Emergency Room has also become Primary Care

From the Beacon:

While we have heard a lot lately about the emergency room as the primary care provided for people who don’t have medical insurance, we have not heard how emergency medicine assumed that role relatively recently.

“When you dial 911 from any phone, someone picks up your call, an ambulance soon arrives, and you are speedily transported to an emergency room,” says a press release about a film on emergency medicine that aired on PBS.

“Once there, a team of specially-trained emergency medicine doctors and personnel with an enormous amount of resources at their fingertips care for you. No one asks if you can pay. No one refuses to treat you if you cannot.”

New IRS rules crack down on nonprofit hospitals

From The Hill:

he federal government is cracking down on nonprofit hospitals under ObamaCare in an attempt to prevent harsh collection practices and steep charges for the uninsured.

Newly finalized regulations from the Internal Revenue Service, announced Monday, will require nonprofit hospitals to “take an active role in improving the health of the communities” by making payment methods more fair and making costs more transparent.

For example, nonprofit hospitals are banned from asking for money in patients’ rooms or selling debt to third-party companies unless they make a “reasonable effort” to offer financial assistance. Each hospital must also take steps to improve the health of its community, including a semi-annual evaluation of the area’s “health needs.”

“For hospitals to be tax-exempt, they should be held to a higher standard,” Emily McMahon, a deputy assistant secretary for tax policy at the Department of the Treasury, wrote in a blog post Monday announcing the rules. ​

Will 2015 deliver the promise of telemedicine?

From Venture Beat:

The year of 2014 was a big year for telemedicine. The idea of using technology to provide remote health care has been around for years, but it really started to take off this year with the proliferation of wearable devices, and providers starting to embrace seeing patients through video chat.

In July, Dignity Health unveiled telemedicine robots to bring in specialist physicians from remote locations. Then, in October, Google unveiled a new ‘talk with a doctor now’ video chat service. Even pharmacies got into the act, with remote medical kiosks popping up in Walgreens, CVS, and Wal-mart.

There are several indicators that 2015 will be the year that telemedicine really takes off. Read any predictions related to healthcare, and telemedicine is central in those discussions.

Widespread flu levels found now in Iowa, Illinois

From the Quad City Times:

An inexact match between this year’s influenza vaccine and the most common strain of influenza virus actually seen in doctors’ offices is one explanation for what is now defined as “widespread” seasonal flu activity in Iowa as well as Illinois.

The Iowa Department of Public Health announced Monday that its surveillance program is showing an increase in cases and related hospitalizations. Some 130 hospitalizations have been recorded, mostly among patients 64 years and older.

Outbreaks have been reported in long-term care facilities, especially in western and central Iowa.

Man fires shotgun inside ED

From KOMO News:

Police say a man who fired a shotgun in the emergency room of Sunnyside Community Hospital hoped to provoke an officer into “suicide by cop.”

The shotgun blast Saturday didn’t hit anyone, but an officer working as a security guard suffered a cut on his head in the fight to disarm the man.

Doctors and paramedics gear up for Arctic blast

From KRDO:

They are the people relied on most during a storm: paramedics and emergency room doctors.

They don’t get holidays off and they don’t get a snow day either.

The good news with this storm is they haven’t seen many emergencies related to snow – but they’ve gotta be ready regardless.

But during an arctic blast, their jobs can mean life or death.

“Every day is an emergency day,” said Dr. Gregory Collins, Memorial Hospital emergency room physician.

Off to the ED: Cheating student gets Bluetooth stuck in ear

From Gulf News:

Manama: A student in Kuwait who was cheating on an exam ended up in the emergency room after a Bluetooth device got stuck deep into his (sic) year. Ed: The typo could have been worse.

According to a report in the local daily Al Seyassah on Tuesday, the student was unable to remove the device after he pushed it too far into his ear in order to avoid detection by exam supervisors.

Remarkably, the student asked for the device back insisting he needed it for an exam on the next day.

Kuwait, meanwhile, has threatened to deport any foreign teachers caught assisting students in cheating.

Gunman opens fire inside ED waiting room

From the Daily Sun News:

Leo C. Vergara, 18, of Sunnyside is facing charges of first degree assault after allegedly firing a gun inside the emergency room at Sunnyside Community Hospital early yesterday morning (Sunday).

Sunnyside Police Commander Scott Bailey said several community members alerted police that shots were fired at about 4 a.m. in the area of South Seventh Street and Harrison Avenue.

They also reported seeing a man carrying a “long” gun as he was walking down the street.

Police officers were racing to the area when another caller reported a gunman entered the emergency room at the hospital and fired a gunshot.

AAP: Best Practices for Improving Emergency Room Flow for Pediatric Patients

From HCP: Live:

Best practices for improved flow and care for pediatric patients in the emergency department are discussed in a technical report published online Dec. 29 in Pediatrics.

The need for emergency medical services outstrips available resources on a daily basis. With this in mind, Isabel Barata, MD, and colleagues from the American Academy of Pediatrics Committee on Pediatric Emergency Medicine discuss best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.


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No one says night shifts are easy

From the Herald:

Occasionally, I have described my career in emergency medicine as enduring 30-plus years of sleep depravation.

Actually, it’s longer than that. In college, I worked several summers in a major-chain, meat-packing plant. The worst shift was from 8 p.m. to 4 a.m., unloading 10,000 to 12,000 pounds of bacon bellies from atop a four-story smokehouse, with the temperature rising to 120 degrees-plus.

The last two years of medical school weren’t much different, with some rotations going to midnight every other night. A few of us also worked one night a week and two weekend days (24 hours) per month as lab techs at a suburban hospital. There was no thought of stimulants, not even coffee. The work was stimulating enough. Nor do I recall any concern about night-shift work and its impact on health or mortality back then. However, the health impacts of nighttime work have more recently been studied – with some bothersome conclusions.