The Impact of Telehealth-Enabled EMS on Ambulance Transports

From JEMS:

Researchers in Houston wanted to measure the ability of using a combination of telemedicine, social service pathways and alternative means of patient transportation for patients who didn’t require an ED visit by ambulance. It was conducted by the Houston Fire Department and termed the Emergency Telehealth and Navigation (ETHAN) program.

Eligible patients included those with primary care-related complaints. The most common categories were “abdominal pain,” “sick,” “injury/wound” and “other pain.” Inclusion criteria included the following: Able to have full history and physical exam by paramedics (non-emergent conditions); age > 3 months; ability to communicate in English; normal vital signs; absence of fever in chronically ill patients or those over 65; ability to care for self; access to private transportation; and access to pediatrician for pediatric patients.

Patients with chest pain, acute neurological changes, altered mental status or difficulty breathing, syncopal episode, suspected non-accidental injury or neglect in pediatric patients and minors with no legal guardian on site were excluded.

Once identified, the patient was interviewed via video by an emergency medicine physician working in the Houston Emergency Center that provides regional telecommunication and dispatch for EMS. If the physician and patient agreed that their condition was non-emergent, the physician would pursue one of three pathways.

Opioid prescribing and practices in Ohio emergency departments

From Science Daily:

“This is a comprehensive look at how ED administrators perceive the role of state guidelines,” says principal investigator Neil MacKinnon, PhD, dean of UC’s James L. Winkle College of Pharmacy, noting that the survey results will be presented to the International Pharmaceutical Federation (FIP) in September 2017.

In the survey, the UC research team queried 163 Ohio hospital administrators and ED physicians to determine the extent and level of adoption of the 2014 Ohio Emergency and Acute Care Facility Opioids and Other Controlled Substances (OOCS) prescribing guidelines and to garner feedback and recommendations for improvements that would assist with implementation.

Trend of drinking hydrogen peroxide can be deadly, Minnesota doctors warn

From the Star Tribune:

“The way people describe it is that they take 3 drops of concentrated peroxide and dissolve it in about eight ounces of water and take it three times a day,” explained Dr. Ann Arens, a medical toxicologist at the Minnesota Poison Control System. “There are a bunch of websites and YouTube videos. There’s no science behind any of it helping. There’s no benefit of doing it and it really opens you up to a lot of potential harm.”

Doctors have seen more cases of hydrogen peroxide poisoning in the last two months, she said.

The hydrogen peroxide in these cases is stronger than the 3 to 5 percent concentration usually found in the drug store. In these cases, the bottle is labeled “food grade quality” and contains 35 percent hydrogen peroxide.

“It burns as soon as you drink it,” Arens said.

Consuming the liquid can burn holes in the esophagus and stomach, and can create oxygen bubbles that can be released in the blood stream. When that happens, explained Dr. Stephen Hendriksen, an emergency medicine doctor at HCMC, the bubbles can travel to the brain and cause seizures and stroke-like symptoms.