Diary of a Concussion

From the Verge:

I opened my eyes to see a clear blue sky and two men leaning over me to put a brace around my neck. I don’t know if I was already on the stretcher or if I was still on the pavement, but there are plenty of things I don’t remember. As I would later find out, I had a brain injury.

Was I badly hurt, I asked. I felt as though someone had smashed a two-by-four across the entire left half of my face. The two men on either side of me carefully lifted my upper body to finish with the brace, giving me a view of my legs. I wiggled my left toes, which were more obliging than my lips. It couldn’t be that bad, I decided. My spinal cord still worked.

 

1 in 5 Americans say they’ve experienced a medical error

From Becker’s:

More than 20 percent of Americans say they have experienced a medical error, according to a recent survey.

The independent research organization NORC at the University of Chicago conducted the survey in partnership with the IHI/NPSF Lucian Leape Institute and with funding from Medtronic. For the survey, NORC polled a nationally representative sample of 2,536 adults between May 12 and June 26 about their experience with medical errors.

New law helps California doctors treat mental health emergencies

From the Reporter News:

Emergency medicine just got a little easier for physicians dealing with patients suffering from a mental health crisis or are unable to provide consent, allowing doctors to make informed decisions before treatment begins.

“This new law gives emergency physicians access to critical medical records, including a patient’s previous diagnoses and prescription history, allowing us to provide better care for patients with mental health needs who come to the ER,” said Dr. Aimee Moulin, president of the California Chapter American College of Emergency Physicians. “The more I know about a patient’s medical history, the better care I can give them when they need it most,”

 

 

How Telemedicine Can Help Reduce Rural Hospital Closures And Provide Easier Access To Care

From Health IT Outcomes:

Rural hospitals can use different forms of telemedicine to improve the outcomes for their patients and reduce their own patient churn:

  1. Remote specialist consultations allow patients to connect with the nearest urban hospital and their physicians for specialized care. This saves the patients and their families’ travel costs and hours of driving time, while still retaining the patient in the local rural health system.
  2. Outsourced diagnostics provide the ability for patients to receive regular specialty lab work without traveling for hours.
  3. Regular monitoring of a patient with a chronic illness often means weekly trips to see a specialist, by being able to see and talk with the patient while they remain at home removes barriers for patients with added limitations.

Nearly 46 million US residents who reside in rural areas are facing the challenge that they may lose out on having access to high-quality emergency care and specialized services from their local hospital. Many rural hospitals are already rising to the challenge and providing direct-to-consumer telemedicine. While it isn’t an easy button, virtual care can help these organizations overcome staffing shortages, heightened readmission rates, low patient census, and patient churn.

Don’t worry about ‘tongue swallowing’ in cardiac arrest victims

From Reuters:

If someone in cardiac arrest needs cardiopulmonary resuscitation (CPR), don’t waste time trying to move the person’s tongue out of the way, experts say.

Attempts to prevent “tongue swallowing” are a major barrier to successful bystander resuscitation of people with cardiac arrest, they warn.

In many cases of cardiac arrests in athletes in recent years, teammates, coaches and fans have tried to clear the athlete’s throat before starting resuscitation because they mistakenly believed there was a danger of tongue swallowing. This practice “is a real obstacle” to lifesaving CPR, researchers wrote in the journal Heart Rhythm.

“There is a gap between what the medical community knows and practices regarding CPR and what is common in society,” study coauthor Dana Viskin of Tel Aviv University in Israel told Reuters Health by email.

Patients Visiting Multiple Emergency Departments: Patterns, Costs and Risk Factors

From Academic Emergency Medicine:

OBJECTIVE:

We sought to characterize the population of patients seeking care at multiple EDs and to quantify the proportion of all ED visits and costs accounted for by these patients.

METHODS:

We performed a retrospective, cohort study of de-identified insurance claims for privately insured patients with ≥ 1 ED visit between 2010 and 2016. We measured the number of EDs visited by each patient and determined the overall proportion of all ED visits and ED costs accounted for by patients who visit multiple EDs. We identified factors associated with visiting multiple EDs.

RESULTS:

8,651,716 patients made 16,390,676 ED visits over the study period, accounting for $26,102,831,740 in ED costs. A significant minority (20.5%) of patients visited more than one ED over the study period. However, these patients accounted for a disproportionate amount of all ED visits (41.4%) and all ED costs (39.2%). A small proportion (0.4%) of patients visited 5 of more EDs but accounted for 2.8% of ED visits and costs. Among patients with two ED visits within 30-days, 32% were to different EDs. Having at least one ED visit for mental health or substance abuse related diagnosis was associated with increased odds of visiting multiple EDs.

CONCLUSIONS:

A substantial minority of patients visit multiple EDs, but account for a disproportionate burden of overall ED utilization and costs. Future work should evaluate the impact of visiting multiple EDs on care utilization and outcomes and explore systems for improving access to patient records across care centers. This article is protected by copyright. All rights reserved.

Study finds gender, racial, and ethnic disparities among academic emergency medicine physicians

From News Medical:

Gender, racial, and ethnic disparities, with regard to academic rank and compensation, continue to exist among academic emergency medicine physicians in spite of a move by leading organizations of emergency medicine to prioritize increasing diversity. That is the primary finding of a study to be published in the October 2017 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

The study by Madsen, et al, found that women earned less than men regardless of rank, clinical hours, or training and that failure to advance or to receive promotion to leadership roles may be a be a factor in why women leave careers in academic medicine. The study proposes that future research is needed to delineate the issues of retention and advancement.

Additionally, the study found that underrepresented minorities (URM) comprise a small proportion of the academic medicine workforce and are less likely to hold senior positions, and are less likely to be promoted at all levels, regardless of gender, tenure status, degree, or NIH award status.