CDC: Two-Thirds of Emergency Visits Occur During Non-Business Hours; Percentage of Non-Urgent Emergency Patients Drops To Less than 8 Percent

From ACEP:

A new report from the Centers for Disease Control and Prevention once again debunks the myth that emergency departments are crowded with non-urgent patients, a finding noted by the American College of Emergency Physicians (ACEP).

“The percentage of non-urgent patients dropped to only 7.9 percent in 2007 [from 12.1 percent in 2006],” said Dr. Angela Gardner, president of ACEP. “The report also makes the excellent point that non-urgent does not imply unnecessary. As we have said repeatedly, our patients are in the ER because that’s where they need to be.”

There were approximately 222 visits to U.S. emergency departments every minute in 2007 (http://bit.ly/9B5kHJ) and the number of visits increased by 23 percent between 1997 and 2007, according to the report. Preliminary data for 2008 indicate that emergency visits will increase to a record high of more than 123 million (http://bit.ly/ak6oRx).

The report, “National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary” offers far more detail than the data brief released by the Centers for Disease Control and Prevention (CDC) in May. The U.S. Department of Health and Human Services, of which the CDC is a part, has indicated that this is the last fully detailed report of its kind to be issued about emergency department visits.

The effect of alcohol, THC and their combination on perceived effects, willingness to drive and performance of driving and non-driving tasks

From Accident Analysis and Prevention:

Background:  Driving under the influence of drugs (DUID) is one of the main causes of car accidents. Alcohol and marijuana are the most popular drugs among recreational users. Many classify these drugs as “Light” drugs and therefore allow themselves to drive after consuming them.

Objective:  The study had two main objectives: 1) to investigate the effect of alcohol (BAC = 0.05%), THC (13 mg) and their combination on driving and non-driving tasks. 2) to investigate the extent to which people are willing to drive based on their subjective sensations and their perceived effects of the drugs.

Method:  7 healthy men and 5 healthy women, ages 24-29, all recreational users of alcohol and marijuana, completed 5 experimental sessions. Sessions included: drinking and smoking placebo, drinking alcohol and smoking placebo, drinking placebo and smoking THC, drinking alcohol and smoking THC, drinking placebo and smoking placebo 24 hours after drinking alcohol and smoking THC. Three types of measures were used: subjective perceptions (with questionnaires), performance parameters of the driving and non-driving tasks (arithmetic task and a secondary target detection task) and physiological changes (heart rate).

Results:  Overall, the combination of alcohol and THC had the most intense effect after intake. This effect was reflected in performance impairments observed in the driving and non-driving tasks, in the subjective sensations after intake, and in the physiological measures. Despite significant differences in the size of the effects after the various treatments, there were no differences in the distances subjects were willing to drive while under the influence on each of the treatments.

Illinois governor announces $3 million to reopen hospital

From BND.com:

CARMI, Ill. — Gov. Pat Quinn announced $3 million in capital funding Saturday to resurrect a southeastern Illinois hospital that closed in 2005, and left local residents without a nearby hospital.

Residents in Carmi and surrounding communities have had to travel 32 miles to the nearest hospital in McLeansboro since the facility closed in December 2005, officials said. A study conducted after the closure found that the average time between a 911 call and transport to the hospital ranged from 32 minutes to 116 minutes.

“People living in rural parts of our state do not have the luxury of taking a short drive down the street to see a doctor or visit the hospital,” Quinn said in a statement. “People in every corner of Illinois should have access to quality health care. This capital funding will enable the residents of White County to have access to critical medical care, while creating good-paying jobs.”

California Approves Anthem Blue Cross Rate Hike

From NPR.org:

Hey, health insurers, you can’t always get what you want. But if you try sometimes (and fix the math in your application) you might just find you get approval for a slightly smaller rate hike after all.

In California, Anthem Blue Cross just got the go-ahead from the state for a rate hike averaging 14 percent on individual health policies starting Oct. 1. Some policies may cost as much as 20 percent more, but that’s still a smaller bite than Anthem had first sought.

Earlier this year, the for-profit insurer asked California’s Department of Insurance for the OK to charge 39 percent more for individual policies. The requested rate change quickly became a key talking point in the administration’s push for passage of health overhaul.

Three dead in medical helicopter crash

From CNN:

A medical helicopter crashed early Tuesday near Clinton, Arkansas, killing all three crew members, according to police and the company.

The Air Evac Lifeteam helicopter, based in Vilonia, Arkansas, crashed about 4 a.m, Air Evac Lifeteam said in a statement.

