ER Wait Watcher

From ProPublica:

Heading to the emergency room? You may wait a while before a doctor or other treating professional sees you — and the hospital nearest to you might not be the one that sees you the fastest. Use this tool to look up average ER wait times, as reported by hospitals to the federal government, as well as the time it takes to get there in current traffic, as reported by Google. Find out more »

AHA plans to fight CMS’ ‘two-midnight rule’ this year

From Modern Healthcare:

This week, a few AHA members laid the groundwork for legal action against the two-midnight policy. Banner Health in Arizona, Einstein Healthcare Network in Pennsylvania, Wake Forest University Baptist Medical Center in North Carolina and the Mount Sinai Hospital in New York filed appeals asking the CMS’ Provider Reimbursement Review Board to grant an expedited judicial review for the hospitals’ claims that the 0.2% payment cut is unlawful. The AHA and some other hospital associations are supporting the move. 

The AHA is also lending its support to a House bill that would delay enforcement of the policy until Oct. 1.

ERs Not Curbing Overuse of Antibiotics, Study Reveals

From US News and World Report:

The inappropriate use of antibiotics among adult patients at U.S. emergency departments is not falling, despite increasing concerns about antibiotic resistance, a new study reveals.

Improper antibiotic use is a contributing factor to antibiotic resistance, the University of Alabama at Birmingham researchers noted.

They analyzed U.S.-wide data collected from 2001 to 2010 and found that there was no decrease in emergency department use of antibiotics for adults with respiratory tract infections such as sinusitis and bronchitis, even when those infections were caused by a virus. Antibiotics are not effective against viruses, the study authors pointed out.

The use of antibiotics to treat children with respiratory infections decreased during that time, according to the study published online recently in the journal Antimicrobial Agents and Chemotherapy.

Critical Shortage of IV Saline Solution

From the American Society of Health-System Pharmacists:

ASHP has received the following information from the FDA about the national shortage of sodium chloride 0.9% large volume intravenous solution:

  • The shortage is a result of an unusual spike in demand. 
  • Suppliers are operating at full production but are still experiencing difficulty meeting increased demand. 

Telemedicine Emerging as Rural ICU Solution

From HealthLeaders Media (hat tip: Dr. Menadue):

While the high startup costs associated with telemedicine programs have presented a barrier to many rural hospitals, data suggests they contribute to lower costs and lower mortality rates

“Ignore This Fixed-Dose Philosophy For Morphine”

From Emergency Medicine Literature of Note:

Ultimately, this limited study leads to an erroneous, and potentially harmful conclusion that weight-based doses are unnecessary.  Aggressive, titrated or weight-based, pain control is not in any fashion refuted by this work.

Las Vegas mental clinic to close over EMTALA dispute

From the Review-Journal:

An outpatient clinic inside Rawson-Neal Psychiatric Hospital that federal officials found fell short of standards set by the Emergency Medical Treatment and Labor Act will close its doors at 5 p.m. Friday.

The clinic opened in July to help decrease the number of mentally ill patients seeking treatment at local emergency rooms.

Nevada officials continue to disagree with the federal Centers for Medicare and Medicaid Services’ interpretation of the standards and its insistence that the outpatient clinic falls under the act, referred to as EMTALA, since the clinic was never intended to operate as a medical emergency room.

State officials say the federal agency lacks separate regulations for psychiatric hospitals and doesn’t recognize interim-type facilities, such as the clinic.

“In essence, for CMS you are an ER or you’re not,” Dr. Tracey Green, the state’s chief medical officer, said on Thursday. “We are very saddened by the fact that we are going to close the clinic. The intent was to provide early intervention for clients who were in crisis and did not have to go to an emergency room.”

However, federal officials said on Thursday the statutes they are enforcing at the facility do apply to such clinics. It’s up to Nevada officials to comply or to close the clinic.