Man faces 6 to 30 years in prison after being convicted of aggravated battery for stabbing emergency physician in chest with steak knife. During trial, patient stated “If they’d followed emergency room protocol, we wouldn’t be here right now.”

We do it to the heart … why not to the brain? Stents may help certain stroke patients.

Why we need to dump the FDA. +1.

Cute … or scary. In the Christmas spirit, Loyola Medical Center comes up with the Twelve Days of Trauma and how much trauma care costs.
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You know the ED? No. The OTHER ED. Yeah. That. The one that you get, not the one that you go to.
Well it turns out that researchers did a study comparing men with chronic periodontitis to men without chronic periodontitis and they found that men who had chronic periodontitis were more than 3 times as likely to have ED as were those without chronic periodontitis.
Remember, this is only a correlation. There could be lots of intervening factors that I’m just going to leave alone right now.
It would be interesting if the study included those who wear dentures, also. In that way they could determine whether the presence of teeth or the presence of bacteria were more likely to account for the findings.

That stuff running from your nose every time you bend over may not be boogers … it could be spinal fluid. Amazing University of Arizona surgeons cured this problem with minimally invasive surgery rather than cutting into the patient’s skull.

A medicine “visionary’s” view of seven things that allegedly frighten physicians about Obamacare. I disagree with several of them and others were occurring long before Obamacare was concocted.
By the way, doc, the number “6” comes between 5 and 7. If there’s one thing I can’t stand about people who can’t count, it’s that they don’t pay attention to detail and they confuse their readers.

When the cure is worse than the disease … fighting bedbugs. Several people dying from pesticide overdose – although using 18 foggers in your home over a two day period probably exceeds the manufacturer recommendations.
Maybe some brainiac DA will file murder charges against the owner of the store who sold the woman all the insecticide. That’s about how bizarre things are getting in this world lately.
Great. Now I’m itching.

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Can a total mattress ban be far behind? Pediatricians publish paper noting that an average of 31 children each day are treated for inflatable bounce house-related injuries and urging that policy makers either “recommend against pediatric bouncer usage” or “formulate recommendations for safer bouncer usage and design.”
Because regulation is the key to everyone’s safety.
See Shadowfax’s blog for another take on the issue.

How much longer will you live by staying in shape and running your marathons? More than one study says … about as long as the guy with the beer belly munching chips on the couch.

It’s about 350 times more likely that this obstetrical coincidence would occur than it would have been to win the PowerBall jackpot. Still, 524,288 to 1 are some pretty longshot odds.

Interfaith Hospital in Brooklyn, which serves mostly indigent population, planning to declare bankruptcy. Why? Cuts in Medicaid reimbursement a couple of years ago cost it 40% of its inpatient revenue. New York Governor Andrew Cuomo doesn’t plan to offer any more assistance to keep the hospital open.
What’s going to happen to all the patients? They’ll take ambulances to other emergency departments and the state will pay more for the added transportation costs.
Then the state will cut reimbursement for ambulance transport and the ambulance companies will go bankrupt.
Curling up and dying at home is still free, though.

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Whatever the hospital is paying this person … it’s not enough. After Hurricane Sandy hit, ED tech Marsha Hedgepeth swam down the flooded road from her apartment to a major highway and then hitchhiked ride with out-of-state utility truck to get to work so she could help other hurricane victims. Amazing dedication.

Note to criminals, if you get injured committing a crime, one of the first places that police look for you is … in the emergency department. Five kids beat up one kid and steal his belongings. When victim goes to the ED for treatment, guess who shows up? Now 18-year-old Joseph Scott is charged with several felonies and will take a nice vacation in the Greybar Motel.
http://murrieta.patch.com/articles/robbery-suspect-arrested-in-hospital-emergency-room

New Hampshire jury awards plaintiff $5 million after radiologist mis-reads CT scan of 25 year old headache patient showing evidence of a stroke. Later, allegedly due to the delay, the patient suffered brain hemorrhage and permanent disabilities.

Excellent review article on the accuracy of the Broselow Tape. You may recall that not too long ago Dr. Broselow wrote an interesting article in EP Monthly about how he came up with the idea for his invention. Now it seems as if the weight estimations on the Broselow tape are too low in almost 50% of the cases – which would result in underdosing of medications during a pediatric code.
Best estimate of how much a child weighs? Ask the child’s parent.

