World Cup Medics Avoid Basic Blood-Safety Guidelines

From Wired:

On-site medics at the 2010 World Cup in South Africa did not use inexpensive, disease-preventing gloves in any blood-related injury, raising questions about the potential spread of blood-borne diseases at one of the world’s most attended and diverse international sporting events, according to an analysis of match footage.

Through years of watching professional sports, infectious-disease expert Jennifer Furin noticed a disturbing trend: Trainers handling the bloody injuries of athletes often weren’t wearing protective gloves.

Since 1987, the Centers for Disease Control has called for health care workers to use latex or nitrile gloves when dealing with patients’ bodily fluids, a key part of the so-called Universal Precautions that helps prevent the spread of infectious disease from blood-borne pathogens like HIVhepatitis B orhepatitis C.

Sending CD’s of Radiology Images Decreases Re-Imaging

From 7th Space:

Each year, more than two million critically ill patients are transferred from one hospital emergency department (ED) to another for appropriate care. With the ability to successfully import data from a CD-ROM containing the patient’s diagnostic medical images, hospitals may be able to significantly reduce unnecessary medical imaging tests, some of which expose patients to radiation. These findings are reported in a new study published in the July issue of Radiology.

According to researchers at Brigham and Women’s Hospital in Boston, the implementing a system to upload CD images of emergency transfer patients into the receiving institution’s picture archiving and communication system (PACS) decreased the rate of subsequent imaging by 17 percent.

“”Tweener” Hospitals Get Cost-Based Reimbursement Trial

From H&HN:

Tucked away in the Affordable Care Act is a provision that may give some rural hospitals a little bit of—and much needed—financial breathing room. The law expands the Rural Community Hospital Demonstration Project, which tests what happens when so-called tweener hospitals are paid on cost-based reimbursement. Tweeners are too big to be a critical access hospital, and thus are ineligible for cost-plus reimbursement, but too small to thrive under traditional Medicare PPS. The demonstration actually started in 2004 and was slated to fade into the sunset, but it was given an extra life thanks to the ACA.

Low Income, Poor Insurance Tied to Leaving ED Without Being Seen

From ACEP:

Low-income and poorly insured patients are at a disproportionately increased risk of leaving emergency departments without being seen, according to an analysis of 262 California hospitals.

The proportion of patients who leave emergency departments (EDs) without being seen has increased significantly over the last 15 years, as strains on the emergency care system have mounted. And, although it’s logical to assume that vulnerable populations and the hospitals that serve them are at greatest risk, there are few multicenter studies to show it, said Dr. Renee Y. Hsia of the University of California, San Francisco, and her associates (Ann. Emerg. Med. 2011 Feb. 21 [doi:10.1016/j.annemergmed.2011.01.009]).

“Patients who leave without being seen from an ED are a glaring measure of impaired health care access. Their observed behavior represents individual attempts to enter the health care system without success. Our study provides descriptive data about [patients who] left without being seen from a large statewide cohort of hospital EDs. … The increasing phenomenon of left without being seen patients differentially affects those at hospitals that tend to serve the most vulnerable. Real action and resources should be applied to address the disparities on a systems level,” the investigators said.

Required EM Rural Rotations Influence Job Choice

From ACEP:

Increasing the number of residency programs that require rotations in rural areas would help address the shortage of emergency physicians who choose to work in rural U.S. emergency departments, according to a survey of 2,380 graduates of 111 residency training programs.

Based on the findings of their nationwide July-December 2009 survey, “exposure to rural emergency department (ED) rotations may positively enhance rural recruitment after graduation,” wrote Dr. Brad E. Talley of the department of emergency medicine at Denver Health Medical Center, and his coauthors.

The investigators surveyed the program directors of all 126 emergency medicine residency training programs recognized by the Accreditation Council for Graduate Medical Education, with the exception of military programs and those started after 2006. Of the 111 programs that provided complete responses, only 6 (5%) required residents to have a rotation in a rural area. Of the remainder, 16 (14%) offered residents rural rotations at predesignated sites as an elective, 76 (69%) offered rural rotations as an elective but students were required to find their own site, and 13 (12%) offered no opportunity for a rural rotation.

Programs that required rural rotations had a significantly greater percentage of residents who later chose to start their careers in rural areas (22%) than did programs with electives at predesignated sites (7%), programs with electives at student-selected sites (6%), and programs with no rural rotations (7%), Dr. Talley and his coinvestigators reported.

Playing Operation with the da Vinci Surgical Robot

From Neatorama:

Ever played the game Operation? Sure you have – but have you ever played it with a surgical robot?

Johns Hopkins graduate student Carol Reiley has access to the da Vinci surgical robot, and put it to good use

Pilot of statewide EHR

From TheDay:

Suppose a patient who goes to the Community Health Center for routine primary care ends up one night at the Lawrence & Memorial Hospital emergency room with chest pains.

The hospital doctor orders an EKG and other tests, and taps into his computer to check the center’s records for the patient’s medication list and his regular doctor’s most recent report. After determining there’s no crisis, the L&M doctor prescribes a new medication, sends the patient home with instructions to see his primary care doctor, and even secures an appointment for him for the next day by logging into the center’s online scheduling system. The next morning at the center, the man’s doctor taps into his computer to access the report from the emergency room visit to begin follow-up care.

The pilot project also involves Hartford Hospital, St. Francis Hospital and Medical Center in Hartford and Staywell Health Center in Waterbury. It is being run by eHealthConnecticut Inc., a nonprofit set up by the state in 2006 to advance the establishment of a fully electronic medical records system statewide. The pilot is a means of demonstrating the workability of what could become a statewide system, and having such a system prepares the state for a future phase of implementation of the federal Affordable Care Act passed last year, according to a news release from eHealthConnecticut.

14 symptoms that warrant a visit to the ER

From Suburban Journal:

Most doctors agree there is a list of conditions that always merit an ER visit:

• Chest pain or shortness of breath

• Weakness or numbness in face, arm or leg

• Sudden blurred vision, loss of coordination or balance

• Difficulty speaking

• Loss of consciousness, seizures

• Uncontrolled bleeding after 10 minutes of direct pressure

• Sudden, severe pain

• Coughing up or vomiting blood

• Head injury

• Fractures with bone showing

• Poisoning or suspected overdose

• Severe burns

• Severe reaction to insect bite, medication or food

• Suicidal feelings

Ky., Ohio cooperating in fight over prescription drug abuse

From Cincinnati.com

Accidental drug-overdose deaths are cutting a swath across southern Ohio and eastern Kentucky, as well as Northern Kentucky, destroying families in rural and suburban areas at higher rates in both states than in the urban centers like Cincinnati, Louisville and Lexington.

To counter abuse of highly addictive prescription narcotics such as hydrocodone (Vicodin), oxycodone (OxyContin and Percoset), alprazolam (Xanax) and diazepam (Valium) the governors of Kentucky and Ohio met this week in Cincinnati to develop a battle strategy.

Rural Emergency Services Seek $300,000 from Oregon Legislature

From the Lund Report:

A bill before the legislature would plug what rural emergency services personnel are calling a major gap in the training available to them.
House Bill 3580 would appropriate $300,000 from the state’s general fund for a second mobile training unit (MTU) for rural and frontier emergency services districts. “Frontier” districts are those where the population density is less than six people per square mile.