Home / Healthcare Updates / Healthcare Update — 11-13-2011

Healthcare Update — 11-13-2011

See more medical stories from around the web over at the Satellite Edition of this week’s update at ER Stories.net

Remember how the Congressional Budget Office predicted that so many more people would have health care “insurance” after health care reform was enacted?
A recent Gallup poll shows that the CBO is inept at making these predictions.
Instead of a 6 million people gaining health insurance as the CBO predicted, more than 4.5 million people LOST their health insurance.
And we already know that health care insurance doesn’t equate to health care access any more than automobile insurance means that you have access to a car.

What was voted the most hazardous technology in hospitals this year? It’s not what you would think. Finally an agency looks into the unintended consequences of “safety” measures.

Patients really gone wild. Bronx hood punk shoots up emergency department after rival gang member called to triage for treatment.

Let’s legalize marijuana. After all, it’s [synthetic counterparts are] harmless … right? Right? (edited 11/15/2011)

The good kind of payback. Man stops to help someone change a flat tire. A few miles down the road, the same man has a heart attack and is unconscious. People with formerly flat tire drive up, perform CPR, and, when help arrives, use AED to save his life.

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Another amazing story. Baltimore marathon participant collapses 200 feet from finish line and goes into cardiac arrest, finishes the race, and lives to tell about it!

I was going to bring it to Baltimore for next year’s marathon, really. Tennessee woman arrested for stealing medications from two emergency department crash carts. Attention future miscreants: Nothing in a crash cart is going to give you a buzz. Succinylcholine – the bottle with the red flip cap – will paralyze you and probably kill you if you inject yourself with it. Many of the other medications will also kill you if used inappropriately. Think Michael Jackson. Plus, if you steal medications out of the crash cart, then they might not be available if we need to use them on someone that is in cardiac arrest. And … chances are that you’ll get busted for stealing it, anyway. Don’t do it.

Because baby wipes are so easy to swallow. Man charged with child endangerment after his infant child had to have baby wipe “surgically removed” from his throat.

Patient holds knife to her chest after being discharged from one hospital emergency department and demands to be taken to another hospital. Instead, gets sent to the Greybar Motel.

Yet more patients gone wild. Nurses recount stories about how they have been strangled and beaten with billy-clubs. Do hospital administrators bat an eye? If nurses strangled patients or beat patients with a billy club, it would make international news.

Patients gone wild International Edition. New Zealand nurses get punched in the chest and a doctor is racially abused by patients. Hospital has “zero tolerance” policy, but also has close to a “zero follow through” policy. Sometimes the patients get letters to “let them know we are pissed off.” Ooooooh. That’ll fix ‘em.

Older patients in pain less likely to receive pain medicine in the emergency department.

$963.70 for a couple of band-aids and a tetanus shot? Why is emergency department care so expensive?

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9 comments

  1. ER costs? I use an urgent care up the street. My kid stepped on a nail. They cleaned it, gave her a tetanus, an RX and we were done. Total was $203.00.
    Sprained my ankle pretty bad, used same urgent care. X-rays, exam, etc…$312.00. My actual cost for that was 68.00 because of insurance. We didn’t have insurance when nail incident happened. I avoid the ER at all costs…no pun intended.

  2. Both the news stories are about synthetic marijuana, not marijuana. Each substance has a different active ingredient. Moreover, the rise of synthetic drug substitutes could be seen as a result of illegality of marijuana.

    Regardless of your opinion on that matter, the substance which resulted in illness should be corrected in the post, if only for the sake of transparency.

    • Even the guy who invented the chemical in the 1970’s that was resurrected in the recent fake pot push thinks actually ingesting the synthetic meth-lab cannabinoids is crazy and dangerous. Do you want your kinds their freshman year of college to have a Budweiser or some moonshine, this dilemma isn’t all that different. Cannabis with documented effects or crazy third world brewed simulacrum with unknown dangers.

      • Good job at completely ignoring what I wrote.

