Articles Posted in Emergency Medicine

traumatower2-300x205In the torrent of the relentless 24/7 news cycle, let’s not allow a new normal to prevail. We can’t forget that just days ago, a madman opened fire on a church in a small town south of San Antonio, Texas, killing at least 26 and wounding 20 or so. It was the worst mass shooting in the Lone Star State’s history, and it added to a horrific and growing toll for recent such gun-related outbreaks.

These incidents not only devastate the communities in which they occur. They also put giant strains of doctors, nurses, emergency medical technicians, and hospitals. All respond in ways that deserve a major salute, as well as empathy, compassion, and shared grief for the victims, their families, and those who seek to save and protect lives in chaotic situations.

The killing in Sutherland, Texas, posed its own unique stresses, with medical experts heaping praise on EMTs and first-responders for their heroic work at the scene, and then speeding those in need to care at hospitals at least 35 miles away.

epipen-300x119Big Pharma’s rapacious profit-seeking can seem to hit no bounds, even if it afflicts millions: Just consider what federal and state regulators are mulling about the makers of a popular anti-allergy therapy and those who supply a critical diabetes medication.

The federal Food and Drug Administration has replied to Bloomberg News Service that, so far, in 2017, it has recorded 228 reports of EpiPen or EpiPen Jr. failures, and the failure of EpiPens to deploy correctly has been cited in seven deaths through mid-September.

The agency said it is monitoring closely these “adverse event complaints.” These are unconfirmed reports that do not necessarily tie a product to a harm. But they might constitute sufficient grounds to investigate further and to potentially order product recalls, though, so far, the FDA says it believes patients can keep using EpiPens on the market without worry.

bowser-240x300Even as District of Columbia officials struggle with deepening woes at the United Medical Center (UMC), advocates from a national, independent, and nonprofit group have offered a dim review of hospitals in the DC area.

The bad news keeps piling on at UMC, a leading provider of medical care for communities of color in the District’s Southeast area and in Prince George’s County, Md.

To its credit, the sometimes locally slumbering Washington Post has put out a disturbing, well-documented report about the death of a 47-year-old HIV-AIDS patient in UMC’s nursing home care. As others witnessing the scene clamored for them to help, UMC nurses, the Post says, let the patient fall to the floor, where he sprawled in his own waste for 20 minutes while his caregivers argued with a security guard. When the patient finally was returned to his bed, he was dead.

calwildfire-300x222As California’s Wine Country deals with the prospect that the toll will rise more and the largely unchecked blazes will wreak greater havoc, doctors and hospitals have struggled with patient evacuations and the destruction of medical facilities. Millions of residents are coping with noxious smoke, terrible air quality, and breathing woes.

The Golden State crisis should offer a tough reminder to all of us in the rest of the country: Fire dangers remain real and lethal,  last year alone killing 3,390 Americans, injuring 14,650, and causing an estimated $10.6 billion. Families should not only do what they can to fire-proof their residences, they also should make emergency plans and practice them periodically.

Seniors may be at heightened risk, and they, their friends and loved ones, should make special precautions to safeguard them, planning for dire circumstance.

LV100117-300x215Caregivers and the community in Las Vegas, Nev., deserve a salute for their response to the gun violence last week, which could have overwhelmed a less-prepared community’s medical system.

Las Vegas  isn’t a giant metropolis (pop. 2 million in its metro area), and, due to the high costs to operate such a facility, it has just one Level 1 trauma center. That’s a facility staffed and equipped to provide a “gold standard” of emergency care. In the state of Nevada, the only such center is at the 541-bed University Medical Center of Southern Nevada.

It was slammed with more than 100 critical patients, many with life-threatening or fatal gunshot wounds.  A torrent of patients also was routed to the hospital, some for treatment of injuries they suffered while fleeing Stephen Paddock’s rampage. First-responders soon were flooding another facility, Sunrise Hospital and Medical Center in Las Vegas—a Level II trauma facility—with hundreds more.

Donald_Trump-1-225x300Even as President Trump belittles Puerto Rican political leaders, the Americans on the island have been swamped by a hurricane-caused health care crisis, according to doctors, hospitals, and nursing homes there.

The disturbing news reports show that sick and injured patients, with gas supplies limited, are struggling to navigate tree-blocked roads to get to hospitals that often lack power for cooling and to provide medical services. Doctors are reporting shortages of drugs and medical supplies.

Public health experts increasingly fear that health conditions will worsen, even as more rescue and recovery aid slowly trickles to a spot that long has wrestled with poverty and the isolation of many of its rural communities.

mwhc-front-entrance-300x174MedStar Washington Hospital Center, described by its chief medical officer as “the most important hospital in the most important city in the most important country in the world,” is under investigation by regulators in the District of Columbia due to maintenance failures that allowed sewage to seep down walls and onto operating room floors.

USA Today deserves credit for reporting on problems  in the 900-plus-bed hospital, which serves many of the District’s poor as well as providing trauma care sufficiently vital that it is supposed to be the go-to place of emergency treatment for top officials.

Its elite patients have included House Majority Whip Steve Scalise, who was taken to MedStar Washington after a deranged gunman wounded him while shooting up a Congressional baseball practice. USA Today says a room where Scalise was treated, later, after he was out of it, was among those affected by maintenance and sanitation woes.

flanursinghome-300x190Although Hurricanes Harvey and Irma have stormed off into the record books, their harms, particularly to health, persist for Texans, Floridians, and residents of the Caribbean. Recovery and return to normalcy will take the ravaged areas longer than many Americans realize, experts say. And they already are uncovering systemic woes, some fatal, with which planners and lawmakers will need to reckon with to better prepare for the next storm.

In Florida, for example, while hospitals, generally speaking, had adapted and rode out Irma maybe better than might be expected, nursing homes did not. They’re under new scrutiny, notably after eight residents died in an already troubled and roasting Hollywood, Fla., nursing home.

That incident refocused official attention on a sizable and particularly storm-afflicted population in the Sunshine State: its senior citizens. Whether in others’ care or ostensibly on their own, millions of older Floridians were left even more vulnerable after Irma, which cut off critical life services, including power, cooling, transportation, and access to medical services and food and other supplies.

harvey-300x200Houston’s medical system was staggered, but it stood up to the pounding inflicted by Hurricane Harvey’s winds and rains. But for the millions of residents of the nation’s fourth largest city huge challenges will persist for some time to their health and well-being.  Texans’ tragedies may offer us painful reminders we should heed about planning and disaster preparedness.

The Gulf Coast, of course, knows hurricanes well, and experiences with Katrina, Rita, and other storms had gotten doctors, hospitals, nursing homes, and other care=giving facilities well-launched into emergency planning.

Still, Ben Taub—one of the metropolis’s major emergency and public care facilities—found itself inundated and struggling with sudden patient evacuations, while other hospitals, including many in the city’s sprawling medical center complex, stayed drier and open. The big Texas Medical Center had installed huge submarine protective doors, which it shut to successfully protect vital equipment critical to running hospital infrastructure. Even so, rising, rushing waters cut the center and many other hospitals off, making them islands away from stranded staff and patients in potential need.

clockYour time is precious, and when you are a patient, you may feel it’s more so, especially if you’re ill or even in the end stage of your life.

So why do health care providers keep us waiting, or worse, why must doctors and hospitals act downright oblivious to how valuable our time might be as opposed to theirs—and what might be done about it?

Take a look at a thoughtful piece on how one health system has tried to keep true to the idea that patients matter above everything else and the delivery of care needs to focus on them:

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