“ERs aren’t just for emergencies anymore — and that’s the problem”

From Public Opinion:

About half of the people who go to a hospital emergency room for medical care don’t belong there, according to Keystone Health’s President and CEO Joann Cochran.

That is one reason Keystone has opened it’s third urgent care clinic in the area, located at Walker Road and Norland Avenue.

Cochran said the walk-in clinics are designed to provide urgent care for people with non-critical illnesses who either don’t have a family physician or who can’t get to their regular doctor.

The clinic joins Keystone’s urgent care clinics at its Fifth Avenue facility and in Shippensburg. The privately run Med-Express also has an urgent care clinic in Chambersburg.

Cochran, who has extensive expertise in the medical planning field, says too many people treat hospital emergency rooms like a doctor’s office, going there instead of to a doctor when they have non-emergencies.

Tourniquet Use Recommendations from the American College of Surgeons

From ACEP Now:

So your prehospital guys want to use tourniquets. This seems to be a pretty frequent situation nowadays. Everyone has heard about the success of tourniquets in the battlefield; why not use them in civilian care? After all, isolated extremity trauma carries a significant risk of morbidity and mortality. Kauvar et al published a study focusing on the rate of death and amputation among a cohort of patients with isolated lower-extremity trauma as recorded in the National Trauma Data Bank. They found that the mortality rate is 2.8 percent and the major amputation rate is more than double that at 6.5 percent.2 Moreover, a committee that included representatives from ACEP and the National Association of Emergency Medical Services Physicians recommended that all basic and advanced life support ambulances carry commercially available arterial tourniquets.3 With all this in mind, the ACS Committee on Trauma also reviewed this topic and published new evidence-based guidelines in 2014 on appropriate use of tourniquets.1 The project looked at extremity and junctional (ie, in the groin proximal to the inguinal ligament, the buttocks, the gluteal and pelvic areas, the perineum, the axilla and shoulder girdle, and the base of the neck) hemorrhage.