Docs admit hospital VIPs get faster care in the ER

From MSNBC:

In a country where the average emergency room wait now tops four hours, it’s a rare American patient who doesn’t wonder whether a hefty hospital donation or a family connection may be the secret to getting speedier care.

Now, it turns out, the answer appears to be yes, at least according to a pair of small but telling surveys that conclude that being a VIP in the ER does come with certain perks.

In a letter published in this week’s Annals of Emergency Medicine, Dr. A.J. Smally of Hartford Hospital and the University of Connecticut reports that more than half of the 33 emergency department medical directors in his state said they routinely provide so-called “expedited” care to influential people.

Heart attack patients are now being treated 32 minutes faster than they were five years ago

From CardioSource:

Study Reflects Achievements of ACC’s Door-to-Balloon Campaign

A new study that shows heart attack patients are now being treated on average 32 minutes faster than they were five years ago provides evidence of the success of a national campaign to treat heart attacks within 90 minutes in order to reduce heart damage and costs associated with treatment, said David Holmes, MD, FACC, president of the American College of Cardiology (ACC).

The study, “Improvements in Door-to-Balloon Time in the United States: 2005-2010,” found that the average time from hospital arrival to treatment declined from 96 minutes in 2005 to just 64 minutes in 2010. In addition, more than 90 percent of heart attack patients who required emergency angioplasty in 2010 received treatment within the recommended 90 minutes, up from 44 percent in 2005.

When to call 911

From When To Call 911:

Panicked ER Doctor Calls 911

It’s from the Onion, so it must be true!

CHARLOTTE, NC—In the midst of performing an emergency appendectomy Thursday, panicked ER doctor Caleb Morrison dropped his surgical instruments mid-operation and dialed 911. “You’ve got to get over here! There’s a guy lying on a table with a hole in his stomach,” a frantic Morrison can be heard saying in a recording of the emer≠gency phone call, shortly before giving his location as operating room 3 at St. Andrew’s Hospital. “Please hurry! He’s losing a lot of type O positive blood and his vital signs are increasingly unstable.” When the 911 operator’s attempts to guide the doctor through the necessary triage procedures proved unsuccessful, the deceased patient was taken to the morgue, where the forensic pathologist on duty fainted at the sight of a dead body.

Ambulance-Based Telemedicine

From Emergency Management Blogs:

What do you get when you invest $14 million and 6 years of field tests in an emergency medical services telemedicine system? You get DREAMSTM– Disaster Relief and Emergency Medical Services – described as the most advanced EMS telemedicine system in the world.  The $14 million came from the U. S. Army Medical Research and Materiel Command and the Telemedicine and Technology Research Center (TATRC) through a Congressionally Funded military research project.

Palliative care comes to the ED

From Philly:

When Joseph Morelli’s medical history popped up on her computer screen early one Sunday this month, Meg Greene, a nurse case manager in Bryn Mawr Hospital’s emergency department, immediately recognized that he might benefit from her specialty: palliative care.

Greene is part of a small but growing group of medical providers who say many patients in emergency departments are not appropriate for the all-out rescue medicine these units are designed to deliver. Instead, they are suffering from the pain and inexorable decline of cancer and chronic illness or old age, and may be better served by care aimed at comfort, not cure.

EMTALA Investigation

From Twin Cities:

The Minnesota Department of Health on Tuesday said it had substantiated a complaint of patient “dumping” by Unity Hospital in Fridley.

The hospital could be out of compliance with a federal law that governs treatment of emergency-room patients, the Health Department said, after a patient who sought treatment at Unity’s ER in April was not given a screening examination.

According to the Health Department’s report, released Tuesday, a cabdriver went to the emergency-room triage desk the morning of April 10 and said he had an intoxicated patient in his cab. Two hospital workers at Unity went to the cab, determined the patient should go to a detox unit and called for police transport, the report said.

The report paraphrased a police officer as saying: “The triage nurse indicated to the police officer that the patient was passing out in the waiting room, that they could not have that and that the (emergency room) was too full and they could not take him.”

Hospital settles lawsuits over availability of deaf services in the ED

From the Des Moines Register:

The hospital agreed last week to settle a lawsuit brought by Fullbright and a similar one brought by the family of a second deaf patient. Mercy leaders promised that from now on, sign-language interpreters will be provided when needed. When feasible, the hospital may use other methods of communication, including video links to interpreters elsewhere, the settlement says. In a statement Monday, hospital leaders defended their record but indicated they decided to settle as a way to work together to improve services.

Noise of ERs put care at risk

From the National Post:

The controlled chaos and din of the hospital emergency department makes for compelling television drama, but in real life the constant noise can stress out ER staff and threaten the care they give, a new Canadian study suggests.

The research at Toronto’s Sick Kids Hospital found ER sound levels equivalent to having a vacuum cleaner running through the day.

“The background noise and the amount of stress level has the potential for miscommunication, and therefore the potential to do patient harm,” said Dr. Bill Mounstephen, lead author of the paper published in the journal Pediatric Emergency Care. “If we can’t hear each other and we’re stressed out because of that noise, then we’re not giving our patients our best service.”

Almost 80% of the staff doctors interviewed said they had to shout at least once during their shift to be heard, and some as much as 10 times a day. All the noise made them irritated and tired, they said.

How Emergency Medicine Could Serve As An Inspiration To The Health Care Industry

From Fast Company:

It’s no secret that the health care industry is technologically backwards. With very few exceptions, patients are forced to navigate a system that lacks any kind of central coordination, and where records and test results are left to the mercy of fax machines. But there is one area in the health care industry where care is patient-centric, quick, and well-coordinated: the emergency room.