Healthcare Update Satellite — 10-03-2013


Via @mdaware … ever wonder whether you need to prescribe two antibiotics for patients with uncomplicated cellulitis? EM Literature of Note’s Ryan Radecki pulls an article showing that there isn’t much difference in outcome/cure rates between treatment of uncomplicated cellulitis with only cephalexin versus combination treatment with cephalexin and Bactrim.

This is important. And it’s from Fox News, so you know it’s fair and balanced. Be very careful about how you sign up for the Obamacare exchanges. Experts expect that there will be a lot of hacking/phishing attacks using phony web sites to try to get unsuspecting users’ information. Experts suggest not clicking on links in unsolicited e-mails or on social media sites, avoiding downloading any e-mail attachments, and making sure that the sites you visit have “https://” in the address.

The drug that eats the junkies. Called “krokodil,” the drug desomorphine is mixed with adulterants such as gasoline, paint thinner, iodine, or oil and then injected. Reportedly it can get the user hooked in one or two uses and reportedly rots the brain and liver. Not so sure whether it is the drug or the adulterant doing the rotting, but the end results are still nasty.
If you want to see examples of what the drug does to the skin of users, click on this link, but do it on an empty stomach. The site is in Russian and some of the pictures are gross. You’ve been warned.

This link is more for the clipboard patrol and the office-based docs. The Department of Health and Human Services has published model privacy notices which be provided to patients under HIPAA. You can download them here.

We’re from the government and we’re here to help. Karen Sibert notes how the Veteran’s Administration plans to force all advance practice RNs and nurse anesthetists to practice independently – even if they want to work with a physician.
The final draft of the VA Nursing Handbook is here (.pdf file). Check pages 26-27.

Texas emergency department patient lights garbage can on fire, then flees from ED, jumping two barricades then jumping off a 25 foot high helipad and injuring himself … before being brought back to the ED to treat his injuries.

Patients gone wild. Intoxicated Hoboken emergency department patient slaps and punches a paramedic in the face.

More patients gone wild. Pennsylvania man spit on paramedic and tried to bite paramedic in face. Then he kicks and punched hospital staff. Then he threatened physical harm to everyone in the ED. Police didn’t say why the patient was in the hospital, but anyone who threatens to beat up a room full of people has to be intoxicated.

And even more patients gone wild. Where will it end? Shooting outside of Hoppy’s Bar in Ohio spills over into the local ED where the hospital went into “lockdown mode” at 4:30 AM due to the threat of continued violence.
And all I want to do is find out where these people live, drive a police car up to their houses and randomly turn on the lights and sirens for the rest of the morning when they’re trying to sleep.

Another Pennsylvania patient who attacked an emergency nurse last year and who had a long history of run-ins with the law was sentenced to between 27 and 85 months in state prison.

Study in Pediatrics shows that the incidence of ED visits for sports-related head injuries in children has increased by 92% in the past 10 years, but there was no change in the percentage of children being admitted. In addition, the severity of injury for those being admitted decreased significantly during the study period.
Why are more kids being seen in the EDs? I think it is a combination of increased attention on the effects of head injuries on children and policies of the sports leagues.

Ottawa terrier gets picked up and shaken around by German Shepherd. Then runs across field and six lanes of rush hour traffic to get to the local hospital emergency department.
Unfortunately, the dog hadn’t signed up for the Obamacare exchanges, so she had to be transferred to a veterinary hospital for three hours of surgery.

Lawyers complaining because patient emergency department charges are too expensive.
Why don’t you lawyers start with your own house. Charging $600,000 to tweak a proxy statement and create a 1,300 word supplement in order to settle a class action suit? Makes a $10,000 visit to the ED for abdominal pain seem kind of reasonable, doesn’t it?

Medical providers in Ireland changing their practices or retiring early after being sued for medical malpractice and then developing “medical malpractice syndrome.”
Will that qualify medical providers for disability benefits?


  1. Calm down. NP’s are just going to take care of the boring chronic patients you don’t want to see in your ED for cheaper prices and less referrals than you would provide. No one is trying to take away your precious power.

    • And what of the poor hapless military veterans who will have to submit to pretending a nurse is their “doctor”, who will not be ALLOWED to be treated by a real doctor anymore, all in the name of some retarded power play by your nurses union in conjunction with the government wanting to screw them out of proper (and more expensive) health care? Spare a thought for them.

      It’s one thing to let patients who prefer to see a nurse rather than a real doctor, do so. It’s quite another to FORCE them to get their medical treatment from a nurse “for cheaper prices” because Uncle Sam wants to screw them, and the nurses unions are happily playing along because MOAR POWER, baby!

  2. I thought administering anesthesia takes the skill of a physician/anesthesiologist? And is why they specialize.

    That little dog must have CAT in him …using up all those lives. A GSD can shake a small animal like a dishrag ..and kill it. But then for this little dog to cross 6 lanes safely as if in Super Mario game …it must’ve had an angel helping too. And some skilled drivers.

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