Healthcare Update Satellite — 12-16-2014
Answering the important questions … why does the flu vaccine suck this year? Keep a lookout for next month’s issue of EP Monthly which will tell you everything you need to know about influenza diagnosis and treatment.
Of course, if you had read the backboard article in EP Monthly’s November issue, you’d already be doing this … Florida fire department abandons use of backboards for most trauma patients.
4 year old boy develops carotid artery dissection and left sided hemiparesis after riding a roller coaster. Fortunately, he had made significant recovery by six months. How scary is that, though...
Source: WhiteCoat's Call Room - December 17, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Healthcare Update Satellite — 12-01-2014
According to this study recently published in the journal Neurology, etodolac (Lodine) (which may have been discontinued) creates the biggest risk of the medications studied.
Think hand dryers are more “sanitary” than using paper towels? Think again. Bacterial counts in the air around jet air dryers were 27 times as high as those around paper towel dispensers and stayed around for up to 15 minutes after the drying ended. Bacterial counts for warm air dryers were about 6 times as high as those around paper towel dispensers. In other words, using a public bathroom with electric hand dryers is likely causing you t...
Source: WhiteCoat's Call Room - December 1, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
An Argument With No Clear Winner
“You’re going to the hospital.”
“I’m NOT going to the hospital. There’s nothing they’d do and it would cost us thousands of dollars for nothing. Besides … we have to leave. We’re already late.”
A husband was attempting to attach the family’s camper onto the trailer hitch of the family’s truck when the trailer slipped. His middle finger didn’t make it out of the way and got caught between the ball of the trailer and the top of the hitch. When family members helped him pull the camper back off of the hitch, they saw a lot of blood. Then the last portion of his middle finger dropped from inside the t...
Source: WhiteCoat's Call Room - November 23, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
Healthcare Update Satellite — 11-04-2014
Back with more of the Ebola Chronicles …
Ebola fears causing discrimination problems all over the US. Thomas Duncan died from Ebola. Now his fiancee is having difficulty finding a place to live as landlords are refusing to rent to her. People of African descent are facing discrimination just because they are from Africa. Mothers of some school children told one African cafeteria worker to leave the school because she “might have Ebola.”
In Liberia, bleeding patients are often refused medical care due to Ebola fears. The picture at the link shows a picture of a woman who was bleeding heavily from a miscarr...
Source: WhiteCoat's Call Room - November 4, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Healthcare Update Satellite — 10-21-2014
This study makes a good case for requiring orthopedic evaluation in the emergency department for every pediatric patient suffering from any type of bone or joint injury – regardless of the time of day or night.
What no one is telling you about Ebola … from a Hazmat Trained Hospital Worker. The gear used to protect providers from Ebola is difficult to put on, difficult to remove, and can usually only be worn for 30 minutes at a time. The medical providers in Dallas who contracted Ebola had no protocols in place and this author believes that the “system failed them.”
Patients apparently believe that b...
Source: WhiteCoat's Call Room - October 21, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Healthcare Update Satellite — 10-13-2014
More medical news from around the web on my other blog over at DrWhitecoat.com
So what are medical providers supposed to do if they are faced with a potential or actual Ebola victim? Who knows?
Here’s a case you don’t see every day … Patient transferred to University of Alabama Medical Center after having what was thought to be a hand grenade embedded in his thigh. He wasn’t allowed in the emergency department, but was instead treated in an ambulance in the parking lot for more than six hours as a military consultant advised medical personnel how to remove it. Eventually was determined to be the 40...
Source: WhiteCoat's Call Room - October 13, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Healthcare Update Satellite — 09-30-2014
This article mocks some of the entries in the government’s new ICD-10 coding scheme. For example, “Bizarre personal appearance” is actually a codeable diagnosis. Estimates are that the costs for a doctor’s practice to change to the new coding system will average from $56,000 to $226,000. And sure, being required to differentiate between Orca bites and piranha bites or between first and subsequent run-ins with a lamp post may seem idiotic to most people, but if the coding isn’t accurate, it gives the government the ability to allege that there was false billing and to levy huge fines or even im...
Source: WhiteCoat's Call Room - September 30, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
How To Discourage A Doctor
This study showed that time lost in dealing with electronic medical records was “large and pervasive”, costing physicians an average of 48 extra minutes a day – during which they could have been performing other tasks such as patient care.
