Years ago I had a conversation with a surgeon at our facility. He was unhappy that a seriously injured trauma patient came to our facility after a MVC. ‘These patients shouldn’t come here Ed, they should go to a trauma center!’
Fair enough; we aren’t a trauma center. Not a Level I, not a Level II or III; not even a level 0.5! But we are the only hospital in a large rural county, and the closest, largest facility for portions of a few other counties nearby. The nearest hospital with neurosurgery and thoracic surgery is at least 30 minutes further away.
The problem is, torn blood vessels, crushed spleens, collapsed lungs, swollen brains don’t look at the clock, and cars aren’t designed to wreck only near trauma centers, any more than assailants shoot and stab people only within proximity of appropriate care. (It rather defeats the purpose of attempted murder, you know. )
Recently, my partner had the same conversation with the same surgeon. The patient had been shot twice and was hypotensive. ‘These patients shouldn’t come here!’ We understand, the conditions may not be ideal and trauma is, to be quite honest, fraught with medical and legal peril. Read more »
*This blog post was originally published at edwinleap.com*
We learn from the healthcare reform bill that the federal government will help subsidize Medicaid funding for all the new patients who qualify, but they will only do it for two years. After that, the states are on their own. Medicaid unfunded liabilities will crush state governments everywhere.
Why is Medicaid so expensive and going bankrupt? I’ll give you one example why. This is played out day after day, night after night in communities all across our country. And the only ones paying for it are you and me. The ones spending all the money have no incentive to stop.
I’m in the ER the other day when I see a chief complaint fly by on the radar. What is that chief complaint, you ask? Let me tell you a story.
Refused By Detox
The patient was so drunk even the community detox center refused him. So how did this play out? The patient was taken by ambulance from his home to a small-town community ER for altered mental status. There he was checked into the ER and seen by a small-town community ER physician, family practice resident, or PA or NP.
Diagnosis: Acute alcohol intoxication. Plan: Discharge to community detox center. Read more »
*This blog post was originally published at The Happy Hospitalist*
This isn’t really my story, but in a sense it belongs to all South Africans. It’s our shame and may be part of our downfall.
We are a people at war. We war against ourselves and we war against peace. Each fights for himself and bugger the rest. But who heals the fallen? It seems in South Africa that quite soon it may be no one.
Recently a story made the news. It was shocking, but it actually gives an inclination of how morally decayed South African society has become. An ambulance was despatched to some informal settlement after a household fire burned a child. The caretakers of the child brought the child to an intersection that the ambulance would actually be able to find. quite soon the paramedics were hard at work stabilising the screaming child. At about this stage, two armed thugs turned up. They threatened the child’s caretakers with their lives and forced them to flee. Then, while the child continued to scream in pain, they raped the female paramedic. They were not caught. Read more »
*This blog post was originally published at other things amanzi*
Would you know what to do if you needed an ambulance or if you had to go to an emergency room? During 2005, an estimated 115 million visits were made to emergency rooms in the United States – up 31 percent from 1995. About 14 percent of patients arrive via ambulance. Emergency rooms across America are overloaded – partly because many of the almost 50 million uninsured use the emergency room as their primary physician (and partly because we tend to focus on treatment of illness rather than prevention – but that’s another blog post).
During the next two segments, I will take you way behind the scenes and give you tips on how to be prepared in case the unexpected happens and you end up on your way to an emergency room. This week I play the part of a patient with chest pain and take you inside a New York City ambulance with paramedics Ray Cordi and Hanan Cohen. Next week my colleague, Richard Schlesinger, and I continue your tour inside the emergency room at New York Presbyterian Hospital/Columbia University Medical Center, the first time this institution (where I am on staff) has ever allowed such inside access to the media.
Watch CBS Videos Online
**This blog post was first published at CBSDOC.COM**