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Can you imagine your kids on this stuff? Two ounces of Cracker Jack’d will have 70 mg of caffeine – as much caffeine as a cup of coffee. Frito-Lay reports that the snack won’t be marketed to children and will be labeled different from the traditional Cracker Jack boxes.
Not sure how I feel about this.
On one hand, I think that companies should be able to market any legal product that they want. How is taking Cracker Jack’d any different than using energy drinks or No-Doz caffeine pills?
On the other hand, I don’t think that changing the labeling and marketing the product only to adults is going to prevent children from eating the Jack’d version. Kids still smoke a lot of cigarettes. In addition, unless Frito-Lay colors the popcorn differently – such as red popcorn for Jack’d version and traditional caramel color for the regular version – I foresee a lot of unintentional ingestions/overdoses. If there’s no way to differentiate caramel corn outside of the box, how can someone tell if their snack has been Jack’d?

One way to bring down medical costs. GruntDoc mentioned this group of docs on his blog as well. Oklahoma surgery center publishes list of prices for pretty much all-inclusive surgical care, and the prices are one-fifth of what the nearby Integris Health hospital system charges. For example, a bilateral sinus procedure costs $33,000 at the hospital – not including surgeon or anesthesiologist fees. The same procedure at the surgery center – including all doctors’ fees – is $5,885.
A plane trip and hotel plus surgical fees would cost a lot less than what most local hospitals charge. Domestic medical tourism – what a concept.
Hoping this care model expands.

VA Medical Center sued for prescribing four month supply of Seqoquel to patient who abused prescription drugs and previously attempted suicide by overdose. The patient was successful in her fourth suicide attempt when she took most or all of the pills and was found dead in her apartment.
When the shoe is on the other foot, now government attorneys argue that Seroquel is not particularly lethal (good thing for that or else the patient may have died from her overdose) and was “effective in treating [the patient’s] psychosis when taken as directed” (it was also effective in killing the patient when she took too much of it). Despite the risk of overdose, the attorneys argue that the greater risk to the patient was that she would run out of Seroquel, which seemed to help her. But one of the documented side effects of Seroquel is “suicide attempts.”
Obviously, we need to charge all the government employees involved in the patient’s care with murder.
After all, how is this case that much different from all the cases where the government is charging doctors with murder when patients overdose from using narcotic prescriptions inappropriately?

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What does President Obama’s victory mean for your future prospects of health care? Here’s one doctor’s opinion: Rising insurance premiums, restricted choices for patients, more visits to nurse practitioners or physician assistants, doctors cherry-picking healthy patients for their practice, extra taxes to fund mandates, fewer employment opportunities so that employers can avoid the ACA mandates, decreased emphasis on medical innovation, rising prices, decreased availability of care.
Good thing that everyone is going to have “insurance” now.

Georgia’s Newton Medical Center becomes one of the latest hospitals to require payment in advance for non-emergency treatment in the emergency department. Uninsured patients must pay $150 and insured patients must pay their co-pay (or their entire deductible) before receiving care.

Think those crotch shots are funny? They happen almost 16,000 times per year according to one study.

Pregnancy tests in males are no longer considered an “unnecessary” test. Man jokingly reports on Reddit that friend urinated on leftover pregnancy test in his medicine cabinet after breaking up with his girlfriend. To the man’s surprise, it was positive. After being posted to Reddit, several readers recommended that he go to be checked for testicular cancer. After seeing the doctor, the patient did indeed have a small tumor in his testicle.
Given that the entire case is anonymous and based upon the accounts of a “friend,” we can’t judge the veracity of the story, but since pregnancy testing in men “could” lead to the discovery of cancer, pregnancy tests in men are no longer unnecessary, right?
Now the government can start paying for pregnancy tests as a screening test for testicular cancer in males.

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What will the form for paying your new health care tax look like once 2014 rolls around? Americans for Tax Reform creates one possibility. If you are looking for a list of legislators who voted in favor of the Affordable Care Act on this day before election day, one list broken down by state is here.

Supreme Court ruling on Affordable Care Act allowing states to opt out of Medicaid expansion estimated to cost states an extra $53 billion in unfunded care. Six to ten million additional patients will remain uninsured because many states are reigning in Medicaid costs and are not expanding Medicaid services or coverage. In addition, many hospitals agreed to accept lower payments for Medicaid patients, expecting that there would be fewer uninsured patients with the expansion of Medicaid. Now those hospitals will likely eat the cost of treating the uninsured patients.
Another reason why our government needs to provide patients with health care rather than “insurance.”

How are NY City hospitals functioning after Hurricane Sandy aftermath? Struggling. Several hospitals are still closed. No emergency services being offered. No electricity. Backup generators failing because of flooding.
Similar story in Connecticut where Norwalk Hospital experienced “bedlam.”

