Articles Posted in Emergency Medicine

drunkstop-300x161As federal, state, and local officials seek to slash the nation’s spiking road toll of injury and death, law enforcement authorities need to crack down on the scary prevalence of motorists who get behind the wheel while intoxicated by marijuana or alcohol.

Indeed, as NPR reported:

“A large study by U.S. highway safety regulators found that more than half the people injured or killed in traffic crashes had one or more drugs, or alcohol, in their bloodstreams. Also, just over 54% of injured drivers had drugs or alcohol in their systems, with tetrahydrocannabinol (THC), an active ingredient in marijuana, the most prevalent, followed by alcohol, the study published [Dec. 13] by the National Highway Traffic Safety Administration found. Although the study authors say the results can’t be used to gauge drug use on the roads nationwide, they say the high number of drivers, passengers, and other road users with drugs in their systems is concerning.”

Doctors working in hospital emergency departments face chaos, violence and high stress every day, and usually they get the diagnosis and treatment right. But, and it’s a big but, as often as one in seventeen ER visits ends with a misdiagnosis, which can have deadly consequences. Those medical misdiagnosis are newly estimated by Johns Hopkins medical school researchers as a significant peril for patients across the country.

Doctors in the too-often harried ER environs fail to correctly “identify serious medical conditions like stroke, sepsis and pneumonia,” leading to the deaths of as many as 250,000 patients each year, researchers at the Johns Hopkins University Evidence-based Practice Center found in their work for a federal health care oversight agency. The New York Times reported this of the work:

“The study, released [Dec. 15] by the Agency for Healthcare Research and Quality, estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result. Researchers from Johns Hopkins University, under a contract with the agency, analyzed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake. Many of the studies were based on incidents in European countries and Canada, leading some officials of U.S. medical organizations to criticize the researchers’ conclusions.

boozexmas-150x150Cardiologists and other doctors have words to the wise for the aging, party-hearty-for-the-holidays crowd: Excessive boozing, as part of their seasonal merry making, puts those who partake of too much liquid cheer at heightened risk of heart problems.

The last thing, too, that public safety advocates would want to see in times when the nation is battling a rising road toll is any more intoxicated motorists.

Experts have become sufficiently savvy about the health damage caused heavy seasonal drinking that they developed a name for the harmful condition: holiday heart syndrome, the New York Times reported:

kmccarthy-150x150The nation’s military defense understandably takes a leading priority in public spending. But congressional Republicans have managed to put plenty of unpalatable elements into a Brobdingnagian appropriations bill that affirms an extreme view, undercutting the value of service personnel protecting themselves from deadly infections.

Over the objections of Pentagon brass and the White House, GOP members threatened to torpedo an $858 billion military spending bill unless the nation rolled back a requirement for U.S. troops to receive the coronavirus vaccine to serve.

The New York Times quoted Kevin McCarthy, the aspiring next House speaker and a California Republican (shown above), as saying this about GOP efforts to eliminate the vaccine mandate:

fluill-150x150The coronavirus pandemic may not hold the iron grip it once held on newspaper front pages and lead stories on broadcast and online news outlets.

The infection, however, keeps inflicting major harms — taking a disproportionate and lethal toll now on older Americans, wreaking sustained havoc on the credibility of public health information and medical expertise, and debilitating as many as 15 million people with the perplexing problems of long Covid.

Hospitals across the country are warning the public that they are teetering on the brink of getting overwhelmed yet again as they battle a “tripledemic” — an unusually early wave of RSV cases, an early and virulent seasonal flu, and a rising and still challenging number of coronavirus illnesses.

fdnybatteryfire-150x150For consumers who were too stuffed from their Thanksgiving feasting or too weary of stressful bargain hunting to jam the malls or to flock to the internet for Black Friday deals, the words to the wise have started flowing on how the savvy will ensure their holiday gifts also keep loved ones safe from unintended harms.

Kids toys, of course, are always cause for caution at this time of year, federal regulators say. But grownups also can glean safety reminders from disconcerting reports about an increasingly popular and practical potential seasonal acquisition — the so-called “e-bikes.”

With toys, the federal Consumer Product Safety Commission has issued a timely and distressing study. The federal watchdog agency reported that in 2021:

tksgiving-300x177Millions of us will have much to give thanks for during the annual holiday, which, like several of its recent versions, again will be a time of health wariness and uncertainty, too.

The seasonal feast — which brings so many the joy of not only a grand meal but also the pleasure of gathering with friends, family, and other loved ones — will be more costly than any in recent memory due to economic inflation and supply chain problems, the Associated Press reported:

“Americans are bracing for a costly Thanksgiving this year, with double-digit percent increases in the price of turkey, potatoes, stuffing, canned pumpkin, and other staples. The U.S. government estimates food prices will be up 9.5% to 10.5% this year; historically, they’ve risen only 2% annually. Lower production and higher costs for labor, transportation and items are part of the reason; disease, rough weather and the war in Ukraine are also contributors.”

walmartlogo-300x117Walmart has offered to pay $3.1 billion to settle thousands of lawsuits filed against the deep-pocketed retailing giant, accusing it of complicity through its nationwide pharmacy operations in the lethal opioid abuse and overdose crisis.

The Bentonville, Ark., -based company insists it committed no wrong and the states, counties, cities, Indian tribes, and others who sued Walmart said it did not have as large a part as other pharmacy chains in inundating the country with powerful, prescribed painkillers.

Still, Walmart joins CVS and Walgreens in settling rather than confronting those who have found sustained success in seeking justice in the civil system, various news organizations have reported.

ACEP-300x98Almost three dozen leading groups representing a range of doctors, specialists, and other health workers have called on the Biden Administration to deal urgently with the long-running but increasing and dangerous practice of hospitals allowing their emergency care facilities to be overwhelmed because they also are parking patients waiting for rooms and treatment.

This “boarding” crisis, already at breaking points for many exhausted ER staffs, will worsen and imperil patients even more if the nation gets hit — as growing indicators suggest is occurring — with a “tripledemic,” a choking load of coronavirus, flu, and other respiratory infections serious enough to require hospitalization.

The American College of Emergency Physicians (38,000 members), has been joined by the American Medical Association, the American Nurses Association, American Academy of Emergency Medicine (8,000 members) and groups representing family doctors, allergists, anesthesiologists, radiologists, osteopaths, psychiatrists, and many others in a recent letter to the administration, reporting:

pulseoximeter-150x150Until the coronavirus pandemic struck, few regular folks knew about pulse oximeters, much less had one on hand for urgent use. The devices, which fit over a finger, are supposed to give fast readings on the levels of oxygen in patients’ blood — a key measure of their respiratory wellness.

But the devices, whether in relatively inexpensive consumer versions or in medical-grade units used in doctor’s offices, clinics, and hospitals, are far from perfect. They suffer major inaccuracies when used by those with darker skin.

Federal regulators have known about this flaw for years. But at a time when patients, families, doctors, and hospitals relied on the devices routinely to make critical treatment decisions affecting those struggling with likely coronavirus infections, an information chasm opened. Doctors urged people to pop by drug stores and other retailers to pick up the devices, saying that they could be helpful in letting them know when their oxygen levels were dipping in concerning enough fashion that they should seek emergency treatment.

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