WhiteCoat

Healthcare Update 07-25-2011

What? MRSA infection? Get that patient a super mocha latte … STAT! That morning cup of Joe may decrease your risk of getting a “superbug” infection – by up to 50%.

Prescription abuse kills. In 2010, more than 80 percent of the drug-related deaths in Oklahoma involved prescription medicines. Yet they’re still on the market and the pediatricians say nothing about it! Meanwhile pediatricians had a fit over cold medications that allegedly killed three children in 2005 and caused them to be largely removed from the market.

More patients gone wild. This patient started out wild. He was brought to the emergency department for suicidal ideations, struggles with police, then tries to run from the department yelling at police to shoot him and to “aim for the head or the heart.”

Places that are dangerous to go on vacation – not necessarily because of crime, but because there is no access to timely trauma care. Almost the entire state of South Dakota and Arkansas are on the list. So are more frequent tourist attractions such as Maui, the Grand Canyon, and Nantucket. See the interactive map from the American Trauma Society here. Related article in Time Magazine here.

[wp_campaign_2]

Counterintuitive, but those patients who are treated by doctors with more experience tend to have worse outcomes. Tell that to patients admitted to the hospital in July.

$925,000 settlement in case where resident injects anesthetic into patient’s eye for surgery and patient’s eye “literally exploded.”

Interesting legal question. Child sees psychiatrist. Child gets put on antipsychotic medications. Child then is taken off of medications due to the possibility of developing a “dangerous syndrome.” Child then brutally murders his mother.
Should father be allowed to bring a malpractice suit against the psychiatrist for stopping the medications when state law forbids criminals or their families from profiting from wrongful or illegal conduct?

Ummm. Yeah. That’s called the Crouching Tiger Hidden Artery move. Child gets impaled in the neck by a bamboo pole while playing “Ninja” with friends. How this pole missed major blood vessels boggles my mind. Just glad the kid is OK.

Even if you have insurance, psychiatric care can be next to impossible to find. Researchers in Boston called 64 mental health treatment centers stating that they had commercial insurance and were seeking follow up care from the emergency department for depression. Only 4 of 64 centers could offer appointments within 2 weeks. Almost half of facilities never returned the calls or refused to see the patient unless the patient already had a doctor on staff at the facility.

Duct tape is expensive – especially when it goes over a plaintiff’s mouth. While University of Iowa medical malpractice settlements routinely contain confidentiality clauses, a court decision questions the enforceability of such clauses against a publicly-funded hospital. Plaintiffs may not be able to divulge details about the case, but the settlements are public records under Iowa law and must be divulged under a Freedom of Information Act request.  Plaintiff attorneys allegedly don’t mind confidentiality clauses because the settlement value of the cases increase.

Informative article about some of the financial incentives and disincentives behind why some patients are admitted to hospitals and some are discharged – and what the government and hospitals are doing about it.

Not really “news” per se, but a great quote promoting a reality series about emergency medicine in the UK.
“Everyone should walk through an Emergency Room (sic – should be Emergency DEPARTMENT) at least once in their life, because it makes you realize what your priorities are … It’s the people you love, and the fact that one minute they might be there, and one minute they might be gone.”
Seen it happen all too often and wholeheartedly agree.

[wp_campaign_2]

15 Responses to “Healthcare Update 07-25-2011”

  1. rlbates says:

    Arkansas is working on improving it’s trauma system. Recently the state legislature approved a bill to help fund it. I think UAMS (Little Rock) has been designated as a Trauma I and BMC (LR) as a Trauma II

    So come visit us. You’ll be okay. :)

  2. MiniMedic says:

    The coffee/tea now explains why paramedics might have super-immune systems, as we consider coffee a major food group.

    :-D

  3. Marilyn says:

    On the issue of “experienced physicians/worse outcomes” story:

    I wonder if they took into account how those patients got assigned to those physicians in the first place. Could it be that the experienced physicians simply got more complicated cases, because it was thought they could better deal with them? I don’t see where the study took that possibility into account.

    For example, from my own experience. I had my first two children via C-section. I wanted very much to have a natural childbirth if at all possible. When searching for physicians, I was advised to look for physicians with low c-sections rates. On the other hand, I found it important to take into consideration whether the potential physician was a “high-risk” ob, because naturally a doctor who takes more high-risk patients is going to have a higher rate of poor outcomes and surgical deliveries.

    That little bit of information would be helpful in evaluating the study.

    • Marilyn says:

      I wanted very much to have a natural childbirth if at all possible

      I meant, after finding out I was expecting a third. I didn’t get pregnant just for the purpose of birthing experience. Ack! ;-)

  4. SeaSpray says:

    So …then …if it’s possible that coffee and tea are linked to a decrease in MRSA infections …then perhaps JCAHO should lift their ban on said beverages in work station areas in medical facilities? :)

  5. DefendUSA says:

    RX abuse? I just heard from a drug educator that there are kids who will go into Mom and Dad’s medicine cabinet, take whatever and then go to a “Trail Mix” party…wherein they ante up the drugs, put them all together in a bowl and then grab a handful of the “trail mix” and swallow with alcohol…Can you say Karen Ann Quindlan? I am very ignorant, it would appear. Thank God my kids are always vigilant.

    • ThorMD says:

      I’ve been seeing kids in the ED for this for at least 5-6 years – so it’s not a new thing.

      • ThorMD says:

        Although I’ve always heard the kids referring to it as eating “Skittles”. Not trail mix. Maybe it’s a regional thing.

    • MamaOnABudget says:

      They portrayed one of these “prescription parties” on a Cold Case/Law & Order/CSI: (they all blend after awhile) 3-4 years ago.

  6. MamaOnABudget says:

    I used to live in South Dakota – that report doesn’t surprise me at all. But I’ve also seen how quickly the life flight got a young teen to the trauma center after a tractor roll-over. The centers are few and far between, but they’re excellent at what they do!

  7. doc99 says:

    WC, I don’t think I’d continually harp on identifying with the initials of a syndrome popularized by Bob Dole and two bath tubs.

  8. Ben S says:

    That bamboo-through-the-neck reminds me of this season of Torchwood. Some interesting discussions on living forever, topics I never would have thought of.

  9. Hueydoc says:

    The poorer outcomes with the older doctors make me wonder if they realized the futility of overtreating certain patients. Sure, you cardioverted that 90 year old dying of cancer.
    But was it worth it ?

  10. Don Miller says:

    I wonder how they decided where the “Advanced Trauma Hospitals were”

    The hospital in Idaho Falls Idaho is listed, but neither Trauma Center in Boise is listed. To the best of my knowledge there are no Level I trauma centers in the State, but the one in Boise does advertise itself as the State’s only Level II trauma center

Leave a Reply


3 + = eleven

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM