WhiteCoat back with more news from around the web. See more at my blog over at EP Monthly if you’re dying for more.
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“No one ever got well in a waiting room.” The growing trend of hospitals posting emergency department wait times online and via text message is nice for business, but it also contributes to rising health care costs. “They encourage some people to use the emergency room when a less expensive option would be more appropriate, such as a doctor’s office or urgent care center.”
Another source aimed at hospital administrators thinks that catching the “post-your-waiting-time” wave is good for business.
Part of me wonders what’s going to happen the first time that someone sues a hospital because they went to a hospital advertising a shorter wait time then didn’t receive timely care.
Kind of like Burger King opposing building another McDonalds … One hospital system wants to build a new emergency department, another hospital opposes it doing so. If a hospital wants to invest assets in creating more facilities, let them.
Still playing hot-potato with the Grady dialysis patients. No one wants to pay for their costly treatment. Grady Hospital closed 96 patients out of its dialysis center in October 2009 and told them to go to another state, get care at an emergency room, or return to their homelands. Since then, there have been contracts with some private providers to provide dialysis, but it appears that those services will soon end. Many are now expected to go to the emergency departments for care.
Check out this funny account of an emergency department visit from Mother.
Medical care at USC-LA County Medical Center getting harder to find. Overcrowding in emergency department is now “dangerous” 8 hours per day. During a recent inspection, one post operative brain surgery patient who was brought by ambulance after passing out waited for 15 hours to be medically screened. The County is crying poverty. “We have no money. We have no financial resources to expand our services in order to meet this growing demand.”
When taxpayers don’t pay their bills, governments seize and sell their assets. Anyone ever looked at what kind of assets LA County has?
I guess the sex-toy/porno industry is just waiting for the next big celebrity sex-meltdown. Here is evidence that Tiger Woods has made it finally. Although, the “Boy Butter” almost cracked me up more.
OK, so I know you don’t like to take medications – most normal people don’t. But normal people also realise that when they are sick, they may need some! In fact, normal people who come to the ER in severe pain EXPECT to be given some meds. The fact that you are refusing all meds for your severe pain means either A). You really are not in any pain, or more likely B). That you are a total whack job.
I’m not a pediatric endocrinologist but it seems to me that when someone calls that their kid with Type I Diabetes is puking his head off with blood sugars of 400+ probably needs more treatment than just “give him some pedialyte and see how he does”. But hey, I’m just an ER doc, what do I know?!?!?
Of couse he continued puking and getting worse and more dehydrated. By the time he came in, his BS was 490 with a PH of 7.1 and a Bicarb of 8.
Hello Peds ICU…..
Me: “Ma’am, we need you to give a stool sample”
Pt: “What! That’s disgusting! I ain’t gonna sh** in a cup!”
Me: “Well, you can go in this bed pan and then scoop some out with the included spoon in the collection set”
Pt’s Husband (holding a bucket of Popeye’s chicken and laughing at her): “HA HA! You gotta go crap in a cup! HA HA!”
Pt: “You shut your face or I’ll give my stool sample in that Goddam chicken bucket!”
Me: “Lets not do that”
The answer to Friday’s quiz is….
Air in the Cavernous Sinuses. (see the areas circled in red and around them)
How did it get there? Well, when the EMS people put the IV in and gave him fluids and Zofran, somehow some air got into the line and was injected into the vein. The air rises so it went straight up to the brain where it is seen in the Cavernous Sinus (in the veins that run there).
Basically there is no treatment for this except that you have to make sure it goes away – and that it hopefully does not travel back to the heart and get shot out the arterial system and cause a stroke or infarct somewhere.
He stayed overnight and got a repeat CT the next day which showed resolution of it and he was fine. The reason he came in was vertigo, the reason he was admitted was due to a “medical error”. We had a conversation about the whole thing and the patient understood and seemed happy I gave him the low down on it.
People often do anything to get out of work. Faking illness, faking injuries, sabotaging something, calling in bomb threats, you name it.
The other day we had a fire alarm go off at night. 99% of the time it is a false alarm or a test of the system. This time as I was talking to a patient, we both smelled something burning!
Wow! A real fire? How can that be? It seemed like it was coming through the vents in the ceiling so I went out into the dept to see what was going on. The smell got stronger and I followed my nose around the corner to the break room. There in the room was a nurse trying to fan away smoke from a smouldering piece of chicken she was pulling from the microwave. The whole place was smoke filled – no wonder the alarm went off.
Of course when the alarm goes off like that in a hospital, the troops come running. Within 5 minutes a cadre of full-clad firemen with axes, oxygen tanks, and picks showed up ready to save the day.
We promptly paraded the microwave-challenged nurse (3 minutes for a piece of chicken?!?!) in front of them as the chief suspect in the ensuing arson investigation. God, I know the weekend evening shifts suck, but come on, trying to burn down the hospital is a little impulsive.
Obviously we were kidding but she is gonna get razzed on this one for a while…
BTW, I will post the answer to yesterday’s CT question tomorrow.
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