Patients at (Swedish) EDs regarded as ‘symptoms’

From MedicalXpress:

The healthcare work of providing care at Emergency departments is medicalized and result-driven. As a consequence of this, patients are regarded as “symptoms”, and are shunted around the department as “production units”. These are the conclusions of a thesis presented at the Sahlgrenska Academy.

What is central for Swedish Emergency departments are short waiting times, efficient care processes and a balanced budget. The healthcare work is dominated by a medical perspective. This gives limited opportunities to satisfy the individual care needs of the patients.

Online clock deters hospital ER visits for patients with minor issues

From the Record:

One in five visits to Canadian emergency departments is for minor medical conditions that could be treated in a doctor’s office or clinic, according to a new report.

While many emergency units are busy treating colds, sore throats, earaches and other complaints that could be handled elsewhere, St. Mary’s General Hospital has seen a drop in the number of visits by healthier patients thanks to its innovative online clock showing emergency room wait times.

“What we found was there were some patients who just decided not to come,” said hospital president Don Shilton.

CHI vs. the Blues in Nebraska Update: “CHI official: Emergency care is in-network”

From the Telegraph:

While negotiations between CHI and Blue Cross and Blue Shield of Nebraska remain at an impasse, people with emergency medical needs are still covered at CHI Health St. Francis, the hospital’s president said on Tuesday.

“One of the things that we think there is confusion out there [about] is emergency room care,” Dan McElligott told the Grand Island Rotary Club. “By law, patients are considered in-network for a true emergency at the hospital. We want people to know that they can come to the emergency room and, if they think that it is a true emergency, get the care they need because their life matters.”

Automated CPR machines help South Dakota hospitals

From the Times:

The newest addition to the Avera Weskota Memorial Hospital emergency room is always at the ready. And its hospital colleagues know it will correctly do its job every time.

The Wessington Springs hospital recently received its Lucas 2 chest compression device, which is a machine that senses the size of a patient and delivers standard CPR compressions to help resuscitate a patient who has suffered cardiac arrest and showing no pulse or is unconscious.

JoAnn Hettinger, director of nursing services at Avera Weskota, said this machine “doesn’t get tired.”

The ER: Holiday Sanctuary for the Broken

From Huffington Post:

People ran to the church for refuge in Medieval times. It was considered a place of safety, a sanctuary from civil punishment. In the church, one could claim a right to justice, food, water and shelter. That role was recognized by church and government authorities alike; doubtless sometimes grudgingly as the wanted escaped harsh punishments.

These days, America’s emergency rooms have filled a similar role. I’m reminded of this because the holidays are here. For the next six weeks or so, my colleague around the country will be inundated by patients in their already packed emergency departments, whether local community hospitals or major teaching and trauma centers.

“Beware the ER on Thanksgiving!”

From KOMO:

The last place you want to be on Thanksgiving is the emergency room. But unfortunately many of us end up there due to cuts and burns from all that food preparation.

For example, you’ve decided to try deep-frying the turkey this year.

For rural veterans with PTSD, telemedicine may help

From Reuters:

For the many veterans with post-traumatic stress disorder (PTSD) who don’t have access to a trained mental health care team, connecting with such a team remotely by phone and video chats may help, a new study suggests.

At least 500,000 veterans in the Veterans Health Administration (VHA) system, or nearly 10 percent of the VHA population, were diagnosed with PTSD in 2012, the researchers write in JAMA Psychiatry.

“Why you don’t want a high-tech ambulance if you’re in cardiac arrest”

From PBS:

Emergency treatments delivered in ambulances that offer “Advanced Life Support” for cardiac arrest may be linked to more death, comas and brain damage than those providing “Basic Life Support.”

That’s according to a study published Monday in JAMA Internal Medicine, which suggests that high-tech equipment and sophisticated treatment techniques may distract from what’s most important during cardiac arrest — transporting a critically ill patient to the hospital quickly.

“They’re taking a lot of time in the field to perform interventions that don’t seem to be as effective in that environment,” said Prachi Sanghavi, lead author of the study and a PhD student in Harvard University’s Program in Health Policy. Those interventions include the use of advanced defibrillators to shock the heart, the administration of IV drugs, and perhaps most risky in the field, intubation — the insertion of a plastic tube in the airway to help with breathing.

“Of course, these are treatments we know are good in the emergency room, but they’ve been pushed into the field without really bei

Senators urge President Obama to protect Critical Access Hospitals

From Rural Health Voices:

Senator Tammy Baldwin (D-WI) and 26 other senators wrote a bipartisan letter to President Obama urging him to exclude the Critical Access Hospital (CAH) reimbursement cuts and the 10-mile exclusion proposal from his Fiscal Year 2016 Budget request.

Obama’s Fiscal Year 2015 budget proposed reducing Medicare reimbursements for CAHs and removing the CAH designation for hospitals located within 10 miles of another hospital.

“Rural Hospitals have experienced significant Medicare reimbursement cuts that have strained critical resources. CAH facilities already face unique challenges, such as remote geographic location, workforce shortages, and limited resources, as they continue to provide 24 hour access to care for isolated rural communities,” the letter says. “Since the beginning of 2013, 24 rural hospitals have closed; this is double the pace of the previous 20 months. Proposals to reduce payments to CAHs will only serve to exacerbate the current problem and cause further care shortages in these isolated areas.”

The National Rural Health Association applauds Senator Baldwin and the other cosigners. NRHA urges members of Congress to stand up and protect the rural health care safety net.

Stroke Rounds: Mobile Unit Speeds Access to tPA

From MedPage Today:

Treating acute ischemic stroke patients in a stroke emergency mobile unit (STEMO) boosted the percentage of patients who received thrombolysis within the “golden hour,” according to a German study.

Nearly one-third of (32.6%) ischemic stroke patients who were transported in the special ambulance received thrombolysis, compared with 22% of patients who received conventional care (P<0.001), reported researcher Martin Ebinger, MD, of the Charite-Universitatsmedizin in Berlin, and colleagues.

Hospital transport in the STEMO increased the number of tissue plasminogen activator (tPA) treatments within the critical window of 1 hour (the “golden hour”) from symptom onset almost 10-fold, they wrote online in JAMA Neurology.