ER tech, police officer save suicidal man trying five-story jump

From the NC Times:

A hospital emergency room technician and an Escondido police officer saved a suicidal patient Sunday night, “miraculously” grabbing the patient’s arm after he’d thrown himself off a five-story drop, authorities said Monday.

About 8:40 p.m Sunday, the patient was in an internal stairwell, between the fifth and sixth floors at Palomar Medical Center, and threatening to jump. The worker, Chad Brabander, was trying to persuade him not to do so, Escondido police said.

But the patient jumped.

Brabander caught the man’s wrist as he started his plunge, catching him in midair, Escondido police said.

Dying of Cold: Hypothermia in Trauma Victims

From Science Daily (hat tip: Steve Flugrad):

Hypothermia in trauma victims is a serious complication and is associated with an increased risk of dying. A new study published in BioMed Central’s open access journal Critical Care has found that the key risk factor was severity of injury. However, environmental conditions and medical care, such as the temperature of the ambulance or temperature of any fluids administered intravenously, also increased risk.

Minn. settles lawsuit over hospital debt collections; Accretive to stop operations in state

From the Washington Post:

Attorney General Lori Swanson announced a legal settlement Monday that will bar a Chicago medical revenue company from doing business in Minnesota for six years after she accused Accretive Health Inc. of intrusive efforts to collect money from patients in several hospitals.

The settlement requires Accretive to stop operations in Minnesota by November. Accretive will be banned for two years outright and another four years after that unless the attorney general approves.

Accretive also will pay $2.5 million to set up a restitution fund for patients and return patient data to its client hospitals in the state, which include Fairview Health Systems hospitals, North Memorial Health Care and Maple Grove Hospital. Fairview terminated its contract with Accretive in April.

Q&A with Dr. Brian Phelps on mobile ER technology

From EHR Intelligence:

What’s worked so far with iPad applications? What hasn’t?

The most important thing is that we re-imagined the way a physician and nurse can interact with medical data for the post-PC era. So far, there have been two approaches in the marketplace. One, which is a truly dumb idea in my opinion, is to try to run desktop software on their iPad through remote virtualization or Citrix. And that’s just a disaster waiting to happen because of all the pinching and zooming and you can’t do that any easier than you can point and click on your iPhone; it doesn’t make any sense. A lot of hospitals are doing that, it really speaks to how urgent doctors and nurses feel about mobility and how important it is. The remote virtualization is a stopgap measure until actual native iOS and Android software is available to run these systems. The other thing that people do, now I’m not going to name any names, is that many of the most dominant hospital information systems are releasing iPad versions. They reorganize the information a little bit, make the buttons bigger and say ‘voila’ here’s a native iPad application.
Apple has been researching mobile device navigation for a very long time and are very good at what they do. They offer a very easy to read human interface guideline that any developer can read on their website. No major vendor has actually read that short document. If you follow those guidelines, there’s a great amount of complex data that you can interact with. And not just for consuming data, that’s the big argument against the iPad. You can read your email etc…, but the actual production of data doesn’t work so well, and I would vehemently disagree with that. If you look at some of the built in Apple applications, there’s a lot of data that can be input. If you just look at the settings application on an iPad and see how much data you can plug in and modify there. We actually looked at what Apple had done and worked closely with Apple to create a new navigation paradigm to allow doctors and nurses to review EHR and enter a new way of thinking.

Localized Care Improves Cardiac Arrest Outcomes

From MedPage Today:

Better regional systems of postresuscitation care for out-of-hospital cardiac arrest appeared to improve outcomes, a Japanese study showed.

A program to transport patients directly to centers for advanced care or move them there once the heart restarts boosted the proportion who survived with good neurological status at 1 month from 0.5% to 3.0% (P<0.001), Takashi Tagami, MD, PhD, of Nippon Medical School in Tokyo, and colleagues found.

Survivors were 10 times more likely to recover with minimal neurological impairment after the postresuscitation care program went into effect when adjusted for other factors (rate 51% versus 19%, P<0.001), they reported online inCirculation: Journal of the American Heart Association.

The effect of Helicopter Emergency Medical Services on trauma patient mortality in the Netherlands

From Injury, via MDLinx:

Helicopter Emergency Medical Services (HEMS) treatment is associated with a non–significantly higher risk of in–hospital mortality for patients with traumatic brain injury (TBI) and a non–significantly lower risk for patients without TBI. This increased risk of mortality in TBI patients is attributable to the increased prehospital time. These results indicate that HEMS does not have a positive impact on survival.

Untold Stories From Jamaica’s ER – Respect Due

From the Gleaner:

He recalled several similar incidents, one of which included a policeman who used an expletive at him because in his bid to get the cop to the emergency room quickly the wheelchair bounced the door.

NIH: Amiodarone vs. Lidocaine in Cardiac Arrest and Fluid in Trauma Resuscitation Studied

From Live Well:

Cardiac Arrest

The purpose of the study is to determine whether the heart rhythm drugs Amiodarone and Lidocaine improve survival rates for people in cardiac arrest. The study will take up to three years to complete.

Emergency responders use the heart rhythm drugs when patients’ hearts don’t have a shockable rhythm, in other words, people whose hearts are beating chaotically. Typically, responders will administer one of the two medications to try and steady the rhythm.

Trauma

The purpose of the trial is to determine whether trauma patients with low blood pressure benefit from receiving small or large amounts of saline.

Typically, when responders encounter someone with traumatic injuries (other than a head injury) and low blood pressure, they administer saline to increase blood pressure, Daya said.

“The current standard is to give lots of fluid through an intravenous line to keep blood flowing to vital organs,” he said. “Now we suspect that too much fluid may actually increase bleeding by popping established clots off holes in blood vessels.”

Paging Dr. Smartphone

From BusinessWeek:

Hon Weng Chong, a 24-year-old student at Melbourne Medical School, has developed a quick way to diagnose children in areas where health care is scarce. He’s built a stethoscope that can plug into a smartphone and doesn’t require medical training to use. “It seems simple that you just have to diagnose someone and give them antibiotics,” Chong says. “The problem is, how do you diagnose them?”

Community Assistance Response Team provides resources to decrease frequent use of EMS

From the Spokesman-Review:

Of the 10 calls for service that Engine 2 may run each day, eight of them are for repeat or recurring calls for medical services, usually by people who either lack medical insurance coverage or have minimal coverage and slip through the system. Instead of visiting a doctor for noncritical concerns, the patients call 911, and the fire department responds.

“Everybody has the same problem: People are losing their health care in droves and they use us as their medical provider,” said Assistant Chief Brian Schaeffer.

To combat the problem, the department created the Community Assistance Response Team, or CARES Team, a group of grant-funded social work students from Eastern Washington University who help “regular customers” of the fire department access social services and basic needs.

Since the partnership began in 2008, the department has seen a 77 percent decrease in recurring medical calls, statistics showed this month, Schaeffer said.