Doctor saves woman overdosing on flight; plane makes emergency landing in Buffalo

From New York Upstate:

A female passenger was slumped over in her seat and didn’t have a pulse, turning grey after reportedly spending an extended amount of time in the plane’s bathroom.

The cardiologist told the TV station that he and an OBGYN nurse also on the flight discovered a needle hidden in her bra. An opioid overdose was suspected, and the plane made an emergency landing in Buffalo.

The woman was “completely unresponsive,” Punjabi said. He and the nurse gave her mouth-to-mouth CPR to keep her alive until they could get naloxone, a drug also known as Narcan that revives overdose victims.

Epidemiology of Sepsis Among Adolescents at Community Hospital Emergency Departments

From JAMA (subscription required for Full Text):

In 2012, Rory Staunton, a healthy 12-year-old boy, presented to the emergency department (ED) of a community hospital in New York with symptoms that, in retrospect, were determined to be caused by sepsis. He was seen, discharged, and subsequently died of septic shock. Consequently, the governor introduced Rory’s Regulations, which mandated that hospitals in New York implement protocols to recognize and treat sepsis according to evidence-based guidelines. These efforts may result in large public health benefits for patients.1 However, crucial to Rory’s case was that his diagnosis was missed. Efforts to avoid missed or delayed diagnosis are greatly enhanced by knowledge of the frequency and course of similar cases, yet such data are unknown. We therefore examined the electronic health records of healthy adolescents who presented to 12 community hospital EDs in southwestern Pennsylvania during the same period (January 1, 2010, through December 31, 2012) with signs and symptoms similar to those of Rory Staunton.

Risk Factors for Malpractice

From Urgent Matters:

This article shows that emergency medicine physicians who have practiced longer and who see more patients are more likely to be named in a malpractice lawsuit.  Malpractice claims are, unfortunately, inevitable due to the environment that emergency medicine physicians operate in.  Malpractice litigation also places a heavy burden on both the health system and the providers.  As with many things in medicine, one of the first steps is identifying who is at risk.  This article helps advance our understanding of which physicians are at a higher risk; knowing this will be invaluable in developing strategies for making the healthcare system safer and hopefully reducing the number of malpractice claims filed.

The Consent Dilemma

From Politico:

Patient consent is an important principle in medicine, but when it comes to mental illness, things get complicated. Other diseases don’t affect a patient’s cognition the way a mental illness can. When the organ with the disease is a patient’s brain, how can it be trusted to make decisions?

That’s one reason that, historically, psychiatric patients were given very little authority to make decisions about their own care. Mental illness and incompetence were considered the same thing. People could be hospitalized and treated against their will if they were considered mentally ill and “in need of treatment.” The presumption was that people with mental illness—essentially by definition—lacked the ability to appreciate their own need for treatment.