Home / Healthcare Updates / Healthcare Update — 10-21-2014

Healthcare Update — 10-21-2014

More healthcare related news from around the web on my other blog at EP Monthly

Let’s call the first part of this post the

Ebola Chronicles

Treating one Ebola patient would wipe out the ICU in an average-sized hospital and may even bankrupt some smaller facilities. Most states won’t even allow disposal of waste from Ebola patients.

Then there’s the Ebola patient in the US you didn’t know about. Doctor infected with Ebola while working for the WHO in Sierra Leone was treated in Emory Hospital’s biocontainment unit for the past 6 weeks. Now is “well on his way to a full recovery.”

Baylor Medical Center in Texas requires that patients knock on glass door and answer Ebola screening questions before being allowed in emergency department.

Clipboard idiot walking alongside Dallas Ebola patient Amber Vinson and directing people in hazmat suits grabs hazmat trash bag and discards it, then boards the flight — with no hazmat gear. Were he and his clipboard quarantined after touching waste from the Ebola patient? Of course not. The only conclusion we can make from this scenario is that clipboards must prevent Ebola.

Vomiting is now an actionable offense. California’s Southwestern College evacuates and institutes quarantine after student who flew on same airplane as Amber Vinson gets sick and vomits in class

But vomiting and dying … not so much. Patient on Nigeria flight to JFK vomits and dies. Officials give corpse a “cursory” exam, declare he does not have Ebola, then whisk him from the airplane. Nothing to see here, folks. Move along. Move along.

Don’t look now … actress Tori Spelling quarantined in hospital with symptoms of Ebola. Well, she did have a fever and an “uncontrollable” cough, but she was hospitalized for bronchitis.
That reminds me. I have symptoms of Ebola, too. My muscles are sore … after I worked out yesterday.
Just wait until flu season hits.

And finally, the lawyers are already figuring out ways to profit from Ebola, suggesting that hospitals may have liability if they miss a diagnosis of Ebola.

Now back to regular news …

Buying insurance on the Obamacare exchange? Last year’s enrollment period began October 1. This year, you can enroll and find out how much your rates have increased … on November 15, 2014 … after the elections.
This strategic timing can only mean that rates are set to skyrocket. If they were trending downward, the elected officials who voted to pass Obamacare would be using that fact in their campaigns.
Want to see the names of the numbskulls who voted for this abominable law?
Roll call of Senators who voted for Obamacare (a party line vote by Democrats)
Roll call of House members who voted for Obamacare (pretty much a party line vote by Democrats as well)
Did I mention that elections are a couple of weeks away and that many of these people want to be re-elected?

More on the microbiome. Stress and shock may really cause a heart attack – by affecting the bacteria present in arterial walls. The stress hormones released during sudden stress may cause the bacterial biofilm over the arterial walls to dissolve, causing placques within the walls to rupture. In the future, managing bacteria within an arterial plaque (carotid arteries typically have Pseudomonas growing inside) may be just as important as managing a patient’s cholesterol.

What happens to all the kids who are sent from schools to the emergency department for psychiatric evaluations? In 92.2% of cases, they’re sent home, and in half of those cases they aren’t even given psychiatric follow up.
The study notes that only 18% of kids receive any evaluation from a school nurse or social worker before being sent to the emergency department, even though the screening decreases the chance of “unnecessary” ED evaluations by 50%.
Even though the study was done in Europe, I suspect that many of the cases of ED referrals were initiated due to liability concerns. If a child acts out and a teacher disciplines the child, the teacher may be accused of inappropriate actions. The safer and easier approach is to call the police or call the ambulance. Disruptive student is removed from the premises, hassle eliminated, no liabilty for having child evaluated by a professional.

Neat idea for a self-help emergency department kiosk. Hey – they have them in airports and grocery stores. Why not? They are being tried out in New Zealand, but it would be interesting to see whether they would be of benefit in busy US emergency departments. The kiosks collect key data like patients name, date of birth and gender and allow hospitals to check screening questions such as medication allergies and medical history. In addition, the kiosks measure blood pressure, height, weight, heart rate, oxygen saturation, and calculate that useless metric called BMI. It could technically be used to tell patients they need to go see their primary care doctor instead of being in the emergency department as well, but I’m sure someone would get pissed off at the suggestion and break the machine.

The video link of the week is enough to make you yak and make your head itch.
I present you with … a girl with head lice getting her hair combed. Scroll to the end of the video for the retchworthy part.  Just get rid of the comb and get an electric razor, pal.

3 comments

  1. WC…After the Spouse got a new job, we have insurance. We’ve already been informed that the company will no longer offer benefits after 2015, choosing to pay the penalty as it is…wait for it…cheaper than providing employees with health insurance. The premiums went up 20%. And now after having insurance for one year, we’ll be without again. Can you say “repeal”?

  2. I’ve been doing non-stop Ebola-blogging the last three weeks, and I’ve been raising the issue since late July/early August specifically.
    My rule of thumb is to look at open-source public news sites, and connect the dots with 4th-grade back of an envelope math (literally did it that exact way). And to, as a rule, assume the government powers-that-be are lying idiots. I’ve even shown my work.

    I have a flawless record so far, and got to where the WHO and CDC are getting now mere weeks before them, while predicting the current clusterflock of the response efforts almost to a “t”.
    If anything, I underestimated both common and official stupidity by orders of magnitude.

    Given that if Ebola keeps doubling every three weeks another 19-20 times, that 7,000,000,000 of us won’t be around anymore somewhere between next fall and the following Christmas, I’d be a darned sight happier if they would start making me look bad on this.

    No chance of that anywhere in sight so far, and rather just the opposite.

    My thought for the day was that officials noting that the chances of contracting Ebola casually from Dr. Thinklittle’s forays about town are “one-in-a-million” are a bit less than comforting in a metropolis of 8.4 million people. This is why math matters beyond the 4th grade.

    Also, the continued posting of two Bellevue nurses’ pics from an AP story of Oct. 9th, one in suitable hazmat precautions, and one dressed in a way guaranteed to acquire Ebola, and both exhibited as examples of “Ebola preparedness” for Ebola aren’t filling me with any cheerful thoughts about our long-term prospects as a species either.

    I can understand an unemployed box-shuffler lying to get here for treatment.
    But a Fellow of Emergency Medicine skipping around greater NYC is proof that nothing less than a draconian medieval confinement quarantine for all entry of suspected person is the only way to mitigate the pending catastrophe.

    Hence such is the only option not on the official table.

    If you fly, you can get a CT scan, pelvic, proctological, and podiatric exam, and a temperature check, which for most Americans is the closest they’ll get to a doctor under Obamacare all year.

    And if you like your Ebola, you can keep your Ebola.

    • Aesop–
      My job in the Army included Infectious Disease and so much more…My former OIC boss used to work with Primates and a deadly Herpes strain for 12 years! It was BSL-4 kind of work. He sent me the SOP for decontaminating…they did it ALL.DAY.LONG. The news showed people with rubber boots merely stepping in a bucket of bleach for seconds versus 15 minutes that Doc and his colleagues would do all day long, hourly. The lack of protocol to say the least based on my own experiences working with TB and deadly fungal agents is astounding.
      To wit, Doc used to say that someday I would convert to positive with the tine and PPD tests. Never did. (Go me!) He never had anyone convert in the primate research, either.
      And the idea that medical professionals are even allowed to “self-quarantine” and they don’t — (Nancy Snyderman, and NYC doc) should prevent them from ever practicing medicine again, IMO.

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