Coverage Denials Draw Ire of Emergency Docs

From MedPage Today:

Medicaid officials in some states are denying coverage for emergency department visits based on final diagnosis codes rather than the symptoms that brought the patient in, according to the American College of Emergency Physicians (ACEP).

ACEP said cash-strapped Medicaid officials are increasingly implementing plans to deny payment for emergency department services if the patient is ultimately determined to have a non-urgent condition.

Hospitals and state unlikely to reach charity tax-exempt deal

From FierceHealthcare:

Illinois hospitals and state officials don’t seem close to reaching a deal to determine how much free healthcare hospitals must provide to qualify for tax breaks. If talks fall through, the Illinois Hospital Association (IHA) plans to take its own proposal for charity tax exemptions straight to the state legislature.

N.C. Man Drinks Gasoline from Jar, Lights Up, Dies

From JEMS:

City Spokeswoman Diane Miller said investigators believe Banning was at a friend’s apartment when he apparently mistook a jar of gasoline sitting by the kitchen sink for a beverage. After taking a gulp, he spit the gas out and got some on his clothes.

Sometime later, investigators say Banning went outside to smoke a cigarette and burst into flame.

Prehospital Trauma Life Support (PHTLS) Training of Ambulance Caregivers and Impact on Survival of Trauma Victims

From Resuscitation:

Background: The Prehospital Trauma Life Support (PHTLS) course has been widely implemented and approximately half a million prehospital caregivers in over 50 countries have taken this course. Still, the effect on injury outcome remains to be established. The objective of this study was to investigate the association between PHTLS training of ambulance crew members and the mortality in trauma patients.

Methods: A population-based observational study of 2830 injured patients, who either died or were hospitalized for more than 24hours, was performed during gradual implementation of PHTLS in Uppsala County in Sweden between 1998 and 2004. Prehospital patient records were linked to hospital-discharge records, cause-of-death records, and information on PHTLS training and the educational level of ambulance crews. The main outcome measure was death, on scene or in hospital.

Results: Adjusting for multiple potential confounders, PHTLS training appeared to be associated with a reduction in mortality, but the precision of this estimate was poor (odds ratio, 0.71; 95% confidence interval, 0.42-1.19). The mortality risk was 4.7% (36/763) without PHTLS training and 4.5% (94/2067) with PHTLS training. The predicted absolute risk reduction is estimated to correspond to 0.5 lives saved annually per 100 000 population with PHTLS fully implemented.

Conclusions: PHTLS training of ambulance crew members may be associated with reduced mortality in trauma patients, but the precision in this estimate was low due to the overall low mortality. While there may be a relative risk reduction, the predicted absolute risk reduction in this population was low.

Measure to Flag Unneeded CT Scans Flops

From MedPage Today:

A measure to test whether brain computed tomography (CT) scans are necessary for emergency department patients who present with non-trauma-related head pain is not reliable and should be eliminated, a new study concluded.

The measure, which was developed by the Centers for Medicare and Medicaid Services (CMS), had an overall accuracy of about 17%, concluded researchers led by JeremiahSchuur, MD, of Brigham and Women’s Hospital.

Healthcare CEO turnover higher than other industries

From Fierce Healthcare:

2012 is shaping up to be the “musical chairs” year, full of multiple CEO turnovers, particularly in healthcare, according to The Fiscal Times.

The number of CEOs across industries who left their posts in January jumped 48 percent month-over-month, rising to 123, the highest level since May 2010, according to this month’s data from outplacement service firm Challenger, Gray & Christmas.  Fifty-one percent resigned or stepped down, 26 percent retired and 9 percent left to take other jobs, according to the article.

Suspected Drunken Driver Hits N.M. Ambulance as Crews Handle Dead Body

From JEMS:

A suspected drunken driver crashed into the truck of a rescue crew that was handling a body found on the shoulder of a roadway.

The Albuquerque Journal reports ( ) 27-year-old Thomas Montano has been charged with aggravated drunken driving, failure to yield to emergency equipment, reckless driving and failure to maintain his lane.

Authorities say the incident occurred early Friday when Montano crashed his car into the rescue truck, slammed into a guardrail, spun around and hit an ambulance.

Study: ED CT protocol linked with excess rad exposure

From Health Imaging:

The introduction of a whole-body panscan CT protocol for blunt trauma in the emergency department (ED) raised the proportion of patients exposed to more than 20 mSv of radiation by 8 percent, according to a study published in the February issue of Emergency Medicine Australasia.

Saving seconds: Ames police install defibrillators in cars

From the Ames Tribune:

The Ames Police Department is in the process of installing automatic external defibrillators (AEDs) in its fleet of squad cars to improve emergency medical response.

Painless MI in Younger Women More Deadly

From ACEP News:

Among patients with myocardial infarction, women are more likely than men to present without chest pain or discomfort, and are more likely to die from the event, according to a report in the Feb. 22/29 issue of JAMA.

However, these sex-based differences are most pronounced at younger ages; they become attenuated and nearly disappear with increasing age, said Dr. John G. Canto of the Watson Clinic and Lakeland (Fla.) Regional Medical Center and his associates.