Trapped in Sinkhole, Florida Woman Dials 911 and Tosses Phone For Help

From JEMS:

Using her cell phone, Carla Chapman desperately tried to call for help, but she kept losing her signal.  So in what she thought was her last chance, she punched in 911 and then threw the phone out of the sinkhole where she was trapped.

Truck Crash Heimlech

From Neatorama:

Richard M. Paylor, 55, Fairless Hills, Bucks County, told city police he was driving the rig west about 9 when he started to choke on a piece of apple and blacked out, investigators said. The next thing he knew, his truck had smashed through the concrete barrier near Lancaster Avenue, he told police.

“This accident saved his life,” police Lt. Madison Winchester said. “Witnesses said that he was slumped over the wheel before the truck crashed. It appears that the apple chunk was dislodged when he hit the concrete barrier and his body hit the steering wheel.”

Hospital CEO Pay Under Fire

From Fierce Healthcare:

In Washington state, however, an investigative reporter for KOUW radio unearthed a tax law that requires the state to verify that their top hospital salaries are comparable to private-sector pay, or possibly lose their tax-exempt status. The reporter, John Ryan, indicates that many state hospital CEO salaries don’t meet the requirement, with at least 15 making $1 million or more per year. The reporter also created a “how-to” guide for journalists, encouraging them to dig into their own state records and create similar reports.

Night Vision for Entire Air Evac LifeTeam Fleet

From JEMS:

Air Evac Lifeteam is now the largest air medical company to complete the implementation of Night Vision Technology at all of its air ambulance  bases. Air Evac Lifeteam, the largest independently-owned and operated air medical service in the United States, operates 92 bases in 14 states.

Framework for Analyzing Wait Times and Other Factors that Impact Patient Satisfaction in the Emergency Department

From the Journal of Emergency Medicine:

Wait times and patient satisfaction are important administrative metrics in emergency departments (EDs), as they are critical to return patronage, liability, and remuneration. Although several factors have been shown to impact patient satisfaction, little attention has been paid to understanding the psychology of waiting and patient satisfaction.

Objective: We utilize concepts that have been applied in other service industries to conceptualize factors that impact patient satisfaction. We focus on wait times, a key factor in patient satisfaction, and describe how these concepts can be applied in research and daily practice.

Discussion: Patient satisfaction can be conceptualized as the difference between a patient’s perceptions and their expectations. Perception is the psychological process by which an individual understands and interprets sensory information. Changes in the wait experience can decrease the perceived wait times without a change in actual wait times. Other changes such as improved staff interpersonal and communication skills that provide patients with an increased sense of the staff’s dedication as well as a greater understanding of their care, can also affect patient perceptions of their care quality. These changes in patient perception can synergize with more expensive investments such as state-of-the-art facilities and increased ED beds to magnify their impact on patient satisfaction. Expectation is the level of service a patient believes they will receive during their ED visit. Patients arrive with expectations around the component of their care such as wait times, needed diagnostic tests, and overall time in the ED. These expectations are affected by individual-specific, pre-encounter, and intra-encounter factors. When these factors are identified and understood, they can be managed during the care process to improve patient satisfaction.

Conclusions: Interventions to decrease perception of wait times and increase the perception of service being provided, when combined with management of patient expectations, can improve patient satisfaction.

“Army Begins War on Pain”

From MedPage Today:

“We began to understand that the choices we were making from an anesthesia standpoint may have far-reaching impacts on the morbidity and mortality of the patient,” Buckenmaier said here at the American Academy of Pain Medicine meeting.

But there is a big barrier to changing the way pain is managed in the military: the way soldiers and commanders think about pain.

“We have to redesign the system to support case recognition,” said Rollin Gallagher, MD, deputy national program director of pain management at the Veterans Health Administration. “So it’s not ‘Pain is weakness leaving the body,’ but ‘I’m going to tell you about my pain; let’s manage it so I can get back to work or back to the field successfully.'”

So the military medical establishment has launched a campaign to change the way pain is treated both on and off the battlefield.

Man Ends Up In Emergency Room After Gluing Tiny Hat To His Head

From the Huffington Post:

From the lovely ladies at the Hairpin comes this hysterical video of a guy who superglued a tiny, sequined top hat to his head on Halloween and ended up in the emergency room after being unable to remove it.

Federal Trade Commission supports full prescriptive authority for nurse practitioners in Florida

From Fierce Healthcare:

The Federal Trade Commission has voiced its support of a bill to reduce Florida’s current supervision requirements on nurse practitioners, calling it “a pro-competitive improvement in the law.”

In a letter addressed to state Rep. Daphne Campbell (D-Miami), the FTC urged that nurse practitioners be authorized to practice at their “full scope,” according to Sunshine State News. The agency noted that lifting the restrictions would benefit Florida consumers by lowering the cost and increasing the availability of healthcare services.

When a half-truth is the best medicine

From the Boston Globe:

…every once in a while I am faced with a patient I feel soul-wrenchingly horrible about, one I take a look at and know there is no way this family’s day is going to do anything but go from bad to worse. And when this happens, I find it hard to know exactly what to say.

For instance, the 4-year-old who had been happy and energetic a week ago but is now dehydrated and listless and has a hard mass in his abdomen that I am almost certain is cancer.

Subcutaneous Rehydration: Updating a Traditional Technique

From Pediatric Emergency Care:

Subcutaneous (SC) rehydration therapy (SCRT), originally referred to as “hypodermoclysis,” shows promise as an alternative to intravenous (IV) fluid administration for treatment of dehydration. A simple, safe, and effective technique, SCRT is indicated for treatment of mild-to-moderate dehydration. Augmentation of SCRT with administration of a recombinant human formulation of the hyaluronidase enzyme at the infusion site gives rise to SC fluid administration rates up to 5-fold faster than those achieved without the enzyme, making the technique more clinically practical. Unlike older, animal-derived forms of hyaluronidase, recombinant human hyaluronidase has a lower chance of allergic reactions with repeated dosing. Clinical trials have demonstrated that recombinant human hyaluronidase effectively and safely facilitates fluid delivery in adults and children and is well accepted by parents and clinicians. In the emergency department setting, SCRT may be an appropriate alternative to IV fluid administration in certain situations because it is less invasive and generally less painful, while still permitting administration of appropriate volumes of rehydration fluids. Subcutaneous rehydration therapy appears to be particularly useful in patients who present with mild-to-moderate dehydration and have had failed attempts at oral rehydration. The SC route also provides benefits in patients with small, collapsed, or difficult-to-visualize veins or in those who may be agitated or distressed by IV catheterization. Continued research will further clarify the role of recombinant human hyaluronidase-facilitated SCRT in the rehydration treatment algorithm.