Articles Posted in Emergency Medicine

unoslogo-300x190UNOS, the independent medical network responsible for procuring and distributing human organs for transplants in this country, needs big changes because it is failing desperate patients, making screening errors, among other missteps, that have killed dozens of them and caused hundreds to develop procedure-related diseases.

The U.S. Senate Finance Committee reviewed hundreds of thousands of pages of subpoenaed documents and other material and investigated the nation’s transplant network for 2½ years, assailing UNOS  for its operational and oversight laxity, the Washington Post reported:

“Testing errors and overlooked communications [in organ procurement] allowed the transmission of cancer, a rare bacterial infection, and other diseases …The errors included failures to identify disease in donor kidneys, hearts and livers, as well as mix-ups in matching blood types and delays in blood and urine tests that were not completed before transplant surgeries occurred, the investigators concluded in a report obtained by The Washington Post. The Senate committee partly blamed lax oversight of organ procurement organizations (OPOs), the regional nonprofits responsible for collecting donated organs, by the United Network for Organ Sharing (UNOS), the Richmond-based contractor that oversees the system. It listed as problems careless treatment of donated organs, organs lost in transit, and technological issues.”

debtnprkhnnursinghomesuits-247x300When seniors need full-time institutional care, or when the injured or debilitated require similar 24/7 attention, loved ones — and even friends — must take care to read and re-read any documents that nursing homes and other long-term care facilities shove before them to sign during the stressful admissions process.

That’s because the owners and operators of the facilities soon may create a financial nightmare for the unwitting document signers, fueling what is the huge shame of the U.S. health care system: medical debt.

Most regular folks might think that the financial obligations incurred in long-term care facilities rightly belong to the adult residents. They’re 21 and older, and unlike minor kids carted into urgent, or emergency rooms for treatment, the residents typically have, until their situations suddenly shift, been responsible, including legally, for their lives and personal business.

cdcoverdosedeaths-300x175The opioid drug abuse and overdose crisis is not only smashing fatality records, it also is slamming poorer people and communities of color and taking a savage toll on younger black Americans.

The federal Centers for Disease Control and Prevention has analyzed data from Washington, D.C., and 25 states, finding in its study published online, as the New York Times reported:

“Overall, overdose deaths jumped 30% from 2019 to 2020 … Deaths among black people rose 44%, about twice the increase in deaths among white people (22%) or Hispanic people (21%). Deaths among American Indians and Alaska Natives increased 39%. Measured as a portion of the population, in 2020, deaths among black people were higher than in any other racial or ethnic group — 39 per 100,000, compared with 31 for white people, 36 for American Indian and Alaska Native people and 21 for Hispanic people. ‘The disproportionate increase in overdose death rates among blacks and American Indian and Alaska Native people may partly be due to health inequities, like unequal access to substance use treatment and treatment biases,’ said Dr. Debra Houry, acting principal deputy director of the CDC.”

monkeypoxNIAID-300x259The worldwide struggle to contain a fast-spreading outbreak of monkeypox took on new urgency, with the World Health Organization declaring a global emergency and U.S. experts discussing whether the  viral infection is becoming yet another significant sexually transmitted disease that this country is ill-prepared to quell.

The WHO declaration, by WHO Director-General Tedros Adhanom Ghebreyesus, divided experts, some of whom were critical about the already pokey response to monkeypox or by others who said it was misguided.

Dr. Tedros conceded that the committee that advises him on global health emergencies had met twice, declining once to issue its alarm about the current monkeypox spread and then deadlocking on the issue. The WHO director used his authority to issue the emergency declaration, citing data showing that more than 16,500 cases have been reported in 75 countries.

suicidehotlineFederal officials have launched a new 988 number for callers with suicidal thoughts or other mental health emergencies, hoping that the public adopts this three-digit alternative and finds it as familiar and useful as 911 has become for medical and other urgent help needs.

The National Suicide Prevention Lifeline, which those in distress could reach by calling 800-273-TALK (8255) or texting HOME to 741741, will keep operating for a time.

But mental health advocates say they hope 988 soon will become embedded in the public consciousness as the line to call 24/7 to tap into resources — many of them which will rely more on individual states — for what have become big needs. Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, a nationwide grass-roots group, told the Washington Post this about the new hotline:

candidanew-300x150With the coronavirus pandemic surging anew due to the highly infectious Omicron BA.5 variant, federal authorities reported recent data that should give Americans plenty of reason to heed public health warnings and avoid hospitalization if they possibly can.

