Kansas Woman Drives Car Up Stairs, Hits Building, Rolls Over

From JEMS:

TOPEKA, Kan. — A woman escaped serious injury Wednesday evening during a wild ride in which she accidentally applied the accelerator instead of her brakes and went up a small flight of stairs before ultimately coming to rest upside down.

First responders were sent about 6:50 p.m. to the 1100 block of S.E. Washington on a report of a single-vehicle rollover.

Topeka police first to the location found a black four-door passenger car on its top in the grass next to a parking lot for Antioch Missionary Baptist Church, 1100 S.E. Washington.

A Topeka police officer said the woman was attempting to park in a stall on the east side of the church when she accidentally hit the gas pedal. The vehicle went over a concrete parking block, up a flight of concrete stairs and crashed into the building before rolling off the side of the steps and onto its top.

Mechanical CPR devices compared to manual CPR during out-of-hospital cardiac arrest and ambulance transport: a systematic review

From the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine:

The authors found insufficient evidence to support or refute the use of mechanical Cardio–Pulmonary Resuscitation (CPR) devices in settings of out–of–hospital cardiac arrest and during ambulance transport. While there is some low quality evidence suggesting that mechanical CPR can improve consistency and reduce interruptions in chest compressions, there is no evidence that mechanical CPR devices improve survival, to the contrary they may worsen neurological outcome.

Methods

  • Databases including PubMed, Cochrane Library (including Cochrane database for systematic reviews and Cochrane Central Register of Controlled Trials), Embase, and AHA EndNote Master Library were systematically searched.
  • Further references were gathered from cross–references from articles and reviews as well as forward search using SCOPUS and Google scholar.
  • The inclusion criteria for this review included manikin and human studies of adult cardiac arrest and anti–arrhythmic agents, peer–review.
  • Excluded were review articles, case series and case reports.

Results

  • Out of 88 articles identified, only 10 studies met the inclusion criteria for further review.
  • Of these 10 articles, 1 was Level of Evidence (LOE) 1, 4 LOE 2, 3 LOE 3, 0 LOE 4, 2 LOE 5.
  • 4 studies evaluated the quality of CPR in terms of compression adequacy while the remaining six studies evaluated on clinical outcomes in terms of return of spontaneous circulation (ROSC), survival to hospital admission, survival to discharge and Cerebral Performance Categories (CPC).
  • 7 studies were supporting the clinical question, 1 neutral and 2 opposing.

Four Iowa Health Systems Form Alliance

From Wall Street Journal Martketwatch:

Four of Iowa’s premier health care organizations announced today they are creating a health care alliance in Iowa and contiguous areas. The announcement was made in a statewide press conference, held today in several cities simultaneously.

The new alliance, to be called University of Iowa Health Alliance (UIHA), will include over 50 hospitals and more than 160 clinics. The members of the alliance will work together to advance the high quality of health care services, to improve the health status of patients and communities, and to achieve efficiencies that will help member organizations reduce the rising cost of care for their patients.

UIHA will create a platform for sharing expertise, selected support services and information technologies needed to succeed in the emerging “accountable care” systems and payment programs. Working together in UIHA, members will strive to increase the value of services provided, improve clinical integration between the members, provide more streamlined and coordinated care to patients, and ultimately improve the health of people in Iowa and other regions served.

Members of the new alliance are Mercy Health Network, Genesis Health System, Mercy-Cedar Rapids, and University of Iowa Healthcare.

Boston Hospital Designs Microparticles to Help During Cardiac Arrest

From JEMS Medical Service:

Patients unable to breathe because of acute lung failure or an obstructed airway need another way to get oxygen to their blood-and fast-to avoid cardiac arrest and brain injury. A team led by researchers at Boston Children’s Hospital has designed tiny, gas-filled microparticles that can be injected directly into the bloodstream to quickly oxygenate the blood.

The microparticles consist of a single layer of lipids (fatty molecules) that surround a tiny pocket of oxygen gas, and are delivered in a liquid solution. In a cover article in the June 27 issue of Science Translational Medicine, John Kheir, M.D., of the Department of Cardiology at Boston Children’s Hospital, and colleagues report that an infusion of these microparticles into animals with low blood oxygen levels restored blood oxygen saturation to near-normal levels, within seconds.

The microparticle solutions are portable and could stabilize patients in emergency situations, buying time for paramedics, emergency clinicians or intensive care clinicians to more safely place a breathing tube or perform other life-saving therapies, says Kheir.

“This is a short-term oxygen substitute-a way to safely inject oxygen gas to support patients during a critical few minutes,” he says. “Eventually, this could be stored in syringes on every code cart in a hospital, ambulance or transport helicopter to help stabilize patients who are having difficulty breathing.”

The microparticles would likely only be administered for a short time, between 15 and 30 minutes, because they are carried in fluid that would overload the blood if used for longer periods, Kheir says.

Psych and Tired of School ER Calls

From NYDailyNews.com:

City schools are overusing the 911 emergency system to ship off emotionally troubled kids instead of trying to help them, advocates charge.

New Education Department numbers released Wednesday reveal that schools called 911 a whopping 3,600 times during the last school year to deal with non-suicide-related mental health problems. That means that 17 students a day were sent to the emergency room with emotional problems.

The calls were more than a quarter of all 911 calls from schools.

“These schools don’t have the resources to deal with students who are either having a bad day or having issues going on,” said Nelson Mar of Legal Services NYC – Bronx, which is suing the city for more data on the problem.

Third-grader Victoria Okezie, 9, who has ADHD, has been sent so many times to Lincoln Hospital that doctors there wrote a note saying the girl did not belong in the psych ER, her mother said.

But that didn’t stop Public School 161 in the Bronx from calling 911 again — and sending her to a new hospital, Bronx Lebanon.

Supreme Court upholds Obama health care law

In case you missed it elsewhere.  Via USA Today:

The Supreme Court upheld President Obama’s health care law today in a splintered, complex opinion that gives Obama a major election-year victory.

Basically, the justices said that the individual mandate — the requirement that most Americans buy health insurance or pay a fine — is constitutional as a tax.

The government had argued that Congress had the authority to pass the individual mandate as part of its power to regulate interstate commerce; the court disagreed with that analysis, but preserved the mandate because the fine amounts to a tax that is within Congress’ constitutional taxing powers.

The announcement will have a major impact on the nation’s health care system, the actions of both federal and state governments, and the course of the November presidential and congressional elections.

Study Links EMRs to Lower Risk of Malpractice Claims

From Becker’s Hospital Review:

A study has found a relationship between Massachusetts physicians’ use of electronic medical records and a dip in malpractice claims, suggesting EMRs reduce rather than increase medical malpractice risk, according to a HealthDay News report.

Researchers tracked malpractice cases for 275 physicians who were surveyed in 2005 and 2007. Thirty-three of them were targeted by malpractice claims, and 49 claims were related to alleged medical malpractice that occurred before the physicians adopted EMRs. Two claims occurred after EMR implementation.

Researchers estimate the likelihood of medical malpractice claims dropped by 84 percent after EMRs were installed. Study authors said the research provides more evidence that EMRs improve quality and safety of care, reducing the risk of malpractice claims as a result.