergency Medicine Journal:

Background Patient satisfaction is related to the perception of care. Some patients prefer, and are more satisfied with, providers of the same gender, race or religious faith. This study examined emergency medical provider attitudes towards, as well as patient and provider characteristics that are associated with, accommodating such requests.

Methods A survey administered to a convenience sample of participants at the 2007 American College of Emergency Physicians Scientific Assembly. The nine-question survey ascertained Likert-type responses to the likelihood of accommodating patient requests for specific provider types. Statistical analyses used Wilcoxon rank-sum, Wilcoxon signed-rank and Cochran’s Q tests.

Results The 176 respondents were predominately white (83%) and male (74%), with a mean age of 42 y. Nearly a third of providers felt that patients perceive better care from providers of shared demographics with racial matching perceived as more important than gender or religion (p=0.02). Female providers supported patient requests for same gender providers more so than males (p<0.01). Provider race, practice location, type and duration did not significantly affect the level of accommodation. When requesting like providers, female patients had higher accommodation scores than male patients (p<0.001), non-whites than whites (p<0.05), with Muslim patients (male or female) most likely to be accommodated (p<0.01).

Conclusion Accommodating patient requests for providers of specific demographics within the emergency department may be related to provider characteristics. When patients ask for same gender providers, female providers are more likely to accommodate such a request than male providers. Female, non-white and Muslim patients may be more likely to have their requests honoured for matched providers.

Surgeries continue during hazmat spill

From BND.com:

Emergency personnel and members of the St. Clair County Hazardous Materials Team were called Thursday afternoon to Memorial Hospital in Belleville after a small amount of a caustic chemical was spilled in an operating room.

Four employees who were exposed to the fumes were checked out for respiratory issues, Memorial Hospital spokeswoman Anne Thomure said.

Four surgeries, including one open heart surgery, were in progress in adjoining rooms during the spill and had to be allowed to continue, Belleville Fire Chief Scott Lanxon said. Firefighters sealed the contaminated operating room and emptied the other operating rooms as the surgeries were completed.

Lanxon said a man was splashed when a glass bottle of phenol shattered on the floor and three nurses were exposed to the fumes. They were all treated at the hospital’s emergency room.

Phenol is a caustic substance used by doctors to cauterize wounds.

HealthGrades Identifies Hospitals Among the Top 5% for Emergency Medicine

From GruntDoc:

HealthGrades is proud to announce that the first annual analysis of hospital emergency medicine programs found that the best-performing hospitals consistently outperformed all other hospitals for all eleven cohorts studied.