Emergency Medicine

November 19, 2019

Superbugs’ deadly rise has plunged planet into risky ‘post-antibiotic’ era

Federal officials have put out some scary new findings about the state of patients’ health in the 21st century: Superbugs may be more common and potent than previously believed. And we may now have plummeted into what experts are calling the perilous “post-antibiotic age.”

This all amounts to far more than a hypothetical menace. It could affect you if you get, for instance, a urinary tract infection. Or if you undergo a surgery, say, for a joint replacement or a C-section. Depending where and how you live, you may see the significance of this health problem if you contract tuberculosis or some sexually transmitted diseases.

As the news website Vox reported of the startling new information from the federal Centers for Disease Control and Prevention: “Every 15 minutes, one person in the U.S. dies because of an infection that antibiotics can no longer treat effectively.”

November 12, 2019

New doubts cast on a key safety tool: police roadside alcohol-testing devices

by Patrick A. Malone

Although drunk drivers inflict terrible carnage on others traveling on the nation’s streets and highways, law enforcement agencies and skeevy device makers may be unwinding the trust in what has become a cornerstone of the nation’s safety regimes: roadside alcohol testing machines.

The New York Times reported that it “interviewed more than 100 lawyers, scientists, executives and police officers and reviewed tens of thousands of pages of court records, corporate filings, confidential emails and contracts” to discover “the depth of a nationwide problem that has attracted only sporadic attention.”

As the newspaper noted of roadside “breathalyzer” exams and devices used for them:

November 7, 2019

‘Any One of Us’ shows harsh realities and hope for spinal cord injury patients

by Patrick A. Malone

Extreme sports may be to blame. Or it might be a falling tree, an error with a surgery, or an auto wreck.

As the title of the tough, direct, and new HBO documentary makes clear, “Any One of Us” might suffer from a calamitous spinal cord injury (SCI). The 1-hour and 25-minute work by first-time director Fernando Villena focuses on pro mountain biker Paul Basagoitia but is carried by a “chorus” of 17 women and men who all have had significant injuries to their spinal cords.

November 3, 2019

Raging wildfires and major power shutoffs: Big tests in Calif. raise questions for the rest of us

by Patrick A. Malone

California’s raging wildfires may seem a far coast away, and this seasonal calamity attracts little attention among policy makers in official Washington. But the fires are sending sharp warnings that the rest of the nation might well heed.

The disasters have uprooted hundreds of thousands, destroyed dozens of homes and other buildings, and led to shutoffs of a basic service — electricity — to huge swaths of the nation’s most populous state. They also raise serious issues to anyone who is concerned about the:

fragility of the health care system, particularly the vulnerability of hospitals that the public will desperately need but may not be open in crises, despite the notable resilience that care givers and institutions now display;

October 30, 2019

For patients, a glimpse into data on the quality and safety of surgery centers

by Patrick A. Malone

They may be more appealing and convenient because they’re located in the neighborhood with better hours and more parking. They also may be less costly because they lack the high overheard of big hospitals. But those booming same-day surgery centers have patient safety issues of their own.

Their doctors and nurses may not be as well-trained as patients might find at big hospitals or academic medical centers, with 1 in 3 centers not having staff who were all board-certified, according to the Leapfrog Group, a consortium of big companies and other major health care users focused on patient concerns.

Leapfrog has issued — to its considerable credit — its first safety and quality study of the facilities, also finding that, “not all ambulatory surgery centers and hospital outpatient departments provide surgery consent materials before the day of surgery. Just 14% of ambulatory surgery centers provided the information one to three days before the surgery, while just 20.7% of hospital outpatient departments do so,” Modern Healthcare, an industry news source, reported.

October 16, 2019

Get ready, Washingtonians — 20,000 scooters soon may be part of cityscape

by Patrick A. Malone

In the cooler, rainier autumnal weather, transportation officials may be planting the seeds of significant change for the health, safety, and way that residents and visitors get around Washington, D.C. They may allow a smaller number of private companies to double the number of scooters zipping around the nation’s capital by the new year. By the spring, the devices may quadruple in number.

This could mean the estimated 5,000 or more scooters in the district now would increase to 10,000 by January and to 20,000 by June.

District officials say they’re responding to a spike in demand from the public for convenient ways to get around and to do so with needing to use multiple clumsy and confusing smart phone apps.

October 4, 2019

With data and disclosures, experts, families, and friends battle suicide’s toll

by Patrick A. Malone

Dogged medical detective work combined with public advocacy to dispel the shame that surrounds suicide — these may be productive ways to attack the public health nightmare of increasing numbers of Americans taking their own lives.

This is a crisis that can’t be hidden or allowed to keep going up, with some experts estimating that roughly 47,000 Americans commit suicide annually. That’s about 129 lives lost each day. Suicide, hitting a record-setting pace, also is a significant problem for the U.S. military.

If you are in crisis or know someone who may be, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or text HOME to 741741. Both work 24/7. More resources are available at SpeakingOfSuicide.com/resources.

August 12, 2019

Gun violence is a public health crisis. Research and treatment are needed now.

by Patrick A. Malone

With back-to-back-to-back incidents of mass gun violence killing almost three dozen children, women, and men, can this nation muster the political courage to treat this lethal scourge as a public health menace?

Can it, finally, green light and fund rigorous research that could inform public policies that both could protect Americans’ Second Amendment rights while also reducing the estimated 40,000 or so firearm deaths that occurred in 2018 alone?

For what it is worth, there is considerable and (what should be) convincing evidence that:

July 28, 2019

Can lives be saved with lessons learned from a space pioneer’s botched care?

by Patrick A. Malone

Neil Armstrong served as a naval aviator, test pilot, federal administrator, and a university professor. He earned his place in history as space pioneer — the first astronaut to walk on the moon. The American hero, who spoke the legendary phrase about “one small step for man and one giant leap for mankind,” also now offers a textbook case about nightmares in health care. Can others avoid these by learning about what happened to him?

As the nation celebrates the 50^th anniversary of Armstrong’s Apollo 11 flight, an anonymous tipster has disclosed information to two news organizations that his death was due to botched care. His family, which included a lawyer who represented their interests, reached a $6 million settlement with the community hospital involved.

Armstrong was known for keeping out of the media and public glare. His family kept that tradition in keeping private how he died in 2012, why, and the tense negotiations that resulted in the sizable payment to them by the hospital. Full information about his case may never be fully disclosed. But it already provides a possible series of check points for patients to protect themselves and their loved ones in dealing with doctors and hospitals:

July 3, 2019

Suffering of rural poor a reminder of how much health policy debates matter

by Patrick A. Malone

Twenty Democrats who are campaigning for president took to network television for four hours and two nights last week to put health care as a central issue of their campaigns.

The format of this initial candidate “debate,” including hand-raised answers to complex issues, failed to allow the presidential aspirants to delve much into the details of their proposals. But tons of news coverage followed on — and likely will keep doing so up until Americans enter the voting booth — about Medicare, the government health coverage for seniors, and how it might be expanded to benefit tens of millions more. Those interested may wish to check out this podcast primer on the issue.

These future-looking discussions also already have tended to eclipse a key part of the existing Affordable Care Act, the Obama Administration initiative that remains a subject of hot dispute a decade after its passage: The expansion of Medicaid, the federal program to assist the poor and working poor with health coverage.