Emergencies / First Aid
Emergency Medicaid for Immigrants Goes to Childbirth
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An analysis of state Emergency Medicaid spending contradicts assumptions about emergency care provided to recent immigrants, researchers from the University of North Carolina at Chapel Hill and the Carolinas Center for Medical Excellence have found.
The study appears in the March 15 issue of the Journal of the American Medical Association. Dr. Annette DuBard, a research associate at UNC’s Cecil G. Sheps Center for Health Services Research, will present the results Tuesday (March 13) at a JAMA media briefing on access to care at the National Press Club.
U.S. weighs emergency research without consent
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Emergency medical research without patient consent should be allowed in some cases where quick treatment is critical and getting permission is difficult or impossible, researchers on Wednesday told U.S. officials who are reconsidering the rules for such studies.
The issue gained new attention this year when the Food and Drug Administration was criticized for letting Northfield Laboratories Inc. study an experimental blood substitute, PolyHeme, in trauma patients without getting their permission first.
Several emergency medicine and trauma specialists, who dominated the speakers at an FDA public meeting on the issue, said waiving the consent requirement was needed in some cases.
For some men, sports pre-empts emergency room stop
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Not even a medical emergency can pull some men away from a television showing their favorite sports teams, a U.S. study has determined.
University of Maryland emergency physician David Jerrard tracked nearly 800 regular season college and professional football, baseball and basketball games in the state over three years and found there always was an increase in the number of men who checked into emergency rooms after these events.
Jerrard’s study, to be presented on Sunday at the annual meeting of the American College of Emergency Physicians Research Forum in New Orleans, showed about 50 percent more men registered in emergency rooms after a football game than during the event itself. Thirty to 40 percent more men sought care following a baseball game.
No easy fix for emergency rooms, experts say
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A lack of staff, space and equipment hobbles the U.S. emergency medical system and almost no steps have been taken to improve things despite numerous warnings, emergency room professionals told Congress on Wednesday.
But emergency room physicians and members of Congress alike were at a loss about what to do to fix a system that almost everyone agrees is at a breaking point.
“It isn’t too clear and that is because what is required is so big,” Dr. Rick Blum, an emergency room doctor from West Virginia who is president of the American College of Emergency Physicians, said in an interview.
Rapid flu test curbs diagnostic testing in the ER
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A point-of-care rapid influenza test used during the flu season in the pediatric emergency department of a children’s hospital was sensitive and specific for influenza infection, and led to less diagnostic testing, a Tennessee-based team of doctors found.
“Influenza is one of the common causes of illness during the winter,” lead researcher Dr. Katherine A. Poehling pointed out in remarks to Reuters Health. “We found that rapid influenza tests were associated with fewer tests being ordered in the emergency department.”
To investigate the impact of such testing, Poehling and colleagues at Vanderbilt University Medical Center, Nashville, conducted a study during the influenza seasons between 2002 and 2004. Surveillance days were randomly allocated to use or non-use of the test. Rapid results were compared with results of standard culture or another method of detecting viruses called PCR.
CT Colonography Even Safer Than Previously Reported
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The safety profile for CT colonography (CTC) is extremely favorable, particularly for the purposes of screening patients with no symptoms and when distending the colon using an automated carbon dioxide technique, a finding that goes against the higher complication rates for CTC reported by other groups, according to a new study.
For this study, researchers analyzed 21,923 CTC procedures, including both diagnostic and screening procedures. Colonic distention was achieved by manual room air insufflation in 60% of cases and by automated carbon dioxide delivery in 40%. No perforations were recorded in patients undergoing screening CTC or with those who underwent the automated carbon dioxide delivery technique.
Lack of Basic Research Putting Patients at Risk
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Patients are suffering because not enough basic clinical research is being done, warns a senior doctor in this week’s BMJ. He believes that medical academia is failing patients and clinicians by neglecting this vital area of research.
Basic observational research provides the information that doctors need to diagnose and treat patients appropriately, writes neurologist Professor Peter Rothwell. But in the field of neurology alone, many examples exist where a lack of basic data is the main barrier for effective treatment in routine practice.
For instance, little is known about the reliability of diagnosing stroke and, until very recently, no reliable data existed on the early risk of stroke in certain patients. Countless patients have suffered as a result, yet much of this research is easy and relatively cheap to do, so why has it not been done, he asks?
