Man crashes in emergency room

From the Sacramento Bee:

A Gastonia man has been charged with drunken driving after he crashed into the emergency room of Gaston Memorial Hospital.

Police say 50-year-old Gary Edwin Bledsoe drove his pickup truck into planter that hit a large window at the emergency department Wednesday night.

Case of the upside-down woman in the emergency room

From Boing Boing:

A 7-foot-man walked into an emergency room dangling a 5-foot-woman by her feet. She told the staff that if she was upright, she’d pass out. She was only able to maintain consciousness while upside down. No, this isn’t a joke. This is a true story that her attending physician, cardiac electrophysiologist Louis F. Janeira, recounts in Discover Magazine. Spoiler: The tip of her newly-installed pacemaker had become disconnected from her heart muscle. When she was upside down, the lead reconnected and stimulated her heart.

What I did this summer: Stanford medical student works to improve emergency care in Cambodia

From the Sanford Scope:

As part of Stanford Emergency Medicine International (SEMI), School of Medicine faculty and students are actively involved in a variety of overseas projects aimed at advancing global emergency medical care through systems development, infrastructure expansion and educational innovations.

One such project is an ongoing initiative in Cambodia to develop video-based education modules for the management of common emergency complaints. SEMI co-directors Swaminatha Mahadevan, MD, and Matthew Strehlow, MD, have partnered with Center for Human Services, the non-profit arm of University Research Consortium, in Cambodia to develop these modules – but doing so requires learning more about the background of patients served by emergency departments at Cambodian hospitals and evaluating the effectiveness of current triage systems.

Hospitals hire actors to improve patient satisfaction, communication

From Fierce Healthcare:

Stony Brook (N.Y.) University Medical Center finds that playacting (using actors as patients) improves its staff’s performance in real life, HealthLeaders Media reported. The hospital uses the approach to teach doctors, nurses and other providers how to keep patients satisfied, improving the overall experience.

“We have actors pretending to be patients, and these four-hour sessions are scenario-based for nurses specifically to hone their communication skills,” Michael Maione, Stony Brook’s director of customer relations told HealthLeaders.

A Wristband To Force Doctors To Wash Their Hands, Save Lives

From Co.EXIST:

Hyginex, developed in Israel, is an integrated soap-dispensing-and-wristband-alert system. When a doctor approaches a new patient, a nearby unit will sense his or her presence and send a signal, setting off first an LED light, then a vibration in the bracelet. The band also alerts workers if they haven’t washed well enough: The dispenser knows how much liquid has been taken, and has motion sensors that tell how long hands are rubbed together.

With dozens of sensor-dispensers around the hospitals, the system can also keep a detailed log of hand-cleaning compliance. At the end of the month, managers can review the figures to see how well the hospital is doing and make adjustments, if necessary.


Elvis experience starts ER career

From the Cleveland Daily Banner:

DeVane said he did not know he was working on Elvis Presley, explaining, “When you go into resuscitation your mind goes into a series of steps that you have to take to give the person the best opportunity for survival. We were in those steps — not really thinking about outcome or who the person is, but thinking about getting things done as efficiently as possible.”

Why are some doctors so emotionally distant? Maybe it’s the economy.

From Boing Boing:

It’s hard to make people feel valued and cared about if you’ve only got a couple of minutes to see them before you have to move on to the next person. Unfortunately, packing as many patients into a day as possible is more efficient in a business sense. A 2005 study of 11 doctors found that they spent an average of 13.3 minutes on each patientif you combined both face-to-face time and time spent working directly on the patient’s case outside the exam room. The next year, anesthesiologist Peter Salgo wrote an op-ed in the New York Times about the pressure put on doctors by hospital administration to see as many patients as possible and move them on through with conveyer-like efficiency.

Optimal Cardiac Arrest Resuscitation Associated with Compression Rate of 100-120/minute

From JEMS:

The quality of CPR and chest compressions are key factors for survival from cardiac arrest.1 Over the past 50 years, there has been a progressive increase in the recommended rate of chest compressions during CPR.

In 1960, the recommended rate was 60 compressions/minute; this increased to at least 100 compressions/minute in the latest guidelines from the American Heart Association (AHA) in 2010. However, guidance is not provided for a maximum chest compression rate.

In this article, I’ll review key studies and gaps in our knowledge about chest compression rate, including the study recently published in the journal Circulation and how it can be used to guide clinical practice. I’ll also review what further studies need to be done regarding chest compression rate and quality of CPR in general.


The state-of-the science in cardiac care & resuscitation

From JEMS:

The state-of-the-science in cardiac care and resuscitation is constantly evolving. American Heart Association (AHA) resuscitation guidelines, clinical trials, prehospital protocol revisions, equipment innovations and recent research are changing the way we provide care in the field. More importantly, many new recommendations and studies are making an impact on our ability to improve resuscitation outcomes. This article will address several of the major impact areas.

The Merits of Mechanical CPR

From JEMS:

Approximately 460,000 individuals die every year from out-of-hospital cardiac arrest (OHCA).(1) Studies have consistently shown only an average of 5–15% of patients treated with standard CPR survive cardiac arrest, and providing optimal blood flow to a patient in cardiac arrest by performing quality, uninterrupted CPR is uniformly thought to have a positive impact on improving overall survival.(2,3)

The quality of CPR has been an underappreciated factor and is only now beginning to emerge as an important aspect of successful resuscitation. Manual chest compressions are often done incorrectly, especially in the back of a moving ambulance, and incorrect chest compression can negatively impact survival.(4,5)

Fortunately, there are tools that hold promise for helping providers overcome these inaccuracies: mechanical CPR devices.