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Study in the journal Pediatrics shows that about 10,000 children are hospitalized each year for accidental medication ingestions. Three quarters of those hospitalizations involved 1 or 2 year olds. Twelve medications were responsible for 45% of all pediatric emergency hospitalizations for accidental drug ingestions. Opioids were not surprisingly the top classification prompting hospitalizations, but buprenorphine and clonidine were the top two medications – responsible for 15% of all hospitalizations. The rate of hospitalization for buprenorphine products was 100 times greater than that for oxycodone-containing products.
Keep in mind that we’re not talking about overdose rate, we’re talking about hospitalization rates.
I looked up suboxone which seems to be a major source of buprenorphine prescriptions, but didn’t see anything that would suggest more of a danger over other opiates. Can any tox folks out there comment on why hospitalization rates are so much higher for buprenorphine ingestions?
Not a good day for this Iowa emergency department patient. Goes to the emergency department with abdominal pain. Apparently doesn’t like the treatment he’s receiving, so he tries to call an ambulance to come and get him inside the emergency department. Then prepares to spit on a security guard and gets sprayed with mace as a result. Police called and find out that he has warrants for his arrest. Handcuffed and runs out of the emergency department, then falls and scrapes his back all up. Eventually ends up in the Greybar Motel.
Attempts to keep the NYU-Langone Medical Center open appear to be falling through. The hospital was losing money and the current owners of the facility can’t find a health care provider to operate the emergency department. New York Mayor Bill de Blasio then makes the idiotic statement that it is SUNY’s “responsibility to ensure that people who relied on LICH in the past will continue to have access to the care they need.”
Actually, Mayor de Blasio, that’s YOUR responsibility. Maybe you and Governor Cuomo could put a little more emphasis on providing health care to the citizens in your city and state.
New study shows tort reform savings are mythical. LA Times investigative reporter Michael Hiltzik cites “copious evidence” (which his investigation doesn’t identify) that defensive medicine accounts for only 2-3% of all US healthcare costs before concluding that tort reform savings are a myth and that tort reform is really just “nastiness” intended to defund Democratic party supporting trial lawyers. Now there’s a new article in JAMA that Mr. Hiltzik mentions to bolster his arguments, but even that article doesn’t say what Mr. Hiltzik asserts. The graph in the article which is reproduced in Mr. Hiltzik’s column shows that “defensiveness” can play a role in more than 60% of a physician’s orders and that 28% of orders and 13% of all healthcare costs were at least partly “defensive.” A little more than 2-3%, but don’t let statistics get in the way of a good story.
And if tort reform is bad and full liability for all one’s actions is good, then why is there government immunity for medical treatment of our veterans and why is there full immunity for legislators, prosecutors, and judges?
Fortunately, there was an investigation into the events at the Phoenix department of Veteran’s Affairs. That report concluded that officials could not “conclusively assert” that delays in care at the VA caused more than 40 patient deaths. However the “conclusively assert” statement wasn’t included in prior versions of the report. The former medical director of the clinic calls the report “at best, a whitewash, at worst, a feeble attempt at a cover-up.”
How would the investigation have been different if the incident didn’t involve a government-run facility?
Should states make it easier to get medication to treat heroin overdoses? Pennsylvania is debating the issue now. Should police and firefighters be allowed, or required, to carry and administer naloxone? Should other users have immunity from prosecution if they are using heroin with the victim and call for help?
Why not just make naloxone over-the-counter and solve all the problems with access?
What if you’re a female in Saudi Arabia, you have a medical emergency at home, and need to go to the emergency department? Whatever you do, don’t get in your car and drive to the hospital. One Saudi woman who was recently caught driving herself to the hospital was pulled over by police and fined. It is forbidden for women in Saudi Arabia to drive because, according to an Islamic cleric’s interpretation of the Quran, driving causes women to lose their modesty, allows women to leave the house when their “homes are better for them,” allows divorced women to go wherever they want, and would lead to “overcrowding in the streets.”
Proponents of California’s Proposition 46, which would increase damage limits in malpractice cases to $1.1 million and would require drug testing of all physicians, put out an ad using assertions and statistics that are deemed “mostly misleading” by the Sacramento Bee.
Then again, opponents of the Proposition put out an ad that is also deemed misleading by the Sacramento Bee.
Dr. Steven Passik, a PhD lecturing at “PAINWeek” Conference recommends doing risk assessment for opioid abuse before reaching for their prescription pads. If you have risk factors for drug abuse such as “younger age, male gender, comorbid psychiatric problems, a history of substance abuse, a family history of substance abuse, [or] a history of smoking,” maybe you get drug tested every visit or maybe you just don’t deserve to have your pain treated.