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CALL FOR FCEP COMMITTEE MEMBERS
Participation on an FCEP Committee is an essential part of our program activity. Committees help us with important initiatives such as setting our legislative and regulatory priorities. They also help us to identify clinical issues affecting patients and our members.
I encourage you to consider serving on an FCEP Committee. It is a great way to learn about how others are dealing with hospital ED issues and to help FCEP remain strong in so many areas.
Committees typically meet quarterly, in conjunction with FCEP Board meetings:
DATES AND LOCATIONS:
Feb. 18, 2015 — FCEP Offices, Orlando
May 20, 2015 — FCEP Offices, Orlando
Aug. 6, 2015 — Symposium by the Sea, Amelia Island
Please use these links to connect to the Committee Interest Form and view the Committee Objectives.
Ashley Booth-Norse, M.D. FACEP
Note to our members currently participating on committees: We ask that you please also submit a committee interest form to renew your committee membership.
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EMERGENCY MEDICINE IN THE NEWS — AROUND FLORIDA
Legislative delegation meetings
FCEP encourages members to participate in their local legislative delegation meetings. These sessions provide a great opportunity for FCEP members to learn about their individual legislator’s priorities as well as to contribute to the discussion. FCEP would be happy to provide talking points on our 2015 legislative priorities.
Click here to see the 2014-2015 Legislative Delegation Meeting Schedule.
5th Annual National Hospital Disaster Planning, Preparations and Response Symposium: An All-Hazards Approach
Friday, Feb. 13, 2015
This symposium is jointly sponsored by Jackson Health System and the University of Miami Miller School of Medicine. Click here to learn more.
Push for bill to advance telemedicine in Florida grows
Florida lawmakers should propose a simple bill in 2015 that would allow for the growth of telehealth services, according to the Sun-Sentinel's editorial board.
The Legislature should "approve a measure that provides safe and smart remote medical care, while establishing incentives to encourage insurers to reimburse health care providers for telehealth services," according to a recent editorial.
Saving lives at the hospital: Bacteria-resistant gowns
For 52 years, the Youngbloods have endured life's ups and downs, but a trip to the hospital for his heart became "a holy nightmare," according to Richard Youngblood. Richard lost two toes to MRSA; and later, a urinary tract infection. "And that turned out to be e-coli," said his wife, Nancy. Then the infection D. Diff struck, causing uncontrollable bouts of diarrhea. "He would just stand up and it would just run out," Nancy explained. Richard is one of the two million patients in the United States suffering with hospital-acquired infections each year. That's why Baptist Health in Florida said it's the first system in the world to unveil new bacteria-resistant uniforms and gowns.
No Florida hospitals designated Ebola treatment centers
Tampa Bay Times
Republican Gov. Rick Scott made Ebola preparedness a top priority in October during the final weeks of his re-election campaign — so much so that he appeared on live television to tout his plans for keeping Floridians safe. But as of recently, no Florida hospitals have been designated Ebola treatment centers.
The 36 treatment centers are in New York, California and 10 other states, along with the District of Columbia, according to a list released by the federal Centers for Disease Control and Prevention. The closest to Florida is Emory University Hospital in Atlanta.
Health law impacts primary care doc shortage
Health News Florida
When Olivia Papa signed up for a new health plan last year, her insurance company assigned her to a primary care doctor. The relatively healthy 61-year-old didn't try to see the doctor until last month, when she and her husband both needed authorization to see separate specialists.
She called the doctor's office several times without luck.
"They told me that they were not on the plan, they were never on the plan and they'd been trying to get their name off the plan all year," said Papa, who recently bought a plan from a different insurance company.
EMERGENCY MEDICINE IN THE NEWS — NATIONAL
Are freestanding ERs about access or profit?
Freestanding emergency departments (EDs) carry high costs despite their benefits, many of which organizations could achieve through other methods, according to the Milwaukee Journal-Sentinel.
Freestanding EDs, which are growing in popularity across the country, are widely considered a potential solution to long wait times and access issues in traditional EDs. The total number in the U.S. has grown to more than 400 in the last five years, according to the article. But critics of the model say freestanding EDs provide a much more expensive variation on urgent care.
CDC health advisory regarding the potential for circulation of drifted influenza A (H3N2) viruses
Centers for Disease Control and Prevention
The U.S. Centers for Disease Control and Prevention (CDC) has issued new guidelines for flu vaccinations and use of antiviral medication in instances of the flu due to mutations of the flu virus. The CDC continues to encourage all patients six months and older who have not yet received an influenza vaccine this season to be vaccinated against influenza.
Efforts to improve patient safety result in 1.3 million fewer patient harms
Agency for Healthcare Research and Quality
The report from AHRQ provides preliminary estimates for 2013 on hospital-acquired conditions (HACs), indicating a 17 percent decline, from 145 to 121 HACs per 1,000 discharges, from 2010 to 2013. A cumulative total of 1.3 million fewer HACs were experienced by hospital patients in 2011, 2012, and 2013 relative to the number of HACs that would have occurred if rates had remained steady at the 2010 level. Approximately 50,000 fewer patients died in the hospital as a result of the reduction in HACs, and approximately $12 billion in health care costs were saved from 2010 to 2013.
Study: Online checklists can reduce improper antibiotic prescribing
Using an online checklist can help reduce unnecessary or improper prescribing of antibiotics, thereby cutting costs, according to a study published in the Annals of Internal Medicine. For the study, researchers from the McGill University Health Center in Montreal examined the use of "time-outs" during treatment, when providers re-evaluate treatment plans as situations change. Specifically, physicians used online checklists to review changes in the type of prescribed antibiotics, doses and duration of treatment.
ED antipsych meds: To inhale or not to inhale?
Emergency physicians often struggle with acutely agitated patients, balancing the hope that patients will improve with oral medications against the often dangerous options of physical restraint or involuntary medications.
For psychiatric patients, that often means intramuscular (IM) antipsychotic medications such as haloperidol or droperidol, with or without benzodiazepines.
The measles outbreak coming near you
The Wall Street Journal (opinion)
Author Haider Javed Warraich writes: I was working on the hospital infectious-disease service when our team was asked to see a young girl with a mysterious illness that no one had been able to diagnose. She had come to the emergency room with a fever and runny nose and had a rash spreading across her body. She had developed a cough so harsh that “whooping cough” had been added to the long list of possible infirmities.
Study: Many kids exposed to unnecessary X-rays
Many American children receive unnecessary chest X-rays, a new study indicates. "Chest X-rays can be a valuable exam when ordered for the correct indications. However, there are several indications where pediatric chest X-rays offer no benefit and likely should not be performed to decrease radiation dose and cost," said study author Ann Packard, M.D., a radiologist at the Mayo Clinic in Rochester, Minnesota.
New cardiac monitor process reduces alarm fatigue in hospitals
By Lynn Hetzler
A hospital monitor alarm can save a patient's life, as a single beep or high-pitched wail spurs doctors and nurses into action. However, the chorus of alarms that go off in the typical hospital ward can be mind-numbing to healthcare workers. The constant din of alarms can desensitize them, leading to "alarm fatigue" where audible alerts fail to catch the attention of workers.
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In search of a 'safe harbor'
At the dead center of the healthcare reform debate is the tension between saving lives and saving money. The reformers say that American healthcare costs too much and one of the ways to cut costs is to pay providers less. Providers warn that such cuts incentivize them to see more patients in a shorter amount of time, relying more and more on lab testing. Thus, these kinds of cuts could actually end up costing the system more in the long run. Providers are also incentivized to overtest because doing otherwise can expose them to potentially devastating litigation.
Emergency rooms often skip the epinephrine for severe allergies
An epinephrine injection can be life-saving for someone with a severe allergic reaction to a bee sting, a peanut or a piece of shrimp. But just half of internal medicine doctors know that epinephrine should be the first treatment, a recent study finds.
And it gets worse in the emergency room — up to 80 percent of the time, a person experiencing anaphylaxis, a severe allergic reaction, isn't receiving epinephrine when they should, another study found.
Hospital vanquishes 'monster number' of false alarms
A common and not-so-silent killer is lurking in hospitals. The Joint Commission reports that there were 98 alarm-related sentinel events and 80 alarm-related deaths in the U.S. between January 2009 and June 2012. While these alarms were designed to alert hospital staff that something needs to be attended to immediately. But in practice, the number of alarms can be overwhelming for hospital staff, patients and their families. But staff at one Ohio hospital discovered a way to quell the noise — and in the process created a better environment for patients and their families.
Current approach to treating feed intolerance during critical illness
By Dr. Afsaneh Motamed-Khorasani
Impaired gastric emptying as well as impaired antropyloro-duodonal and intestinal motilities are common observations during critical illness. The underlying mechanisms for gastrointestinal motility dysfunctions during critical illness are not quite clear, but there have been many contributing factors mentioned in the literature.
Researchers examining new paths to treat pain and inflammation
By Dorothy L. Tengler
Pain of any type — whether acute or chronic — is the most frequent reason for physician consultation in the United States, prompting half of all Americans to seek medical care annually. Although separate conditions, pain and inflammation are nearly always associated with each other. Despite the prevalence of these conditions, the primary options available for their treatment have changed surprisingly little in recent years. Steroids, nonsteroidal anti-inflammatory drugs and opiates are still the mainstay treatments, although all have their drawbacks.
Why you doctors avoid saying 'drug overdose'
The Huffington Post
The term 'drug overdose' is thrown around a lot, but new findings suggest that patients at risk for "overdose" may not like that term.
Dr. Phillip Coffin, Director of Substance Use Research at the San Francisco Department of Public Health, runs clinical trials and implementation science related to substance use. In response to high rates of drug overdose deaths from opiates, in 2003 San Francisco began distributing naloxone (an opioid antagonist that reverses the drugs' effects) to heroin users through syringe exchange programs and community outreach. Remarkably, heroin overdose death rates have plummeted to less than a dozen a year in a city with a population over 830,000.
Health information exchanges may cut emergency room use, costs
HealthDay News via Healthcare Professionals Network
Health information exchanges (HIEs) are valuable for providers and patients, and their use may reduce emergency department usage and costs, according to a review published in the Dec. 2 issue of the Annals of Internal Medicine.
Robert S. Rudin, Ph.D., from the RAND Corporation in Boston, and colleagues conducted a systematic review and examined evidence of the use and effect of HIEs on clinical care. Data were obtained from selected databases from Jan. 1, 2003, to May 31, 2014.
Deaths from heart disease down, up for blood pressure, irregular heartbeat
Deaths from heart disease are dropping, but deaths related to high blood pressure and irregular heartbeats are on the rise, a new government study finds.
From 2000 to 2010, the overall death rate from heart disease dropped almost 4 percent each year, the U.S. Centers for Disease Control and Prevention, researchers found. At the same time, death rates linked to high blood pressure-related heart disease increased 1.3 percent a year, according to the study. The researchers also found that deaths tied to irregular heartbeats rose 1 percent a year.
Out of the frying pan, into the fire: A case of heat shock and its fatal complications
Pediatric Emergency Care
Exertional heat stroke incidence is on the rise and has become the third leading cause of death in high school athletes. It is entirely preventable, yet this is a case of a 15-year-old, 97-kg male football player who presented unresponsive and hyperthermic after an August football practice. His blood pressure was 80/30, and his pulse was 180.
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