Emergency Departments Score Poorly in Child-Saving Drills
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A mock-drill study conducted in a third of North Carolina’s hospital emergency departments (EDs) revealed that nearly all failed to properly stabilize seriously injured children during trauma simulations, according to a team of researchers at the Johns Hopkins Children’s Center and Duke University Medical Center. Simulations were conducted in 35 of North Carolina’s 106 EDs. Of the 35 EDs in the study, five were designated trauma centers (out of a total of 11 in the State of North Carolina), and 30 were located in community hospitals. A report on the work by the research team stating the results probably apply to hospitals nationwide is published in the March issue of Pediatrics.
Although researchers caution that observations during mock codes do not necessarily represent performance in an actual health emergency, the study’s results do suggest that hospital EDs are not fully prepared to deal with pediatric emergencies, according to lead author Elizabeth A. Hunt, M. D., M. P. H., assistant professor of Anesthesiology and Critical Care Medicine at Johns Hopkins.
Ukraine lifts bird flu state of emergency
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President Viktor Yushchenko lifted the state of emergency in Ukraine’s Crimea as an outbreak of the deadly H5N1 bird flu in the region has been eliminated, a presidential decree said on Thursday.
Ukraine reported its first outbreak of the disease in a dozen villages on the peninsula, a major stopover point for migratory birds, in late November.
MRI Provides Better Diagnosis & Treatment for Uterine Fibroids
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Research of 100 women suffering from uterine fibroids showed that magnetic resonance imaging (MRI) improves the patient selection for who should receive non-surgical uterine fibroid embolization (UFE) to kill their tumors. Uterine fibroids are very common benign (non-cancerous) growths that develop in the muscular wall of the uterus in up to 40 percent of women age 35 and older. Research also showed interventional radiologists can use MRIs to determine if a tumor can be embolized, detect alternate causes for the symptoms, identify pathology that could prevent a women from having UFE and avoid ineffective treatments.
Women typically undergo an ultrasound at their gynecologist’s office as part of the evaluation process to determine the presence of uterine fibroids. It is a rudimentary imaging tool for fibroids that often does not show other underlying diseases or all the existing fibroids. For this reason, MRI is the standard imaging tool used by interventional radiologists.
Bird flu kills a Vietnamese, emergency plan at work
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The deadly bird flu virus, now feared heading for Europe, has killed a Vietnamese, taking the number of deaths in Asia from the disease to 63, a senior official said on Thursday.
The victim, whose gender was not disclosed, died from acute Pneumonia on Sunday and tests showed the H5 component of the H5N1 avian influenza virus in the body, the Tuoi Tre newspaper quoted Deputy Health Minister Trinh Quan Huan as saying.
Malpractice fears drive docs to order excess tests
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In evaluating patients who have chest pain, some emergency room physicians too often order unnecessary tests and hospitalizations out of fear of malpractice lawsuits, according to a new study. “Concern about malpractice has a formidable effect on physician decision making,” particularly in the scenario of a possible heart attack or unstable angina, collectively referred to as acute coronary syndrome, Dr. David A. Katz told Reuters Health.
Katz, from University of Iowa, Iowa City, and colleagues developed a malpractice fear scale and used it to evaluate the association between emergency physicians’ fear of malpractice and the evaluation and treatment of patients with symptoms suggestive of an acute coronary syndrome.
During a chemical fire, evacuation may not be best
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Evacuation of local residents during a chemical air pollution incident is not necessarily the best way to prevent exposure to toxic fumes, according to UK investigators.
“Unplanned evacuations where a lot of folks are moved around have the potential for both psychological and physical problems,” Dr. Sanjay Kinra, from the University of Bristol, told Reuters Health.
Israel moves to halt unauthorised patient tests
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Israel has tightened hospital supervision after an investigation uncovered a spate of unauthorised experiments on children, psychiatric patients and the elderly, the Health Ministry said on Wednesday.
A report from the state comptroller found that in one hospital, 40 geriatric patients had signed consent forms to undergo experiments - some with only a fingerprint - even though they had mental illnesses, including dementia.
The report has drawn intense criticism in the Israeli media with one headline calling it a ‘scandal’ and another accusing the ministry of negligence.