I’m sure that hospitals, their administrators, and their attorneys will all deny that they are trying to discourage physicians or to drive a wedge between physicians and their patients. Draw your own conclusions.
However, as more physicians move to hospital based practices and exhibit less autonomy, think about who stands to gain and who stands to lose from such t...
Source: WhiteCoat's Call Room - September 26, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Policy Source Type: blogs
Healthcare Update Satellite — 09-22-2014
More updated from around the web at my other blog at DrWhiteCoat.com
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 pr...
Source: WhiteCoat's Call Room - September 22, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Another Example of Defensive Medicine
The ultrasound images above show a circular clot in the superficial femoral vein. The image on the left is without compression and the image on the right is with compression. Normally blood vessels flatten out when compressed. Since the vessel did not flatten with compression it confirmed the presence of a blood clot.
While discussing a case with one of the nurses with whom I work, I saw how once again defensive medicine had affected my medical practice.
I gave a few examples of defensive medicine in a post several years ago and I also mentioned how sometimes doctors have to prove a negative when dealing with patients. Bot...
Source: WhiteCoat's Call Room - September 18, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Defensive Medicine Patient Encounters Source Type: blogs
Healthcare Update Satellite — 09-15-2014
This study should be required reading in every emergency medicine residency in this country. In fact, the concepts in the studies should be tested on the emergency medicine board exams.
Now if the study only compared the type of a patient’s insurance with the likelihood of emergency department recidivism.
How else can the media try to tarnish this guy’s reputation? The doctor who oversaw Joan Rivers’ fatal endoscopy was once *sued* 10 years ago. Gasp.
The former patient’s attorneys are really trying to create their 15 minutes of fame. They alleged that 10 years ago the patient received no informed ...
Source: WhiteCoat's Call Room - September 15, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Healthcare Update Satellite — 09-08-2014
Think a patient is faking alcohol withdrawal tremors? Yeah. There’s an app for that. Canadian researchers develop app that uses iPod’s built-in accelerometer to determine whether or not tremors are more than seven cycles per second. 75% of true alcohol withdrawal tremors have rates faster than that. Only one in six volunteers could fake tremors that fast.
Malpractice fees in British Columbia set to double. Physicians pay anywhere from $2,000 (for family physicians) to $20,000 (for obstetricians) in a defense fund every year in order to offset the costs of malpractice defense. The reserve requirements for the fu...
Source: WhiteCoat's Call Room - September 8, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Healthcare Update Satellite — 08-28-2014
Good news is that the number of medical malpractice cases in Pennsylvania is decreasing. Bad news is that if you practice medicine in the Philadelphia area, you’ve got a big target painted on your back. Philadelphia accounts for only 12 percent of the state’s population yet in 2013, 40 percent of medical malpractice trials resulting in verdicts took place in the city. Philadelphia medical malpractice plaintiffs won 45% of trials, more than any other jurisdiction and significantly higher rate than the national average.
Looks like we’ve found another place to avoid when looking for your next place to practi...
Source: WhiteCoat's Call Room - August 28, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Driving With A Foot Out The Window
I saw this while driving down the road recently. A person just tooling down a major road with their foot hanging out the window.
What possesses people do drive with their feet out the window? I see it every once in a while from both drivers and passengers. This time my daughter just happened to be in the car with me so she could catch this picture.
I did a quick search of the internet and of the medical literature and wasn’t able to find any specific literature on the potential downsides from driving like this.
I was, however, able to find other pictures/posts/comments …
calling a driver doing this a “j...
Source: WhiteCoat's Call Room - August 21, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Medical Topics Source Type: blogs
Healthcare Update Satellite — 08-12-2014
** CLEAR! **
Not dead yet. Having withdrawal symptoms from lack of blogging and actually violating a cardinal rule of blogging by posting from work. Now that travel is done and life is getting back to normal, will hopefully have more time to write.
Sabrina Kropp had damaged the cartilage in her nose from all of her cocaine use. She went to a plastic surgeon who repaired her nose and who then published anonymous before and after pictures of her nose on his web site. Ms. Kropp then sued the doctor for violating her privacy. The pictures pretty much isolate the patient’s nose, so it appears unlikely that anyone would be...
Source: WhiteCoat's Call Room - August 12, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