The helicopter was en route to a site in Crabtree, Arkansas, the statement said. No patients were on board, and the chopper was able to utilize a night vision system for travel in darkness.

OxyContin-Free Emergency Room

From KUOW:

Doctors who work in Swedish Hospitals’ Cherry Hill and First Hill emergency departments will no longer write prescriptions for Schedule II narcotics. Those are powerful but highly addictive medications used for pain. The move at the Seattle emergency rooms is an effort to combat the dramatic rise in abuse and overdose deaths associated with drugs like OxyContin, Dilaudid and morphine.

Carlisle: “In many ways this is actually directed at trying to prevent people who don’t understand addiction from becoming addicted. Of course if you’re abusing the system this is a message that we’re not going to participate in inappropriate prescribing of medications.”

Public Hospitals, ‘Poorly Equipped to Survive,’ Are Being Sold

From the Wall Street Journal Health Blog:

For public hospitals, the conditions couldn’t be much worse: Local governments have less tax revenue coming in because of hard economic times, and more patients lack health-insurance coverage. Meantime costs keep rising, and many hospitals have debt to service. And looking forward to the next several years, all hospitals will be prodded by health-care overhaul legislation to make investments in electronic medical records and other health IT systems, and to better coordinate increasingly complex care. That’s tough to do without economies of scale.

As a result, many governments are selling or forging partnerships with for-profit entities to offload their public hospitals, reports the WSJ. The story quotes James Burgdorfer, a partner with investment banker Juniper Advisory, as saying most public systems wouldn’t be around in two decades because health-care is too complex for local politicians. “By the nature of their small size, their independence and their political entanglements, they are poorly equipped to survive,” he tells the WSJ.

Residents of areas where public hospitals have been or might be sold to for-profit companies worry about both logistical and financial access to care, particularly for the poorest of people.

Therapeutic Hypothermia: Quick response, new technique help heart attack victim

From the Las Vegas Journal Review:

You’re not taking much poetic license when you say that 68-year-old Robert Mallory died, but lived to tell the tale.

And for that he has to thank his wife and his daughter and paramedics and doctors and nurses and respiratory therapists. …

And therapeutic hypothermia, a deliberate lowering of his body temperature that can reduce brain damage and increase survivability after cardiac arrest.

Landing Sites and Intubation May Influence Helicopter Emergency Medical Services On-scene Time

From the Journal of Emergency Medicine:

Reduced transport time of patients from the scene of an accident to definitive surgical treatment is one important reason to employ ambulance helicopters on trauma missions. However, if the helicopter is unable to land close to the scene, the transport time may be increased compared to transport with ground ambulance, due to time-consuming transfer of the patient between vehicles.

Objective:  The objective of this study was to evaluate how the landing site, as determined by distance from the scene, and rapid sequence intubation (RSI) affected on-scene time (OST).

Methods:  This was a prospective observational study performed during a 12-month period in a mixed urban and rural anesthesiologist-staffed Helicopter Emergency Medical Service in Norway. Data regarding the landing sites, the accident, and patient treatment were recorded.

Results:  A total of 252 primary trauma missions were included in the study. In 75% of the missions, the aircraft landed<50 meters from the scene, and in 7% the distance exceeded 200 meters. Mean OST when the patient was not intubated was 14.5min (median 14min). When an RSI was performed, the mean OST was significantly higher (22.7min, median 20min; p<0.001).

Conclusion:  Usually, a helicopter can land close to the accident scene and the location of the landing site does not contribute to a delay in arrival of the patient at the hospital. The OST is significantly higher, however, in those patients who receive endotracheal intubation before take-off. This reflects the time needed for intubation, as well as the increased complexity and workload when the patient is severely injured.

Illegal Lasers Distract Pa. Medical Helicopter Pilots

From EMSResponder:

Authorities are trying to determine who shined lasers into the cockpits of two separate STAT MedEvac helicopters Saturday night, according to a Federal Aviation Administration spokesman.

No injuries were reported in either incident.

Spokesman Jim Peters said the first incident occurred at 9:10 p.m., as someone directed a green laser light into the cockpit of the the medical helicopter, which was about 11 1/2 miles southeast of Pittsburgh, at an altitude of 1,800 feet.

Allegheny County emergency dispatchers said the helicopter was landing at Children’s Hospital of Pittsburgh. It wasn’t clear if medical crews were transporting a patient.

In the second incident, Peters said, another MedEvac helicopter was about 7 1/2 miles north of Pittsburgh, at an altitude of 2,400 feet, when someone illuminated the cockpit with a laser.