Cutting opioid prescriptions may be as easy as asking patients how many they’ll need

From Becker’s:

Asking patients to be involved in deciding how many opioids they need could help lower opioid prescribing rates, according to a study published in The Green Journal.

Researchers from Ann Arbor-based Michigan Medicine designed a shared decision-making intervention to help educate patients about postoperative pain management and their options. Patients were shown a pain management-focused visual aid after surgery and physicians discussed the typical number of opioids required to help manage pain as well as the risks and side effects of opioid use.

Physicians also told patients the maximum number of opioids that may be prescribed. Patients were then asked to choose how many they think they would need, with reassurance that the prescription could be altered if necessary.

Is the stethoscope dying? High-tech rivals pose a threat

From the AP:

 Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.

It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, artificial intelligence and smartphone apps instead of doctors’ ears to help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.

Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”

What if you call 911 and no one comes? Inside the collapse of America’s emergency medical services.

From NBC:

There is no hospital in Hebron. In fact, when someone calls 911, there isn’t even a law that requires anyone in Hebron to answer the phone. Like so many other low-income, rural communities across the country, the small town’s ambulance runs on altruism alone.

And those ambulance services are closing in record numbers, putting around 60 million Americans at risk of being stranded in a medical emergency. Because so many emergency medical services (EMS) agencies have been struggling financially, some states are stepping in with funding. But emergency medical experts say it’s not enough to cure the dire situation.

Insulin Therapy for Hyperkalemia Is a Common Iatrogenic Cause of Emergency Department Hypoglycemia Cases

From Renal & Urology News:

Insulin administration to treat hyperkalemia is the most frequent iatrogenic cause of hypoglycemia cases encountered in emergency departments, according to investigators.

Chaitanya Chittieneni, BS, of Hennepin County Medical Center and University of Minnesota School of Medicine in Minneapolis, and colleagues performed a chart review of 591 adult patients with a chief complaint or emergency department diagnosis of hypoglycemia, or an emergency department glucose value of 70 mg/dL or less. In 99 (17%) of the 591 patients, the cause of hypoglycemia was iatrogenic, the investigators reported in the Western Journal of Emergency Medicine. In 61 (61%) of the 99 patients, insulin administration was the cause of hypoglycemia. In 38 patients (38%), the cause was unrecognized malnutrition.

10 most common antibiotics administered in the ER

From Becker’s:

Ceftriaxone and azithromycin are the top two most commonly administered antibiotics in U.S. emergency rooms for patients who are not admitted to the hospital, according to a study published in the American Journal of Health-System Pharmacy.

Researchers conducted a review of health system-evel electronic data compiled from 145 U.S. emergency departments. They assessed prescribing patterns, most common infectious diseases diagnosed and most commonly administered antibiotics in the emergency room among patients who were discharged.

AI Platform Screens Chest X-Rays for Potential Pneumonia in Under 10 Seconds

From Doc Wire:

Researchers from Intermountain Healthcare and Stanford University have recently evaluated an artificial intelligence (AI) platform that can analyze chest X-rays of a potential pneumonia patient in 10 seconds. This tool greatly facilitates a process that typically takes 20 minutes and has the potential to enable more accurate and prompt pneumonia diagnosis. The team’s findings were presented at the European Respiratory Society’s International Congress 2019 on September 30.

By speeding up the analysis of chest X-rays and the administration of a treatment plan, this AI system could significantly improve the management of patients with pneumonia. In their work, these Intermountain and Stanford scientists used an AI interpretation model to evaluate chest X-ray images taken from several emergency departments at Intermountain hospitals in Utah. This technology, known as the CheXpert system, was developed at Stanford University.

This research found that CheXpert accurately identified key findings of these X-ray images, with the AI analysis being consistent with those of three radiologists. CheXpert was able to do so in only 10 seconds, which is a significant improvement from current clinical practice.

Does telehealth save money? The jury’s still out.

From Politico:

Telehealth advocates have long argued that virtual consults can cut medical spending. But researchers still don’t know whether that’s true, though more patients use the technology each year and hundreds of millions of dollars are being spent on it.

In a recent assessment of a telehealth-related bill, the Congressional Budget Office concluded that covering the technology sometimes increases and sometimes reduces spending, at least for private payers. “In either case, the effects on spending tend to be small.”