Hospitals, Along with Providence Health System and BlueCross BlueShield, Team Up to Stop Bill Requiring Telemedicine Payments

From the Lund Report:

Portland clinic chain ZoomCare is pushing a bill with the Telehealth Alliance of Oregon to require private insurance companies to pay for Skype diagnoses, but the hospital association wants the bill to wait for another session. If the law is enacted, its members could end up with fewer emergency room visits, and a significant loss of revenue.

The effect of adherence to ACLS protocols on survival of event in the setting of in-hospital cardiac arrest

From Resuscitation:


Advanced Cardiac Life Support (ACLS) algorithms are the default standard of care for in-hospital cardiac arrest (IHCA) management. However, adherence to published guidelines is relatively poor. The records of 149 patients who experienced IHCA were examined to begin to understand the association between overall adherence to ACLS protocols and successful return of spontaneous circulation (ROSC).


A retrospective chart review of medical records and code team worksheets was conducted for 75 patients who had ROSC after an IHCA event (SE group) and 74 who did not survive an IHCA event (DNS group). Protocol adherence was assessed using a detailed checklist based on the 2005 ACLS Update protocols. Several additional patient characteristics and circumstances were also examined as potential predictors of ROSC.


In unadjusted analyses, the percentage of correct steps performed was positively correlated with ROSC from an IHCA (p<0.01), and the number of errors of commission and omission were both negatively correlated with ROSC from an IHCA (p<0.01). In multivariable models, the percentage of correct steps performed and the number of errors of commission and omission remained significantly predictive of ROSC (p<0.01 and p<0.0001, respectively) even after accounting for confounders such as the difference in age and location of the IHCAs.


Our results show that adherence to ACLS protocols throughout an event is correlated with increased ROSC in the setting of cardiac arrest. Furthermore, the results suggest that, in addition to correct actions, both wrong actions and omissions of indicated actions lead to decreased ROSC after IHCA.

Giant sponge-filled syringe for plugging gunshot wounds

From Boing Boing:

ImageXStat’s Rapid Hemostasis System is a giant syringe filled with pellet-shaped sterile sponges doped with hemostatic agents for squiring directly into shotgun gunshot wounds. Within 15 seconds, the sponges absorb blood and expand, staunching the wound.

Two-Handed Bag Valve Mask Ventilation

From Emergency Medicine Literature of Note:

What we have here are two studies showing benefit of a 2-hand BVM technique on mannequins that requires no increased equipment and a minimal increase in necessary resources. Using a 2-hand system is likely a better way to bring the mandible forward and open the nasopharynx allowing for nasal oxygenation. Since we’re unlikely to see a study done on actual patients, this should be enough to change practice.