Let’s see … Alcohol? Check. 17 ounce sodas? Check. Hmmmm. What’s next? I know! It’s time for government to regulate energy drinks. After all, it’s for our safety, you know.
Next up … coffee. Ooooh. Oooooh. What about water? People can die from drinking too much of that, too, you know.

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Electronic medical records causing significant delays in medical care and less face time with patients.

In the “that’s why they call it dope” department: Man high on PCP undresses at intersection, runs street naked, randomly pounding on hoods of cars. Tries to pull driver out of car and is arrested by police. Taken to ED where he was medically cleared for jail. Once in jail, he eats his medical bracelet, then gnaws at his wrists. Initially reported to have bitten his finger off and swallowed it, but later story changed to just gnawing at his finger, too.

I’ve commented on this before, and the stories just keep coming. More on the “Liverpool Pathway” from Great Britain. Almost a third of the deaths in Britain each year are patients on the Pathway. “It is a roach-motel for patients deemed to have a terminal condition. They check in but they don’t check out.” But the care is free …

Another medical theory goes up in smoke. Large federal study shows that weight loss has no effect on rate of heart attacks and strokes in overweight patients with Type 2 diabetes. Interesting. I would feel comfortable extrapolating that obesity is not a risk for heart attacks and strokes in the non-diabetic patient as well. This was a huge study and it was stopped early because there was no benefit in weight loss over a decade.
My bigger question is what about diabetes is so damaging to blood vessels?

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We wipe our buttocks on your hospital food? Study of 100 food samples from a university hospital in Houston showed that one quarter of them were contaminated with Clostridium difficile – the organism that causes severe diarrhea and colitis in infected individuals and that causes 14,000 deaths per year.
Safest bets (at least for this hospital) included beef and pork which tested positive only 13% of the time and grains which had no positive tests. Skip dessert, though. 60% of dessert samples were C. diff positive.
Mmmmmmm. Pudding.

Who are the most influential physicians on Twitter? Here’s a ranking site and a list of 10 physicians to follow. Unfortunately, I’m not on either list. Must not twit enough. Seems as if the ones that are on the list are also the ones who tweet almost every day. They also seem to follow a lot of others. I only follow about 25 people and I can’t keep up with all of their tweets. How in the heck does someone follow 5000 people?

Who’s more to blame? Is it the paramedics who keep leaving the keys in the ignition of the ambulance or the Georgia woman who has stolen the same ambulance more than once?

Acute “incarceritis” turns into a bigger problem. California man arrested for drug possession complains of a “medical problem”. Gets taken to an emergency department for evaluation. Handcuffed to the stretcher and one of his arms is freed so that he can sign admission papers. Then grabs deputy’s gun. Shortly thereafter dies of one gunshot wound to the head.
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Patient in VA hospital has groin packed in ice for 19 straight hours. Later develops frostbite and gangrene on his penis requiring 5 inches of his penis to be amputated. Man files claim under the Federal Tort Claims Act seeking compensation. Attorney for the Department of Veteran’s Affairs reviews case and writes letter to patient stating:
“It is our opinion that there was no negligence on the part of the Department of Veterans Affairs or any of its employees in connection with the claimed loss; therefore your claim is denied.”
“Claimed loss?” Give me a break. Freeze dried penis … nope … no negligence there.
Well, at least patients can go to www.hospitalcompare.gov and review all the poor ratings that the VA Centers get. Ooops. No they can’t. The government won’t disclose any VA hospital ratings.

Kind of missed this story … during the ACEP conference in Denver, one of the exhibitors collapsed and went pulseless. Two docs did CPR and shocked him back to life.

Got a question about the meningitis scare with tainted steroid injections? Call the hotline number that Florida Governor Rick Scott gave out and you’ll hear the following sultry message: “Hello boys, thank you for calling me on my anniversary … “ Oops. He accidentally gave out the number to an adult phone line.

More than 500 federal agents “take down” 91 health care providers for allegations of health care fraud. Multiple doctors, nurses, paramedics, and other healthcare professionals are arrested for allegedly billing for services they never provided and/or for billing for unnecessary services. In Florida, an ambulance company was charged with providing medically unnecessary ambulance rides. In Louisiana, providers were charged with false claims for medically unnecessary durable medical equipment. In Chicago, two doctors were charged for billing for medically unnecessary medical services (laser treatment and psychotherapy).
Criminal charges after billing for “unnecessary services.” Now where have I heard the term “unnecessary” medical care before?
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