        The post should be corrected to say ‘synthetic marijuana’ not ‘marijuana’ because the articles are about synthetic marijuana.

        How is correcting a factual error controversial?

    • Exactly what I was going to comment on.

      If you’re going to try to demonize marijuana, then don’t talk about other substances that share a name because people are unimaginative.

    • I updated the post to reflect your concerns. You will note in the USA Today article that the people involved were using both marijuana and K2.

      I think it’s a little disingenuous to suggest that the active ingredient in marijuana has no adverse effects upon the body while suggesting that synthetic THC and its derivatives wreak havoc on the body.

      I could link to dozens of articles regarding the adverse effects of marijuana. I’m sure you could find quite a few articles saying that those effects don’t exist. We’ll have to agree to disagree.

      But I am curious – do you agree with banning synthetic marijuana use? Why or why not?

      • Straw man.

        Few would suggest that marijuana, synthetic or otherwise, has no adverse effects. The strong argument for legalization, which you are welcome to try to refute, is that the adverse effects of a ban are worse than the adverse effects of the drug itself.

      • I support banning synthetic marijuana use, but legalizing marijuana. Marijuana’s active ingredients can have adverse effects, but they are fairly well documented and for a majority of users manageable.

        A methyl group here and a hydroxy group there is all that separates norepinephrine from amphetamine. Drug response is controlled by a variety of factors beyond the two big ones delivering the active effect, steric and chemical compatibility with a site of action.

        Synthetic marijuana (K2, K3, etc) are like bath salts. Designer chemicals designed to avoid legal obstacles with no meaningful testing for safety and only testing really for “does it get people high?” Some of the synthetic cannabinoids used in certain varieties of fake marijuana have cardiotoxicity that doesn’t manifest in natural cannabis. Synthetic marijuana isn’t about duplicating the active chemicals perfectly, but about approximating the subjective experience.

        The inclusion of the right handed isomer of the active drug compound in Celexa which is absent in Lexapro in some patients manifests as a theraputic benefit in Lexapro’s favor.

        Lipid solubility, ability to be degraded by enzymes, and receptor specificity aren’t necessarily going to be big things for people looking to make a chemical to get people high. They can have a tremendous impact on drug safety though.

        I think of it as considering the hazards of bathtub gin in lifting permitting lawful alcohol production in consumption. A moonshiner doesn’t have the incentive to discard the dangerous methanol containing foreshots that result from distilling that a licensed and accountable distiller has. Legalize marijuana and regulate the producer’s and a lot of the shady stuff that might happen to stretch the product and boost the effect will fade away. Maybe taking this industry away from the cartels will open up the opportunity to get some hippies in on the gainful employment thing.

      • First, Joe B, stop playing semantics like Matt used to do. Frame the question however you’d like. If there is a “strong argument” for legalization of marijuana, then do you agree that there is also a “strong argument” for legalization of synthetic marijuana? Why or why not?

        Aaron, I’m not going to pretend that I know the chemistry behind marijuana and all of its derivatives. You say that “some” of the synthetic cannabinoids have cardiotoxicity. I’m not aware of those studies. Could you cite a couple?

        When you discuss “duplicating chemicals” between “natural” and “synthetic” marijuana, why does it make a difference whether the chemicals are perfectly duplicated?

        You can cite all the examples of differences in isomeric compounds you’d like. In clinical practice, the only difference I see in the latest and greatest isomers of common medications such as Xopenex and Clarinex is that they allow drug companies to claim patents and charge patients much more money for medications that have the same or similar effects as their non-patented counterparts. I sincerely doubt that there are any studies showing the effects of synthetic marijuana are materially different than those of “natural” marijuana.

        It seems to be a tenuous argument to insinuate that marijuana’s side effect profile including pulmonary infections/respiratory cancer, frontal lobe dysfunction, psychosis/schizophrenia, and others is acceptable while that of synthetic marijuana is not. Again, I’m not intending that this become a dissertation on pros/cons of marijuana use, only to show you that marijuana is not as “safe” as you assert.

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