That’s in part because institutions, overwhelmed by the pandemic, have taken giant steps backward in preventing patients in their care from acquiring nasty bacterial and fungal infections in addition to the coronavirus, and from overusing and misusing lifesaving antibiotics, further fueling the rise of virulent super bugs, the federal Centers for Disease Control and Prevention says. As the New York Times reported:

“The spread of drug-resistant infections surged during the coronavirus pandemic, killing nearly 30,000 people in 2020 and upending much of the recent progress made in containing the spread of so-called superbugs, according to an analysis by the Centers for Disease Control and Prevention. Deaths caused by infections impervious to antibiotics and antifungal medications rose 15% during the first year of the pandemic compared to 2019, federal health officials found. Much of the increase was tied to the chaos wrought by the coronavirus as doctors and nurses struggled to treat waves of grievously sick patients whose illness they did not fully understand before vaccines and treatments were widely available. About 40% of the deaths were among hospitalized patients, with the remainder occurring in nursing homes and other health care settings, the CDC report found. Early on, many frontline hospital workers mistakenly administered antibiotics for viral lung infections that did not respond to such drugs, according to the study. Many of the sickest patients spent weeks or months in intensive care units, increasing the chances for drug-resistant bugs to enter their bodies through intravenous lines, catheters, and ventilator tubes.”

apachedash-300x177Anyone who has so much as contemplated buying a vehicle in recent times will quickly catch on to what experts fear may be a root cause of the nation’s spiking road toll: Step back and consider just how much importance manufacturers — and consumers — pay to those rolling infotainment systems.

Their screens have grown and dominate the dash. They no longer just control a tinny AM radio. They’re the gateway to powerful and all-encompassing entertainment systems. These can deliver high-fidelity music of all varieties, sports contests, news, and political commentary, as well as digital visual content viewable by passengers. The touchpad systems regulate the heat, air conditioning, and interior lighting. They also display ever-more sophisticated navigation, with dizzying maps, road and traffic conditions and warnings, as well as audio narratives of directions and even route highlights.

And what motorist now doesn’t have her cellphone linked into the “smart” vehicle system. This means dozens of contacts can be reached via conversation with a digital assistant, who then can hook a motorist up with the office, boss, spouse or partner, kids — and who knows who else? Combine this all, of course, with other driver displays — including speed, RPM, fuel consumption and conservation, engine temperature, and more.

bag-150x150If patients can benefit from price transparency by hospitals, shouldn’t employers and health insurers post online what they are paying for medical services? Yes, say federal regulators, who started requiring this effective July 1.

The federal Centers for Medicare and Medicaid Services (CMS) has ordered parties that act as health payers to make public a wealth of economic information that previously had been closely held, NPR and the Kaiser Health News service reported:

“[H]ealth insurers and self-insured employers must post on websites just about every price they’ve negotiated with providers for health care services, item by item. About the only exclusion is the prices paid for prescription drugs, except those administered in hospitals or doctors’ offices. The federally required data release could affect future prices or even how employers contract for health care. Many will see for the first time how well their insurers are doing compared with others. The new rules are far broader than those that went into effect last year requiring hospitals to post their negotiated rates for the public to see. Now insurers must post the amounts paid for ‘every physician in network, every hospital, every surgery center, every nursing facility,’ said Jeffrey Leibach, a partner at the consulting firm Guidehouse.

fireworkspm-196x300This great country will celebrate its 246th birthday on July 4, 2022 — a national holiday marking the anniversary of the adoption of the Declaration of Independence by the Continental Congress.

Here’s hoping one and all have a glorious, fun, and safe Fourth!

Wouldn’t the holiday be all the finer if folks, especially those fortunate to be in the area of the nation’s capital, enjoyed the flashy public festivities. And if the annual bunch of knuckleheads didn’t partake of illegal fireworks, or the even more dangerous practice of firing guns into the air?

abortionbanstates-300x205Congress has passed a modest gun control law for the first time in three decades. The breakthrough, compromise measure, quickly signed by President Biden, not only provides for background checks for would-be weapons buyers younger than 21 and a push for states to pass laws to take guns away from the dangerous, it also provides a rare boost of tens of millions of dollars for desperately needed mental health services across the country.

kidshealthanniecasey-300x155But at the same time, the U.S. Supreme Court has upended New York’s long-standing restrictions on concealed weapons and the justices threw out a half century of established precedent in reversing Roe v. Wade.

In a blink, women’s reproductive health and their rights suffered a damaging blow, with medical experts, including the American Medical Association, the American College of Physicians, and the editors of the New England Journal of Medicine, condemning the high court’s allowing states to ban abortion, notably without allowing for exceptions for rape, incest, or when mothers’ lives are imperiled.

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