1 dead as 100-mph driver hits ambulance

From KRQE:

A wrong-way driver speeding at over 100 mph crashed head-on crash into an ambulance on Interstate 25 early Tuesday killing one person and injuring two others, according to Santa Fe police.

Santa Fe Police Chief Aric Wheeler said the wrong-way car was exceeding 100 mph at the time of the crash. Santa Fe County sheriff’s deputies had been looking for the car before the accident after getting reports it was going south in the northbound lanes of I-25.

Meth suspect falls through ER ceiling

From Fox41:

Louisville Metro Police say the doctors and patients in the Southwest Hospital emergency room got a rude awakening to the dangers of drugs Tuesday night when a meth suspect allegedly came crashing through the ceiling.

Meanwhile, Fultz — who had been in a hospital room while the investigation was taking place — allegedly climbed into the ceiling and crawled over into the next room.

A short time later, police say, Fultz came crashing through the ceiling into the hallway of the ER, “causing major damage.”

Top 20 Free iPhone Medical Apps For Health Care Professionals

From iMedicalApps (via Medgadget):

Earlier in the year we released a “Top 10 Free iPhone Medical Apps” list.  Since then we’ve gotten multiple requests from readers asking us to update the original list.  But when we researched for free medical apps, we were impressed to find many new free ones worth downloading — causing us to make a new Top 20 list.  Just like the last best medical apps list, this list isn’t based on the most downloaded free medical apps in the App Store or on iTunes star ratings.  If you look in the Apple App Store at the current top 10 downloaded free medical apps, the category is still littered with apps called “Dream Meanings”, “Relax Ocean Waves”, and “Beauty List” — worthless to medical professionals.  This list contains no such apps.

Can venous blood gas analysis replace arterial in emergency medical care?

From Emergency Medicine Australasia:

The objectives of the present review are to describe the agreement between variables on arterial and venous blood gas analysis (in particular pH, pCO2, bicarbonate and base excess) and to identify unanswered questions. MEDLINE search of papers published from 1966 to January 2010 for studies comparing arterial and peripheral venous blood gas values for any of pH, pCO2, bicarbonate and base excess in adult patients with any condition in an emergency department setting. The outcome of interest was mean difference weighted for study sample size with 95% limits of agreement. The weighted mean arterio-venous difference in pH was 0.035 pH units (n= 1252), with narrow limits of agreement. The weighted mean arterio-venous difference for pCO2 was 5.7 mmHg (n= 760), but with 95% limits of agreement up to the order of ±20 mmHg. For bicarbonate, the weighted mean difference between arterial and venous values was -1.41 mmol/L (n= 905), with 95% limits of agreement of the order of ±5 mmol/L. Regarding base excess, the mean arterio-venous difference is 0.089 mmol/L (n= 103). There is insufficient data to determine if these relationships persist in shocked patients or those with mixed acid-base disorders. For patients who are not in shock, venous pH, bicarbonate and base excess have sufficient agreement to be clinically interchangeable for arterial values. Agreement between arterial and venous pCO2 is too poor and unpredictable to be clinically useful as a one-off test but venous pCO2 might be useful to screen for arterial hypercarbia or to monitor trends in pCO2 for selected patients.

Does Critical Incident Stress Debriefing Work?

From Emergency Medicine Australasia:

The impact of work related stressors on emergency clinicians has long been recognized, yet there is little formal research into the benefits of debriefing hospital staff after critical incidents, such as failed resuscitation. This article examines current models of debriefing and their application to emergency staff through a review of the literature. The goal being, to outline best practice, with recommendations for guideline development and future research directives. An electronic database search was a conducted in Ovid and Psychinfo. All available abstracts were read and a hand search was completed of the references. Included articles were selected by a panel of two experts. Models and evidence relating to their efficacy were identified from the literature, and detailed evaluation included. The reviewed literature revealed a distinct paucity regarding the efficacy of debriefing of clinicians post CI and in particular randomized controlled trials. Despite this debriefing is perceived as important by emergency clinicians. However evidence presents both benefits and disadvantages to debriefing interventions. In the absence of evidence based practice guidelines, any development of models of debriefing in the emergency healthcare setting should be closely evaluated. And future research directives should aim towards large randomized control trials.

Another kind of diversion

From Brandenton:

Rural Health to get $1.5M state grant

Manatee County Rural Health will receive a $1.5 million grant earmarked for primary care services, according to a news release from the Florida Senate.

The funding comes from an initiative by Sens. Mike Haridopolos, R-Merritt Island, Don Gaetz R-Niceville and Health Appropriations Chairman Joe Negron, R-Stuart, to provide a lower cost alternative than the emergency room for non-insured and Medicaid patients with health problems.

Manatee County Rural Health already has a emergency room diversion program in place.

Rural Health launched an emergency room diversion program several years ago, designed to ease ER overcrowding by diverting non-emergency cases to the agency. The agency added staff and expanded operating hours at some locations to accomodate those patients and provide follow-up care.

Medevac Crash Survivor Sues Federal Govt. For $50M

From WJTV:

The sole survivor of a 2008 Maryland medevac crash is suing the federal government for $50 million.

The suit filed on behalf of Jordan Wells last week in U.S. District Court in Greenbelt alleges Federal Aviation Administration air traffic controllers provided outdated weather information.

It also says they didn’t dispatch an adequate search and rescue response after the crash.